N320 EXAM 1, STUDY GUIDE WITH FREQUENTLY TESTED QUESTIONS AND COMPLETE ANSWERS

N320 EXAM 1, STUDY GUIDE WITH FREQUENTLY TESTED QUESTIONS AND COMPLETE ANSWERS .A 14-year-old female and her mother have presented to their nurse practitioner seeking treatment for the daughter's acne. The nurse would recognize that acne is characterized by the presence of multiple: A. Ulcers. B. Wheals. C. Vesicles. D. Pustules. - Answer-D. Pustules are elevated, superficial lesions filled with purulent fluid, such as those commonly associated with acne. Wheals, ulcers, and vesicles are not common manifestations of acne. .A client develops L5-S1 herniated nucleus propulsus, which impinges on the left nerve root. Most likely, the client would experience pain that radiates: 1. Up the spinal column 2. To the lower abdomen 3. Down the left leg 4. Across to the right pelvis - Answer-3. The pain associated with herniated nucleus propulses of L5-S1 primarily affects the lower back, with radiation down one leg. .A client has a diabetic stasis ulcer on the lower leg. The nurse uses a hydrocolloid dressing to cover it. The procedure for application includes: Cleaning the skin and wound with betadine Removing all traces of residues for the old dressing Choosing a dressing no more than quarter-inch larger than the wound size Holding in place for one minute to allow it to adhere - Answer-Holding in place for one minute to allow it to adhere The skin is cleansed with normal saline or a mild cleanser. Residue of old dressings will dissolve. The dressing size is to be 3-4 cm (1.5 inches) larger than the size of the wound. .A client has a pressure ulcer with a shallow, partial skin thickness, eroded area but no necrotic areas. The nurse would treat the area with which of the following dressings? Alginate Dry gauze Hydrocolloid No dressing is indicated - Answer-Hydrocolloid Rationale: Hydrocolloid dressings protect shallow ulcers and maintain an appropriate healing environment. Alginates (option 1) are used for wounds with significant drainage; dry gauze (option 2) will stick to new granulation tissue, causing more damage. A dressing is needed to protect the wound and enhance healing. .A client has been admitted to the orthopedic floor to have a right total knee arthroplasty performed. Which of the following statements demonstrates to the nurse that the client understands the preoperative teaching? "I will A. have my knee placed in a continuous passive motion machine for 24 hours a day." B. ask for pain medicine whenever the pain gets bad." C. wear elastic stockings on both legs until I am discharged." D. have to stay in bed for a week after my surgery." - Answer-Answer C .A client has fallen and sustained a leg injury. Which question should the nurse ask the client to help determine if the injury caused a fracture? 1. "Is the pain a dull ache?" 2. "Is the pain sharp and continuous?" 3. "Does the discomfort feel like a cramp?" 4. "Does the pain feel like the muscle was stretched?" - Answer-2 .A client in balanced suspension traction for a fractured femur needs to be repositioned toward the head of the bed. During repositioning, the nurse should: 1. Place slight additional tension on the traction cords. 2. Release the weights and replace immediately after repositioning. 3. Lift the traction and the client during repositioning. 4. Maintain the same degree of traction tension - Answer-4. Traction is used to reduce the fracture and must be maintained at all times, including during repositioning. It isn't appropriate to increase traction tension or release or lift the traction during repositioning. .A client in the emergency department has a cast applied. The client arrives at the nursing unit, and the nurse prepares to transfer the client into the bed by: 1. Placing ice on top of the cast 2. Supporting the cast with the fingertips only 3. Asking the client to support the cast during transfer 4. Using the palms of the hands and soft pillows to support the cast - Answer-4 .A client is admitted to the Emergency Department after a motorcycle accident that resulted in the client's skidding across a cement parking lot. Since the client was wearing shorts, there are large areas on the legs where the skin is ripped off. This wound is best described as: Abrasion Unapproximated Laceration Eschar - Answer-Laceration best describes the wound, because skin is ripped off. An abrasion is a scrape. Unapproximated is a general term for a wound that is not closed. Eschar is a scab-like covering over a wound. .A client is discharged after having an ORIF of a fractured tibia with application of a plaster cast. The nurse teaches the client to evaluate for early signs of decreased circulation related to postsurgical edema. The nurse determines that the teaching was understood when the client identifies a manifestation of decreased circulation as A. coldness of the toes B. capillary refill of 3 seconds C. blanching of the nailbeds with pressure D. pain at the surgical site - Answer-Answer A .A client is undergoing rehabilitation following a fracture. As part of his regimen. the client performs isometric exercises. Which action provides the best evidence that the client understands the proper technique? 1. Exercising of bilateral extremities simultaneously. 2. Periodic monitoring of his heart rate. 3. Forced resistance against stable objects. 4. Swinging of limbs through full range of motion. - Answer-3. Isometric exercises involve applying pressure against a stable object, such as pressing the hands together or pushing an arm against a wall. Exercising extremities simultaneously isn't a characteristic of isometrics. Heart rate monitoring is associated with aerobic exercise. Limb swinging isn't isometric. .A client sustains an open fracture of the left femur. An intramedullary pin in inserted, and the client is placed in skeletal traction. While performing the initial assessment, the nurse finds the client has slipped down towards the foot of the bed and the traction weight is resting on the floor. the appropriate nursing action is to: A. remove the weight and move the client to the correct alignment in bed B. check for movement of the toes in the left foot C. notify the attending orthopedic physician D. help the client use the trapeze to pull himself up in bed - Answer-Answer D .A client undergoes a lumbar puncture for a myelogram. Shortly after the procedure. he reports a severe headache. What should the nurse do? 1. Increase the client's fluid intake. 2. Administer prescribed antihypertensives. 3. Offer roll lenses to the client. 4. Place cooling packs over the lumbar puncture site. - Answer-1. Headache following a lumbar puncture is usually cause by cerebrospinal fluid leakage. Increased fluid intake will help restore CSF volume. Antihypertensives don't address the problem. Roll lenses reduce light irritation to the eyes and ice may reduce site pain, but neither intervention addresses the problem of reduced CSF volume, which caused the headache. .A client undergoes cast placement for a fractured left radius. The nurse should suspect compartment syndrome if the client experiences pain that: 1. Intensifies with elevation of the left arm. 2. Disappears with left arm flexion. 3. Increases with the arm in a dependent