A patient arrives in the emergency department with a swollen ...

[tuffie]

A patient arrives in the emergency department with a swollen ankle after an injury incurred while playing soccer. Which action by the nurse is most appropriate?
 
  a. Elevate the ankle above heart level.
  b. Apply a warm moist pack to the ankle.
  c. Assess the ankle's range of motion (ROM).
  d. Assess whether the patient can bear weight on the affected ankle.

Question 2

After receiving a change-of-shift report, which patient should the nurse assess first?
 
  a. The patient who has multiple black wounds on the feet and ankles
  b. The newly admitted patient with a stage IV pressure ulcer on the coccyx
  c. The patient who has been receiving chemotherapy and has a temperature of 102 F
  d. The patient who needs to be medicated with multiple analgesics before a scheduled dressing change

[Bigfoot1984]

Answer to Question 1

ANS: A
Soft tissue injuries are treated with rest, ice, compression, and elevation (RICE). Elevation of the ankle will decrease tissue swelling. Moving the ankle through the ROM will increase swelling and risk further injury. Cold packs should be applied the first 24 hours to reduce swelling. The nurse should not ask the patient to move or bear weight on the swollen ankle because immobilization of the inflamed or injured area promotes healing by decreasing metabolic needs of the tissues.

Answer to Question 2

ANS: C
Chemotherapy is an immunosuppressant. Even a low fever in an immunosuppressed patient is a sign of serious infection and should be treated immediately with cultures and rapid initiation of antibiotic therapy. The nurse should assess the other patients as soon as possible after assessing and implementing appropriate care for the immunosuppressed patient.