Nokea
You are working in a long-term care setting. One of the residents is able to ambulate but sits in a wheelchair each day. What action will you take?
- A. Check the orders for ambulation and be sure that they are followed to promote mobility.
- B. Change the activity order to wheelchair only because the resident prefers to sit rather than ambulate.
- C. Instruct the CNA to do passive range-of-motion exercises because the resident is not ambulating anymore.
- D. Call the doctor and report that the resident is no longer ambulating.
Correct Answer: A
Rationale: Promoting mobility by following ambulation orders prevents complications like muscle atrophy. Changing orders or assuming non-ambulation is premature without assessment.
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You are caring for a patient who had a partial knee replacement 2 days ago. She has orders for CPM for 2 hours four times per day at 35 degrees of flexion. Which would concern you the most?
- A. The patient's leg and the CPM machine are in alignment with the rest of the patient's body.
- B. The patient complains of severe pain with each flexion of the knee.
- C. The patient is using relaxation breathing to prevent tensing of the leg muscles while on the CPM machine.
- D. The platform of the CPM machine is centered beneath the patient's knee.
Correct Answer: B
Rationale: Severe pain during CPM use suggests potential complications (e.g., improper settings or joint issues), requiring immediate assessment. Other options indicate proper use or management.
The purpose of a trapeze bar is to
- A. Prop the linens off of the patient's legs and feet.
- B. Hold the ropes and weights in traction.
- C. Provide a hand grip for the patient to use when moving in bed.
- D. Provide attachment points for skeletal traction.
Correct Answer: C
Rationale: A trapeze bar allows patients to grip and reposition in bed, promoting independence and mobility.
Explain the purpose of an abduction pillow.
- A. To maintain hip alignment post-surgery.
- B. To elevate the legssome text missing legs.
- C. To reduce pain during movement.
- D. To support the back during recovery.
Correct Answer: A
Rationale: An abduction pillow maintains hip alignment post-surgery (e.g., hip replacement) to prevent dislocation. It does not primarily elevate legs, reduce pain, or support the back.
A patient who is 3 days post left total hip replacement with the lateral approach is sitting in a chair and drops a magazine. How should he or she retrieve it?
- A. Bend laterally at the waist to pick it up.
- B. Bend over with the knees flexed to pick it up.
- C. Call for someone else to pick it up.
- D. Use an extension gripper to pick it up.
Correct Answer: C,D
Rationale: Post-hip replacement patients with a lateral approach must avoid bending or twisting to prevent dislocation. Calling for help or using a gripper is safe.
The reason(s) that a limb might have to be amputated include
- A. Severe tissue damage from trauma.
- B. Severely decreased blood flow to the limb.
- C. Failure of skeletal traction to successfully treat a fracture.
- D. Gangrene (death of tissue) in the limb.
- E. Cancerous tumor of the bone.
Correct Answer: A,B,D,E
Rationale: Amputation may be necessary due to severe trauma, poor blood flow (e.g., peripheral vascular disease), gangrene, or bone cancer. Failure of skeletal traction is not a typical reason for amputation.