ch 29 adaptive quiz Flashcards
What does therapeutic management of the patient with systemic lupus erythematosus include?
1
A high-protein, low-salt diet
Correct2
Administration of corticosteroids to control inflammation
3
Application of cold salts to suppress the inflammatory process
4
A rigorous exercise regimen to build muscle strength and endurance
Corticosteroid administration is the primary mode of therapy currently for systematic lupus erythematosus (SLE). The application of cold salts will not affect the inflammatory process associated with SLE. A balanced diet without exceeding caloric expenditures is recommended. The affected person should exercise in moderation.
The nurse on a home visit finds that a person has sustained a severe sprain. What suggestions are appropriate for providing first aid for sprain?
1
Provide limb movements, apply ice, and avoid splinting.
2
Provide warmth, splint, and keep the affected limb elevated.
Correct3
Provide rest, apply ice, and provide compression.
4
Provide rest and warmth, and apply compression
First aid in cases of sprains or suspected fractures involves interventions that can be remembered with the acronym RICE. R stands for rest; I stands for ice; C stands for compression; E stands for elevation. Therefore the nurse suggests that caregivers provide rest, apply ice, and provide compression to the affected limb. Providing limb movements would worsen the sprain and may lead to complete rupture of the ligament. There should be no warm application for sprains, because it can worsen the edema associated with sprains.
Test-Taking Tip: If you are unable to answer a multiple-choice question immediately, eliminate the alternatives that you know are incorrect and proceed from that point. The same goes for a multiple-response question that requires you to choose two or more of the given alternatives. If a fill-in-the-blank question poses a problem, read the situation and essential information carefully and then formulate your response.
What is the most comprehensive way to treat an overuse syndrome?
1
Activity and acetaminophen
Incorrect2
Rest and nonsteroidal antiinflammatory drugs (NSAIDs)
3
Activity and nonsteroidal antiinflammatory drugs (NSAIDs)
Correct4
Rest, physical therapy, and nonsteroidal antiinflammatory drugs (NSAIDs)
Rest, physical therapy, and nonsteroidal antiinflammatory drugs are the recommended way to treat an overuse syndrome. Activity and acetaminophen are not recommended for the therapeutic management of overuse syndrome.
What is a vascular clinical manifestation of systemic lupus erythematosus? 1 Fever 2 Atelectasis 3 Hepatomegaly Correct4 Raynaud phenomenon
Raynaud phenomenon is a vascular clinical manifestation of systematic lupus erythematosus (SLE). Fever is a constitutional clinical manifestation of SLE. Atelectasis is a pulmonary clinical manifestation of SLE. Hepatomegaly is a hepatic clinical manifestation of SLE.
Test-Taking Tip: Notice how the subjects of the questions are related and, through that relationship, the answers to some of the questions you skipped may be provided within other questions of the test.
What are some local clinical manifestations of acute osteomyelitis? Select all that apply. Incorrect1 Irritability Correct2 Tenderness Incorrect3 Restlessness Correct4 Increased warmth Correct5 Diffuse swelling over the involved bone
Tenderness, increased warmth, and diffuse swelling over involved bone are local clinical manifestations of acute osteomyelitis. Irritability and restlessness are general manifestations of acute osteomyelitis.
The nurse is caring for a child with contractures and ankylosis of the joints. Which strategies does the nurse include in the nursing care plan? Incorrect1 Use of compression stockings 2 Immobilization of the joints Correct3 Use of joint splints for affected joints 4 Use of calcium and vitamin D supplements
In cases of joint contractures and ankylosis, joint splints are used. Splints support the joints and prevent further deformity. Stockings are used to increase the venous load and prevent thromboembolism. They are not useful in preventing joint deformity. Immobilizing the joint completely is inappropriate, because it may worsen the joint deformity. The nurse encourages the patient to move and thus maintain full range of motion. The nurse cannot prescribe medications or supplements.
Test-Taking Tip: Never leave a question unanswered. Even if answering is no more than an educated guess on your part, go ahead and mark an answer. You might be right, but if you leave it blank, you will certainly be wrong and lose precious points.
Which is a characteristic of fractures in children?
Correct1
Rapidity of healing is inversely related to the child’s age.
2
The pliable bones of growing children are less porous than those of adults.
3
Fractures rarely occur at the growth plate site because it absorbs shock well.
