Nokea
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.
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Which will the nurse stress to a patient, who recently had a hip replacement, in quadriceps setting exercises?
- A. Push knee down to mattress and raise heel off the bed.
- B. Flex knee and extend foot.
- C. Adduct leg and flex foot.
- D. Lift leg and heel off the bed.
Correct Answer: A
Rationale: Pushing the knee down into the mattress and raising the heel will strengthen the quadriceps muscles. Flexing the knee and extending the foot will not strengthen the quadriceps muscles. Likewise, adducting the legs and flexing the knee will not strengthen the quadriceps muscles.
A 16-year-old male patient presents in the emergency room with a pathologic fracture of the left femur and complains of pain on weight-bearing. These are common indicators of which disorder?
- A. osteogenic sarcoma.
- B. osteoporosis.
- C. rheumatoid arthritis.
- D. osteochondroma.
Correct Answer: A
Rationale: Osteogenic sarcoma occurs in young men aged 10 to 25. They are malignant bone tumors that can cause a pathologic fracture and they are accompanied by pain on weight-bearing. Osteoporosis is a disorder that results in loss of bone density. Rheumatoid arthritis is a systemic inflammatory autoimmune disease. Osteochondromas are benign and usually do not cause fractures.
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.
The nurse explains to a patient who has had a hip replacement that warfarin is prescribed for which reason?
- A. increase the red blood cells.
- B. reduce the threat of hemorrhage.
- C. prevent formation of emboli.
- D. help stabilize the prosthesis.
Correct Answer: C
Rationale: Warfarin is a standard postsurgical drug to prevent the formation of emboli. Warfarin does not increase red blood cells. The risk of hemorrhage is higher when an anticoagulant is taken. Warfarin does not help stabilize the prosthesis.
Which action should the nurse take when a patient with osteomyelitis of the right forearm is admitted with an open wound that is draining?
- A. Enforce a low-calorie diet.
- B. Initiate drainage and secretion precautions.
- C. Frequently do passive ROM on the elbow.
- D. Ambulate several times daily.
Correct Answer: B
Rationale: The patient with osteomyelitis should be at least in drainage and secretion precaution. The limb should be positioned for maximum comfort and left at rest. These patients are usually on bed rest and require a high-calorie, high-protein diet.