A nurse is assessing a client who is in skeletal traction. Which of the following findings should the nurse identify as an indication of infection at the pin sites?

Mild erythema

Serosanguineous drainage

Fever

Warmth

Answer and Explanation

The Correct Answer is C

A. Mild erythema (redness) at the pin sites can be a normal finding due to the body's response to the presence of foreign objects. It may not necessarily indicate infection.

B. Serosanguineous drainage (a mixture of clear and bloody fluid) can also be a normal finding initially after the insertion of pins. It may not necessarily indicate infection.

C. Fever is a systemic response to infection. In a client with skeletal traction, fever can be an indication of an infection at the pin sites or a more systemic infection related to the traction device.

D. Warmth around the pin sites can be a normal finding due to the inflammatory response that occurs after pin insertion. It may not necessarily indicate infection.

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Correct Answer is D

Explanation

A. Transverse fractures occur straight across the bone. In this case, the bone is splintered, which is not characteristic of a transverse fracture.

B. Oblique fractures have a diagonal break across the bone. This does not match the description provided in the scenario.

C. Impacted fractures occur when one end of the bone is forced into the adjacent bone. This does not align with the description of the fracture in the scenario.

D. Correct. A comminuted fracture involves the bone breaking into multiple fragments or pieces. This aligns with the description provided in the scenario where the bone is splintered into several pieces around the shaft.

A. When moving an object to one side, the client puts his weight on his heels. B. The client stands with his feet close together when lifting an object. C. The Client faces the direction of movement when sliding an object across the floor. D. When pushing an object, the client moves his front foot backward.

Correct Answer is C

Explanation

A. Placing weight on the heels when moving an object can lead to an improper body mechanic. The client should shift their weight onto the balls of their feet for better stability.

B. Standing with feet close together when lifting an object can also lead to improper body mechanics. The client should maintain a wide base of support by keeping their feet shoulder-width apart.

C. Facing the direction of movement when sliding an object across the floor is an example of proper body mechanics. It helps ensure that the client uses their body weight and strength efficiently.

D. Moving the front foot backward when pushing an object can help maintain balance and provide better leverage, which is a correct body mechanics technique. However, the question specifically asks about sliding an object across the floor, not pushing.

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A nurse is assessing a client who is in skeletal traction. Which of the following findings should the nurse identify as an indication of infection at the pin sites?

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Naxlex Comprehensive Predictor Exams

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