A client who had a right total shoulder replacement is being prepared for discharge. What should the nurse emphasize to the client to prevent complications?
- A. Avoid lifting objects with the right arm until cleared by the surgeon.
- B. Perform shoulder exercises to regain strength.
- C. Use a sling at all times, even during sleep.
- D. Apply heat to the shoulder to reduce stiffness.
Correct Answer: A
Rationale: The correct answer is to avoid lifting objects with the right arm until cleared by the surgeon. After a total shoulder replacement, it is essential to protect the new joint to prevent dislocation or injury. Lifting heavy objects prematurely can lead to complications. While performing shoulder exercises is important for strength, they should be done as per the healthcare provider's instructions to avoid strain on the new joint. Using a sling at all times, as in choice C, is not necessary once the client has regained enough strength and mobility. Applying heat, as in choice D, may not be recommended post-surgery; cold therapy is often preferred to reduce swelling and pain.
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Which of the following areas does the Patient's Bill of Rights cover?
- A. Information disclosure
- B. Choice of providers
- C. Choice of plans
- D. All of the above
Correct Answer: D
Rationale: The Patient's Bill of Rights encompasses various areas to protect patients' rights. These include ensuring information disclosure, allowing patients to choose their healthcare providers, and giving them options to select plans that suit their needs. Therefore, all the choices - information disclosure, choice of providers, and choice of plans - are covered under the Patient's Bill of Rights. The option 'Best payment options' is not relevant to the areas typically addressed by the Patient's Bill of Rights.
After adding feeding solution to a client's tube feeding system as seen in the picture, what action should the PN take next?
- A. Remove the air from the solution bag
- B. Obtain a piston syringe and irrigation set
- C. Record the solution added as fluid intake
- D. Calculate the rate of flow of the solution
Correct Answer: B
Rationale: After adding feeding solution, obtaining a piston syringe and irrigation set is necessary to flush the feeding tube and ensure patency before starting the feeding. This helps prevent blockages and ensures proper delivery of the nutritional solution. Option A is incorrect because removing air from the solution bag is not the immediate next step after adding the feeding solution. Option C is incorrect as recording the solution added as fluid intake is important but not the immediate next step. Option D is incorrect as calculating the rate of flow of the solution is not the next step after adding the feeding solution.
In what order should the PN implement these steps to provide wound care? (Place in correct order.)
- A. Don procedure gloves
- B. Remove the dressing
- C. Apply prescribed medications to the wound
- D. All of the Above
Correct Answer: D
Rationale: The correct answer is 'D - All of the Above.' The PN should first don procedure gloves to maintain aseptic technique, then remove the dressing to assess the wound, and finally apply prescribed medications to the wound. This sequence ensures that non-sterile tasks like donning gloves are done before sterile tasks like applying medications, reducing the risk of wound contamination. Choices A, B, and C are all essential steps in providing effective wound care.
A client with a recent total knee replacement is scheduled for physical therapy. The client refuses to participate, stating that the pain is too intense. What should the nurse do first?
- A. Administer the prescribed analgesic and encourage participation after it takes effect.
- B. Reschedule the physical therapy session for later in the day.
- C. Explain the importance of physical therapy for recovery.
- D. Notify the physical therapist of the client's refusal.
Correct Answer: A
Rationale: Administering pain medication before physical therapy helps manage the pain, making it easier for the client to participate in the necessary exercises to improve recovery and prevent complications such as joint stiffness. Choice B is not the first step as addressing the pain should take precedence. Choice C is important but should come after managing the pain to facilitate participation. Choice D involves another healthcare provider and is not the immediate action needed in this situation.
Which task could the nurse safely delegate to the UAP?
- A. Oral feeding of a two-year-old child after application of a hip spica cast
- B. Assessment of the placement and patency of an NG tube
- C. Participation in staff rounds to record notes regarding client goals
- D. Evaluation of a client's incisional pain following narcotic administration
Correct Answer: A
Rationale: The correct answer is A because oral feeding of a stable child is a task that can be safely delegated to a UAP. This task does not require nursing assessment or clinical judgment. Choice B involves assessment, which requires the nurse's clinical judgment. Choice C involves recording client goals during staff rounds, which may require interpretation and understanding of the goals set. Choice D involves evaluating a client's pain following medication administration, which requires assessment and clinical judgment by a nurse.