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The nurse is caring for four clients. Which of these clients will the nurse see first?

A client with sudden and increasing pain in his fractured arm

A client with a fractured ankle who would like a glass of water

A client with rheumatoid arthritis and a scheduled pain medication

A client being discharged in two hours and needs to be taught how to use his crutches

Answer and Explanation

The Correct Answer is A

Choice A reason: This is the highest priority client because sudden and increasing pain in a fractured arm can indicate a complication, such as compartment syndrome, infection, or nerve damage. Compartment syndrome is a condition where the pressure inside the muscles increases to dangerous levels, causing severe pain, reduced blood flow, and tissue death. Infection is a condition where microorganisms invade the wound site, causing inflammation, pus, and fever. Nerve damage is a condition where the nerves are injured by the fracture, causing numbness, tingling, or weakness. The nurse should see this client first and assess the arm for any signs of these complications, such as swelling, pallor, loss of sensation, or impaired movement. The nurse should also elevate the arm, loosen any bandages or casts, and administer pain medication as ordered.

Choice B reason: This is not the highest priority client because a fractured ankle is a common and stable condition that affects the lower extremity. A glass of water is a comfort and hydration need that can be met by the nurse or another staff member. The nurse should see this client after the more urgent clients and provide the glass of water, as well as monitor the ankle for any signs of complications, such as edema, infection, or impaired circulation.

Choice C reason: This is not the highest priority client because rheumatoid arthritis is a chronic and manageable condition that affects the joints. A scheduled pain medication is a routine and preventive need that can be met by the nurse or another staff member. The nurse should see this client after the more urgent clients and administer the pain medication, as well as assess the joints for any signs of inflammation, stiffness, or deformity.

Choice D reason: This is not the highest priority client because a discharge teaching is a discharge and education need that can be met by the nurse or another staff member. The nurse should see this client last and teach the client how to use the crutches, as well as provide any other discharge instructions, such as wound care, activity restrictions, or followup appointments.

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Correct Answer is D

Explanation

Choice A reason: Truck driver is not an occupation that increases the risk for carpal tunnel syndrome, because it does not involve repetitive or forceful flexion or extension of the wrist. Carpal tunnel syndrome is a condition that occurs when the median nerve, which runs through the carpal tunnel in the wrist, is compressed or irritated by inflammation, swelling, or pressure. Truck drivers may experience other musculoskeletal problems, such as back pain, neck pain, or shoulder pain, due to prolonged sitting, vibration, or poor posture.

Choice B reason: Nursing assistant is an occupation that increases the risk for carpal tunnel syndrome, but it is not the best answer, because it involves other factors besides repetitive motion that can contribute to the condition. Nursing assistants may perform repetitive tasks, such as lifting, transferring, or bathing patients, that can strain the wrist and the median nerve. However, they may also experience other risk factors, such as trauma, infection, arthritis, or pregnancy, that can cause carpal tunnel syndrome.

Choice C reason: Elementary school teacher is not an occupation that increases the risk for carpal tunnel syndrome, because it does not involve repetitive or forceful flexion or extension of the wrist. Elementary school teachers may perform some tasks, such as writing, typing, or grading papers, that can involve wrist movement, but they are not likely to be frequent or intense enough to cause carpal tunnel syndrome. Elementary school teachers may experience other stressrelated problems, such as headaches, fatigue, or burnout, due to the demands of their work.

Choice D reason: Assembly line worker is the best answer, because it is an occupation that increases the risk for carpal tunnel syndrome, due to the nature and duration of the work. Assembly line workers may perform repetitive, forceful, or awkward movements of the wrist, such as twisting, bending, or gripping, that can cause compression or irritation of the median nerve. Assembly line workers may also work for long hours, with little rest or variation, that can exacerbate the condition.

A. Medicare B. The American Nurses Association C. The Joint Commission D. The Institute of Medicine

Correct Answer is C

Explanation

Choice A reason: This is an incorrect answer because Medicare is a federal health insurance program that covers certain groups of people, such as the elderly, the disabled, and the lowincome. Medicare does not publish the National Patient Safety Goals, but it does have its own quality and safety standards that health care providers must meet to receive reimbursement.

Choice B reason: This is an incorrect answer because the American Nurses Association (ANA) is a professional organization that represents the interests of registered nurses in the United States. The ANA does not publish the National Patient Safety Goals, but it does have its own code of ethics, standards of practice, and policies that guide nursing practice and promote quality and safety.

Choice C reason: This is the correct answer because the Joint Commission is an independent, nonprofit organization that accredits and certifies more than 22,000 health care organizations and programs in the United States. The Joint Commission publishes the National Patient Safety Goals, which are specific and measurable goals that address the most critical patient safety issues in health care. The Joint Commission updates the goals annually based on the latest evidence and expert input.

Choice D reason: This is an incorrect answer because the Institute of Medicine (IOM) is a division of the National Academies of Sciences, Engineering, and Medicine, which is a private, nonprofit organization that provides independent, objective, and authoritative advice to inform policy and practice. The IOM does not publish the National Patient Safety Goals, but it does conduct research and issue reports on various topics related to health and health care, including quality and safety.

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This is the edited text:The nurse is caring for four clients. Which of these clients will the nurse see first?

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Naxlex Comprehensive Predictor Exams

A nurse is preparing a community presentation about repetitive motion injuries. Which of the following occupations should the nurse identify as increasing a client’s risk for carpal tunnel syndrome?

Correct Answer is D

Explanation

This is the edited text:Which organization publishes the National Patient Safety Goals?

Correct Answer is C

Explanation

This is the edited text:What is not an expected assessment finding in a client with inflammation? (Select all that apply.)

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The most appropriate response by the nurse is:"Ice packs can be used to reduce swelling but should be removed after 20 minutes."The nurse is caring for four clients. Which of these clients will the nurse see first?

This is the edited text:

The nurse is caring for four clients. Which of these clients will the nurse see first?