Which information obtained during the nurse’s assessment of a patient’s nutritional-metabolic pattern may indicate increased risk for musculoskeletal problems?

Correct Answer: C

Rationale: The correct answer is C because the patient being 5 ft, 2 in tall and weighing 180 lb indicates potential obesity, which can increase the risk for musculoskeletal problems. Excess weight puts strain on the bones and joints, leading to conditions like osteoarthritis. A: Taking a multivitamin daily is generally positive for overall health but does not directly indicate an increased risk for musculoskeletal problems. B: Disliking fruits and vegetables may point to potential nutritional deficiencies but does not directly indicate musculoskeletal issues. D: Preferring whole milk over nonfat milk may impact overall nutritional intake but is not directly linked to musculoskeletal problems. In summary, choice C is correct because obesity is a significant risk factor for musculoskeletal problems, while choices A, B, and D do not directly indicate an increased risk in this context.

Correct Answer: B

Rationale: The correct answer is B: Ask the patient about abdominal discomfort. This is important because the patient with a hip spica cast may experience pressure on the abdomen, leading to potential abdominal discomfort or complications. It is crucial to monitor for signs of abdominal issues promptly. A: Avoid placing the patient in prone position - While this is generally a good practice to prevent pressure ulcers, it is not directly related to the specific concern of abdominal discomfort in this scenario. C: Discuss remaining on bed rest for several weeks - While bed rest may be necessary for a period, it is not directly addressing the potential issue of abdominal discomfort from the spica cast. D: Use the cast support bar to reposition the patient - While repositioning the patient is important, the primary concern in this situation is monitoring for abdominal discomfort, not repositioning the patient.

Correct Answer: B

Rationale: The correct answer is B: how and when to cut the immobilizing wires. This is crucial information for the patient post-repair of a fractured mandible to ensure safe removal of the immobilizing wires as per the surgeon's instructions. Cutting them incorrectly can lead to complications or injury. A: Administration of nasogastric tube feedings is not directly related to the patient's mandible fracture repair. C: While high-fiber foods may be important for overall health, it is not specifically related to the immediate postoperative care of a fractured mandible. D: The use of sterile technique for dressing changes is important for wound care but is not directly related to the immobilizing wires for a fractured mandible.

Correct Answer: B

Rationale: The correct answer is B because leaning over to pull on shoes and socks can put excessive strain on the hip joint, potentially leading to dislocation or injury post-hip arthroplasty. This action should be avoided to prevent complications. The other choices (A, C, D) are safe post-hip arthroplasty actions that promote proper weight-bearing, mobility, and independence without risking injury or dislocation.

Correct Answer: A

Rationale: The correct action is to take the blood pressure first because sudden confusion in a patient with a fractured pelvis could indicate a potential medical emergency like hypotension or hemorrhage. Assessing blood pressure is crucial to rule out these life-threatening conditions promptly. Checking O2 saturation, observing for facial asymmetry, and assessing patient orientation are important assessments but not the priority in this situation. O2 saturation is important for assessing respiratory status, facial asymmetry for neurological issues, and patient orientation for cognitive function, but these can be done after ruling out immediate life-threatening conditions like hypotension.