Mr. Smith is soon to be discharged. This morning he is complaining of soreness and stiffness and wants to be fed his breakfast. The best initial nursing action at this time is to

Correct Answer: D

Rationale: The correct answer, D) encourage him to feed himself at his own pace, is the best initial nursing action in this scenario for several reasons. Encouraging Mr. Smith to feed himself promotes independence and autonomy, which are crucial for his overall well-being and self-esteem. It also allows him to have control over his own care, fostering a sense of empowerment and dignity. Option A) arranging to have someone feed him may undermine his independence and not address the underlying reason for his reluctance to feed himself. Option B) delaying his breakfast could lead to further discomfort and agitation for Mr. Smith without addressing the issue at hand. Option C) asking him why he does not want to feed himself is important but should come after encouraging him to try feeding himself, as it prioritizes autonomy first. In an educational context, this question highlights the importance of person-centered care and the promotion of patient autonomy in nursing practice. It emphasizes the need to empower patients in their care decisions and to approach situations with a focus on individual preferences and abilities. By choosing the correct answer, nurses can support patients in maintaining their independence and dignity, ultimately enhancing their overall quality of life.

Correct Answer: B

Rationale: The correct answer is B) Canned salmon with bones. This option is the best choice because it contains both calcium and vitamin D, which are essential for optimal calcium absorption in the body. The bones in canned salmon are a rich source of easily absorbable calcium, making it an ideal non-dairy source for meeting daily calcium requirements. Option A) Green leafy vegetables are good sources of calcium, but the calcium in them is not as easily absorbed by the body compared to the calcium in salmon with bones. Option C) Broccoli contains some calcium, but the amount is relatively low compared to what the client may need to meet daily requirements. Option D) Calcium-fortified orange juice is a good source of calcium, but it may not provide as much calcium per serving as canned salmon with bones. In an educational context, it is important for healthcare professionals to be knowledgeable about alternative sources of nutrients, especially for clients with specific dietary restrictions or preferences. Understanding the bioavailability of nutrients from different food sources can help in providing appropriate dietary recommendations for clients to support their recovery and overall health.

Correct Answer: A

Rationale: The correct answer is A) Severe pain at the site of the fracture. When assessing a client with a femoral neck fracture, monitoring for severe pain is crucial because it is a typical symptom associated with this type of injury. Femoral neck fractures can cause intense pain in the hip or groin area, which can be exacerbated by movement or weight-bearing. This symptom is indicative of the severity of the injury and can also help in determining the need for immediate medical intervention to manage pain and prevent complications like immobility or further damage. Option B) Bleeding from joint capsules is not typically a common symptom associated with a femoral neck fracture. While there may be internal bleeding associated with the fracture, it is not usually visible externally as bleeding from joint capsules. Option C) Muscle spasms are not specific to femoral neck fractures and can occur due to various reasons such as muscle strain or nerve irritation. While muscle spasms can be a response to pain, they are not unique to this type of fracture. Option D) Crepitus at the site of the fracture, which refers to a grating or grinding sensation or sound with movement, is more commonly associated with conditions like osteoarthritis or joint injuries involving cartilage damage. It is not a typical finding in femoral neck fractures. Educationally, understanding the specific symptoms associated with different types of fractures is crucial for nurses to accurately assess and provide appropriate care to clients. Recognizing the key signs of a femoral neck fracture, such as severe pain, enables prompt intervention and can help prevent complications and promote better outcomes for the patient.

Correct Answer: C

Rationale: In the case of a patient diagnosed with advanced ALS, the priority intervention is to develop a method of communication, which is option C. This is the correct answer because communication is essential for maintaining the patient's dignity, autonomy, and quality of life. ALS progressively impairs the patient's ability to speak and move, making effective communication challenging. By developing a method of communication, such as using communication boards, eye-tracking devices, or other assistive technologies, the healthcare team can ensure the patient's needs, preferences, and concerns are heard and addressed. Option A is incorrect because focusing solely on providing meals without addressing communication neglects the patient's holistic needs and preferences. Option B is inappropriate as it disregards the patient's right to participate in decisions about their care, regardless of their mental status. Option D is incorrect as it prioritizes meal provision over addressing the crucial issue of communication in a patient with ALS. Educationally, this question highlights the importance of recognizing the holistic needs of patients with neurological conditions, such as ALS, and the significance of effective communication in providing patient-centered care. It emphasizes the role of healthcare professionals in ensuring that patients with communication challenges are supported in expressing their needs and maintaining their agency and dignity.

Correct Answer: C

Rationale: In the context of a patient with osteomyelitis, a serious infection of the bone, the most critical vital sign to monitor closely is the heart rate. Osteomyelitis can lead to systemic inflammatory responses in the body, causing an increase in heart rate as the body tries to fight off the infection. A heart rate of 96 beats per minute indicates tachycardia, which can be a sign of the body's stress response to the infection. This rapid heart rate may indicate systemic involvement and the potential for worsening sepsis, requiring immediate attention and intervention. The other vital signs provided in the options are also important in assessing a patient's condition, but they are not as directly linked to the urgency of osteomyelitis as heart rate. A temperature of 99.9°F may indicate a slight fever, which is common in infections but may not be as acutely concerning as an elevated heart rate in this context. The blood pressure and respiratory rate provided fall within normal ranges and do not necessarily indicate an immediate need for intervention in a patient with osteomyelitis. In an educational context, understanding the significance of vital signs in different clinical scenarios is crucial for healthcare providers to prioritize and respond to patient needs effectively. Teaching students to recognize the specific implications of vital signs in conditions like osteomyelitis helps develop their clinical reasoning skills and enhances their ability to provide timely and appropriate care to patients in various healthcare settings.