A client who fractured the right femur from a fall at home is placed in skeletal traction while awaiting surgery. When the client tells the nurse the need to urinate, which intervention should the nurse implement?

Log roll the client and place adult disposable briefs beneath the client.

Maintain traction while the client uses a urinal.

Release the traction so the client can use a bedpan.

Insert an indwelling urinary catheter preoperatively.

Answer and Explanation

The Correct Answer is B

Choice A reason: Log rolling the client and placing adult disposable briefs beneath the client is not a correct intervention, as it can cause displacement or misalignment of the fracture, which can lead to complications, such as delayed healing, nerve damage, or infection. Log rolling is a technique that involves moving the client as a unit, without twisting or bending the spine. Adult disposable briefs are absorbent pads that can be worn to manage urinary incontinence.

Choice B reason: Maintaining traction while the client uses a urinal is the correct intervention, as it can prevent the disruption of the fracture stabilization and allow the client to void comfortably and safely. Traction is a force that is applied to the fractured bone to reduce, align, and immobilize it. A urinal is a container that can be used to collect urine from the client, without requiring the client to get out of bed or change position.

Choice C reason: Releasing the traction so the client can use a bedpan is not a correct intervention, as it can compromise the fracture reduction and alignment, and cause pain and discomfort to the client. A bedpan is a shallow vessel that can be used to collect urine or feces from the client, by placing it under the client's buttocks. Releasing the traction can also increase the risk of bleeding, swelling, or infection.

Choice D reason: Inserting an indwelling urinary catheter preoperatively is not a necessary intervention, unless the client has urinary retention, obstruction, or infection. An indwelling urinary catheter is a tube that is inserted into the bladder through the urethra, and attached to a drainage bag. An indwelling urinary catheter can pose risks of trauma, infection, or bladder spasms, and should be avoided unless indicated.

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Correct Answer is A

Explanation

Choice A reason: Varicella is another name for chickenpox, which is caused by the varicella-zoster virus. Herpes zoster, also known as shingles, is a reactivation of the same virus that causes a painful rash along a nerve pathway. People who have had chickenpox are at risk of developing shingles later in life, especially if their immune system is weakened. Asking the client if everyone at home has already had varicella can help the nurse determine the risk of transmission and the need for isolation precautions.

Choice B reason: Antifungal creams are not effective for herpes zoster, which is caused by a virus, not a fungus. Antifungal creams are used to treat fungal infections, such as athlete's foot, ringworm, or candidiasis. Asking the client if the antifungal creams have been effective is not relevant to the condition and can indicate a lack of knowledge or a misdiagnosis.

Choice C reason: Dry patches on the feet and hands are not typical signs of herpes zoster, which usually causes a blistering rash along a nerve pathway. Dry patches on the feet and hands can be caused by other conditions, such as eczema, psoriasis, or diabetes. Asking the client if they have any dry patches on their feet and hands is not helpful to assess the condition and can divert the attention from the main problem.

Choice D reason: Sharing combs and brushes is not a common mode of transmission for herpes zoster, which is spread by direct contact with the fluid from the blisters. Sharing combs and brushes can transmit other infections, such as lice, scabies, or impetigo. Asking the client if their family members share combs and brushes is not pertinent to the condition and can imply a poor hygiene or a stigma.

A. Husky voice and complaints of hoarseness. B. Warm, soft, moist, salmon-colored skin. C. Visible swelling of the neck, with no pain. D. Central-type obesity, with thin extremities.

Correct Answer is D

Explanation

Choice A reason: A husky voice and complaints of hoarseness are not related to Cushing's syndrome, but may indicate a thyroid disorder or vocal cord damage.

Choice B reason: Warm, soft, moist, salmon-colored skin is not a characteristic of Cushing's syndrome, but may be seen in hyperthyroidism or infection.

Choice C reason: Visible swelling of the neck, with no pain, is not a sign of Cushing's syndrome, but may indicate a goiter or thyroid enlargement.

Choice D reason: Central-type obesity, with thin extremities, is a common feature of Cushing's syndrome, which is caused by excess cortisol production or exposure. Cortisol causes fat redistribution to the trunk, face, and back of the neck, while causing muscle wasting and weakness in the arms and legs.

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A client who fractured the right femur from a fall at home is placed in skeletal traction while awaiting surgery. When the client tells the nurse the need to urinate, which intervention should the nurse implement?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

Which admission assessment findings should the nurse document related to a client who has been diagnosed with Cushing’s syndrome?

Correct Answer is D

Explanation

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