NR 328 CMS Exam Questions and Answers

NR 328 CMS Exam Questions and AnswersA child with sickle cell disease is brought to the hospital reporting right knee pain. On examination, the nurse finds localized swelling and immediately applies a cold compress to the right knee, massages the knee, and administers ibuprofen for pain relief. The nurse informs the mother that the child may need a high dose of an opioid if there is no relief from pain. Which of the measures taken by the nurse need to be corrected? a. Giving ibuprofen to the child for pain relief b. Giving cold compression to the affected area c. Informing the parent that the child needs a high dose of an opioid d. Massaging the affected area for pain relief Answer: B Rationale: Localized swelling over a joint with arthralgia can occur in some children with sickle cell disease. In such situations a nurse should avoid applying a cold compress to the affected area, as it promotes vasoconstriction leading to sickling of cells. Therefore the nurse should apply heat, massage the affected area, and give analgesics such as ibuprofen for pain relief. Parents should be informed that the child may require a high dose of an opioid if the pain is not relieved and that it is completely safe. For a postoperative patient 6 hours after brain surgery, which potential complications can result from improper positioning? Select all that apply. a. Increased risk for aspiration b. Pressure on the surgical site c. Infection d. Skin breakdown e. Increased intracranial pressure