Nursing Elites

1. A nurse assesses an audible grating sound (Crepitus) when a client with osteoarthritis moves his knees. What is the cause of this sound?

• A. A herniated disk in the diseased joint
• B. Pieces of bone and cartilage floating
• C. Popping bursae from standing
• D. Years of an autoimmune process

Correct answer: A

Rationale:

2. The provider orders the client to be placed in a high-Fowler's position. At what angle will the nurse position the client?

• A. 15 degrees
• B. 0 degrees
• C. 90 degrees
• D. 30 degrees

Correct answer: C

Rationale: The correct answer is C: 90 degrees. In a high-Fowler's position, the client's head of the bed is raised to a 90-degree angle. This positioning helps improve breathing and facilitates eating and talking. Choice A, 15 degrees, is incorrect as it is not high enough to be considered a high-Fowler's position. Choice B, 0 degrees, is incorrect as it represents a flat or supine position. Choice D, 30 degrees, is also incorrect as it does not meet the criteria for a high-Fowler's position.

3. A nurse assesses an area of skin over a bony prominence. What finding would be most concerning?

• A. Redness
• B. Non-blanching
• C. Blanching
• D. Warmth

Correct answer: A

Rationale:

4. The nurse is providing medication for a client with osteomyelitis. What teaching should the nurse indicate in the education?

• A. The most common adverse e effect for nonsteroidal anti-inflammatory drugs (NSAIDS)are liver failure and tinnitus
• B. The main side effect of acetaminophen is gastrointestinal GI bleeding
• C. You should not take more than 4000 mg of acetaminophen a day
• D. Nonsteroidal anti-inflammatory drugs (NSAIDS) are very safe and are known to have no side effects

Correct answer: A

Rationale:

5. What is the priority nursing diagnosis for a client with metastatic bone disease?

• A. Chronic pain
• B. Impaired mobility
• C. Risk for falls
• D. Risk for infection

Correct answer: C

Rationale: The correct answer is 'Risk for falls.' In clients with metastatic bone disease, weakened bones can lead to an increased risk of falls, making it a priority nursing diagnosis. Chronic pain (choice A) may be present but addressing the risk for falls is more critical in this situation. While impaired mobility (choice B) can be a consequence of metastatic bone disease, preventing falls takes precedence. Risk for infection (choice D) is not the priority in this case, as falls pose a more immediate threat to the client's safety.

Similar Questions