Nokea
A patient, age 68, has experienced an intertrochanteric fracture of the right hip. Before surgery, to provide support and comfort, an immobilizing device of which type is applied?
- A. Thomas ring
- B. Bryant traction
- C. Russell traction
- D. Buck traction
Correct Answer: D
Rationale: Buck traction is a form of traction used as a temporary measure to provide support and comfort to a fractured extremity until a more definite treatment is initiated. A Thomas ring, Bryant's traction and Russel traction are not used to stabilize a hip fracture.
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The 14-year-old boy who is scheduled for left leg amputation says to the nurse, 'What in the world am I going to do with only one leg?' Which is the nurse's therapeutic response?
- A. This is a tough thing to go through'
- B. With a prosthesis, you will be as good as new.'
- C. It is way too early to be concerned about that now.'
- D. When my brother had his leg removed, he did great!'
Correct Answer: A
Rationale: The patient's concern should be acknowledged and the patient encouraged to express feelings. Telling the patient he will be as good as new is false reassurance and does not further encourage the patient to express feelings. The patient IS concerned about having to deal with one leg; telling the patient it is way too early to be concerned is inappropriate and nontherapeutic. The nurse is changing the subject when talking about the brother who also had his leg removed.
The nurse reinforces instructions for the patient who is to have a unicompartmental knee replacement that which is a major advantage of this partial knee replacement?
- A. the patient will be up and walking 2 to 3 hours after the operation.
- B. the kneecap is completely removed.
- C. the procedure is especially helpful in the treatment of rheumatoid arthritis (RA).
- D. a small titanium disk replaces the worn cartilage.
Correct Answer: A
Rationale: Unicompartmental knee arthroplasty is also referred to as partial knee replacement in which the worn cartilage is replaced with a plastic disk. It is not as invasive as a full knee replacement and does not disturb the kneecap so that the patient can be up and walking in 2 to 3 hours after surgery. It is not recommended for patients with Rheumatoid Arthritis.
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.
A patient's patellar-femoral cartilage has deteriorated due to arthritis. The medial and lateral cartilage is undamaged. This patient is likely to undergo partial or knee replacement surgery.
Correct Answer: unicompartmental
Rationale: Unicompartmental knee arthroplasty is also referred to as partial knee replacement and is performed on patients who have only one of the compartments of the knee affected by arthritis.
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.