A nurse is caring for a client who had total hip arthroplasty 2 days ago. Which of the following actions should the nurse take
Instruct the client to bend at the waist to put on slippers
Keep the client's heels elevated while in bed
Massage the clients affected leg three times daily
Maintain slight adduction of the client's affected hip
The Correct Answer is B
A. Bending at the waist to put on slippers places the hip in flexion greater than 90 degrees, which increases the risk of dislocation after total hip arthroplasty.
B. Keeping the client’s heels elevated while in bed helps prevent pressure injuries and promotes skin integrity. This is a safe and appropriate action for a client post-hip arthroplasty.
C. Massaging the affected leg is contraindicated because it can dislodge a blood clot and increase the risk of deep vein thrombosis.
D. Maintain slight abduction of the client’s affected hip: Keeping the hip in slight abduction with pillows or abduction devices helps prevent dislocation of the prosthetic joint. Proper positioning is essential for safe recovery following total hip arthroplasty.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Rationale:
A. Remove stopcocks from IV tubing: Removing stopcocks is not necessary and may compromise IV line function. The priority is to prevent contact with latex-containing components, not to eliminate all IV hardware, as many are latex-free.
B. Disinfect and powder any latex products before use: Powdered latex products increase the risk of airborne latex particles, which can trigger severe allergic reactions. Disinfecting or using powdered latex items is unsafe for clients with latex sensitivity and should be avoided entirely.
C. Tape stockinet over monitoring devices and cords: Covering monitoring devices, cords, and other equipment with a barrier such as stockinet prevents direct contact with latex-containing components. This reduces the risk of an allergic reaction during surgery while allowing the necessary monitoring and functionality to continue safely.
D. Schedule the client as the last surgery of the day: While scheduling considerations may be made to reduce exposure to residual latex or disinfectants, the timing of surgery is not the primary strategy for preventing a reaction. The focus should be on removing or isolating all latex-containing items from the environment.
Correct Answer is A
Explanation
Rationale:
A. Required immunizations: Immunizations are a key aspect of primary prevention, as they protect children from preventable diseases before exposure occurs. Including information about required vaccines at the kindergarten level helps caregivers ensure children are protected and supports community health.
B. Nutrition for children who have diabetes: Nutrition management for children with diabetes is considered secondary or tertiary prevention, as it involves managing an existing condition rather than preventing disease onset. It is not the focus for primary prevention at a general health fair.
C. Emergency disaster planning: While disaster planning is important for safety, it is not classified as primary prevention of disease. It addresses preparedness rather than preventing the initial occurrence of a health condition.
D. Screening for a pediculosis breakout: Screening is a secondary prevention activity because it involves early detection of an existing condition (lice infestation). It does not prevent the initial occurrence of disease, so it is not a primary prevention topic.
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