Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A 10-year-old girl presents to the urgent care clinic with a dislocated elbow sustained in a roller skating accident. Which of the following is NOT an expected treatment for this girl?
A. Physical therapy
Physical therapy is commonly used after elbow dislocation to restore range of motion and prevent stiffness, making it a standard component of care.
B. Reduction
Reduction, or realignment of the dislocated joint, is the primary initial treatment and is expected in managing elbow dislocations.
C. Splinting
Splinting or immobilization following reduction is standard to maintain stability while soft tissues heal, and it is a routine part of management.
D. Surgical intervention
Surgical intervention is typically not required for uncomplicated elbow dislocations in children, as most can be managed with closed reduction and conservative care. Surgery is reserved for complex fractures or persistent instability.
This question is an excerpt from Nurse Dive's nursing test bank - Mental Health Northern Kentucky University Proctored Exam 6. Take the full exam now
Full Explanation
Choice A reason: Physical therapy is commonly used after elbow dislocation to restore range of motion and prevent stiffness, making it a standard component of care.
Choice B reason: Reduction, or realignment of the dislocated joint, is the primary initial treatment and is expected in managing elbow dislocations.
Choice C reason: Splinting or immobilization following reduction is standard to maintain stability while soft tissues heal, and it is a routine part of management.
Choice D reason: Surgical intervention is typically not required for uncomplicated elbow dislocations in children, as most can be managed with closed reduction and conservative care. Surgery is reserved for complex fractures or persistent instability.
Similar Questions
The psychiatric-mental health nurse practitioner evaluates an 81-year-old man who was admitted to the hospital 3 days ago for community-acquired pneumonia and dehydration. Today, he has an altered level of consciousness and is only oriented to person. The nurses report he has become withdrawn and has refused to eat. He has no previous psychiatric history. Based on this scenario, what medication should the PMHNP prescribe for agitation as needed?
A. Benztropine (Cogentin)
Benztropine is primarily used to treat extrapyramidal symptoms from antipsychotic medications and does not address agitation in delirium.
B. Diphenhydramine (Benadryl)
Diphenhydramine may cause sedation but has anticholinergic properties that can worsen delirium in elderly patients, making it inappropriate.
C. Lorazepam (Ativan)
Lorazepam can exacerbate delirium in older adults and is generally avoided unless agitation is due to alcohol or benzodiazepine withdrawal.
D. Haloperidol (Haldol)
This choice is correct because haloperidol is the preferred first-line antipsychotic for acute agitation in elderly patients with delirium. It has minimal anticholinergic effects and can safely manage agitation while monitoring for extrapyramidal or cardiac side effects.
Full Explanation
Choice A reason: Benztropine is primarily used to treat extrapyramidal symptoms from antipsychotic medications and does not address agitation in delirium.
Choice B reason: Diphenhydramine may cause sedation but has anticholinergic properties that can worsen delirium in elderly patients, making it inappropriate.
Choice C reason: Lorazepam can exacerbate delirium in older adults and is generally avoided unless agitation is due to alcohol or benzodiazepine withdrawal.
Choice D reason: This choice is correct because haloperidol is the preferred first-line antipsychotic for acute agitation in elderly patients with delirium. It has minimal anticholinergic effects and can safely manage agitation while monitoring for extrapyramidal or cardiac side effects.
A pregnant 30-year-old woman complains of persistent numbness on the palmar surface of her right hand and of pain in her right arm. Her symptoms are more severe in the morning. Neurologic examination reveals a sensory deficit in the right thumb and the index and middle fingers, as well as on the lateral half of the ring finger. The patient has weakness when abducting the thumb. Which of the following is considered first-line treatment?
A. Gabapentin (Neurontin)
Gabapentin is used for neuropathic pain but is generally not first-line for mild to moderate carpal tunnel syndrome, especially during pregnancy.
B. Anti-inflammatories
Anti-inflammatory medications may be limited during pregnancy due to safety concerns and are not the most effective treatment for compressive neuropathy in the wrist.
C. Corticosteroids
Corticosteroids can provide relief but systemic steroids are generally avoided in pregnancy unless necessary; localized corticosteroid injections may be used but are second-line.
D. Splinting of the right wrist
This choice is correct because wrist splinting, particularly at night, is the first-line conservative treatment for carpal tunnel syndrome, especially in pregnant patients. It helps maintain the wrist in a neutral position, reducing pressure on the median nerve and alleviating symptoms.
Full Explanation
Choice A reason: Gabapentin is used for neuropathic pain but is generally not first-line for mild to moderate carpal tunnel syndrome, especially during pregnancy.
Choice B reason: Anti-inflammatory medications may be limited during pregnancy due to safety concerns and are not the most effective treatment for compressive neuropathy in the wrist.
Choice C reason: Corticosteroids can provide relief but systemic steroids are generally avoided in pregnancy unless necessary; localized corticosteroid injections may be used but are second-line.
Choice D reason: This choice is correct because wrist splinting, particularly at night, is the first-line conservative treatment for carpal tunnel syndrome, especially in pregnant patients. It helps maintain the wrist in a neutral position, reducing pressure on the median nerve and alleviating symptoms.
Which of the following medications has demonstrated the most evidence for reducing suicide risk in the treatment of bipolar disorder?
A. Lithium (Eskalith)
This choice is correct because lithium has consistently shown robust evidence in reducing suicide risk in patients with bipolar disorder. It stabilizes mood and has anti-suicidal properties independent of its mood-stabilizing effects.
B. Lamotrigine (Lamictal)
Lamotrigine is effective for preventing depressive episodes in bipolar disorder but has limited evidence for reducing suicidal behavior.
C. Oxcarbazepine (Trileptal)
Oxcarbazepine is sometimes used off-label for mood stabilization but lacks strong evidence for suicide risk reduction in bipolar patients.
D. Divalproex (Depakote)
Divalproex is effective for treating mania and mood stabilization but does not have conclusive evidence specifically supporting reduction in suicide risk.
Full Explanation
Choice A reason: This choice is correct because lithium has consistently shown robust evidence in reducing suicide risk in patients with bipolar disorder. It stabilizes mood and has anti-suicidal properties independent of its mood-stabilizing effects.
Choice B reason: Lamotrigine is effective for preventing depressive episodes in bipolar disorder but has limited evidence for reducing suicidal behavior.
Choice C reason: Oxcarbazepine is sometimes used off-label for mood stabilization but lacks strong evidence for suicide risk reduction in bipolar patients.
Choice D reason: Divalproex is effective for treating mania and mood stabilization but does not have conclusive evidence specifically supporting reduction in suicide risk.