What soft tissue musculoskeletal injury is excessive stretching of a ligament?

Correct Answer: A

Rationale: A **sprain** is the correct answer because it specifically refers to the excessive stretching or tearing of a ligament, which is the fibrous connective tissue that connects bones to each other at a joint. Sprains occur when a joint is forced beyond its normal range of motion, causing the ligament to overstretch or partially/completely tear. Common examples include ankle sprains from rolling the foot or knee sprains from sudden twists. The severity of a sprain is graded from I (mild stretching) to III (complete rupture), but the core definition aligns with ligament overstretching. **B: Ligament tear** is incorrect because while a sprain can involve a tear, this option is too narrow. A "ligament tear" typically implies a complete rupture (Grade III sprain), whereas the question asks about *excessive stretching*, which encompasses milder forms of ligament injury (Grades I-II). A tear is a subset of sprains, not a synonym. **C: Strain** is incorrect because it describes an injury to a muscle or tendon (which connects muscle to bone), not a ligament. Strains result from overstretching or tearing muscle fibers or tendons, often due to sudden force or overuse (e.g., hamstring strains). The key distinction lies in the anatomical structure affected: strains involve muscle-tendon units, while sprains involve ligaments. **D: Tendon rupture** is incorrect because it refers specifically to the complete severing of a tendon, which is entirely different from ligament stretching. Tendon ruptures (e.g., Achilles tendon) are acute injuries often requiring surgical repair, whereas ligament overstretching (sprain) may heal with conservative treatment. The question’s focus on ligaments makes this option anatomically irrelevant. The confusion often arises from the similarity in symptoms (pain, swelling) between sprains and strains, but the critical difference lies in the affected tissue. Ligaments stabilize joints; muscles and tendons generate movement. Understanding this anatomical distinction clarifies why "sprain" is the only correct answer for ligament-related overstretching. Additionally, grading systems for sprains account for varying degrees of ligament damage, while the other choices either misrepresent the tissue (strain, tendon rupture) or overspecify the injury (ligament tear).

Correct Answer: A

Rationale: **Rationale:** **Correct Answer (A): Speaking slowly and clearly while facing the client** is the most effective nursing intervention for improving communication with a hearing-impaired individual. This approach leverages visual cues, such as lip-reading and facial expressions, which many hearing-impaired individuals rely on to supplement their auditory comprehension. Speaking slowly allows the client to process words more easily, while enunciating clearly minimizes ambiguity in sound recognition. Facing the client directly ensures they can see the speaker’s mouth movements and gestures, which are critical for understanding. This method is also non-invasive, respectful, and aligns with best practices for accommodating hearing impairments without unnecessary adjustments like assistive devices or written communication. **Incorrect Answers:** **B: Write down the message** – While written communication can be helpful in some cases, it is not the *best* intervention for all hearing-impaired clients. Many individuals with hearing loss can still process spoken language effectively with visual cues, and relying solely on writing may slow down conversation unnecessarily. Additionally, some clients may have limited literacy or vision issues that make this method ineffective. Writing should be a supplementary tool, not the primary method unless the client specifically requests it. **C: Talk in a regular voice in the good ear** – Assuming the client has a "good ear" oversimplifies hearing impairment, as hearing loss is often bilateral or varies in severity. Speaking in a regular voice may still be too soft or unclear, and turning to one side removes the visual component of communication (lip-reading and facial expressions). This approach can also come across as dismissive if the client feels the nurse is not making a full effort to accommodate their needs. **D: Shout in the impaired ear** – Shouting distorts speech, making it harder to understand even for individuals with some residual hearing. It can also appear aggressive or demeaning, negatively impacting the therapeutic relationship. Loud sounds may cause discomfort or pain for those with certain types of hearing loss (e.g., hyperacusis or recruitment). Effective communication requires clarity and patience, not increased volume. In summary, **A** is correct because it optimizes both auditory and visual communication strategies, while the other options either neglect key aspects of effective interaction (B, C) or introduce counterproductive methods (D). The best approach considers the client’s comfort, maximizes comprehension through multiple sensory inputs, and maintains dignity in communication.

