NCLEX-RN
RN Musculoskeletal NCLEX Questions Questions
Extract:
The following scenario applies to the next 1 items
The nurse in a urgent care facility cares for a 46-year-old male
Item 1 of 1
Triage Note
1400: 46-year-old man reports right ankle pain that started one hour ago while playing soccer with his children. He states that he was getting ready to kick the ball and lost his footing on wet grass. Focused assessment: swelling over the lateral malleolus down to the area of the fourth and fifth metatarsals is present, and pedal pulses are 2+ bilaterally. Pain is endorsed with movement, and the range of motion of the right ankle is very limited. No gross deformity of the ankle was observed. Pain is rated 9 on a scale of 0 (no pain) to 10 (severe pain). T 97.5° F (36.4° C), P 98, RR 18, BP 144/90, pulse oximetry reading 96% on room air. The client reports allergies to erythromycin with an unknown reaction. Medical history included a myocardial infarction 8 months ago, irritable bowel syndrome, and plaque psoriasis. Current medications include clopidogrel and atenolol.
Physician Orders
• Discharge home with an orthopedic referral
• Ketorolac 15 mg intramuscular (IM) x 1 dose
• Apply ace wrap to the right ankle
• Home prescription: Ketorolac 10 mg by mouth twice a day PRN pain for three days
• Home prescription: Oxycodone 5 mg by mouth twice a day PRN pain for three days
• Home prescription: Docusate 50 mg by mouth once a day for three days
• Home prescription: Crutches, no weight bearing to the right lower extremity until seen by orthopedics
Diagnostics
Right Ankle X-Ray
No obvious fracture is seen. Bones show normal alignment and architecture. Joint spaces and articular margins are intact. Soft tissue swelling noted.
Question 1 of 5
The nurse implements the physician's orders. Complete the sentences below by choosing from the list of options. The nurse reviews the prescriptions and should question the prescribed……….. with the physician based on the client's medical history of…….The nurse is gathering the prescribed crutches and plans on teaching the client to ambulate using the……..The nurse should instruct the client that the crutches should be………To promote comfort and to reduce swelling, the nurse should instruct the client to apply…………..compresses to the ankle for no greater than………..
Correct Answer: A, B,C,D,E,F
Rationale: A, B: Ketorolac, an NSAID, increases bleeding risk, concerning with a recent myocardial infarction and clopidogrel use. Other options relate to crutch use and swelling management, which are appropriate.
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