A nurse is reinforcing discharge teaching with a client who had an above-the-knee amputation and has a prosthesis. Which of the following instructions should the nurse include?

"Keep initial pressure dressing in place for 1 week after surgery."

"Leave the prosthesis in place when going to bed."

"Avoid extension of the hips when lying down."

"Clean the prosthesis using a damp, soapy cloth."

Answer and Explanation

The Correct Answer is D

Answer: D. "Clean the prosthesis using a damp, soapy cloth."

Rationale:

A. "Keep initial pressure dressing in place for 1 week after surgery":
The pressure dressing is typically changed more frequently to monitor the incision site for signs of infection and to ensure appropriate healing. Keeping it in place for a week without monitoring could increase the risk of infection and complications.

B. "Leave the prosthesis in place when going to bed":
It is generally recommended to remove the prosthesis at night to allow the residual limb to rest and prevent skin irritation or pressure sores. Leaving it on overnight can lead to unnecessary strain on the limb.

C. "Avoid extension of the hips when lying down":
Clients should actually avoid prolonged hip flexion, not extension, as it can lead to hip contractures. Instead, they should try to lie prone periodically to stretch the hip and reduce the risk of contracture formation.

D. "Clean the prosthesis using a damp, soapy cloth":
Using a damp, soapy cloth to clean the prosthesis helps maintain hygiene and prevents skin irritation. It's important to keep the prosthesis clean to avoid any buildup of bacteria or dirt, which can affect both the device and the residual limb’s health.

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Correct Answer is A

Explanation

The correct technique for using an albuterol MDI involves closing the mouth around the mouthpiece to create a seal. This helps ensure that the medication is delivered directly into the lungs and maximizes its effectiveness. It also helps prevent the medication from escaping and being wasted.

"Exhale immediately after inhaling": This instruction is not accurate. After closing the mouth around the mouthpiece and activating the inhaler to release the medication, the client should inhale slowly and deeply through the mouth, holding their breath for about 10 seconds if possible. Exhaling immediately after inhaling would not allow enough time for the medication to be absorbed effectively.

"Tilt your head forward while inhaling": Tilted head position is not necessary when using an albuterol MDI. The client should hold the inhaler in an upright position, with the mouthpiece directed toward their mouth. This allows for proper delivery of the medication.

"Take three quick breaths while depressing the canister": This instruction is not accurate for using an albuterol MDI. The correct technique involves taking a slow and deep breath in through the mouth, while simultaneously depressing the canister to release the medication. Taking three quick breaths may not allow enough time for adequate medication delivery.

A. Place the client in a room that is ventilated to the outside. B. Wear a gown when delivering the client's food tray. C. Prohibit visitors while the client's infection is active. D. Administer a tuberculin skin test prior to discharge.

Correct Answer is A

Explanation

A nurse admitting a client who has active tuberculosis should place the client in a room that is ventilated to

the outside. This is an appropriate nursing intervention to prevent the spread of tuberculosis to others.

The other options are not correct.

b) The nurse does not need to wear a gown when delivering the client's food tray but should wear a mask and gloves.

c) Visitors are not prohibited while the client's infection is activebut should be limited and should wear masks.

d) A tuberculin skin test is not necessary prior to discharge as the client has already been diagnosed with active tuberculosis.

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A nurse is reinforcing discharge teaching with a client who had an above-the-knee amputation and has a prosthesis. Which of the following instructions should the nurse include?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reinforcing teaching with a client who is about to start using an albuterol metered-dose inhaler. Which of the following instructions should the nurse include in the teaching?

Correct Answer is A

Explanation

A nurse is admitting a client who has active tuberculosis. Which of the following nursing interventions is appropriate?

Correct Answer is A

Explanation

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