Nokea
A client has a cast applied to the leg for treatment of a tibia fracture and also has a wound on the leg that requires dressing changes due to drainage. For what should the nurse prepare the client?
- A. Cutting of a bivalve cast
- B. Cutting a cast window
- C. Removal of the cast
- D. Insertion of an external fixator
Correct Answer: B
Rationale: After the cast dries, a cast window, or opening, may be cut. This usually is done when the client reports discomfort under the cast or has a wound that requires a dressing change. The window permits direct inspection of the skin, a means to check the pulse in a casted arm or leg, or a way to change a dressing. A bivalve cast is when the cast is cut in two if the leg swells or if the client is being weaned from a cast, when a sharp x-ray is needed, or as a splint for immobilizing painful joints when a client has arthritis. The cast should not be removed due to the instability of a fracture. The client's condition does not indicate an external fixator is required.
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The nurse is caring for a client who had an amputation of the left leg above the knee. What position can the nurse place the client in several times per day to promote stump extension and prevent contractures?
- A. Supine
- B. Left lateral
- C. Prone
- D. Right lateral
Correct Answer: C
Rationale: Place the client with leg amputation in the prone position several times a day. This position promotes stump extension and prevents contractures. The other positions do neither of these things.
A client has had a knee replacement and will be discharged in the morning. What does the nurse understand is the goal for bending the knee by discharge?
- A. 15?°
- B. 30?°
- C. 60?°
- D. 90?°
Correct Answer: D
Rationale: The goal for the client to have the ability to bend the knee 90?° by discharge. The other answers are incorrect.
The nurse is caring for a client in skeletal traction. When performing pin care, which action by the nurse is most important?
- A. Clean the site, working toward the pin.
- B. Use an applicator only once.
- C. Gently remove crusts around pin sites.
- D. Apply an antimicrobial ointment.
Correct Answer: B
Rationale: When performing pin care, the nurse should use at least one applicator per pin and not use an applicator more than once, cleaning the site from the pin outward. Crusts around pin sites should be gently removed, but that is less important than not re-using applicators. Ointment is avoided unless it is specifically ordered.
The nurse is caring for a patient with a fractured right femur who is not a candidate to repair the femur immediately. What intervention should the nurse anticipate the physician will order to relieve muscle spasm and pain until surgery is performed?
- A. Skeletal traction
- B. Skin traction
- C. Open reduction
- D. External fixator
Correct Answer: B
Rationale: If surgery for a fracture cannot be performed right away, Buck's traction or other skin traction may be applied to relieve muscle spasm and pain until surgery is performed. The other distractors all require surgical intervention.
A client had a surgical amputation of an arm and is having a myoelectric arm applied. What does the nurse understand is the benefit(s) of this type of device? Select all that apply.
- A. Eliminates the need to wear a harness
- B. Terminal device looks natural
- C. Better function than cosmetic hand
- D. Stronger than other devices
- E. Lasts longer than other devices
Correct Answer: A,B,C
Rationale: The myoelectric arm has three advantages: eliminates the need to wear a harness, the terminal device looks natural, and it has somewhat better function than the cosmetic hand. Despite its advantages, the myoelectric arm is not rugged enough to do the work of the mechanical terminal device, and it does not last longer than other devices.