Mrs. Rollo has been instructed to check her urine with a multiple test stick. For which abnormal finding should she be particularly alert and report to you when the test is positive?

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Protein. Mrs. Rollo should be particularly alert and report to you when the multiple test stick shows a positive result for protein in her urine. This is because the presence of protein in the urine, known as proteinuria, can indicate potential kidney damage or dysfunction. It can be a sign of various underlying health conditions such as kidney disease, urinary tract infections, high blood pressure, diabetes, or other systemic diseases. Option A) Glucose is incorrect because the presence of glucose in the urine may indicate diabetes or high blood sugar levels, but it is not the most critical finding to report in this case. Option B) pH of 5 is not the most crucial abnormal finding to report; the pH of urine can vary depending on diet, hydration levels, and other factors. Option D) Ketones are another abnormal finding that may indicate conditions like uncontrolled diabetes or fasting, but protein in the urine is more concerning in this context. Educationally, it is important for individuals to understand the significance of monitoring their urine for abnormal findings like protein as it can serve as an early indicator of potential health issues, especially related to the kidneys. This knowledge empowers individuals to take proactive steps in seeking medical attention and managing their health effectively. Regular monitoring and reporting of abnormal results can lead to timely interventions and improved health outcomes.

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: B

Rationale: In the case of a patient who has just undergone open carpal tunnel release surgery, keeping the hand and arm elevated above the level of the heart is crucial for reducing postoperative swelling. By elevating the extremity, gravity helps to facilitate venous return and prevent the accumulation of excess fluid in the surgical site, which can lead to edema and delayed healing. Option A, reducing lymphatic drainage, is incorrect because elevating the arm actually helps to improve lymphatic drainage by aiding in the movement of lymphatic fluid back towards the central circulation. Option C, restricting hand movements, is not the primary purpose of keeping the hand elevated postoperatively. While some restrictions on hand movements may be necessary to protect the surgical site, the main goal of elevation is to reduce swelling. Option D, decreasing the possibility of nosocomial infection, is not directly related to the rationale for keeping the hand elevated postoperatively. Infection prevention involves other strategies such as maintaining proper hand hygiene and aseptic techniques during wound care. Educationally, it is important for healthcare providers to understand the rationale behind postoperative care instructions to ensure optimal patient outcomes. By grasping the reasons for specific interventions like elevation, healthcare professionals can provide better care and help patients recover more effectively.

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.