Nursing Elites

1. The client with systemic sclerosis (Scleroderma) is experiencing Raynaud's phenomenon. What assessment finding does the nurse anticipate?

• A. Excessive heartburn
• B. Cyanosis of the lips
• C. Excess wrinkled skin
• D. Cold and purple nailbeds

Correct answer: D

Rationale:

2. 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?

• A. The client refused her pain medication this morning and is doing physical therapy.
• B. The client reports a minor headache and states she takes an over-the-counter pain pill at home.
• C. The client reports intermittent flatus and minor abdominal discomfort.
• D. The client has paresthesia in her fingers and intense increasing pain in her shoulder.

Correct answer: D

Rationale: In a client with rheumatoid arthritis one day after shoulder surgery, paresthesia in the fingers and intense increasing pain in the shoulder could indicate nerve compression or damage, which are serious post-operative complications. This situation requires immediate attention from the provider to prevent further complications and ensure appropriate management. The other options, such as refusing pain medication, reporting a minor headache, or experiencing minor abdominal discomfort, are important but not as urgent or indicative of potential serious complications as paresthesia in the fingers and intense increasing pain in the shoulder.

3. What is a sign of inadequate perfusion?

• A. Intact sensation
• B. Pallor in toes
• C. Bounding pulses
• D. Pink fingers

Correct answer: B

Rationale:

4. A nurse is caring for an immobile client. What is the priority assessment of this client?

• A. Palpate for edema
• B. Auscultate for bowel sounds
• C. Inspect the skin for injury
• D. Auscultation of lung sounds

Correct answer: C

Rationale: Inspecting the skin for injury is crucial to prevent pressure ulcers and other complications in immobile clients.

5. What are nonsurgical treatment options for carpal tunnel syndrome? (Select all that apply)

• A. Using a splint
• B. Ultrasound therapy
• C. Endoscopic carpal tunnel release
• D. All of the above

Correct answer: D

Rationale: The correct answer is D, 'All of the above.' Non-surgical treatments for carpal tunnel syndrome include using a splint, ultrasound therapy, corticosteroid injections, and NSAIDs. Choice A is correct as using a splint helps to keep the wrist in a neutral position, reducing pressure on the median nerve. Choice B is correct as ultrasound therapy can help reduce inflammation and alleviate symptoms. Choice C, 'Endoscopic carpal tunnel release,' is incorrect as it is a surgical procedure, not a nonsurgical treatment option for carpal tunnel syndrome.

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