Nokea
A 56-year-old patient is being seen for osteoarthritis of the knee in the clinic. Which should the nurse recommend when discussing strengthening exercises?
- A. Jogging
- B. Walking rapidly on a treadmill
- C. Bicycling
- D. Aerobic exercises
Correct Answer: C
Rationale: Bicycling or swimming is recommended for osteoarthritis of the hip or knee. Jogging would put undue stress on knee joints. Climbing stairs should be avoided. Walking should be done on level ground, not up or down elevations.
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Which will the nurse stress to a patient who has had a knee replacement and is beginning strengthening exercises for the unaffected leg?
- A. Flex the knee and flex the foot.
- B. Lift the leg from the mattress and rotate the foot.
- C. Pull knee to chest and extend the foot.
- D. Push foot down against the footboard for a count of five.
Correct Answer: D
Rationale: The unaffected leg should be strengthened by pushing the foot down against the footboard for a count of five and repeating frequently during the day.
The patient that has a bipolar hip replacement following an intracapsular fracture has an order to be turned every 2 hours. The nurse understands that the correct nursing intervention is to keep the legs in which position?
- A. together so they do not separate while turning.
- B. flexed to stabilize the prosthesis.
- C. abducted so the prosthesis does not become dislocated.
- D. adducted to prevent additional pain for the patient with turning.
Correct Answer: C
Rationale: Nursing interventions also involve postoperative maintenance of leg abduction by using an abduction splint for 7 to 10 days to prevent dislocation of the prosthesis. Leg abduction does not involve keeping the legs together, flexion to stabilize the prosthesis or to keep the legs adducted to prevent additional pain with turning.
What is the large, fan-shaped muscle that covers the anterior chest from the sternum to the proximal end of the humerus and acts on the joint of the shoulder to flex, adduct, and rotate?
- A. Serratus anterior
- B. Intercostal
- C. Transversus abdominis
- D. Pectoralis major
Correct Answer: D
Rationale: Pectoralis major is the large, fan-shaped muscle that covers the anterior chest and is an adductor muscle, which will cause the shoulder to flex.
Which should the nurse expect to see in the plan of care for a patient following a myelogram in which water-soluble dye was used?
- A. Position in a semi-Fowler's position for 8 hours
- B. Place patient flat on back to compress puncture site.
- C. Ambulate for brief periods to lessen postmyelogram headache.
- D. Limit fluids to increase absorption of the dye.
Correct Answer: A
Rationale: The patient should be positioned in the semi-Fowler's position for 8 hours to encourage the dye to stay in the lower spine. After an oil-based dye is used, the patient is placed in a flat position for up to 12 hours. The patient should lie quietly, not ambulate. Fluids should be encouraged to help the body absorb the dye from the spinal column.
When the patient with rheumatoid arthritis reports not liking daily exercise, the nurse encouragingly reminds the patient that exercise has which benefit?
- A. Keeping the joints from 'freezing.'
- B. Ensuring longer and better sleep.
- C. Stimulating joints when done vigorously
- D. When performed weekly, having greater benefits.
Correct Answer: A
Rationale: Daily gentle exercises keep the joints from 'freezing' and keep the muscles from weakening. Exercise does not ensure better sleep. Joint exercises should not be performed vigorously. The patient benefits when gently exercises are performed daily.