MRS. Post is being discharged tomorrow on a regimen of prednisone and aspirin to control her symptoms of systemic lupus erythematosus. She should be told to call her physician immediately if which one of the following occurs?

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Inability to take oral medications because of vomiting. This is the most critical symptom that requires immediate medical attention in a patient with systemic lupus erythematosus (SLE) who is being discharged on prednisone and aspirin. Patients with SLE are often on immunosuppressive medications like prednisone to manage their condition. Vomiting can prevent proper absorption of these medications, leading to inadequate treatment and potential disease exacerbation. Therefore, the patient must contact their physician promptly to address this issue and ensure appropriate management. Now, let's discuss why the other options are incorrect: A) Missed menstrual period: While changes in menstrual periods can occur in patients with SLE, it is not an urgent symptom that necessitates immediate medical attention. C) Temperature elevated to 99.6°F: A mild elevation in temperature is not uncommon and may not be alarming, especially in the context of autoimmune diseases. It is not a critical symptom that requires immediate action. D) Ankle edema: Ankle edema can be a symptom of SLE, but it is not as urgent as the inability to take medications due to vomiting. It can be addressed at the next scheduled appointment or sooner if it worsens significantly. Educationally, this question highlights the importance of recognizing critical symptoms in patients with SLE and understanding the significance of adherence to medication regimens. It emphasizes the need for patients to communicate effectively with their healthcare providers to ensure optimal management of their condition and prevent potential complications.

Correct Answer: C

Rationale: The correct answer is C) Carpal tunnel syndrome. Patients who work in settings that require repetitive hand movements over a long period are at an increased risk for developing carpal tunnel syndrome. This is because repetitive motions can cause swelling or inflammation in the carpal tunnel, a narrow passageway in the wrist where the median nerve and tendons pass through. This can lead to compression of the median nerve, resulting in symptoms such as pain, numbness, tingling, and weakness in the hand and wrist. Option A) Osteomyelitis is incorrect because it is a bone infection typically caused by bacteria, not related to repetitive hand movements. Option B) Osteoporosis is incorrect as it is a condition characterized by weakened bones, usually due to loss of bone density, and is not directly related to repetitive hand movements. Option D) Fracture of the overused area is incorrect because while repetitive stress can lead to overuse injuries like stress fractures, carpal tunnel syndrome is a more common and specific risk associated with repetitive hand movements. Educationally, understanding the risk factors associated with repetitive hand movements and the development of carpal tunnel syndrome is crucial for healthcare professionals, especially those working with patients in occupational therapy, physical therapy, or ergonomics. By recognizing these risks, professionals can provide preventive education, ergonomic interventions, and early interventions to mitigate the impact of repetitive motion injuries on individuals working in high-risk settings.

Correct Answer: B

Rationale: The correct answer is B) Hold the arm or the leg in place. When applying a cylinder cast to a client with a fracture, the nurse's role is crucial in ensuring proper immobilization and alignment of the injured limb. By holding the arm or leg in place during the casting procedure, the nurse helps maintain the correct positioning of the limb, which is essential for optimal healing of the fracture. This action prevents any movement that could disrupt the alignment and stability of the fracture site, promoting the desired therapeutic outcome. Option A) Gently massage the arm or the leg is incorrect because massaging the limb could potentially cause further injury or dislodgment of the fractured bone fragments, leading to complications in the healing process. Option C) Provide intense heat or a cast dryer to speed the evaporation is incorrect because applying heat to the cast can cause burns or discomfort to the client. Additionally, speeding up the evaporation process is not necessary for the proper application of a cast. Option D) Compress the cast on a hard surface for better support is incorrect because compressing the cast on a hard surface could distort its shape and compromise its ability to provide adequate support and immobilization to the injured limb. This action may lead to discomfort and hinder the healing process. In an educational context, understanding the correct role of the nurse in applying a cast is essential for providing safe and effective care to clients with fractures. Nurses must possess the knowledge and skills to perform this procedure correctly to promote optimal healing outcomes and prevent complications. Proper training and ongoing education are necessary to ensure that nurses can competently carry out casting procedures in clinical settings.

Correct Answer: B

Rationale: The correct answer is B) Elevate the extremity. Elevating the extremity helps reduce swelling and improve circulation, which can alleviate throbbing pain in a client with skeletal traction. When a limb is elevated, gravity assists in draining excess fluid from the affected area, reducing inflammation and pressure on nerves, thus decreasing pain. Option A) Administer antibiotics is incorrect because antibiotics are used to treat bacterial infections, not for pain relief in this scenario. Option C) Petal cast edges with waterproof tape is incorrect as it pertains to wound care and preventing skin breakdown under a cast, not addressing the client's current pain. Option D) Massage the area of pain is incorrect as massaging the area of skeletal traction can increase the risk of dislodging the traction or causing further injury. In an educational context, it is crucial for nurses to understand the rationale behind pain management strategies for clients with skeletal traction to provide effective and safe care. Elevating the extremity is a simple yet effective intervention that can significantly improve the client's comfort and promote optimal healing outcomes. It is essential for nurses to prioritize non-pharmacological pain management techniques like elevation to minimize reliance on medications and reduce potential side effects.

Correct Answer: C

Rationale: In this scenario, the correct answer is option C) Cool skin. A client being monitored for complications after surgery to repair a fracture would be at risk for arterial obstruction, which can compromise blood flow to the affected area. Cool skin is indicative of poor perfusion due to decreased blood flow, which is a concerning sign of arterial obstruction. This is a critical symptom that should prompt immediate medical intervention to prevent further complications such as tissue ischemia or necrosis. Now, let's analyze why the other options are incorrect: - Option A) Rapid capillary refill: Rapid capillary refill is a sign of good circulation, not indicative of arterial obstruction. - Option B) Warm skin: Warm skin is also associated with adequate circulation and not a typical sign of arterial obstruction. - Option D) Numbness: Numbness can be a symptom of nerve damage or compression but is not specific to arterial obstruction. In an educational context, understanding the signs and symptoms of arterial obstruction is crucial for healthcare professionals, especially those involved in postoperative care. Recognizing these symptoms promptly can help prevent serious complications and improve patient outcomes. Healthcare providers need to be vigilant in assessing and monitoring patients for any signs of compromised blood flow to ensure timely interventions when necessary.