NURS 510 Nursing Research Methods

Correct Answer: E)

Explanation:

A greenstick fracture is a type of incomplete fracture in which the bone bends and cracks on one side but does not break completely through—similar to bending a green twig. It is most common in children due to their softer, more flexible bones. In the illustration, E clearly shows a bent bone with a partial break on one side, consistent with the appearance of a greenstick fracture.

Why the other options are incorrect:

A) Shows a comminuted fracture, where the bone is broken into multiple pieces.

B) Shows a transverse fracture, a straight horizontal break across the bone.

C) Shows an oblique fracture, which runs at an angle to the bone’s axis.

D) Shows a segmental fracture, with two separate breaks creating a floating segment.

F) Shows a spiral fracture, which wraps around the bone, usually caused by twisting force.

Correct Answer: D) "It is important to maintain adequate nutrition, including a high-protein diet to support wound healing."

Explanation:

D) Adequate nutrition and a high-protein diet are essential after surgery to promote tissue repair, collagen synthesis, and immune function, all of which are vital for wound healing, especially in obese clients, who are at increased risk for wound dehiscence, infection, and delayed healing. Protein helps rebuild tissue and supports the healing process at the cellular level.

Why the other options are incorrect:

A) "You should avoid taking pain medication to prevent constipation.":

While constipation is a valid concern, pain management is essential for mobility and deep breathing. Constipation can be managed with stool softeners and hydration, not by withholding pain relief.

B) "You should rest and avoid moving around too much to prevent strain on your incision.":

Prolonged immobility increases the risk of venous thromboembolism and respiratory complications. Clients should be encouraged to mobilize early, while avoiding strenuous activity.

C) "You may return to your normal activity level once you feel comfortable at home.":

This is too vague and may lead to premature overexertion. Activity should be gradually resumed based on medical advice and the nature of the surgery.

Correct Answer: D) DKA occurs most often in type 1 diabetic clients.

Explanation:

Diabetic ketoacidosis (DKA) is a serious and potentially life-threatening complication that occurs primarily in individuals with type 1 diabetes mellitus. It results from an absolute insulin deficiency, leading to hyperglycemia, ketosis, and metabolic acidosis. Because individuals with type 1 diabetes produce little or no insulin, they are more susceptible to DKA.

Why the other options are incorrect:

A) The client experiencing DKA will have shallow respirations and abdominal pain:

Incorrect. DKA is characterized by deep, rapid respirations (Kussmaul respirations) as the body tries to compensate for metabolic acidosis. Abdominal pain can be present, but the breathing is not shallow.

B) Fluid replacement for DKA would most likely be Dextrose 50%:

Incorrect. Initial fluid replacement involves normal saline (0.9% NaCl) to correct dehydration. Dextrose is only added later (e.g., D5W) once blood glucose falls to around 200 mg/dL to prevent hypoglycemia during insulin therapy.

C) DKA occurs more often in clients with type 2 diabetes:

Incorrect. Hyperosmolar Hyperglycemic State (HHS) is more common in type 2 diabetes, while DKA is more frequent in type 1 diabetics.

Correct Answer: D) Osteoporosis, decreased immunity, hyperglycemia

Explanation:

Cushing’s syndrome is caused by excess cortisol in the body, either due to endogenous overproduction (e.g., from an adrenal tumor or pituitary adenoma) or exogenous corticosteroid use. Elevated cortisol has widespread effects, including:

Osteoporosis: Cortisol suppresses bone formation and increases resorption.

Decreased immunity: It impairs immune responses, making clients more susceptible to infections.

Hyperglycemia: Cortisol promotes gluconeogenesis and insulin resistance, raising blood glucose levels.

Why the other options are incorrect:

A) Hypovolemia, edema, Buffalo hump and fatty deposits:

Cushing’s causes hypervolemia (fluid retention), not hypovolemia. Edema and fat redistribution (e.g., Buffalo hump, moon face, central obesity) are accurate, but the presence of hypovolemia makes this choice incorrect.

B) Hypertension, hyponatremia, Buffalo hump:

Hypertension and Buffalo hump are consistent with Cushing’s, but hyponatremia is not. Cortisol excess tends to cause hypernatremia and fluid retention due to its mineralocorticoid effects.

C) Dehydration, hyperkalemia, hypotension:

These are classic signs of Addison’s disease (adrenal insufficiency), not Cushing’s syndrome, which features the opposite profile (fluid retention, hypokalemia, and hypertension).

Correct Answer: B) Bitter taste in the mouth

Explanation:

A bitter or sour taste in the mouth is a common symptom of GERD, resulting from the backflow (reflux) of gastric contents, including acid and bile, into the esophagus and sometimes into the throat or mouth. This reflux causes heartburn, regurgitation, and sometimes hoarseness or chronic cough.

