Nokea
The nurse is preparing a client for a total hip replacement. Which preoperative teaching should be included to prevent postoperative complications?
- A. Avoid crossing legs after surgery.
- B. Practice using a walker before surgery.
- C. Limit fluid intake the day before surgery.
- D. Perform arm exercises to strengthen muscles.
Correct Answer: A
Rationale: Avoiding leg crossing prevents hip dislocation, a common complication after total hip replacement. This teaching is critical for postoperative safety and recovery.
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Crackles heard on lung auscultation indicate which of the following?
- A. Cyanosis.
- B. Bronchospasm.
- C. Airway narrowing.
- D. Fluid-filled alveoli.
Correct Answer: D
Rationale: Crackles indicate fluid in the alveoli, often due to pulmonary edema in heart failure or post-MI, reflecting left ventricular dysfunction.
Which intervention should the nurse suggest to help a client with multiple sclerosis avoid episodes of urinary incontinence?
- A. Limit fluid intake to 1,000 mL/day.
- B. Insert an indwelling urinary catheter.
- C. Establish a regular voiding schedule.
- D. Administer prophylactic antibiotics, as ordered.
Correct Answer: C
Rationale: A regular voiding schedule helps manage incontinence by promoting bladder emptying before urgency. Fluid restriction risks dehydration, indwelling catheters increase infection risk, and antibiotics are not preventive for incontinence.
The nurse has placed the intubated client with acute respiratory distress syndrome (ARDS) in prone position for 30 minutes. Which of the following would require the nurse to discontinue prone positioning and return the client to the supine position? Select all that apply.
- A. The family is coming in to visit.
- B. The client has increased secretions requiring frequent suctioning.
- C. The SpO2 and PO2 have decreased.
- D. The client is tachycardic with drop in blood pressure.
- E. The face has increased skin breakdown and edema.
Correct Answer: C,D,E
Rationale: Decreased SpO2/PO2 (C), tachycardia with hypotension (D), and facial skin breakdown/edema (E) indicate complications requiring a return to supine position. Family visits and suctioning needs are manageable in prone position.
A client is receiving dopamine hydrochloride for treatment of shock. The nurse should:
- A. Administer pain medication concurrently.
- B. Monitor blood pressure continuously.
- C. Evaluate arterial blood gases at least every 2 hours.
- D. Monitor for signs of infection.
Correct Answer: B
Rationale: Dopamine can cause significant changes in blood pressure due to its inotropic and vasopressor effects. Continuous blood pressure monitoring is essential to titrate the dose and prevent complications. Pain medication, arterial blood gases, and infection monitoring are not primary.
The nurse is planning a staff development conference about measures to reduce medication errors. It would be appropriate for the nurse to state which actions may help reduce medication errors? Select all that apply.
- A. Timely medication reconciliation
- B. Delay documentation of medication administration to the end of the shift
- C. Delegate medication transcription to unlicensed assistive personnel (UAP)
- D. Limit the use of verbal orders to emergent situations
- E. Place medication dispensing systems in high-traffic areas
Correct Answer: A,D
Rationale: Timely reconciliation and limiting verbal orders reduce errors; delayed documentation, UAP transcription, and high-traffic dispensing systems increase error risk.