Nokea
The client with an above-the-knee amputation is to use crutches while his prosthesis is being adjusted. In which of the following exercises should the nurse instruct the client to best prepare him for using crutches?
- A. Abdominal exercises.
- B. Isometric shoulder exercises.
- C. Quadriceps setting exercises.
- D. Triceps stretching exercises.
Correct Answer: B
Rationale: Isometric shoulder exercises strengthen the upper body, essential for crutch walking.
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The nurse is developing a discharge teaching plan for a client who underwent a repair of abdominal aortic aneurysm 4 days ago. The nurse reviews the client's chart for information about the client's history. Key findings are noted in the chart below. Based on the data and expected outcomes, which should the nurse emphasize in the teaching plan?
- A. Food intake
- B. Fluid volume
- C. Skin integrity
- D. Tissue perfusion
Correct Answer: D
Rationale: Post-AAA repair, tissue perfusion is critical to ensure graft patency and prevent ischemia in the lower extremities or organs. Teaching should emphasize signs of poor perfusion (e.g., pain, pallor, pulselessness) and follow-up care. Food, fluid, and skin integrity are less urgent.
When caring for the client who is receiving an aminoglycoside antibiotic, the nurse should monitor which of the following laboratory values?
- A. Serum sodium.
- B. Serum potassium.
- C. Serum creatinine.
- D. Serum calcium.
Correct Answer: C
Rationale: Aminoglycosides are nephrotoxic; monitoring serum creatinine assesses kidney function. Sodium, potassium, and calcium are not primarily affected by aminoglycosides.
A client with acute renal failure has an increase in the serum potassium level. The nurse should monitor the client for:
- A. Cardiac arrest.
- B. Pulmonary edema.
- C. Circulatory collapse.
- D. Hemorrhage.
Correct Answer: A
Rationale: Elevated potassium can cause cardiac arrhythmias, potentially leading to cardiac arrest, requiring close monitoring.
If a client is receiving rescue breaths and the chest wall fails to rise during cardiopulmonary resuscitation, the rescuer should first:
- A. Try using an ambu bag.
- B. Decrease the rate of compressions.
- C. Intubate the client.
- D. Reposition the airway.
Correct Answer: D
Rationale: Failure of the chest to rise during rescue breaths suggests airway obstruction or improper positioning. Repositioning the airway (e.g., head-tilt-chin-lift) is the first step.
A client has returned from surgery during which her jaws were wired as treatment for a fractured mandible. The client is in stable condition. The nurse is instructing the unlicensed nursing personnel (UAP) on how to properly position the client. Which instructions about positioning would be appropriate for the nurse to give the UAP?
- A. Keep the client in a side-lying position with the head slightly elevated.
- B. Do not reposition the client without the assistance of a registered nurse.
- C. The client can assume any position that is comfortable.
- D. Keep the client's head elevated on two pillows at all times.
Correct Answer: A
Rationale: A side-lying position with the head slightly elevated helps prevent aspiration and maintains airway patency in a client with wired jaws. The other options are either overly restrictive, unsafe, or not optimal for airway management.