When Mr. Singer is discharged he should know that, at home, he can best relieve the pain and early morning stiffness after a night's sleep by

Correct Answer: B

Rationale: The correct answer is option B: taking a hot bath followed by a short rest period in the early morning. This is the most appropriate way to relieve pain and stiffness in the joints after a night's sleep for Mr. Singer. Hot baths help to relax the muscles and joints, improve circulation, and reduce stiffness. The warmth from the hot water can also help to alleviate pain and discomfort. Following the hot bath with a short rest period allows the body to continue to relax and adjust before engaging in activities, which can further alleviate stiffness. Options A, C, and D are incorrect. Taking narcotic analgesics when he first arises (option A) may provide temporary relief, but it is not the best long-term solution and may have side effects. Applying cold applications (option C) may help with acute inflammation, but it is not ideal for relieving stiffness in the morning. Applying hot paraffin (option D) may also provide some relief, but it is not as effective as a hot bath followed by rest for overall joint pain and stiffness. In an educational context, it is important to teach patients like Mr. Singer about self-management strategies for pain and stiffness associated with conditions like arthritis. By understanding the benefits of hot baths and rest in the morning, patients can incorporate these simple yet effective practices into their daily routine to improve their quality of life and manage their condition better.

Correct Answer: D

Rationale: In assessing a traumatic musculoskeletal injury, comparing structures and assessment findings on one side of the body with those on the opposite side (Option D) is the best method to determine the degree of injury. This approach allows the nurse to identify any discrepancies or abnormalities between the injured and uninjured sides, providing a clearer picture of the extent of the injury. Palpating the injured area (Option A) may elicit pain but does not provide a comprehensive understanding of the injury's severity. Applying force and asking the client to push back (Option B) can potentially worsen the injury or cause unnecessary discomfort. Encouraging movement of the injured area (Option C) may be contraindicated in certain cases where movement could exacerbate the injury. In an educational context, understanding the rationale behind comparing structures on both sides of the body enhances the nurse's assessment skills. This method not only helps in determining the degree of injury but also aids in identifying asymmetries or abnormalities that may have gone unnoticed with a single-sided assessment. It reinforces the importance of thorough and systematic evaluation in providing optimal patient care.

Correct Answer: D

Rationale: The correct answer is D) Discuss the phenomenon of phantom pain with the client. Phantom pain is a common phenomenon where an individual feels sensations, such as itching or pain, in a limb that has been amputated. By discussing this with the client, the nurse can help educate them about the normalcy of these sensations and provide reassurance that they are not alone in experiencing them. This can help alleviate anxiety and distress associated with these sensations. Option A is incorrect because seeking additional analgesics may not necessarily address phantom limb pain, as it is not caused by physical issues in the residual limb. Option B is incorrect as meeting a psychiatrist may not be necessary unless there are accompanying mental health concerns. Option C is incorrect as surgical removal of nerve endings is not a standard practice for managing phantom pain and may not effectively alleviate the sensations. In an educational context, understanding and addressing phantom pain is crucial for nurses caring for clients who have undergone amputations. By educating clients about phantom pain and providing appropriate support and reassurance, nurses can significantly improve their clients' quality of life and emotional well-being during the recovery process.

Correct Answer: D

Rationale: In the midstage of Lyme disease, the correct symptoms for the nurse to observe include facial palsy and meningitis. Facial palsy, also known as Bell's palsy, is a common neurological manifestation of Lyme disease due to inflammation of the facial nerve. Meningitis, an inflammation of the membranes surrounding the brain and spinal cord, can also occur in Lyme disease. Option A, joint erosion, is more commonly associated with advanced stages of Lyme disease rather than the midstage. Option B, fever, chills, and malaise, are general symptoms that can occur in the early stage of Lyme disease but are not specific to the midstage. Option C, arthritis, typically presents in the later stages of Lyme disease as joint symptoms progress. In an educational context, understanding the progression of symptoms in Lyme disease is crucial for nurses to provide timely and appropriate care. Recognizing the specific symptoms at each stage helps in accurate assessment, diagnosis, and treatment of the disease, ultimately improving patient outcomes. Nurses need to be well-versed in the nuances of Lyme disease presentation to deliver comprehensive care to affected individuals.

Correct Answer: B

Rationale: Paget's disease is a condition characterized by abnormal bone destruction and regrowth, leading to weakened, misshapen bones. Option B, stating that the base of the patient's skull is invaginated (platybasia), is indicative of Paget's disease. Platybasia is a common finding in Paget's disease due to the abnormal bone remodeling in the skull. Option A, bowing of both legs with asymmetric knees, is more indicative of conditions such as rickets or osteomalacia, where there is a disturbance in bone mineralization. Option C, being short and weighing 120 pounds, does not specifically point towards Paget's disease but may be seen in various other conditions or be a normal variant for that individual. Option D, having a soft, thick, and larger than normal skull, does not directly relate to Paget's disease but could suggest conditions like hydrocephalus or acromegaly. In an educational context, understanding the specific manifestations of Paget's disease is crucial for nurses and healthcare providers to recognize and provide appropriate care. Differentiating these signs and symptoms from other conditions helps in accurate diagnosis and timely intervention to manage the patient's condition effectively.