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Exhibits

Which information from the history and physical, nurses' note, and flow sheet requires further evaluation? Select all that apply.

Occupation of legal secretary

Stiffness in hands for 3 months

Radial and pedal pulses 2+

Pain in bilateral hands and wrists

History of asthma using albuterol inhaler PRN

Capillary refill 2 seconds

Body mass index (BMI) of 31 kg/m2

Client's hobbies

Answer and Explanation

Correct Answer : A,B,D,G,H

A. Occupation of legal secretary: The client works as a legal secretary, which may involve extensive typing or repetitive hand movements. This can contribute to musculoskeletal stress or strain, potentially exacerbating symptoms like pain and stiffness in the hands.

B. Stiffness in hands for 3 months: The client reports stiffness in both hands and wrists for the past 3 months, which could suggest an inflammatory arthritis such as rheumatoid arthritis (RA). This warrants further evaluation, especially given her family history of arthritis.

C. Radial and pedal pulses 2+: A rating of 2+ for radial and pedal pulses is normal, indicating no circulation issues, and does not need further evaluation.

D. Pain in bilateral hands and wrists: Persistent, symmetrical pain in the hands and wrists, particularly with palpation, may indicate a condition like rheumatoid arthritis. This symptom, in combination with morning stiffness, needs further investigation.

E. History of asthma using albuterol inhaler PRN: The client's history of well-controlled asthma, managed with an albuterol inhaler as needed for exacerbations, does not directly relate to her current presentation of hand pain and stiffness.

F. Capillary refill 2 seconds: A capillary refill time of 2 seconds is within the normal range, indicating adequate peripheral perfusion. This finding suggests that there are no immediate circulatory issues contributing to her hand pain and stiffness and does not require further evaluation.

G. Body mass index (BMI) of 31 kg/m²: A BMI of 31 falls within the obese range, which can increase the risk for musculoskeletal issues and other chronic conditions. This factor should be evaluated further, as obesity may affect joint health.

H. Client's hobbies: The client enjoys hobbies like gardening and crocheting, which involve repetitive hand movements. These activities could exacerbate the pain and stiffness in her hands, making it important to evaluate whether these hobbies are contributing to her symptoms.

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Free Nursing Study Resources

Correct Answer is {"A":{"answers":"A,B"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"A,B"},"E":{"answers":"A"}}

Explanation

Rationale:

Can be caused by aging: Both arthritis and carpal tunnel syndrome are linked to aging. In arthritis, wear and tear on joints over time causes conditions like osteoarthritis. Carpal tunnel syndrome increases with age due to changes in wrist anatomy and nerve compression.
Inflammatory disease process: Arthritis, especially rheumatoid arthritis, is inflammatory, causing joint pain and damage. Carpal tunnel syndrome, however, is caused by mechanical compression of the median nerve, not by inflammation.
Finger numbness: Numbness in the fingers is common with carpal tunnel syndrome due to median nerve compression. While arthritis can cause pain and stiffness in joints, it does not typically cause finger numbness unless there's significant nerve involvement.
Experience difficulty with fine motor movements: Both conditions can impair fine motor skills. Arthritis causes pain and stiffness in joints, while carpal tunnel syndrome affects nerve function, leading to weakness and difficulty performing precise tasks like writing or holding small objects.
May have a genetic component: Arthritis has a genetic predisposition. Carpal tunnel syndrome does not have a strong genetic link but can be influenced by individual anatomical factors, such as a narrower carpal tunnel.

A. Palpate and compare radial pulses. B. Administer ondansetron 4 mg IV. C. Perform range of motion. D. Check capillary refill on bilateral upper extremities. E. Inspect the bandage for drainage. F. Provide morphine 2 mg IV push (IVP).

Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"A"},"E":{"answers":"A"},"F":{"answers":"A"}}

Explanation

Rationale:

Palpate and compare radial pulses: It is important to check radial pulses to assess circulation to the injured limb. Decreased pulse strength, especially in the left arm, could indicate vascular injury, which requires immediate attention.
Administer ondansetron 4 mg IV: The client is feeling nauseated and worries about vomiting, likely due to postoperative effects, pain medication, or anesthesia. Ondansetron is an antiemetic, which is appropriate to administer to manage nausea and prevent vomiting.
Check capillary refill on bilateral upper extremities: Checking capillary refill is essential to assess perfusion to both arms. The client’s left arm is experiencing coolness, and diminished pulses were noted earlier, so this is necessary to monitor blood flow and prevent complications like compartment syndrome.
Inspect the bandage for drainage: After surgery, it is important to inspect the surgical site for any drainage, bleeding, or signs of infection. This helps ensure that there are no complications or issues with wound healing.

Perform range of motion: Performing range of motion exercises is contraindicated immediately after trauma, especially with a fracture or suspected injury to the shoulder. The shoulder should be immobilized to prevent further damage and to facilitate proper healing. Early movement may worsen the injury or cause additional pain.
Provide morphine 2 mg IV push (IVP): While he had a nerve block, its effectiveness will wane, and he will likely experience significant pain from the fracture and surgical manipulation. Administering prescribed analgesia like morphine is a priority for pain management.

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Exhibits Which information from the history and physical, nurses' note, and flow sheet requires further evaluation? Select all that apply.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is {"A":{"answers":"A,B"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"A,B"},"E":{"answers":"A"}}

Explanation

Exhibits The nurse reviews the prescriptions and plans initial steps for caring for the client. Click to indicate which interventions the nurse should perform to care for this client. Each row must have one response indicated.

Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"A"},"E":{"answers":"A"},"F":{"answers":"A"}}

Explanation

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Exhibits

Which information from the history and physical, nurses' note, and flow sheet requires further evaluation? Select all that apply.