The nurse is caring for a client with rheumatoid arthritis one day after shoulder surgery. What would prompt the nurse to call the provider immediately?

The client reports intermittent flatus and minor abdominal discomfort.

The client reports a minor headache and states she takes an overthe counter pain pill at home.

The client refused her pain medication this morning and is doing physical therapy.

The client has paresthesia in her fingers and intense increasing pain in her shoulder.

Answer and Explanation

The Correct Answer is D

Choice A reason: Intermittent flatus and minor abdominal discomfort are not signs that would prompt the nurse to call the provider immediately. They are common and expected after surgery and anesthesia. They indicate that the client's bowel function is returning to normal.

Choice B reason: A minor headache and taking an overthe counter pain pill at home are not signs that would prompt the nurse to call the provider immediately. They are mild and manageable symptoms that may be related to stress, dehydration, or caffeine withdrawal. They do not indicate a serious complication or adverse reaction.

Choice C reason: Refusing pain medication and doing physical therapy are not signs that would prompt the nurse to call the provider immediately. They are indicators of the client's preference and motivation to recover. They may also suggest that the client's pain is wellcontrolled or tolerable.

Choice D reason: Paresthesia in the fingers and intense increasing pain in the shoulder are signs that would prompt the nurse to call the provider immediately. They are indicators of a possible nerve injury, compression, or ischemia that may result from the surgery, swelling, or hematoma. They may also indicate a worsening of the client's rheumatoid arthritis or a development of a complex regional pain syndrome. They require prompt assessment and intervention to prevent permanent damage or disability.

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Correct Answer is A

Explanation

Choice A reason: A client with leukemia is a susceptible host most at risk for infection. Leukemia is a type of cancer that affects the blood cells, especially the white blood cells, which are responsible for fighting infections. Leukemia causes the production of abnormal and immature white blood cells that cannot function properly and crowd out the normal ones. This leads to a condition called leukopenia, which is a low level of white blood cells. Leukopenia makes the client more vulnerable to infection by reducing the immune system's ability to defend against pathogens.

Choice B reason: A child who is immunized is not a susceptible host most at risk for infection. Immunization is a process that stimulates the immune system to produce antibodies against a specific disease. Immunization protects the child from getting infected by the disease or reduces the severity of the infection if it occurs. Immunization also prevents the spread of the disease to other people who are not immunized or who are immunocompromised.

Choice C reason: A 60yearold client is not a susceptible host most at risk for infection. Age is a factor that may influence the susceptibility to infection, but it is not the most important one. Older adults may have a weaker immune system due to aging, chronic diseases, or medications, but they may also have a stronger immune memory due to previous exposure to pathogens. The risk of infection in older adults depends on their overall health status, lifestyle, and preventive measures.

Choice D reason: A hospitalized 35yearold client is not a susceptible host most at risk for infection. Hospitalization is a factor that may increase the exposure to infection, but it is not the most significant one. Hospitalized clients may encounter various sources of infection, such as health care workers, other clients, medical equipment, or invasive procedures, but they may also receive adequate infection control measures, such as hand hygiene, isolation, sterilization, or prophylaxis. The risk of infection in hospitalized clients depends on their diagnosis, treatment, and compliance.

A. Cleansing the skin routinely after soiling occurs. B. Applying moisturizer to dry areas of skin. C. Using a Hoyer lift for all transfers. D. Massaging the client’s reddened shoulders and heels. E. Repositioning the client once per shift.

Correct Answer is ["A","B","C"]

Explanation

Choice A reason: Cleansing the skin routinely after soiling occurs is an effective intervention to prevent skin injury. This is because soiling from urine, feces, sweat, or wound drainage can irritate the skin and cause inflammation, infection, or breakdown. The nurse should use a gentle cleanser and warm water and pat the skin dry. The nurse should also avoid using harsh chemicals, alcohol, or perfumes on the skin.

Choice B reason: Applying moisturizer to dry areas of skin is an effective intervention to prevent skin injury. This is because dry skin is more prone to cracking, peeling, or tearing. The nurse should use a hypoallergenic moisturizer and apply it to the skin after cleansing and drying. The nurse should also avoid using products that contain alcohol, fragrances, or dyes on the skin.

Choice C reason: Using a Hoyer lift for all transfers is an effective intervention to prevent skin injury. This is because a Hoyer lift is a mechanical device that helps to lift and move the client safely and comfortably. It reduces the friction and shear on the skin by lifting the client off the bed surface and avoiding any sliding or dragging. It also prevents the nurse from injuring themselves by lifting the client manually.

Choice D reason: Massaging the client’s reddened shoulders and heels is not an effective intervention to prevent skin injury. In fact, this may worsen the skin injury by increasing the pressure and damage to the tissues. The nurse should avoid massaging any areas that are reddened, swollen, or blistered, as these are signs of pressure ulcers. The nurse should instead relieve the pressure by repositioning the client or using pressurerelieving devices, such as pillows, foam pads, or air mattresses.

Choice E reason: Repositioning the client once per shift is not an effective intervention to prevent skin injury. This is because repositioning the client once per shift is not frequent enough to prevent the development of pressure ulcers. Pressure ulcers are caused by prolonged pressure on the skin that reduces the blood flow and oxygen to the tissues. The nurse should reposition the client at least every 2 hours or more often if needed, depending on the client's condition and risk factors.

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The nurse is caring for a client with rheumatoid arthritis one day after shoulder surgery. What would prompt the nurse to call the provider immediately?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

What client is a susceptible host most at risk for infection?

Correct Answer is A

Explanation

A client is bedridden and appears to be frail and malnourished. Which nursing interventions will most effectively prevent skin injury? (Select all that apply.)

Correct Answer is ["A","B","C"]

Explanation

The nurse is performing a psychosocial assessment on a client with severe rheumatoid arthritis. What would be the most appropriate statement by the nurse?

The nurse will be using the Braden Scale with each admit to the longterm care center. Which of these will be utilized in a Braden Scale assessment? (Select all that apply.)

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A nurse is caring for an intubated and sedated geriatric client. What intervention is most appropriate for reducing the risk of a friction and shear injury?

The client is at risk for impaired skin integrity related to the need for several weeks of bed rest. The nurse evaluates the client after one week and finds the skin integrity is not impaired. In evaluating the plan of care, what is the nurse’s best action?

This is the edited text:The patient complains of fatigue and joint pain and reports that they are unable to walk due to pain in the knees. What is the most appropriate statement by the nurse?

A client sustains an injury to his heel while the unlicensed assistive personnel and the nurse are moving him in bed. What force caused the injury?

The quality and risk nurse in the local hospital is performing a hospital survey on sentinel events. Which statement would the nurse use to best describe a sentinel event?