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Which intervention should the nurse implement when caring for the child with an Ilizarov external fixator applied to a lower extremity for bone lengthening?
- A. Loosening the bolts and lengthening the rods on the fixator every other day
- B. Cleansing the external fixator pin sites with sterile saline twice daily
- C. Discouraging the child from bearing any weight on the involved extremity
- D. Removing sections of the fixator apparatus when the child is positioned in bed
Correct Answer: B
Rationale: Regular cleansing of pin sites with sterile saline prevents infection in an Ilizarov fixator.
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The nurse gently elevates the client's newly casted arm on a pillow and explains that this is necessary for the first 24 to 48 hours after casting. What is the chief purpose of this action?
- A. It helps a damp cast to dry more evenly.
- B. It reduces the amount of pain medication needed.
- C. Venous return is enhanced, and edema is decreased.
- D. It is more comfortable than keeping the arm dependent.
Correct Answer: C
Rationale: Elevation enhances venous return and reduces edema, the primary reason for this action. It does not directly affect cast drying, pain medication needs, or comfort alone.
The client is being evaluated for osteoporosis. Which diagnostic test is the most accurate when diagnosing osteoporosis?
- A. X-ray of the femur.
- B. Serum alkaline phosphatase.
- C. Dual-energy x-ray absorptiometry (DEXA).
- D. Serum bone Gla-protein test.
Correct Answer: C
Rationale: DEXA is the gold standard for osteoporosis diagnosis, measuring bone mineral density. X-rays detect fractures, alkaline phosphatase is nonspecific, and bone Gla-protein is not diagnostic.
Which nursing instruction is most beneficial to minimize stress on the client's painful joints?
- A. Maintain a normal weight.
- B. Apply a topical analgesic cream.
- C. Take a calcium supplement.
- D. Become more physically active.
Correct Answer: A
Rationale: Maintaining a normal weight reduces mechanical stress on weight-bearing joints like the hip, alleviating pain and slowing osteoarthritis progression. The other options are less impactful for joint stress.
The client has an external fixator for reduction of a tibia fracture. The nurse is evaluating the client's effectiveness in ambulating with crutches. Place an X on each of the three areas where the client should be bearing weight When crutch walking.
- A. The client should be bearing weight on the hand grips when bringing legs forward. When moving crutches, the weight should be borne on the unaffected leg.
Correct Answer: image
Rationale: The client should be bearing weight on the hand grips when bringing legs forward and on the unaffected leg when moving crutches to ensure proper crutch-walking technique and stability.
Which technique is the best strategy for assessing circulation in the leg in Buck's traction?
- A. Observe whether the client can wiggle or move the toes.
- B. Palpate for pulsation of the dorsalis pedis artery.
- C. Take the client's blood pressure with a thigh cuff positioned on the affected leg.
- D. Determine whether the client can feel sharp and dull sensations.
Correct Answer: B
Rationale: Palpating the dorsalis pedis pulse directly assesses arterial circulation in the leg, providing the most accurate indication of blood flow. Toe movement and sensation are less specific, and blood pressure measurement is not relevant.