chapter 65 Flashcards
The nurse is counselling a client about ways to prevent fractures. Which of the following information should the nurse include?
a. Tack down throw rugs in the home.
b. Most falls happen outside the home.
c. Buy shoes that provide good support and are comfortable to wear.
d. Range-of-motion exercises should be taught by a physical therapist.
c. Buy shoes that provide good support and are comfortable to wear.
The nurse is caring for a client in the emergency department who is employed as a checkout clerk in a grocery store and has a repetitive strain injury in the left elbow. Which of the following treatment options should the nurse include in the teaching plan?
a. Surgical options
b. Elbow injections
c. Utilization of a left wrist splint
d. Modifications in arm movement
d. Modifications in arm movement
The nurse is providing health-promotion teaching to a client whose job involves many hours of word processing. Which of the following actions should the nurse include in the client teaching plan?
a. Do stretching and warm-up exercises before starting work.
b. Wrap the wrists with a compression bandage every morning.
c. Use acetaminophen instead of nonsteroidal anti-inflammatory drugs (NSAIDs) for
wrist pain.
d. Obtain a keyboard pad to support the wrist while word processing.
d. Obtain a keyboard pad to support the wrist while word processing.
The nurse is preparing a client for discharge from the emergency department with a sprained wrist. Which of the following information should the nurse include?
a. Keep the wrist loosely wrapped with gauze.
b. Apply a heating pad to reduce muscle spasms.
c. Use pillows to elevate the arm above the heart.
d. Gently move the wrist through the range of motion.
c. Use pillows to elevate the arm above the heart.
The nurse is caring for a client who is a baseball pitcher and had an arthroscopic repair of a rotator cuff injury performed in same-day surgery. Which of the following information should be included in the client’s postoperative teaching plan?
a. “You have an appointment with a physical therapist for tomorrow.”
b. “You can still play baseball but you will not be able to return to pitching.”
c. “The doctor will use the drop-arm test to determine the success of surgery.”
d. “Leave the shoulder immobilizer on for the first few days to minimize pain.”
a. “You have an appointment with a physical therapist for tomorrow.”
The nurse is caring for a client who has a cast in place after fracturing the radius and the client asks when the cast can be removed. Which of the following information related to the length of time that the cast will need to remain in place should the nurse tell the client?
a. Several months
b. At least 3 weeks
c. Until swelling of the wrist has resolved
d. Until x-rays show complete bony union
b. At least 3 weeks
The nurse is caring for a client who has a comminuted fracture of the right femur and has Buck’s traction in place while waiting for surgery. Which of the following actions should the nurse implement to assess for pressure areas on the client’s back and sacral area and to provide skin care?
a. Loosen the traction and have the client turn onto the unaffected side.
b. Place a pillow between the client’s legs and turn gently to each side.
c. Turn the client partially to each side with the assistance of another nurse.
d. Have the client lift the buttocks by bending and pushing with the left leg.
d. Have the client lift the buttocks by bending and pushing with the left leg.
The nurse is caring for a client with a left femur fracture who has a hip spica cast applied. Which of the following nursing interventions should be included in the plan of care?
a. Avoid placing the client in the prone position.
b. Use the cast support bar to reposition the client.
c. Ask the client about any abdominal discomfort or nausea.
d. Discuss the reasons for remaining on bed rest for several weeks.
c. Ask the client about any abdominal discomfort or nausea.
The nurse is caring for a client who has a long-arm plaster cast applied for immobilization of a fractured left radius. Which of the following actions should the nurse implement until the cast has completely dried?
a. Keep the left arm in a dependent position.
b. Handle the cast with the palms of the hands.
c. Place gauze around the cast edge to pad any roughness.
d. Cover the cast with a small blanket to absorb the dampness.
b. Handle the cast with the palms of the hands.
The nurse is providing discharge teaching to a client who has a short-arm plaster cast applied. Which of the following client statements indicates a good understanding of the discharge teaching?
a. “I can get the cast wet as long as I dry it right away with a hair dryer.”
b. “I should avoid moving my fingers and elbow until the cast is removed.”
c. “I will apply an ice pack to the cast over the fracture site for the next 24 hours.”
d. “I can use a cotton-tipped applicator to rub lotion on any dry areas under the cast.”
c. “I will apply an ice pack to the cast over the fracture site for the next 24 hours.”
The nurse is evaluating the crutch-walking technique of a client who is to have no weight bearing on the right leg. Which of the following observations indicates that the client can safely ambulate independently?
a. The client keeps the padded area of the crutch firmly in the axillary area when ambulating.
b. The client advances the right leg and both crutches together and then advances the left leg.
c. The client moves the left crutch with the left leg and then the right crutch with the right leg.
d. The client uses the bedside chair to assist in balance as needed when ambulating in the room.
b. The client advances the right leg and both crutches together and then advances the left leg.
The nurse is caring for a client who has had an open reduction and internal fixation (ORIF) of left lower leg fractures who indicates constant severe pain in the leg which is unrelieved by the prescribed morphine. Pulses are faintly palpable and the foot is cool. Which of the
following actions should the nurse take next?
a. Notify the health care provider.
b. Assess the incision for redness.
c. Reposition the left leg on pillows.
d. Check the client’s blood pressure.
a. Notify the health care provider.
