A nurse applies padded boots to maintain the foot in dorsiflexion to a client who is comatose. The nurse is protecting the client from:

decubitus ulcers.

foot drop.

pooling of blood.

blood pressure changes.

Answer and Explanation

The Correct Answer is B

Choice A rationale: Decubitus ulcers (pressure ulcers) are not directly prevented by applying padded boots for dorsiflexion.
Choice B rationale: Applying padded boots for dorsiflexion helps prevent foot drop, a condition where the foot is permanently in a plantar-flexed position, which can lead to contractures.
Choice C rationale: Pooling of blood is not a primary concern addressed by applying padded boots for dorsiflexion.
Choice D rationale: Blood pressure changes are not directly addressed by applying padded boots for dorsiflexion.

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Correct Answer is D

Explanation

Choice A rationale: Unintentional closed wounds involve blunt force trauma but do not typically result in jagged edges with muscle tissue visible.
Choice B rationale: Intentional closed wounds are typically surgical incisions and do not present with jagged edges and visible muscle tissue.
Choice C rationale: Intentional open wounds are typically surgical incisions, not the result of a biking accident.
Choice D rationale: Unintentional open wounds result from accidents and can present with jagged edges and visible tissue.

A. "I should use my axilla to bear body weight." B. "I should keep my elbows extended." C. "When getting up out of the chair, I should extend my uninjured leg." D. "To climb stairs, I should place weight on my unaffected leg first."

Correct Answer is D

Explanation

Choice A rationale: Using the axilla to bear body weight can lead to nerve damage and is not a proper crutch technique.
Choice B rationale: Keeping the elbows extended can lead to discomfort and poor crutch control. The elbows should be slightly flexed.
Choice C rationale: When getting up from a chair, extending the uninjured leg first is not the correct technique. The patient should keep the injured leg extended for stability.
Choice D rationale: Placing weight on the unaffected leg first when climbing stairs is the correct technique, allowing for better balance and stability.

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A nurse applies padded boots to maintain the foot in dorsiflexion to a client who is comatose. The nurse is protecting the client from:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse working in an emergency room is assessing a client who has a leg wound. The nurse notes a full-thickness wound with jagged edges and muscle tissue visible after a biking accident. The nurse should document this as which of the following types of wounds?

Correct Answer is D

Explanation

The nurse is caring for a patient with a fractured left leg and is using crutches. Which statement indicates the patient has correct understanding of how to properly use her crutches?

Correct Answer is D

Explanation

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A nurse applies padded boots to maintain the foot in dorsiflexion to a client who is comatose. The nurse is protecting the client from: