Nokea
The patient that has a bipolar hip replacement following an intracapsular fracture has an order to be turned every 2 hours. The nurse understands that the correct nursing intervention is to keep the legs in which position?
- A. together so they do not separate while turning.
- B. flexed to stabilize the prosthesis.
- C. abducted so the prosthesis does not become dislocated.
- D. adducted to prevent additional pain for the patient with turning.
Correct Answer: C
Rationale: Nursing interventions also involve postoperative maintenance of leg abduction by using an abduction splint for 7 to 10 days to prevent dislocation of the prosthesis. Leg abduction does not involve keeping the legs together, flexion to stabilize the prosthesis or to keep the legs adducted to prevent additional pain with turning.
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When a patient recovering from a fractured tibia asks what callus formation is, the nurse provides which explanation?
- A. when blood vessels of the bone are compressed.
- B. a part of the bone healing process after a fracture when new bone is being formed over the fracture site.
- C. the formation of a clot over the fracture site.
- D. when the hematoma becomes organized and a fibrin meshwork is formed.
Correct Answer: B
Rationale: Callus formation occurs when the osteoblasts continue to lay the network for bone buildup and osteoclasts destroy dead bone. In compartment syndrome, blood vessels are compressed. Clot formation and hematoma organization occur in different phases of the bone healing process.
Which does prolonged bed rest put the older adult at risk for?
- A. Ankylosing spondylitis
- B. Pathologic fractures
- C. Osteomyelitis
- D. Gout
Correct Answer: B
Rationale: Immobilization results in bone resorption, and the bone tissue becomes less dense. Prolonged bed rest puts the patient at risk for pathologic fracture. This is a serious concern for an older adult in terms of regaining mobility.
Which will the nurse stress to a patient who has had a knee replacement and is beginning strengthening exercises for the unaffected leg?
- A. Flex the knee and flex the foot.
- B. Lift the leg from the mattress and rotate the foot.
- C. Pull knee to chest and extend the foot.
- D. Push foot down against the footboard for a count of five.
Correct Answer: D
Rationale: The unaffected leg should be strengthened by pushing the foot down against the footboard for a count of five and repeating frequently during the day.
The 14-year-old boy who is scheduled for left leg amputation says to the nurse, 'What in the world am I going to do with only one leg?' Which is the nurse's therapeutic response?
- A. This is a tough thing to go through'
- B. With a prosthesis, you will be as good as new.'
- C. It is way too early to be concerned about that now.'
- D. When my brother had his leg removed, he did great!'
Correct Answer: A
Rationale: The patient's concern should be acknowledged and the patient encouraged to express feelings. Telling the patient he will be as good as new is false reassurance and does not further encourage the patient to express feelings. The patient IS concerned about having to deal with one leg; telling the patient it is way too early to be concerned is inappropriate and nontherapeutic. The nurse is changing the subject when talking about the brother who also had his leg removed.
When the patient with rheumatoid arthritis reports not liking daily exercise, the nurse encouragingly reminds the patient that exercise has which benefit?
- A. Keeping the joints from 'freezing.'
- B. Ensuring longer and better sleep.
- C. Stimulating joints when done vigorously
- D. When performed weekly, having greater benefits.
Correct Answer: A
Rationale: Daily gentle exercises keep the joints from 'freezing' and keep the muscles from weakening. Exercise does not ensure better sleep. Joint exercises should not be performed vigorously. The patient benefits when gently exercises are performed daily.