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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Once the tissue has necrosed from high pressure, it does not regenerate is the best explanation, because it describes the mechanism and outcome of glaucoma. Glaucoma is a condition that causes increased intraocular pressure, which damages the optic nerve and the retina, the tissues that are responsible for transmitting and processing visual information. Once these tissues are necrosed, or dead, they do not regenerate, or grow back, resulting in irreversible vision loss.
Choice B reason: Glaucoma always leads to permanent blindness is not a good explanation, because it is inaccurate and pessimistic. Glaucoma does not always lead to permanent blindness, but rather to progressive vision loss that can be prevented or slowed down with early diagnosis and treatment. Glaucoma can cause peripheral vision loss, tunnel vision, or blind spots, but not necessarily complete blindness.
Choice C reason: Once retinal detachment occurs, it does not return to its normal state is not a good explanation, because it is irrelevant and misleading. Retinal detachment is a condition that occurs when the retina separates from the underlying layer of blood vessels, which can cause vision loss or blindness. However, retinal detachment is not caused by glaucoma, nor is it a common complication of glaucoma. Retinal detachment can sometimes be repaired with surgery, depending on the extent and duration of the detachment.
Choice D reason: Once bacterial infection has caused damage, the tissue does not regenerate is not a good explanation, because it is incorrect and confusing. Bacterial infection is not a cause or a consequence of glaucoma, but rather a separate condition that can affect the eye. Bacterial infection can cause inflammation, pain, discharge, or redness in the eye, but not necessarily vision loss or tissue necrosis. Bacterial infection can usually be treated with antibiotics, which can prevent or reverse the damage.
Correct Answer is B
Explanation
Choice A reason: "I will need to limit the number of fruit servings each day." is not a statement that indicates a correct understanding of the teaching, because it is irrelevant and inaccurate. Limiting the number of fruit servings each day is not a part of the lowpurine diet, as fruits are low in purine and do not affect the uric acid levels. Fruits are also beneficial for the health, as they provide vitamins, antioxidants, and fiber.
Choice B reason: "I should avoid eating liver and other organ meats." is a statement that indicates a correct understanding of the teaching, because it is relevant and accurate. Avoiding eating liver and other organ meats is a part of the lowpurine diet, as organ meats are high in purine and can increase the uric acid levels. Uric acid is a waste product that is formed when purine is broken down in the body. High uric acid levels can cause gout, which is a type of arthritis that occurs when uric acid crystals accumulate in the joints, causing pain, inflammation, and swelling.
Choice C reason: "I can drink only white wine." is not a statement that indicates a correct understanding of the teaching, because it is incorrect and misleading. Drinking only white wine is not a part of the lowpurine diet, as white wine is not low in purine and can increase the uric acid levels. Alcohol, in general, can interfere with the excretion of uric acid by the kidneys, and can also trigger or worsen the gout attacks. Therefore, people with gout should limit or avoid alcohol consumption, regardless of the type or color of the wine.
Choice D reason: "I should choose red meat instead of poultry." is not a statement that indicates a correct understanding of the teaching, because it is incorrect and misleading. Choosing red meat instead of poultry is not a part of the lowpurine diet, as red meat is not low in purine and can increase the uric acid levels. Red meat, such as beef, pork, or lamb, is high in purine and can aggravate the gout symptoms. Therefore, people with gout should limit or avoid red meat consumption, and choose poultry, fish, or plantbased proteins instead.
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