A nurse is assessing a client who has an ankle fracture of the right foot and is at risk for complex regional pain syndrome (CRPS). The nurse should identify that which of the following findings is a manifestation of CRPS?

Tingling in the toes

1+ dorsalis pedis pulse

Capillary refill of 3 seconds

Increased edema of the foot

Answer and Explanation

The Correct Answer is D

A. Tingling in the toes: Tingling in the toes is not specific to CRPS. It might be a general symptom but is not a classic sign of CRPS.
B. 1+ dorsalis pedis pulse: A weak pulse might indicate reduced circulation but is not specific to CRPS. CRPS is more associated with pain, swelling, and changes in skin color or temperature.
C. Capillary refill of 3 seconds: A capillary refill time of 3 seconds is prolonged and suggests possible circulation issues, but it is not a specific manifestation of CRPS.
D. Increased edema of the foot: Increased edema of the foot is a common manifestation of CRPS. CRPS often presents with localized swelling, along with other symptoms like pain and changes in skin color or temperature.

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Correct Answer is ["A","D"]

Explanation

A. Place the client in contact isolation. Contact isolation helps prevent the spread of C. difficile to other patients and staff by requiring the use of gowns and gloves when entering the patient's room.
B. Prepare the client for a colonoscopy. This is not typically part of the standard care plan for C. difficile infection. Colonoscopies are not indicated for diagnosing or managing C. difficile.
C. Administer docusate sodium 500 mg daily. Docusate sodium is a stool softener and is not appropriate for treating C. difficile, which causes diarrhea.
D. Use a bleach solution to clean the client's bedside table. Bleach is effective at killing C. difficile spores, which are resistant to many other cleaning agents.
E. Use hand sanitizer immediately after caring for the client. Hand sanitizers are not effective against C. difficile spores. Handwashing with soap and water is necessary.

A. "Increase your intake of dietary calcium." B. "Follow a low-residue diet." C. "Limit fruit intake to 8 oz a day." D. "Increase your intake of dietary fiber."

Correct Answer is D

Explanation

A. "Increase your intake of dietary calcium." Increasing dietary calcium is recommended for overall health, including potential benefits for colon health. However, it is not the primary recommendation for preventing colon cancer.
B. "Follow a low-residue diet." A low-residue diet is not typically recommended for cancer prevention. It is used in specific situations, like managing inflammatory bowel disease or preparing for certain diagnostic tests.
C. "Limit fruit intake to 8 oz a day." Limiting fruit intake is not advised for cancer prevention. In fact, a diet rich in fruits and vegetables is generally recommended for reducing cancer risk.
D. "Increase your intake of dietary fiber." is a well-established recommendation for reducing the risk of colon cancer. Fiber helps to promote regular bowel movements and can aid in the prevention of cancerous lesions in the colon.

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A nurse is assessing a client who has an ankle fracture of the right foot and is at risk for complex regional pain syndrome (CRPS). The nurse should identify that which of the following findings is a manifestation of CRPS?

Nursing Test Bank

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