Nokea
The nurse receives a patient from the recovery room following total hip replacement surgery. What will the nurse include when assessing neurovascular status on this patient?
- A. Pupils
- B. Pain
- C. Sensation
- D. Color
- E. Skin temperature
Correct Answer: B,C,D,E
Rationale: One of the responsibilities of the nurse is to frequently monitor the patient's neurovascular function, or circulation, movement, and sensation (CMS) assessment. The LPN/LVN checks for skin color, temperature, movement, sensation, pulses, capillary refill, and pain. Pupil assessment is part of a neurologic assessment.
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How should the nurse assist the patient with moving when pain is anticipated?
- A. Be supportive.
- B. Apply heat before moving them.
- C. Administer medication before ambulation.
- D. Obtain assistance if the patient is heavy.
Correct Answer: C
Rationale: The nurse may want to administer medication before an activity that may be painful.
What should the nurse do to protect his or her back when lifting or moving a patient?
- A. Lowering the height of the bed
- B. Holding the back straight with locked knees
- C. Bending knees and hips
- D. Getting the patient to the side of the bed
Correct Answer: C
Rationale: The nurse's back can be well protected when he or she bends knees and hips.
The nurse is educating a patient on ways to regain the ability to perform ADLs and maintain normal physiologic activities. What will the nurse relay as a requirement?
- A. Strength
- B. Wellness
- C. Alertness
- D. Mobility
Correct Answer: D
Rationale: The purpose of mobility is completing ADLs and maintaining physiologic activities.
The nurse is performing passive range-of-motion exercises on a patient following a traumatic injury. What is the number of times the nurse should move each joint when performing passive range-of-motion (ROM) exercises?
- A. Three
- B. Four
- C. Five
- D. Six
Correct Answer: C
Rationale: Each movement should be repeated five times.
The nurse is performing passive range of motion (ROM) for the patient. How will the nurse move the joint through ROM?
- A. The fullest extent.
- B. Place the joint in normal position.
- C. The point of pain.
- D. Relax the patient.
Correct Answer: C
Rationale: The joints are moved to the point of resistance or pain.