Nokea
After knee arthroplasty, the client has a sequential compression device (SCD). The nurse should do which of the following?
- A. Elevate the sequential compression device (SCD) on two pillows.
- B. Change the settings on the SCD to make the client more comfortable.
- C. Use the SCD to remove dressings and bathe the leg.
- D. Discontinue the SCD when the client is ambulatory.
Correct Answer: D
Rationale: The SCD is discontinued when the client is ambulatory, as mobility reduces the risk of thrombosis.
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A client is transferred to his room from the intensive care unit after a craniotomy for treatment of a malignant brain tumor in the occipital region. The nurse should question which of these orders?
- A. 400 mg of ibuprofen (Motrin).
- B. 500 mg of naproxen (Naprosyn).
- C. Morphine sulfate.
- D. Acetaminophen (Tylenol).
Correct Answer: A
Rationale: Ibuprofen (an NSAID) should be questioned post-craniotomy due to the risk of bleeding, which can be exacerbated by its antiplatelet effects in the context of recent brain surgery.
The nurse is planning care for a client with a fractured humerus in a sling. Which intervention should be included?
- A. Encourage shoulder shrugging exercises.
- B. Apply heat to the fracture site.
- C. Keep the arm in a dependent position.
- D. Restrict all arm movement.
Correct Answer: A
Rationale: Shoulder shrugging exercises maintain mobility and prevent stiffness without stressing the fracture.
Which of the following systems is not blocked by spinal anesthesia?
- A. The sympathetic nervous system.
- B. The sensory system.
- C. The parasympathetic nervous system.
- D. The motor system.
Correct Answer: C
Rationale: Spinal anesthesia blocks sensory, motor, and sympathetic systems by affecting nerve roots. The parasympathetic system, mediated by cranial and sacral nerves, is not typically blocked.
Which of the following is an expected outcome for a client on the second day of hospitalization after a myocardial infarction (MI)? The client:
- A. Has severe chest pain.
- B. Can identify risk factors for MI.
- C. Agrees to participate in a cardiac rehabilitation walking program.
- D. Can perform personal self-care activities without pain.
Correct Answer: D
Rationale: By the second day post-MI, the client should be able to perform self-care activities without pain, indicating stabilization. Severe pain is not expected, and risk factor identification or rehabilitation planning may occur later.
After an intravenous pyelogram (IVP), the nurse should not include incorporating which of the following measures into the client's plan of care?
- A. Maintaining bed rest.
- B. Encouraging adequate fluid intake.
- C. Assessing for hematuria.
- D. Administering a laxative.
Correct Answer: D
Rationale: Administering a laxative is unnecessary post-IVP, as it does not aid recovery or contrast excretion, unlike fluid intake or hematuria assessment.