Nokea
A patient who has had a total knee replacement asks you to take off the CPM machine after 1 hour, although it is ordered to be on for 2 hours. How will you respond?
- A. Explain the importance of completing the full 2 hours to promote recovery.
- B. Remove the CPM machine as requested to respect patient autonomy.
- C. Adjust the CPM settings to reduce discomfort.
- D. Contact the provider to modify the order.
Correct Answer: A
Rationale: Explaining the importance of the full 2-hour CPM duration encourages compliance to improve joint mobility and recovery. Other options may undermine the treatment plan.
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You are working in a home health setting. Which of the following assessments would cause you to consider asking your supervisor to arrange for a physical therapy referral for your patient?
- A. The patient is ambulating in the home with a walker.
- B. The patient had surgery recently and is holding on to furniture to ambulate.
- C. The patient uses a wheelchair in the home, which has been remodeled to accommodate it.
- D. The patient is able to transfer with the assistance of one person and has a 24-hour caregiver in the home.
Correct Answer: B
Rationale: Holding onto furniture to ambulate post-surgery indicates unsafe mobility, warranting a physical therapy referral to improve strength and safety. Other options suggest stable mobility or adequate support.
What are the articular surfaces in a total knee replacement?
- A. A metal tibial component that articulates with the plastic surface of the femoral component
- B. A metal femoral component that articulates with the plastic fibula component
- C. The patella is replaced with plastic or similar substance or has plastic affixed to the back to provide a smooth articular surface
- D. The patella, tibia, and femur are replaced with plastic or polyethylene components
Correct Answer: A,C
Rationale: In total knee replacement, the tibial component (metal) articulates with the femoral component (plastic), and the patella may have a plastic surface for smooth movement.
A patient has skeletal traction applied to his left lower leg. Why is pin site care critical for this patient?
- A. To prevent infection at the pin insertion sites.
- B. To promote faster bone healing.
- C. To reduce pain during traction.
- D. To maintain traction alignment.
Correct Answer: A
Rationale: Pin site care is critical to prevent infection, as pins penetrate skin and bone, creating an infection risk. Other options are not directly related to pin site care.
Care of the pin insertion sites includes
- A. Cleaning the area with hydrogen peroxide or normal saline solution as ordered.
- B. Applying antibiotic ointment to the site.
- C. Inspecting the site for signs and symptoms of infection.
- D. Shaving the hair around the site.
Correct Answer: A,C
Rationale: Pin site care involves cleaning with ordered solutions (e.g., saline) and inspecting for infection. Antibiotic ointment is not routine, and shaving may increase infection risk.
A patient has a quarter-size amount of drainage on her cast. The next day the amount of drainage has increased to 2 inches (5 cm) in diameter. The nurse would be most concerned about
- A. Swelling beneath the cast.
- B. Neurovascular impairment.
- C. Infection under the cast.
- D. Placing tape petals over the edges of the cast.
Correct Answer: C
Rationale: Increasing drainage on a cast suggests possible infection, requiring immediate attention. Swelling or neurovascular issues are less directly tied to drainage.