Twenty-four hours later Bob is discharged. Which of the following statements would indicate Bob understood your teaching?

Correct Answer: B

Rationale: In this scenario, option B is the correct answer because it demonstrates the patient's understanding of the importance of monitoring for signs of complications post-discharge. Swelling and decreased temperature in the fingers of the left hand could indicate impaired circulation, requiring immediate medical attention. By mentioning elevation and prompt physician contact, the patient shows comprehension of self-care and when to seek professional help, reflecting effective teaching. Option A is incorrect because increasing pain in the arm should not be expected or ignored; persistent pain may indicate complications and should prompt immediate medical evaluation. Option C is incorrect as bleeding on the cast should not be circled but rather reported immediately to healthcare providers, as uncontrolled bleeding can lead to serious issues like infection or compromised healing. Option D is also incorrect as immobilizing the hand for a week without any mention of monitoring for complications or seeking medical advice could lead to potential issues such as stiffness or further complications. From an educational standpoint, this question highlights the importance of patient education in promoting post-discharge self-care and recognizing signs of complications. It emphasizes the significance of clear communication between healthcare providers and patients to ensure optimal outcomes and prevent adverse events. By assessing the patient's understanding through scenarios like this, healthcare professionals can gauge the effectiveness of their teaching and address any misconceptions or gaps in knowledge before discharge.

Correct Answer: B

Rationale: The correct answer is B) have an eye examination every 4-6 months. This is essential because hydroxychloroquine can cause retinopathy, a serious eye condition that can lead to vision loss if not detected early. Regular eye examinations are crucial for monitoring any signs of retinal damage and ensuring prompt intervention if needed. Option A is incorrect because hydroxychloroquine may take several weeks to months to start showing its full effects in managing symptoms of rheumatoid arthritis, so immediate relief within 1-2 weeks is not typical. Option C is incorrect as there is no specific requirement to take hydroxychloroquine before bedtime. The key is to take the medication consistently as prescribed. Option D is also incorrect because while being alert for a skin rash is important when taking any medication, it is not the primary concern associated with hydroxychloroquine therapy in rheumatoid arthritis. In an educational context, it is crucial for healthcare providers to educate patients about the potential side effects of medications they are prescribed, like hydroxychloroquine. Emphasizing the need for regular eye examinations can help prevent serious complications and promote patient safety and well-being. Patients should be empowered with knowledge to actively participate in their treatment and monitoring processes for better health outcomes.

Correct Answer: A

Rationale: The correct answer is A) Nonsteroidal anti-inflammatory medications and colchicine. In the treatment of acute gout attacks, nonsteroidal anti-inflammatory drugs (NSAIDs) help reduce inflammation and pain, while colchicine is specifically effective in treating gout by reducing inflammation and pain associated with crystal deposition in the joints. This combination targets the underlying cause of the acute gout attack and provides symptomatic relief. Option B) Allopurinol and aspirin is incorrect because allopurinol is a medication used for long-term management of gout by lowering uric acid levels and preventing future attacks, not for treating acute symptoms. Aspirin can actually worsen gout symptoms by interfering with uric acid excretion. Option C) Antibiotics and acetaminophen is also incorrect as antibiotics are not indicated for acute gout attacks unless there is an accompanying infection. Acetaminophen may provide some pain relief but does not address the underlying inflammatory process of gout. Option D) Bisphosphonates and calcium are used in the treatment of osteoporosis and have no role in managing acute gout attacks. Educationally, understanding the appropriate management of acute gout attacks is crucial for healthcare professionals to provide effective care and alleviate patient discomfort. This question highlights the importance of differentiating between long-term gout management and acute attack treatment, emphasizing the need for targeted therapies based on the underlying pathophysiology of the condition.

Correct Answer: A

Rationale: In this scenario, the nurse suspects that the client is experiencing problems with circulation, which is the correct answer (Option A). Weak pulses, dusky color in the ankles, and significant local edema are indicative of impaired blood flow to the lower extremities. This could be due to conditions such as peripheral vascular disease or deep vein thrombosis, which can lead to serious complications if not addressed promptly. Option B, problems with sensation, is incorrect in this case because the symptoms described are more closely related to circulatory issues rather than sensory deficits. Problems with sensation would typically involve issues such as numbness, tingling, or loss of feeling in the affected area. Option C, problems with mobility, is also incorrect as the symptoms presented do not directly point to issues with the client's ability to move. While impaired circulation can impact mobility in the long term if left untreated, it is not the primary concern based on the symptoms provided. Option D, problems with pain, is not the most likely issue as the symptoms described are more indicative of compromised blood flow rather than pain perception. While the client may eventually experience pain if circulation is severely compromised, the initial symptoms point more towards circulatory issues. From an educational perspective, understanding the signs and symptoms of circulatory problems in the lower extremities is crucial for nurses working in various clinical settings. Recognizing these indicators early can help prevent complications such as tissue damage, ulceration, and even amputation. Nurses should be able to differentiate between circulatory issues, sensory deficits, mobility problems, and pain to provide timely and appropriate care to their patients.

Correct Answer: D

Rationale: In the context of positioning a client with a fracture, it is crucial to ensure that the joints are positioned in an anatomic alignment to prevent damage to the peripheral nerves and blood vessels, making option D the correct answer. When joints are not in proper alignment, there is a risk of compression or injury to the surrounding nerves and blood vessels due to increased pressure or tension on these structures. This can lead to complications such as impaired circulation, numbness, tingling, or even more serious nerve damage. Option A, to prevent deep vein thrombosis, is incorrect in this scenario because deep vein thrombosis is more related to immobility and blood clot formation in the deep veins, rather than joint alignment. Option B, to facilitate lung expansion and prevent pooling of secretions, is not directly related to joint alignment in a client with a fracture. Option C, to prevent the escalation of pain and swelling, is important but not the primary reason for ensuring anatomic alignment of joints. Educationally, understanding the rationale behind proper positioning in clients with fractures is essential for nurses to provide safe and effective care, prevent complications, and promote optimal healing and recovery. It highlights the importance of attention to detail and precision in nursing interventions to promote positive patient outcomes.