A nurse is assisting in the care of a client who is postoperative following a hip arthroplasty in the orthopedic unit. The primary health care provider has prescribed pain management and positioning strategies to prevent complications.

Exhibits

Complete the following sentence by using the lists of options.

The client is at risk for developing
dropdown
due to
dropdown
.

Answer and Explanation

The Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"A"}

The correct answer is Constipation / Opioid use.

Constipation is a common side effect of opioid use. The client is receiving oxycodone for pain management, which can slow down the digestive system, leading to constipation.

Pressure injuries, also known as pressure ulcers or bedsores, are a risk due to prolonged immobility. This is especially relevant for a client who is postoperative and has limited movement. However, this was not selected as the primary condition based on the given clues.

Hypoglycemia (low blood sugar) is not directly indicated by the client's current medications or conditions. The client is receiving IV dextrose, but there is no indication of a risk of hypoglycemia in the provided information.

Confusion can occur in clients with cognitive impairments or due to medication side effects, but it is not specifically indicated as a primary risk in this case.

Dysrhythmias (abnormal heart rhythms) can be caused by imbalances in potassium or sodium levels, among other factors, but there is no evidence of such imbalances or related symptoms in this client’s case.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is A

Explanation

Choice A rationale

Flexing hips and knees when assisting the client to a standing position provides a stable and balanced stance, reducing the risk of injury to both the nurse and the client. It ensures proper body mechanics and safety during the transfer.

Choice B rationale

Pivoting on the foot farthest from the bed when assisting the client into the chair is incorrect as it can cause instability and increase the risk of falls. It is important to pivot on the foot closest to the bed to maintain a stable center of gravity.

Choice C rationale

Standing on the client's stronger side when moving the client into the chair is not ideal because the nurse should provide support on the weaker side, ensuring the client is balanced and stable during the transfer.

Choice D rationale

Raising the bed to waist level before moving the client is a correct action to ensure proper body mechanics and reduce strain on the nurse's back. However, it is not as critical as ensuring proper support and stability during the transfer process. .

A. Pad bony prominences before applying a restraint. B. Tie the ends of the restraint to the client's bed rail. C. Use a square knot to secure the client's restraint to the bed. D. Observe the client's skin integrity every 2 hr. E. Ensure that 2 fingers can be placed between the restraint and the client.

Correct Answer is ["A","D","E"]

Explanation

Choice A rationale

Padding bony prominences helps prevent skin breakdown and pressure ulcers, which are critical considerations when using restraints to avoid additional complications for the client.

Choice B rationale

Tying restraints to the bed rail is unsafe because it can lead to injury if the bed rail is moved. Restraints should be tied to the bed frame to prevent accidental harm.

Choice C rationale

Using a square knot for restraints is inappropriate as it is difficult to untie quickly in an emergency. Quick-release knots are recommended for safety and efficiency.

Choice D rationale

Observing the client's skin integrity every 2 hours is essential to detect early signs of skin breakdown and take preventive actions to ensure the client's comfort and safety.

Choice E rationale

Ensuring that two fingers can fit between the restraint and the client ensures that the restraint is not too tight, allowing for circulation and reducing the risk of injury.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assisting in the transfer of a client who has left-sided weakness from a bed to a chair.Which of the following actions should the nurse take?

Correct Answer is A

Explanation

A nurse at a long-term care facility is reinforcing teaching with a newly licensed nurse about the proper use of restraints.Which of the following instructions should the nurse include in the teaching? (Select all that apply.)

Correct Answer is ["A","D","E"]

Explanation

A nurse is preparing to clean a blood spill on a bedside table.Which of the following solutions should the nurse plan to use?

A nurse is preparing to administer a medication from an ampule.Which of the following is an appropriate action for the nurse to take?

A nurse is reinforcing teaching with a client about blood glucose monitoring.The client becomes quiet and appears distracted while the nurse is providing the instructions.Which of the following responses should the nurse make?

A nurse is reinforcing teaching about advance directives with a client who has terminal colorectal cancer.Which of the following statements by the client indicates an understanding of the teaching?

A nurse is observing an assistive personnel (AP) apply a belt restraint to a client.Which of the following actions by the AP requires intervention by the nurse?

A nurse is caring for a client who refuses their morning dose of antihypertensive medication. The client tells the nurse, "I'm not going to take this medication because it makes me sick and dizzy.”. Which of the following actions should the nurse take first?

A nurse is reviewing the laboratory results for a client who reports vomiting and diarrhea for 2 days.Which of the following laboratory findings should the nurse expect?