In planning Mr. Smith's preoperative care to minimize the risk of an acute exacerbation, it will be most important to include

Correct Answer: C

Rationale: In the context of preoperative care for Mr. Smith to minimize the risk of an acute exacerbation, the most important action to include is increased active and passive range-of-motion exercises (Option C). This is crucial for preventing complications such as muscle weakness, joint stiffness, and pressure ulcers associated with immobility during the preoperative period. By engaging in range-of-motion exercises, Mr. Smith can maintain muscle strength, joint flexibility, and circulation, which are essential for a successful surgical outcome and postoperative recovery. Option A, discussing postoperative care, while important, is not as critical as ensuring Mr. Smith's physical readiness for surgery through exercises. Option B, increasing protein intake, may be beneficial for wound healing post-surgery but does not directly address the risk of acute exacerbation preoperatively. Option D, allowing Mr. Smith to share his feelings about the surgery, is important for emotional support but does not address the physical preparation needed to minimize acute exacerbation risks. In an educational context, understanding the rationale behind the importance of preoperative care interventions helps healthcare providers optimize patient outcomes. By focusing on evidence-based practices like range-of-motion exercises, educators can emphasize the significance of proactive measures in ensuring patients are physically prepared for surgery. This rationale underscores the holistic approach to patient care, integrating both physical and emotional aspects to promote overall well-being and successful surgical outcomes.

Correct Answer: C

Rationale: In this scenario, option C, the absence of a peripheral pulse, is the correct choice to indicate the presence of ischemia in a client with tissue injury. Ischemia refers to inadequate blood supply to a specific area, leading to tissue damage. The absence of a peripheral pulse suggests a lack of blood flow to the area, which is a critical sign of ischemia. This can be a red flag for healthcare providers to intervene promptly to restore blood flow and prevent further tissue damage. Option A, signs of fatigue, is not a specific indicator of ischemia in tissue injury. Fatigue can be caused by various factors and is not directly linked to the circulatory compromise seen in ischemia. Option B, signs of respiratory depression, are also not directly related to ischemia in tissue injury. Respiratory depression is typically associated with respiratory system dysfunction rather than circulatory issues. Option D, heavy swelling in the injured area, can be a sign of inflammation or fluid accumulation due to tissue injury but does not specifically indicate ischemia. Swelling can occur in various conditions and is not a definitive indicator of compromised blood supply leading to ischemia. In an educational context, understanding the signs and symptoms of ischemia is crucial for healthcare providers to recognize and address circulatory compromise promptly. Detecting ischemia early can prevent further tissue damage and improve patient outcomes. By knowing the specific indicators such as the absence of a peripheral pulse, healthcare professionals can provide timely interventions to restore blood flow and prevent complications in clients with tissue injuries.

Correct Answer: A

Rationale: The correct answer is A) Flexing the affected wrist. Graphic designers often experience hand pain due to prolonged hours of working on the computer, leading to repetitive strain injuries like carpal tunnel syndrome. Flexing the affected wrist helps to stretch and strengthen the muscles and tendons, improving circulation and reducing pain. This simple exercise can prevent further damage and alleviate discomfort. Option B) Shaking the affected hand may provide temporary relief by increasing blood flow, but it does not address the underlying issue of muscle strain and would not be as effective as targeted exercises like flexing the wrist. Option C) Using surgical intervention is not appropriate for a condition that is not serious and can often be managed through conservative measures like exercises and ergonomic adjustments. Option D) Applying physical therapy could be beneficial in the long term to address the pain and prevent further injury, but initially, simple exercises like flexing the wrist can be done at home without the need for formal physical therapy sessions. In an educational context, it is important for nurses to understand the common occupational hazards faced by individuals in certain professions, like graphic designers, and to be able to provide practical and effective recommendations to alleviate and prevent musculoskeletal issues related to their work activities. Educating clients on simple exercises they can incorporate into their daily routine empowers them to take control of their health and well-being.

Correct Answer: A

Rationale: Paget's disease is a chronic bone disorder characterized by abnormal bone remodeling, leading to enlarged and weakened bones. Elevated serum alkaline phosphatase level is common in Paget's disease due to increased bone turnover. Alkaline phosphatase is released from osteoblasts during bone formation, so elevated levels indicate increased bone activity. Option B, decreased urinary hydroxyproline excretion, is not a common finding in Paget's disease. Hydroxyproline is a marker of collagen breakdown, not bone turnover, so it would not be expected to be decreased in Paget's disease. Option C, elevated leukocyte count, is not directly related to Paget's disease. The primary manifestation of Paget's disease is skeletal abnormalities, not alterations in leukocyte count. Option D, elevated creatinine level, is not typically associated with Paget's disease. Creatinine is a marker of kidney function and is not directly influenced by Paget's disease. Educationally, understanding the laboratory findings associated with various diseases is crucial for healthcare professionals to make accurate diagnoses and provide appropriate treatment. In the case of Paget's disease, recognizing the significance of elevated serum alkaline phosphatase levels can aid in early detection and management of the condition.

Correct Answer: D

Rationale: The correct answer is D) A 72-year-old patient with Paget's disease who has just returned from surgery for total knee replacement. The rationale behind this choice is that this patient requires specialized care and attention post-surgery due to the complexity of the procedure and the underlying Paget's disease, which can affect bone health and healing. The nurse pulled from the PACU, with experience in post-operative care and monitoring, is best suited to provide the necessary support and monitoring for this patient. Option A is incorrect because teaching prior to hyperbaric oxygen therapy for osteomyelitis does not require immediate post-operative care expertise. Option B is incorrect as the patient with osteomalacia being discharged to a long-term care facility would benefit more from a nurse specializing in long-term care transitions. Option C is incorrect as assessing knowledge of orthotic device use in a patient with osteoporosis does not require the expertise of a nurse from the PACU. In an educational context, this question highlights the importance of matching nursing expertise with patient needs based on their specific conditions and care requirements. Understanding the role of nurses in different specialties and settings is crucial for providing optimal patient care and ensuring positive outcomes.