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

None

Answer and Explanation

The Correct Answer is B

A. Instructing the client to bend at the waist is incorrect because hip flexion beyond 90 degrees is contraindicated after total hip arthroplasty due to risk of dislocation.

B. Keeping the client’s heels elevated while in bed is correct. This helps prevent pressure ulcers, which are a common postoperative complication due to decreased mobility.

C. Massaging the affected leg is contraindicated because it can dislodge a thrombus and lead to complications such as a pulmonary embolism.

D. Maintaining adduction of the affected hip is incorrect because it increases the risk of hip dislocation. The hip should be kept in abduction using a pillow or abduction device.

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Correct Answer is C

Explanation

Rationale:

A. Remind the client to eat scheduled meals daily.: As clients near the end of life, appetite naturally decreases due to metabolic changes and reduced physiologic demand. Encouraging scheduled meals can create discomfort or distress and does not improve outcomes. Supportive care focuses on comfort rather than forcing nutritional intake.

B. Place the client in a supine position.: A supine position can worsen respiratory effort, increase the sensation of breathlessness, and promote secretion pooling. Terminal clients often breathe more comfortably in semi-Fowler’s or side-lying positions, which help ease ventilation and support comfort-based care.

C. Offer the client a blanket to keep warm.: Clients at the end of life commonly experience decreased body temperature due to reduced circulation and metabolic slowing. Gently providing a blanket supports comfort without invasive measures. Maintaining warmth helps ease physical distress and aligns with palliative goals focused on dignity and relief.

D. Speak in a loud tone when addressing the client.: Hearing is often the last sense to diminish, so speaking loudly is unnecessary and may startle or distress the client. A calm, soft voice preserves a peaceful environment and promotes emotional comfort, supporting both the client and family during end-of-life care.

A. "I will remove my shoes when I'm inside my house. B. "will floss between my teeth every time I brush C. "I will wipe my nose instead of blowing it." D. "I will use an enema to manage my constipation.

Correct Answer is C

Explanation

Rationale:

A. "I will remove my shoes when I'm inside my house.": While keeping the environment safe from tripping hazards is good for general safety, removing shoes does not specifically prevent bleeding, which is the main concern in thrombocytopenia. This action does not demonstrate understanding of bleeding precautions.

B. "I will floss between my teeth every time I brush": Flossing can cause gum bleeding, which is risky for clients with low platelet counts. Effective teaching would emphasize avoiding activities that may cause mucosal or skin bleeding, so this statement reflects a misunderstanding.

C. "I will wipe my nose instead of blowing it.": Gentle wiping reduces the risk of nasal bleeding, which is important in clients with thrombocytopenia. This statement shows the client understands the need to minimize trauma to areas prone to bleeding and demonstrates correct application of bleeding precautions.

D. "I will use an enema to manage my constipation.": Using an enema can cause mucosal trauma and rectal bleeding, which is unsafe for clients with thrombocytopenia. Safe constipation management would involve gentle measures such as stool softeners and increased hydration.

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A nurse is caring for a client who had total hip arthroplasty 2 days ago. Which of the following actions should the nurse take

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