Nokea
Six weeks after an above-the-knee amputation (AKA), a patient returns to the outpatient office for a routine postoperative checkup. During the nurses assessment, the patient reports symptoms of phantom pain. What should the nurse tell the patient to do to reduce the discomfort of the phantom pain?
- A. Apply intermittent hot compresses to the area of the amputation.
- B. Avoid activity until the pain subsides.
- C. Take opioid analgesics as ordered.
- D. Elevate the level of the amputation site.
Correct Answer: C
Rationale: Opioid analgesics may be effective in relieving phantom pain. Heat, immobility, and elevation are not noted to relieve this form of pain.
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A nurse is planning the care of an older adult patient who will soon be discharged home after treatment for a fractured hip. In an effort to prevent future fractures, the nurse should encourage which of the following? Select all that apply.
- A. Regular bone density testing
- B. A high-calcium diet
- C. Use of falls prevention precautions
- D. Use of corticosteroids as ordered
- E. Weight-bearing exercise
Correct Answer: A,B,C,E
Rationale: Health promotion measures after an older adults hip fracture include weight-bearing exercise, promotion of a healthy diet, falls prevention, and bone density testing. Corticosteroids have the potential to reduce bone density and increase the risk for fractures.
An emergency department nurse is assessing a 17-year-old soccer player who presented with a knee injury. The patients description of the injury indicates that his knee was struck medially while his foot was on the ground. The nurse knows that the patient likely has experienced what injury?
- A. Lateral collateral ligament injury
- B. Medial collateral ligament injury
- C. Anterior cruciate ligament injury
- D. Posterior cruciate ligament injury
Correct Answer: A
Rationale: When the knee is struck medially, damage may occur to the lateral collateral ligament. If the knee is struck laterally, damage may occur to the medial collateral ligament. The ACL and PCL are not typically injured in this way.
Radiographs of a boys upper arm show that the humerus appears to be fractured on one side and slightly bent on the other. This diagnostic result suggests what type of fracture?
- A. Impacted
- B. Compound
- C. Compression
- D. Greenstick
Correct Answer: D
Rationale: Greenstick fractures are an incomplete fracture that results in the bone being broken on one side, while the other side is bent. This is not characteristic of an impacted, compound, or compression fracture.
A patient has returned to the postsurgical unit from the PACU after an above-the-knee amputation of the right leg. Results of the nurses initial postsurgical assessment were unremarkable but the patient has called out. The nurse enters the room and observes copious quantities of blood at the surgical site. What should be the nurses initial action?
- A. Apply a tourniquet.
- B. Elevate the residual limb.
- C. Apply sterile gauze.
- D. Call the surgeon.
Correct Answer: A
Rationale: The nurse should apply a tourniquet in the event of postsurgical hemorrhage. Elevating the limb and applying sterile gauze are likely insufficient to stop the hemorrhage. The nurse should attempt to control the immediate bleeding before contacting the surgeon.
An older adult patient experienced a fall and required treatment for a fractured hip on the orthopedic unit. Which of the following are contributory factors to the incidence of falls and fractured hips among the older adult population? Select all that apply.
- A. Loss of visual acuity
- B. Adverse medication effects
- C. Slowed reflexes
- D. Hearing loss
- E. Muscle weakness
Correct Answer: A,B,C,E
Rationale: Older adults are generally vulnerable to falls and have a high incidence of hip fracture. Weak quadriceps muscles, medication effects, vision loss, and slowed reflexes are among the factors that contribute to the incidence of falls. Decreased hearing is not noted to contribute to the incidence of falls.