An older adult woman is admitted to the emergency department after falling at home. The nurse cautions her not to put weight on the leg after finding what in the patient assessment?

Correct Answer: D

Rationale: In this scenario, option D, which is "Shortening and external rotation of the leg," is the correct answer. This presentation is indicative of a hip fracture, specifically a femoral neck fracture. This injury typically results in the affected leg appearing shorter and externally rotated due to the displacement of the fractured bone. It is crucial for the nurse to caution the patient not to put weight on the leg to prevent further damage or complications. Option A, "Inability to move the toes and ankle," is incorrect as it is more related to nerve or muscle damage rather than a hip fracture. Option B, "Edema of the thigh extending to the knee," is incorrect as edema is a general symptom and not specific to a hip fracture. Option C, "Internal rotation of the leg with groin pain," is incorrect as internal rotation is not typically seen in hip fractures, and groin pain is more commonly associated with hip joint issues rather than fractures. Educationally, understanding the physical signs and symptoms of different types of fractures, especially in the elderly population who are more prone to falls and fractures, is vital for healthcare providers. Recognizing these signs promptly can lead to appropriate interventions and prevent further complications. This case highlights the importance of thorough assessment skills and knowledge of musculoskeletal injuries in the clinical setting.

Correct Answer: A

Rationale: The correct answer is A) Raise the head of the bed 30 degrees. Rationale: Before repositioning a patient post-lumbar laminectomy, it is crucial to elevate the head of the bed to minimize the risk of increased intracranial pressure. This position helps to promote optimal cerebrospinal fluid drainage, reducing the likelihood of complications such as headaches, nausea, and potential neurological deficits. Explanation of Incorrect Options: B) Having the patient flex the knees and hips may be beneficial for comfort and proper alignment but is not the priority action to take before repositioning the patient post-lumbar laminectomy. C) Placing a pillow between the patient's legs is a good practice to maintain proper body alignment and reduce pressure on the lower back but is not the priority action in this scenario. D) Having the patient grasp the side rail on the opposite side of the bed does not address the immediate need to ensure proper positioning to prevent complications post-lumbar laminectomy. Educational Context: Understanding the rationale behind the correct action is crucial for nurses caring for patients post-lumbar laminectomy. By prioritizing the elevation of the head of the bed, nurses can demonstrate their knowledge of best practices to promote patient safety and prevent potential complications associated with neurosurgical procedures. This educational context highlights the importance of evidence-based interventions in nursing care to optimize patient outcomes and ensure quality postoperative recovery.

Correct Answer: B

Rationale: In this question, the correct answer is B) Felty syndrome. Rheumatoid nodules are a common extraarticular manifestation of rheumatoid arthritis (RA). Felty syndrome is a complication of RA characterized by the triad of rheumatoid arthritis, splenomegaly, and neutropenia. Patients with Felty syndrome often present with rheumatoid nodules, making it the most likely extraarticular manifestation to be seen in these patients. Option A) Lyme disease is incorrect because it is a separate infectious disease caused by a tick bite, not directly related to RA. Option C) Sjögren's syndrome is incorrect as it is an autoimmune condition primarily affecting the exocrine glands, leading to symptoms like dry eyes and dry mouth, but it is not typically associated with rheumatoid nodules. Option D) Spondyloarthropathies are a group of inflammatory diseases that primarily affect the spine and joints. While they can share some similarities with RA, they do not commonly present with rheumatoid nodules as seen in Felty syndrome. Educationally, understanding the various extraarticular manifestations of RA is crucial for healthcare professionals to provide comprehensive care to patients with this condition. Recognizing the specific manifestations can aid in early diagnosis, appropriate management, and improved patient outcomes. This question highlights the importance of differentiating between the extraarticular manifestations of RA to guide clinical decision-making and enhance patient care.

Correct Answer: D

Rationale: The correct answer is D) Cognitive dysfunction from immune complex deposit in the brain. In advanced systemic lupus erythematosus (SLE), immune complexes can deposit in various organs, including the brain, leading to cognitive dysfunction. This can manifest as memory loss, confusion, and other neuropsychiatric symptoms. Option A) Proteinuria from early glomerulonephritis is a common renal manifestation of SLE, but it is not considered an ominous sign of advanced disease. It typically occurs earlier in the disease course. Option B) Anemia from antibodies against blood cells is a common hematologic manifestation of SLE but is not specific to advanced disease. It can occur at any stage of the disease. Option C) Dysrhythmias from fibrosis of the atrioventricular node is not a typical manifestation of advanced SLE. While cardiac involvement can occur in SLE, dysrhythmias are not a hallmark of advanced disease. Educationally, understanding the neurological manifestations of advanced SLE is crucial for healthcare providers to recognize and manage the potentially severe consequences of the disease. Recognizing cognitive dysfunction as an ominous sign can prompt timely intervention and prevent further neurological damage in patients with advanced SLE.

Correct Answer: A

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.