To assess for neurologic status in a patient with a fractured humerus, what should the nurse ask the patient to do?

Correct Answer: B

Rationale: The correct answer is B) Abduct, adduct, and oppose the fingers and pronate and supinate the hand. This option is correct because assessing the patient's ability to perform these specific movements helps evaluate the function of the radial, median, and ulnar nerves that innervate the upper extremity. The nurse is checking for any signs of nerve damage or impairment due to the fractured humerus. Option A is incorrect because the movements mentioned (evert, invert, dorsiflex, and plantar flex the foot) are related to assessing the function of the lower extremity nerves, not the upper extremity as in the case of a fractured humerus. Option C is incorrect as assessing pain below the injury site is important but does not specifically address neurologic status related to the upper extremity. Option D is incorrect as it focuses on assessing vascular status (color, temperature, capillary refill, pulses, edema) rather than neurologic function, which is the primary concern in this scenario. In an educational context, understanding the specific nerve innervations and corresponding movements for each part of the body is crucial for accurate neurological assessment. Nurses must be able to differentiate between sensory, motor, and vascular assessments to provide comprehensive care and detect any neurologic deficits early, especially in the case of injuries like a fractured humerus.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Gently handle the involved extremity during movement. This is the most appropriate nursing intervention for a patient with osteomyelitis and a nursing diagnosis of risk for injury because aggressive handling can exacerbate the condition or lead to complications such as fractures or spread of infection. Option A) Use careful and appropriate disposal of soiled dressings is important for infection control but does not directly address the risk for injury in this case. Option C) Measure the circumference of the affected extremity daily is more related to monitoring for edema or changes in the affected limb rather than preventing injury. Option D) Provide ROM exercises q4hr to the involved extremity can be too aggressive and potentially harmful in a patient with osteomyelitis. Educationally, it is crucial for nursing students to understand the principles of gentle handling and movement when caring for patients with musculoskeletal infections like osteomyelitis. This knowledge helps prevent complications, promote patient safety, and demonstrates the importance of individualized care based on the patient's specific condition. Healthcare professionals must always prioritize patient safety and tailor interventions to meet the unique needs of each patient to ensure optimal outcomes.

Correct Answer: A

Rationale: In this scenario, option A is the correct answer because alendronate (Fosamax) should be taken on an empty stomach first thing in the morning with a full glass of water, at least 30 minutes before eating or drinking anything else, to enhance absorption and reduce the risk of esophageal irritation. Taking it with a meal may interfere with absorption and efficacy of the medication. Option B is incorrect because alendronate does not increase bone density but rather helps prevent further bone loss. Option C is incorrect because the patient should sit or stand upright for at least 30 minutes after taking the medication to minimize the risk of esophageal irritation and ensure proper absorption. Option D is incorrect because calcium supplements should not be taken at the same time as alendronate as they can interfere with its absorption. Educationally, this question highlights the importance of understanding the specific instructions for taking medications, especially those like alendronate that have specific administration requirements to maximize effectiveness and minimize side effects. It emphasizes the need for healthcare providers to provide clear and accurate medication education to patients to ensure safe and optimal treatment outcomes.

Correct Answer: B

Rationale: The correct answer is B) "I should perform most of my daily chores in the morning when my energy level is highest." This statement indicates a misunderstanding of managing activities with rheumatoid arthritis (RA). Individuals with RA often experience fatigue, joint pain, and stiffness, which can vary throughout the day. It is important for patients to prioritize activities and conserve energy by spreading out tasks and taking breaks as needed. Option A is correct because performing prescribed exercises daily helps maintain joint flexibility and muscle strength, which are crucial in managing RA symptoms. Option C is also correct as applying an ice pack can help reduce inflammation during acute flares. Option D is correct as using assistive devices can help reduce joint stress and strain. Educationally, it is important to emphasize to patients with RA the need for energy conservation, proper exercise, and the use of assistive devices to maintain independence and manage symptoms effectively. Understanding the optimal timing for activities and the importance of self-care strategies can significantly improve the quality of life for individuals with RA.

Correct Answer: A

Rationale: In assessing a patient with scleroderma, the nurse should expect to find thickening of the skin of the fingers and hands. This is due to the excessive collagen deposition that is characteristic of scleroderma. Option A is the correct answer because thickening of the skin is a classic manifestation of scleroderma, especially in the fingers and hands. This thickening can lead to decreased mobility and function in these areas. Option B is incorrect as cool, cyanotic fingers with thinning skin over the joints are more indicative of conditions like Raynaud's phenomenon, which can commonly coexist with scleroderma but are not specific to it. Option C, Swan neck deformity or ulnar drift deformity of the hands, is more commonly associated with conditions like rheumatoid arthritis, not scleroderma. Option D, low back pain, stiffness, and limitation of spine movement, are not typical manifestations of scleroderma. These symptoms are more commonly seen in conditions like ankylosing spondylitis. Educationally, understanding the specific manifestations of scleroderma is crucial for nurses to provide comprehensive care to patients with this condition. By recognizing these signs early, appropriate interventions can be initiated to improve patient outcomes and quality of life.