Nokea
The client is in Russell's traction. Which statement best describes how Russell's traction works?
- A. The legs are suspended vertically with the hip flexed at 90 degrees and knees extended.
- B. A straight pull on the affected leg is assured.
- C. A belt is applied just above and surrounding the iliac crests. The belt is then attached to a pulley system.
- D. Vertical traction is used at the knee while, at the same time, a horizontal force is exerted on the tibia and fibula.
Correct Answer: D
Rationale: Russell's traction uses vertical traction at the knee and horizontal force on the tibia and fibula to align fractures, unlike the other descriptions.
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Which material added by the nurse is best for covering the tips of the pin to prevent injuries while the client is in skeletal leg.
- A. Gauze squares
- B. Cotton balls
- C. Cork blocks
- D. Rubber tubes
Correct Answer: C
Rationale: Cork blocks securely cover pin tips, preventing injury to the client or staff while maintaining stability. Gauze and cotton are less durable, and rubber tubes may not fit securely.
During a physical exam on the 18-month-old, the nurse observes genu varum. What should the nurse do?
- A. Document the finding as normal
- B. Report this finding to the HCP
- C. Teach the parents about rickets
- D. Prepare the parent about using braces
Correct Answer: A
Rationale: Genu varum (bowlegs) is a normal finding in children up to 2 years old and should be documented as normal.
The nurse knows that elevated findings on which laboratory test typically validate a diagnosis of gout?
- A. Creatinine clearance
- B. Blood urea nitrogen
- C. Serum uric acid
- D. Serum calcium
Correct Answer: C
Rationale: Elevated serum uric acid confirms gout, as it causes crystal formation.
The client is taken to the emergency department with an injury to the left arm. Which intervention should the nurse implement first?
- A. Assess the nailbeds for capillary refill time.
- B. Remove the client's clothing from the arm.
- C. Call radiology for a STAT x-ray of the extremity.
- D. Prepare the client for the application of a cast.
Correct Answer: A
Rationale: Assessing capillary refill evaluates neurovascular status, the priority in arm injury to detect compromise. Clothing removal, x-rays, and casting follow assessment.
Which most immediate treatment by the HCP should the nurse anticipate for a child with a dislocated kneecap?
- A. Open surgical intervention to repair the kneecap
- B. Arthroscopy to surgically repair the torn cartilage
- C. Realignment of the kneecap by sliding it back into position
- D. Application of a cast to the affected leg until the kneecap heals
Correct Answer: C
Rationale: Immediate treatment for a dislocated kneecap involves manual realignment to restore position.