Nokea
What equipment is best for preventing external rotation of the operative leg when caring for a client with a total hip replacement?
- A. A footboard
- B. A trochanter roll
- C. A turning sheet
- D. A foam mattress
Correct Answer: B
Rationale: A trochanter roll placed along the hip prevents external rotation of the operative leg, maintaining proper alignment post-hip replacement. The other options do not specifically address rotation.
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Which evidence is the best indication that the client who had a knee arthroplasty is recovering according to expected outcomes and no longer needs the continuous passive motion (CPM) machine?
- A. The client has minimal pain when ambulating.
- B. The client can flex the operative knee 90 degrees.
- C. The client can tolerate full weight bearing.
- D. The edges of the client's surgical wound are approximated.
Correct Answer: B
Rationale: 90-degree knee flexion indicates restored joint function, a key recovery milestone.
When the client asks the nurse what is meant by the term manipulation, which explanation is most accurate?
- A. Manipulation involves making an incision to realign the bones.
- B. Manipulation involves the insertion of a pin or wire into the joint.
- C. Manipulation repositions the bone ends manually.
- D. Manipulation strengthens the joint with exercise.
Correct Answer: C
Rationale: Manipulation for a dislocated shoulder involves manually repositioning the bone ends into their normal alignment without surgical intervention. Incisions or pins are used in surgical procedures, and exercise is for rehabilitation, not repositioning.
The client is postoperative open reduction and internal fixation (ORIF) of a fractured femoral neck. Which long-term goal should the nurse identify for the client?
- A. The client will maintain vital signs within normal limits.
- B. The client will have a decrease in muscle spasms in the affected leg.
- C. The client will have no signs or symptoms of infection.
- D. The client will be able to ambulate down to the nurse’s station.
Correct Answer: D
Rationale: Ambulation to the nurse’s station is a long-term goal post-ORIF, indicating restored mobility. Vital signs, spasms, and infection are short-term or secondary.
The nurse is working on an orthopedic floor. Which client should the nurse assess first after the change-of-shift report?
- A. The 84-year-old female with a fractured right femoral neck in Buck’s traction.
- B. The 64-year-old female with a left total knee replacement who has confusion.
- C. The 88-year-old male post-right total hip replacement with an abduction pillow.
- D. The 50-year-old postop client with a continuous passive motion (CPM) device.
Correct Answer: B
Rationale: Confusion post-TKR may indicate neurological or metabolic complications, requiring urgent assessment. Fractures, THR, and CPM use are stable.
The female client diagnosed with osteoporosis tells the nurse she is going to perform swim aerobics for 30 minutes every day. Which response is most appropriate by the nurse?
- A. Praise the client for committing to do this activity.
- B. Explain to the client walking 30 minutes a day is a better activity.
- C. Encourage the client to swim every other day instead of daily.
- D. Discuss with the client how sedentary activities help prevent osteoporosis.
Correct Answer: B
Rationale: Walking, a weight-bearing exercise, better promotes bone density than swimming for osteoporosis. Daily swimming is less effective, sedentary activities worsen osteoporosis, and praise ignores efficacy.