The nurse is caring for a client who is on bed rest after having a complex pelvic fracture. Which of the following assessment findings is most important to report to the health care provider?
a. The client states that the pelvis feels unstable.
b. Abdominal distention is present and bowel tones are absent.
c. There are ecchymoses on the abdomen and hips.
d. The client complains of pelvic pain with palpation.
b. Abdominal distention is present and bowel tones are absent.
The nurse is caring for a client with Buck’s traction who had an intracapsular fracture of the left femur. Which of the following actions should the nurse take in order to evaluate the effectiveness of Buck’s traction?
a. Assess for hip contractures.
b. Monitor for hip dislocation.
c. Check the peripheral pulses.
d. Ask about left hip pain level.
d. Ask about left hip pain level.
The nurse is preparing a client with lower leg fracture and an external fixation device in place for discharge. Which of the following information should the nurse include in the discharge teaching?
a. “You will need to assess and clean the pin insertion sites daily.”
b. “The external fixator can be removed during the bath or shower.”
c. “You will need to remain on bed rest until bone healing is complete.”
d. “Prophylactic antibiotics are used until the external fixator is removed.”
a. “You will need to assess and clean the pin insertion sites daily.”
The nurse is preparing to assist a client who has had an open reduction and internal fixation (ORIF) of a hip fracture out of bed for the first time. Which of the following actions should the nurse take first?
a. Use a mechanical lift to transfer the client from the bed to the chair.
b. Check the postoperative orders for the client’s weight-bearing status.
c. Avoid administration of pain medications before getting the client up.
d. Delegate the transfer of the client out of bed to an unregulated care provider
(UCP).
b. Check the postoperative orders for the client’s weight-bearing status.
The nurse is planning discharge teaching for a client who has had a repair of a fractured mandible. Which of the following information should the nurse will include in the teaching plan?
a. When and how to cut the immobilizing wires
b. Self-administration of nasogastric tube feedings
c. The use of sterile technique for dressing changes
d. The importance of including high-fibre foods in the diet
a. When and how to cut the immobilizing wires
After the health care provider has recommended an amputation for a client who has ischemic foot ulcers, the client tells the nurse, “If they want to cut off my foot, they should just shoot me instead.” Which of the following responses by the nurse is best?
a. “Many people are able to function normally with a foot prosthesis.”
b. “I understand that you are upset, but you may lose the foot anyway.”
c. “Tell me what you know about what your options for treatment are.”
d. “If you do not want the surgery, you do not have to have an amputation.”
c. “Tell me what you know about what your options for treatment are.”
The nurse is caring for a client who is 1 day postoperative below-the-knee amputation who indicates pain in the amputated limb. Which of the following actions is best for the nurse to take?
a. Explain the reasons for the phantom limb pain.
b. Administer prescribed analgesics to relieve the pain.
c. Loosen the compression bandage to decrease incisional pressure.
d. Remind the client that this phantom pain will diminish over time.
b. Administer prescribed analgesics to relieve the pain.
The nurse is preparing a client who had an above-the-knee amputation for discharge. Which of the following client statements indicates that the nurse’s discharge teaching has been effective?
a. “I should lay on my abdomen for 30 minutes three or four times a day.”
b. “I should elevate my residual limb on a pillow two or three times a day.”
c. “I should change the limb sock when it becomes soiled or stretched out.”
d. “I should use lotion on the stump to prevent drying and cracking of the skin.”
a. “I should lay on my abdomen for 30 minutes three or four times a day.”
The nurse is preparing a client for discharge 4 days after insertion of a femoral head prosthesis using a posterior approach. Which of the following client statements indicates a need for additional discharge instructions?
a. “I should not cross my legs while sitting.”
b. “I will use a toilet elevator on the toilet seat.”
c. “I will have someone else put on my shoes and socks.”
d. “I can sleep in any position that is comfortable for me.”
d. “I can sleep in any position that is comfortable for me.”
Which of the following nursing actions should the nurse include in the plan of care for a client who has had a total knee arthroplasty?
a. Avoid extension of the knee beyond 120 degrees.
b. Use a compression bandage to keep the knee flexed.
c. Start progressive knee exercises to obtain 90-degree flexion.
d. Teach about the need to avoid weight bearing for 4 weeks.
c. Start progressive knee exercises to obtain 90-degree flexion.
The nurse is caring for a client with ulnar drift caused by rheumatoid arthritis (RA) who is scheduled for an arthroplasty of the hand. Which of the following client statements indicates realistic expectation for the surgery?
a. “I will be able to use my fingers to grasp objects better.”
b. “I will not have to do as many hand exercises after the surgery.”
c. “This procedure will prevent further deformity in my hands and fingers.”
d. “My fingers will appear more normal in size and shape after this surgery.”
a. “I will be able to use my fingers to grasp objects better.”
The nurse is providing home care instructions to a client who has multiple forearm fractures and a long-arm cast on the right arm. Which of the following information should the nurse include in the teaching plan?
a. Keep the hand immobile to prevent soft tissue swelling.
b. Keep the right shoulder elevated on a pillow or cushion.
c. Avoid the use of nonsteroidal anti-inflammatory drugs (NSAIDs) for the first 48
hours after the injury.
d. Call the health care provider for increased swelling or numbness.
d. Call the health care provider for increased swelling or numbness.