Why the other options are incorrect:

A) Melena:

Melena (black, tarry stools) may indicate upper GI bleeding, which is not a typical feature of uncomplicated GERD. It would suggest a more serious complication, like esophagitis or ulceration, but is not a routine characteristic.

C) Diarrhea:

GERD affects the upper gastrointestinal tract, and diarrhea is not a typical symptom. It’s more associated with lower GI disorders like infections or irritable bowel syndrome.

D) Irritable bowel syndrome:

IBS is a separate functional GI disorder affecting the colon, and while some patients may have both GERD and IBS, IBS itself is not a feature or symptom of GERD.

Correct Answer: A) Irritable Bowel Syndrome is a type of inflammatory bowel disease

Explanation:

Irritable Bowel Syndrome (IBS) is a functional gastrointestinal disorder, not an inflammatory bowel disease (IBD). IBS involves no structural or inflammatory damage to the intestines, unlike IBD conditions such as Crohn’s disease or ulcerative colitis, which involve chronic inflammation and tissue damage. IBS is diagnosed based on symptoms and the absence of detectable disease.

Why the other options are correct:

B) Severity of the symptoms may vary:

True. IBS symptoms can range from mild to severe and may vary over time and between individuals.

C) Treatment is focused on symptom relief:

Correct. IBS is managed by dietary changes, stress reduction, medications, and lifestyle modifications aimed at alleviating symptoms, as there is no known cure.

D) Symptoms may include cramping, bloating and gas, constipation and/or diarrhea:

Accurate. These are common hallmark symptoms of IBS, and patients may experience either constipation-predominant, diarrhea-predominant, or mixed symptom patterns.

Correct Answer: C) Increased urine flow

Explanation:

Tamsulosin (Flomax) is an alpha-1 adrenergic blocker used primarily to treat benign prostatic hyperplasia (BPH). It works by relaxing the smooth muscle in the bladder neck and prostate, thereby reducing resistance to urinary flow and improving urinary symptoms such as hesitancy, urgency, and weak stream. The desired therapeutic effect is increased urine flow and improved bladder emptying.

Why the other options are incorrect:

A) Hypotension:

Tamsulosin may cause hypotension as a side effect, especially after the first dose, but this is not its intended therapeutic effect.

B) Syncope:

Like hypotension, syncope (fainting) is a potential adverse effect, not the goal of treatment.

D) Increased urinary obstruction:

Tamsulosin is specifically prescribed to relieve urinary obstruction, not worsen it. Increased obstruction would suggest treatment failure or a different underlying problem.

Correct Answer: C) Shock

Explanation:

A comminuted fracture involves the bone being broken into three or more fragments, typically caused by high-energy trauma, such as a fall or motor vehicle accident. While it is a serious injury, the presence of shock is not commonly associated with isolated extremity fractures, such as one in the right arm. Shock, which is a systemic condition involving inadequate tissue perfusion, typically results from massive blood loss, severe trauma, or internal injury—scenarios more typical in pelvic fractures, bilateral femur fractures, or polytrauma, not single limb fractures.

Why the other options are more likely:

A) Ecchymosis:

Bruising or discoloration of the skin (ecchymosis) around the site of the fracture is common. It occurs due to bleeding from soft tissue and blood vessels damaged by bone fragments. In comminuted fractures, with multiple sharp bone ends, this is an expected finding.

B) Crepitus:

Crepitus is a hallmark sign of fractures involving unstable bone fragments. In a comminuted fracture, the broken pieces may grind against each other, producing a grating sound or sensation upon palpation or movement. This is commonly noted during physical assessment.

D) Deformity:

Comminuted fractures often result in visible or palpable deformity due to misalignment of multiple bone pieces and disruption of normal anatomical contours. The limb may appear shortened, angulated, or irregular, which is a significant indicator of bone injury.

Correct Answer: A) Today at 8:30 AM

Explanation:

Insulin Lispro (Humalog) is a rapid-acting insulin. After subcutaneous administration, it:

Begins working in about 15 minutes

Peaks in 1 to 2 hours

Lasts about 3 to 5 hours

A) Today at 8:30 AM is 1 hour after administration, placing the client within the peak action window, when risk for hypoglycemia is highest if food intake is insufficient or delayed.

Why the other options are incorrect:

B) Today at 7:45 AM:

This is only 15 minutes after injection, when insulin action is just beginning. Hypoglycemia is unlikely this early, especially if the client is eating breakfast as planned.

C) Today at 12:30 PM:

This is 5 hours after the dose, when the insulin's effect is tapering off. Hypoglycemia is less likely unless another dose or skipped meal occurs.

D) Tomorrow at 6:30 AM:

There is no relation between today's insulin dose and tomorrow morning. Lispro does not last this long, and there is no lingering hypoglycemic effect expected.