A nurse is caring for a client who has skeletal traction for the treatment of a femur fracture.
Which of the following actions should the nurse take?
Position the weights on the traction so they are touching the head of the client's bed
Encourage isometric exercises every 8 hr
Administer pain medication to the client before performing pin care
Assist the client to shift position every 4 hr.
The Correct Answer is D
The nurse should assist the client to shift position every 4 hours to prevent complications such as pressure ulcers and pneumonia.
Choice A is incorrect because the weights on the traction should be freely hanging and not touching any part of the bed.
Choice B is incorrect because isometric exercises may not be appropriate for a client with a femur fracture and should be prescribed by a healthcare provider.
Choice C is incorrect because administering pain medication before performing pin care may not be necessary and should be based on the client’s level of pain and the healthcare provider’s orders.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
This can help prevent stomach acid from moving up into the esophagus and causing heartburn at night.
Choice A is not correct because exercise is generally safe during pregnancy and can have many benefits.
Choice B is not correct because sodium bicarbonate may not be safe for pregnant women to take.
Choice C is not correct because heartburn during pregnancy is common and usually does not require emergency medical care.
Correct Answer is A
Explanation
A positive urine hCG test is a priority assessment to assess for a possible pregnancy.
The human chorionic gonadotropin (hCG) hormone is produced by the placenta after implantation and can be detected in the urine of pregnant women.
A urine hCG test is a common method used to confirm pregnancy.
Choice B is not an answer because changes in uterine size and shape occur later in pregnancy and are not a priority assessment for early pregnancy detection.
Choice C is not an answer because a fetal heartbeat can usually be detected at around 6-7 weeks of pregnancy and is not a priority assessment for early pregnancy detection.
Choice D is not an answer because Chadwick’s sign, which refers to the bluish discoloration of the cervix, vagina, and vulva due to increased blood flow, occurs later in pregnancy and is not a priority assessment for early pregnancy detection.
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