Nokea
The student nurse is listening to an orthopedic lecture on preoperative education and knee surgeries. Which statement by the student nurse indicates that the teaching has been effective?
- A. Crutch walking instructions should be scheduled before surgery.
- B. Crutch walking instructions should be given on the first postoperative day.
- C. Crutch walking instructions should be scheduled on the second postoperative day.
- D. Crutch walking instructions should be scheduled at the time of discharge after surgery.
Correct Answer: A
Rationale: It is best to assess crutch-walking ability and instruct the client with regard to the use of the crutches before surgery because this task can be difficult to learn when the client is in pain and not used to the imbalance that may occur after surgery. None of the remaining options are appropriate times to teach a client about crutch walking.
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A 10-year-old child has been diagnosed with type 1 diabetes mellitus. What instruction should the nurse provide concerning the monitoring of the child's insulin needs?
- A. The child should be taught to self-monitor insulin needs.
- B. The parents will need to be available to monitor the child's insulin needs.
- C. The child's school teacher will assume responsibility of insulin need monitoring.
- D. Friends and family will need to be involved with monitoring the child's insulin needs.
Correct Answer: A
Rationale: Most children 9 years old or older can understand the principles of monitoring their own insulin requirements. They are usually responsible enough to determine the appropriate intervention needed to maintain their health. Parents, friends, and family cannot always be available. The school teacher should not be expected to take responsibility for health care interventions.
A client with a short leg plaster cast reports intense itching under the cast. The nurse provides instructions to the client regarding relief measures for the itching. Which statement by the client indicates an understanding of the measures used to relieve the itching?
- A. I can use the blunt part of a ruler to scratch the area.
- B. I can trickle small amounts of water down inside the cast.
- C. I need to obtain assistance when placing an object into the cast for the itching.
- D. I can use a hair dryer on the low setting and allow the air to blow into the cast.
Correct Answer: D
Rationale: Itching is a common complaint of clients with casts. Objects should not be put inside a cast because of the risk of scratching the skin and providing a point of entry for bacteria. A plaster cast can break down when wet. Therefore, the best way to relieve itching is with the forceful injection of air inside the cast.
A client is being treated for an atrial dysrhythmia with quinidine gluconate. Which statement by the client indicates to the nurse that the medication instructions about what to do if a dose is missed have been understood?
- A. I should call my primary health care provider.
- B. I should take the next prescribed dose as usual.
- C. I should take the dose as soon as I realize I've missed it.
- D. I take two doses of the medication at the next scheduled time.
Correct Answer: B
Rationale: Quinidine gluconate needs to be taken exactly as prescribed. Because of the action and effects of this medication, the client should be instructed to take the medication if remembered within 2 hours of the missed dose, or omit the dose and then resume the normal schedule. There is no need to call the doctor. It is not safe to take the dose whenever it is remembered or to take an extra dose.
The nurse has provided home care instructions to a client with prostate cancer who has been hospitalized for a transurethral resection of the prostate (TURP). Which statement by the client indicates the need for further teaching?
- A. Prune juice needs to be included in my diet.
- B. I need to avoid strenuous activity for 4 to 6 weeks.
- C. My intake of water needs to be at least 6 to 8 glasses daily.
- D. I can't lift or push objects that weigh more than 30 pounds.
Correct Answer: D
Rationale: The client needs to be advised to avoid strenuous activity for 4 to 6 weeks and avoid lifting items that weigh more than 20 pounds. Straining during defecation is avoided to prevent bleeding. Prune juice is a satisfactory bowel stimulant. The client needs to consume a daily intake of at least 6 to 8 glasses of nonalcoholic fluids to minimize clot formation.
During a health assessment the nurse provides instructions to a client regarding the testicular self-examination (TSE). Which statement by the client indicates that the client needs further teaching regarding TSE?
- A. I know to report any small lumps.
- B. I should examine myself every 2 months.
- C. I should examine myself after I take a warm shower.
- D. I know it's normal to feel something that is cord-like in the back.
Correct Answer: B
Rationale: TSE should be performed every month. Small lumps or abnormalities should be reported. The spermatic cord finding is normal. After a warm bath or shower, the scrotum is relaxed, which makes it easier to perform TSE.