A nurse is reinforcing teaching with a client who is 24 hr postoperative following a total hip arthroplasty. Which of the following instructions should the nurse include in the teaching?
Perform range of motion by adducting the hip.
Sit in a straight-backed chair.
Cleanse the surgical incision with hydrogen peroxide.
Apply moist heat to the incision while in bed.
The Correct Answer is B
Choice A reason: Performing range of motion by adducting the hip is an incorrect instruction for a client who had a total hip arthroplasty. Adduction is moving the leg toward the midline of the body, which can cause dislocation of the prosthesis. The nurse should instruct the client to perform range of motion by abducting (moving away from midline), flexing (bending), and extending (straightening) the hip as prescribed by physical therapy.
Choice B reason: Sitting in a straight-backed chair is a correct instruction for a client who had a total hip arthroplasty. This position helps to maintain proper alignment and stability of the hip joint and prevents excessive flexion or rotation that can cause dislocation. The nurse should also instruct the client to avoid crossing legs, bending forward more than 90 degrees, or twisting at the waist.
Choice C reason: Cleansing the surgical incision with hydrogen peroxide is an incorrect instruction for a client who had a total hip arthroplasty. Hydrogen peroxide is a harsh agent that can damage healthy tissue and delay healing. The nurse should instruct the client to cleanse the incision with mild soap and water or as directed by the provider and keep it dry and covered with sterile dressing.
Choice D reason: Applying moist heat to the incision while in bed is an incorrect instruction for a client who had a total hip arthroplasty. Moist heat can increase swelling, inflammation, and infection risk at the incision site. The nurse should instruct the client to apply ice packs or cold compresses to the incision as needed to reduce pain and swelling.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: This is not a correct instruction because increasing daily intake of vitamin E has no proven benefit for preventing or treating osteoporosis. Vitamin E is an antioxidant that may protect cells from damage, but it does not affect bone density or strength.
Choice B reason: This is not a correct instruction because limiting vitamin D intake can increase the risk of osteoporosis. Vitamin D is essential for calcium absorption and bone health, and many postmenopausal women are deficient in vitamin D due to reduced sun exposure, skin aging, or dietary factors. The nurse should advise the client to get adequate vitamin D from food sources, such as fatty fish, egg yolks, or fortified dairy products, or from supplements as prescribed.
Choice C reason: This is a correct instruction because adding a weight-bearing exercise regimen can prevent or slow down bone loss and improve muscle strength and balance. Weight-bearing exercises are those that make the bones work against gravity, such as walking, jogging, dancing, or lifting weights. The nurse should recommend that the client perform at least 30 minutes of moderate-intensity weight-bearing exercise on most days of the week.
Choice D reason: This is not a correct instruction because taking calcium carbonate supplements once a day with breakfast can reduce the absorption and effectiveness of calcium. Calcium carbonate is a type of calcium supplement that requires an acidic environment in the stomach to dissolve and be absorbed, and it can interfere with the absorption of other nutrients, such as iron. The nurse should suggest that the client take calcium carbonate supplements with meals other than breakfast or switch to another form of calcium supplement, such as calcium citrate, that does not depend on stomach acidity.
Correct Answer is B
Explanation
Choice A reason: This is not an accurate statement because a BMI of 30 indicates obesity, which is a risk factor for hypertension. The client should aim to lose weight and achieve a healthy BMI of 18.5 to 24.9.
Choice B reason: This is an accurate statement because reducing sodium intake can help lower blood pressure and prevent hypertension. The American Heart Association recommends consuming no more than 2,300 milligrams of sodium per day and ideally less than 1,500 milligrams.
Choice C reason: This is not an accurate statement because the client should exercise for at least 30 minutes most days of the week, not just three times per week. Physical activity can help lower blood pressure and prevent hypertension by improving cardiovascular health and reducing stress.
Choice D reason: This is not an accurate statement because the client should consume fish at least twice per week, not just once per week. Fish is a good source of omega-3 fatty acids, which can help lower blood pressure and prevent hypertension by reducing inflammation and improving blood vessel function.
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