A nurse is assessing a client who has a puncture wound on his foot. Which of the following findings is a manifestation of acute osteomyelitis?

Bradycardia

Numbness of toes on the affected foot

Localized erythema

Hypothermia

Answer and Explanation

The Correct Answer is C

A. Bradycardia - This is a slow heart rate and is not a typical manifestation of acute osteomyelitis.

B. Numbness of toes on the affected foot - Numbness may be associated with nerve involvement but is not a classic manifestation of acute osteomyelitis.

C. Localized erythema - This is a characteristic sign of acute osteomyelitis. It indicates inflammation and infection in the affected area.

D. Hypothermia - This is a low body temperature, which is not typically associated with acute osteomyelitis.

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Correct Answer is A

Explanation

A. Placing a bath seat in the shower is a safety measure to prevent falls while bathing. This statement indicates an understanding of the importance of bathroom safety.

B. Placing an area rug at the entry of the bathroom can actually increase the risk of falls, as rugs can be tripping hazards. This statement does not demonstrate an understanding of home safety.

C. Keeping the walker at the end of the bed is a good practice for easy access, but it doesn't specifically address fall prevention in the home.

D. Keeping the fluorescent ceiling light on at night can provide better visibility and reduce the risk of tripping, but it doesn't address specific fall prevention measures elsewhere in the home.

A. Position the client in a high-Fowler's position if clear drainage is noted on the dressing B. Monitor sensory perception of the lower extremities. C. Assist the client into a knee-chest position to manage postoperative discomfort. D. Maintain strict bed rest for the first 48 hr postoperative.

Correct Answer is B

Explanation

A. Positioning the client in a high-Fowler's position if clear drainage is noted on the dressing is not a specific intervention for a laminectomy with spinal fusion. The nurse should follow the surgeon's specific postoperative orders regarding positioning and wound care.

B. Monitoring sensory perception of the lower extremities is a crucial nursing intervention after a laminectomy with spinal fusion. This is to assess for any signs of neurovascular compromise or nerve damage.

C. Assisting the client into the knee-chest position to manage postoperative discomfort is not a recommended position after a laminectomy with spinal fusion. The nurse should follow the surgeon's specific postoperative orders regarding positioning.

D. Maintaining strict bed rest for the first 48 hours postoperative is not typically indicated after a laminectomy with spinal fusion. Early mobilization and ambulation are often encouraged to prevent complications and promote recovery. The nurse should follow the surgeon's specific postoperative orders regarding activity and mobility.

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A nurse is assessing a client who has a puncture wound on his foot. Which of the following findings is a manifestation of acute osteomyelitis?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

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