Nokea
The nurse is assigned to care for a client who has had a total knee arthroplasty yesterday. What type of pharmacologic therapy does the nurse anticipate administering to this client to prevent complications related to the surgery?
- A. Antidysrhythmic therapy
- B. Antianginal therapy
- C. Antineoplastic therapy
- D. Anticoagulation therapy
Correct Answer: D
Rationale: Anticoagulation therapy and early ambulation are very important for clients who have knee or hip replacement to prevent thrombus formation. The other therapies are not indicated for the knee or hip arthroplasty.
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A group of students is reviewing information about cast composition in preparation for a discussion on the advantages and disadvantages of each. The students demonstrate understanding of the topic when they cite what as an advantage of a plaster cast?
- A. Better molding to the client
- B. Quicker drying
- C. Longer lasting
- D. More breathable
Correct Answer: A
Rationale: Plaster casts require a longer time for drying but mold better to the client and are initially used until the swelling subsides. Fiberglass casts dry more quickly, are lighter in weight, longer lasting, and breathable.
A client having a cast applied for a fractured leg that extends from below the knee to the base of the toes. The foot is flexed at a right angle in a neutral position. What type of cast is the client having applied?
- A. Short leg cast
- B. Long leg cast
- C. Walking cast
- D. Hip spica cast
Correct Answer: A
Rationale: A short leg cast extends from below the knee to the base of the toes. The foot is flexed at a right angle in a neutral position. A long leg cast extends from the junction of the upper and middle third of the thigh to the base of the toes. The knee may be slightly flexed. A walking cast is a short or long leg cast reinforced for strength. A hip spica cast encloses the trunk and a lower extremity.
The nurse is caring for a client who sustained rib fractures in an automobile accident. What symptoms does the nurse recognize as a complication of rib fractures and should immediately be reported to the physician?
- A. Blood pressure of 140/90 mm Hg
- B. Crackles in the lung bases
- C. SUBJECT: Client complains of pain in the affected rib area when taking a deep breath
- D. Heart rate of 94 beats/minute
Correct Answer: B
Rationale: Crackles in the lung bases can be an indicator that the client has developed pneumonia from shallow respirations. The blood pressure is high but may be due to pain. It is expected that the client will have pain in the rib area when taking deep breaths. A heart rate of 94 beats/minute is within normal range.
The nurse is caring for a client who had a surgical amputation of the left leg related to complication from diabetes. The client asks the nurse: 'If my leg is really gone, then why am I having such bad pain?' What is an appropriate response by the nurse?
- A. You are only imagining that you are having pain.
- B. It is called phantom pain and may come and go.
- C. You will continue to have this pain, and you will have to learn to ignore it.
- D. This is called false pain and is a brain dysfunction.
Correct Answer: B
Rationale: Phantom pain is pain or other discomfort, such as burning, tingling, throbbing, or itching. Pain felt from the phantom limb can be an extremely serious problem in relation to the client's emotional status and ability to use prosthesis. The other responses are nontherapeutic.
The nurse is caring for a client with an external fixator that requires pin care twice a day. The nurse observes that there is a new purulent drainage around one of the pins. What intervention should the nurse anticipate doing?
- A. Scrubbing the drainage from around the pin site
- B. Obtaining a culture
- C. Applying iodine-based solution
- D. Apply ointment to the pin site.
Correct Answer: B
Rationale: A culture should be obtained if purulent drainage is present. Drainage should be gently removed, not scrubbed. Iodine-based products interfere with tissue healing and are not recommended for cleaning pin sites. Ointment should not be applied to the pin site unless specifically ordered.