Correct Answer: D

Rationale: Lifting an object while holding it close to the body (D) is the correct choice because it reduces strain on the spine and engages larger muscle groups more effectively. When the load is near the center of gravity, the back experiences less torque, minimizing the risk of injury. Additionally, keeping the object close allows the legs—which are stronger than the back—to bear most of the weight during the lift. Proper body mechanics also involve bending at the knees, maintaining a neutral spine, and tightening the core, all of which are more easily achieved when the object is held near the torso. Lifting with the back (A) is incorrect because it places excessive stress on the lumbar spine, increasing the risk of herniated discs or muscle strains. The spine is not designed to handle heavy loads in a flexed or twisted position. Instead, the legs should be the primary drivers of the lift, as they contain larger muscle groups capable of generating force safely. Relying on the back shifts the burden to weaker structures, making injury far more likely. Standing with a narrow stance (B) is incorrect because it reduces stability and balance during the lift. A wider stance lowers the center of gravity and provides a stronger base, allowing for better control of the load. A narrow stance increases the likelihood of losing balance, especially when lifting asymmetrical or heavy objects, which could lead to falls or sudden, awkward movements that strain muscles or joints. Lifting excessive weight to strengthen muscles (C) is incorrect because it violates the principle of progressive overload, which should be applied gradually under controlled conditions. Attempting to lift beyond one's capacity with improper form often leads to compensatory movements, such as arching the back or jerking the weight, which can cause acute injuries or long-term damage. Strength training should be structured and supervised, not attempted haphazardly during everyday lifting tasks. Proper body mechanics prioritize safety over momentary exertion, ensuring that the musculoskeletal system is protected. Each incorrect choice disregards biomechanical efficiency and safety, while the correct answer aligns with evidence-based practices for reducing injury risk and maximizing lifting effectiveness. The principles of proper body mechanics are rooted in physics and anatomy, emphasizing load distribution, stability, and the use of the body's strongest muscles to perform work safely.

Correct Answer: A

Rationale: To determine how many milligrams (mg) are in 5000 micrograms (mcg), it’s essential to understand the relationship between these units of measurement. The metric system uses a base-10 scale, making conversions straightforward once the prefixes are understood. The prefix "micro-" denotes one-millionth (10^-6), while "milli-" denotes one-thousandth (10^-3). This means that 1 milligram (mg) is equal to 1000 micrograms (mcg). The conversion from micrograms to milligrams involves dividing the number of micrograms by 1000 since there are 1000 mcg in 1 mg. Applying this to the question: 5000 mcg ÷ 1000 = 5 mg. This calculation confirms that 5000 mcg is equivalent to 5 mg, making **A (5)** the correct answer. Now, let’s examine why the other choices are incorrect: - **B (6)**: This is incorrect because dividing 5000 mcg by 1000 yields 5, not 6. A mistake here could stem from adding 1 erroneously or misplacing a decimal point. - **C (4)**: This is incorrect because 4000 mcg would be equivalent to 4 mg, but the given value is 5000 mcg. Choosing this suggests a subtraction error or confusion with the conversion factor. - **D (3)**: This is incorrect as it significantly underestimates the conversion. 3000 mcg would be 3 mg, but 5000 mcg is notably higher, meaning this choice reflects a misunderstanding of the relationship between the units or a calculation error. The key takeaway is that converting mcg to mg requires dividing by 1000 due to the metric system’s structure. Missteps in this process, such as multiplying instead of dividing or using an incorrect divisor, lead to the wrong selections. Mastery of metric unit conversions is foundational in fields like medicine and science, where precise measurements are critical.

Correct Answer: A

Rationale: The best initial action is to inquire about the frequency, quality, and location of the pain (Option A). Pain assessment is the first critical step in nursing care because it provides essential information needed to determine the appropriate intervention. Without a thorough understanding of the pain’s characteristics—whether it is sharp, dull, throbbing, localized, or radiating—the nurse cannot effectively advocate for the patient or make informed clinical decisions. Proper pain assessment also helps differentiate between expected cancer-related pain and potential complications, such as a new fracture or infection, which may require immediate medical attention. This step ensures that subsequent interventions, including medication administration, are tailored to the patient’s specific needs rather than being applied generically. Option B (Get the client pain medication) may seem urgent, but administering medication without a proper assessment risks inappropriate dosing, masking critical symptoms, or overlooking complications. Pain management is important, but it must be based on a clear understanding of the pain’s nature and severity. Blindly administering medication could delay identifying a more serious issue, such as pathological fracture or spinal cord compression, which requires additional interventions beyond analgesia. Option C (Ensure the client knows he will have negative effects from immobility) is inappropriate as an initial response. While immobility complications (e.g., muscle atrophy, pressure injuries, or thrombus formation) are legitimate concerns, they are secondary to addressing the patient’s acute pain. Educating the patient about immobility risks at this moment dismisses their immediate distress and fails to prioritize their most pressing need—pain relief. This approach could also erode trust, as the patient may perceive the nurse as minimizing their suffering. Option D (Review the client’s medication administration record) is a useful step but should follow, not precede, a pain assessment. Reviewing the MAR provides information on previously administered medications, scheduled doses, and potential gaps in pain management. However, without first assessing the current pain, the nurse lacks context for interpreting the MAR’s data. For example, if the pain is new or worsening despite recent medication, this could signal a need for reevaluation of the treatment plan rather than simply administering the next scheduled dose. In summary, pain assessment (Option A) is foundational. It ensures patient-centered care, guides safe and effective interventions, and prevents oversight of critical clinical changes. The other options, while relevant, should only be pursued after a thorough assessment or as part of a broader pain management strategy.