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A client is getting out of bed into the chair for the first time after an uncemented hip replacement. What action by the nurse is most important?
- A. Have adequate help to transfer the client
- B. Provide brown socks to transfer the client
- C. Tell the client full weight bearing is allowed
- D. Use a footstool to elevate the client's leg
Correct Answer: A
Rationale: The client with an uncemented hip will be on toe-touch only right after surgery. The nurse should ensure adequate help to transfer the client while preventing falls. Slippery socks and elevating the leg are not appropriate.
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A client comes to the family medicine clinic and reports joint pain and stiffness. The nurse is asked to assess the client for Heberden's nodules. What assessment technique is correct?
- A. Inspect the client's distal finger joints
- B. Palpate the client's upper body lymph nodes
- C. Assess the client's range of motion
- D. Perform a musculoskeletal strength test
Correct Answer: A
Rationale: Heberden's nodules are bony swellings at the distal interphalangeal joints, commonly associated with osteoarthritis. Inspecting the distal finger joints is the correct assessment technique.
A client recently diagnosed with systemic lupus erythematosus (SLE) is in the clinic for a follow-up visit. The nurse evaluates that the client practices good self-care when the client makes which statement?
- A. I always wear long sleeves, pants, and a hat when outdoors
- B. I try not to use concentrate that contains any type of sunblock
- C. Since I tend to sweat a lot, I use a lot of baby powder
- D. Since I can be exposed to the sun, I have been using a tanning bed
Correct Answer: A
Rationale: Good self-management of the skin in SLE includes protecting the skin from sun exposure, using sunblock, and avoiding drying agents such as powder and tanning beds.
A nurse is discharging a client after a total hip replacement. What statement by the client indicates good understanding of discharge instructions?
- A. I can bend down to pick something up
- B. I no longer need to do my exercises
- C. I will not cross my legs when sitting
- D. I will avoid weight-bearing exercises
Correct Answer: C
Rationale: The client should avoid crossing their legs to prevent dislocation of the new hip joint. Bending down, stopping exercises, and avoiding weight-bearing exercises are not appropriate instructions for recovery.
A home health care nurse is visiting a client discharged home after a hip replacement. The client is still using a walker. What safety precautions can the nurse recommend to the client? (Select all that apply.)
- A. Buy and install an elevated toilet seat
- B. Install grab bars in the shower and by the toilet
- C. Step into the bathtub with the affected leg first
- D. Remove throw rugs throughout the house
- E. Use a shower chair
Correct Answer: A,B,D,E
Rationale: Buying and installing an elevated toilet seat, installing grab bars, removing throw rugs, and using a shower chair will all promote safety for this client. The client is still on partial weight-bearing, so stepping into the bathtub with the affected leg first is not appropriate.
A nurse works in the rheumatology clinic and sees clients with rheumatoid arthritis (RA). Which client should the nurse see first?
- A. Client who reports jaw pain when eating
- B. Client with a red, hot, swollen right wrist
- C. Client who has a puffy-looking area behind the knee
- D. Client with a worse joint deformity since the last visit
Correct Answer: B
Rationale: All of the options are possible manifestations of RA. However, the presence of one joint that is much redder, hotter, or more swollen than other joints may indicate infection. The nurse needs to see this client first.