4
The periosteum of a child’s bone is thinner and weaker and has less osteogenic potential than that of the adult
Fractures heal in less time in children than in adults. As the child ages, the healing time increases. The cartilage epiphyseal plate is the weakest point of the long bone. Therefore it is a frequent site of damage and fractures. The periosteum is thickened, and there is a great production of osteoclasts when a bone injury occurs. Bone healing in children is also rapid because of the generous blood supply.
Which measure is most important in managing hypercalcemia in a child who is immobilized? 1 Changing position frequently Correct2 Promoting adequate hydration 3 Encouraging a diet high in calcium 4 Providing a diet high in protein and calories
Hydration is extremely important in helping remove excess calcium from the body. This can help prevent hypercalcemia. Changing the child’s position frequently will help with managing skin integrity but will not affect the calcium level. The calcium will not be incorporated into bone because of the lack of weight bearing. The child is at risk for hypercalcemia. The child’s metabolism is slower because of the immobilization. A diet with sufficient calories and nutrients for healing is important.
A home care nurse is caring for a 4-month-old infant with developmental dysplasia of the hip (DDH). The baby is in a Pavlik harness. The baby’s mother tells the nurse, “I don’t think my baby will be able to sleep while wearing the harness.” What is an appropriate response by the nurse?
1
“The harness can be removed during a short 30-minute nap.”
2
“You can reapply the harness after the baby falls asleep.”
Correct3
“It is important for the harness to be worn continuously.”
4
“You can have the baby not take one of the daily naps.”
The harness is worn continuously until the hip is proved stable on clinical and ultrasound examination, usually in 6 to 12 weeks. Some practitioners permit its removal for bathing. Removal or re-application of the harness will probably awaken the infant. Babies should not be prevented from taking naps, because such naps are essential for good health.
What is an appropriate nursing intervention in the care of the child with chronic osteomyelitis?
1
Encouraging frequent ambulation
Incorrect2
Administering pain medication with meals
Correct3
Moving and turning the child carefully and gently to minimize pain
4
Providing active range-of-motion exercises of the affected extremity
Osteomyelitis is extremely painful. Movement is carried out only as needed and then carefully and gently. Active range-of-motion exercises are contraindicated until pain has subsided. Pain medication should be administered as needed. Ambulation is contraindicated until pain has subsided.
What is the goal of treatment for a newborn with clubfoot?
1
Correction of the deformity with a single cast worn for a year and follow-up observation
2
Surgical correction of the deformity and maintenance of the correction until normal muscle balance is regained
Correct3
Correction of the deformity, maintenance of the correction until normal muscle balance is regained, and follow-up observation
Incorrect4
Correction of the deformity with casting for 3 to 8 weeks and maintenance of the correction until normal muscle balance is regained
The goal of treatment for clubfoot is to achieve a painless, plantigrade, and stable foot by correcting the deformity; maintenance of the correction until normal muscle balance is regained; and follow-up observation. Serial casts, rather than a single cast worn for a year, are the typical treatment protocol. Surgical correction is rarely required. Casting lasts 6 to 10 weeks for maximal correction, rather than 3 to 8 weeks.
The nurse is caring for a child who has decreased muscle strength and muscle tone. What is the most appropriate nursing intervention to ensure a sufficient venous return? 1 Immobilize the child. 2 Limit the hours of sleep. Correct3 Use compression stockings. 4 Ensure sufficient fluid intake.
In the presence of decreased muscle strength and tone, the venous return to the heart is also reduced. This stagnation of the venous blood can lead to the formation of thromboembolism, especially in the lower limbs. The best intervention in this condition is the use of compression or antiembolism stockings. The nurse encourages the child to move to improve the venous return. Immobilizing the child aggravates the condition and increases the risk of thrombus formation. The hours of sleeping are not related to thrombus formation as long as there is sufficient movement of the limb during the daytime. Adequate fluid intake is essential for the maintenance of normal health, but is not directly related to thrombus formation.
Test-Taking Tip: The presence of absolute words and phrases can also help you determine the correct answer to a multiple-choice item. If answer choices contain an absolute (e.g., none, never, must, cannot), be very cautious. Remember that there are not many things in the world that are absolute, and in an area as complex as nursing, an absolute may be a reason to eliminate it from consideration as the best choice. This is only a guideline and should not be taken to be true 100% of the time; however, it can help you reduce the number of choices.
