A nurse is caring for a client who is 6 hr postoperative following application of an external fixator for a tibial fracture. Which of the following actions should the nurse take?

Maintain the affected extremity in a dependent position.

Palpate the dorsalis pedis pulse.

Wrap sterile gauze on the sharp point of the pins.

Adjust the clamps on the fixator frame.

Answer and Explanation

The Correct Answer is B

Palpating the dorsalis pedis pulse is an essential action to monitor for adequate circulation and perfusion in an extremity with an external fixator, which is a device that stabilizes and aligns fractured bones with metal pins and rods outside of the skin. The other options are incorrect because they could cause complications such as edema, infection, or malalignment.

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Correct Answer is A

Explanation

The nurse's priority is to ensure that the client has given informed consent for the surgery, which requires that the client is competent and understands the risks and benefits of the procedure. A client with a high blood alcohol level may not have the mental capacity to consent and may need a legal representative or a court order to proceed with the surgery.

The other actions are important but not as urgent as obtaining consent.

A. WBC count 8,400/mm3 B. Reports pain of 4 on a scale from 0 to 10 when coughing C. Serosanguineous exudate noted on dressing change D. Hemoglobin 10 mg/dL

Correct Answer is D

Explanation

This is a low hemoglobin level, which may indicate blood loss. The nurse should report this finding to the provider immediately, as it may require further investigation and intervention, such as blood transfusion.

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A nurse is caring for a client who is 6 hr postoperative following application of an external fixator for a tibial fracture. Which of the following actions should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse in an emergency department is preparing a client for emergency surgery. The client's blood alcohol level is 180 mg/dL. Which of the following actions is the nurse's priority?

Correct Answer is A

Explanation

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Correct Answer is D

Explanation

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