A 68-year-old male patient, who underwent bilateral total hip arthroplasty two years ago, has been brought to the emergency department (ED) by ambulance.
He reports that he slipped while putting away groceries at home.
He fell face-forward, hitting his head on the wall and his left shoulder on the floor.
He is experiencing pain mainly in his shoulder, but also in his right knee.
Additionally, he feels nauseated and tired.
Based on this information, which of the following are potential diagnoses?
Rotator cuff injury
Humeral fracture
Concussion
Knee sprain .
Correct Answer : A,B,C,D
Choice A rationale
A rotator cuff injury could be a possibility given the patient’s age and the nature of the fall. The rotator cuff is a group of muscles and tendons that surround the shoulder joint, and injuries to this area are common in falls where the shoulder takes the impact.
Choice B rationale
A humeral fracture could also be a possibility. The humerus is the bone in the upper arm, and it can be fractured in falls, especially in older adults who may have weaker bones.
Choice C rationale
A concussion could be a possibility given that the patient hit his head on the wall. Symptoms of a concussion can include nausea and fatigue, which the patient is experiencing.
Choice D rationale
A knee sprain could be a possibility given that the patient is experiencing pain in his right knee. Sprains occur when the ligaments, which are the bands of tissue that hold bones together, are stretched or torn.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Exenatide is a medication used to improve blood sugar control in adults with type 2 diabetes. One of the potential side effects of exenatide is pancreatitis, which can cause severe abdominal pain. Therefore, patients should be instructed to notify their healthcare provider if they start having abdominal pain after starting exenatide.
Choice B rationale
Exenatide should be injected within 60 minutes (1 hour) before the morning and evening meal (or before the two main meals of the day, at least 6 hours apart), not 30 minutes before or after a meal. Therefore, this instruction is incorrect.
Choice C rationale
Exenatide does not act in the same way as insulin. While both insulin and exenatide help to control high blood sugar, they work in different ways. Insulin allows sugar in your blood to enter your cells, while exenatide works by increasing the release of insulin when blood sugar levels are high, decreasing the amount of glucose produced and released by the liver, and slowing gastric emptying.
Choice D rationale
There are precautions about taking exenatide with other medications. For example, exenatide may affect the absorption of some orally administered drugs due to its effect on gastric emptying. Therefore, patients should be advised to take oral medications that require rapid absorption at least 1 hour before injecting exenatide.
Correct Answer is A
Explanation
The correct answer is A. The nurse should first implement the prescription of Cefazolin 1 gram intravenously every 6 hours.
This is because, on admission of a patient to the postanesthesia care unit (PACU) from surgery, the first priority is to assess the airway and breathing status. Administering Cefazolin, an antibiotic, helps prevent postoperative infections, which is crucial in the immediate postoperative period.
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