A nurse is reviewing the plan of care for a client following a total hip arthroplasty. Which of the following actions should the nurse plan to take?
Assess the client's incision every 8 hours for the first 48 hours.
Inform the assistive personnel of the client's weight-bearing status.
Instruct the client to cross their legs at the ankles when sitting in a chair.
Teach the client's partner to assist the client to flex the hip at least 120° each hour.
The Correct Answer is B
The correct answer is b. Inform the assistive personnel of the client’s weight-bearing status.
Choice A: Assess the client’s incision every 8 hours for the first 48 hours. While it is important to monitor the incision site for signs of infection, the frequency of every 8 hours for the first 48 hours may not be necessary unless specified by the surgeon or the patient’s condition warrants it.
Choice B: Inform the assistive personnel of the client’s weight-bearing status. This is the correct answer. After a total hip arthroplasty, it’s crucial to communicate the client’s weight-bearing status to all members of the healthcare team, including assistive personnel. This helps ensure that everyone is aware of the client’s mobility limitations and can assist the client safely.
Choice C: Instruct the client to cross their legs at the ankles when sitting in a chair. This is not recommended. After a hip arthroplasty, patients are typically advised not to cross their legs to prevent dislocation of the new hip joint.
Choice D: Teach the client’s partner to assist the client to flex the hip at least 120° each hour. This is not recommended. After a hip arthroplasty, patients are typically advised to avoid flexing the hip more than 90 degrees to prevent dislocation of the new hip joint1. Therefore, flexing the hip at least 120° each hour could potentially harm the patient.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale:
Informing the staff of the penalties that can result from medication errors represents an authoritarian approach to managing the issue. This approach relies on authority and fear to enforce compliance. By emphasizing the potential consequences, the nurse manager is attempting to control behavior through fear of punishment. While this might create a short-term change in behavior, it does not address the root causes of the errors or promote a culture of safety.
Choice B rationale:
Encouraging the staff to have two nurses verify medication orders to prevent errors is not an authoritarian approach. It involves collaboration and peer support to enhance medication safety. This approach promotes shared responsibility and accountability, which are not associated with authoritarian leadership.
Choice C rationale:
Providing a suggestion box for the staff to submit ideas for error prevention is not an authoritarian approach. This strategy fosters a participative and democratic leadership style. It encourages staff engagement and input, which contrasts with the top-down nature of authoritarian leadership.
Choice D rationale:
Asking three experienced nurses to help investigate common causes of the errors is not an authoritarian approach. It involves a collaborative and problem-solving approach that seeks input from knowledgeable staff members. This approach aims to identify systemic issues contributing to errors rather than focusing solely on punitive measures.
Correct Answer is B
Explanation
The correct answer is choice B: Perform a chart review to gather data about the clients who developed infections.
Choice A rationale: Conducting an in-service on proper catheter insertion and maintenance may be helpful in addressing the issue but should not be the first step.
Choice B rationale: Performing a chart review to gather data about the clients who developed infections is an essential first step. This allows the nurse manager to analyze potential trends or common factors contributing to the infections, which can help identify specific areas for improvement or intervention (NurseLabs, n.d.).
Choice C rationale: Observing each staff nurse perform a urinary catheter insertion could help identify improper techniques that contribute to the infections. However, this is time-consuming and should be done after a chart review has been conducted.
Choice D rationale: Requiring completion of a self-paced instruction program might improve staff knowledge, but it should not be the first action taken by the nurse manager.
In conclusion, the nurse manager should first perform a chart review to gather data about the clients who developed urinary tract infections. This will help identify possible factors contributing to the infections and guide the nurse manager in developing targeted interventions to address the issue.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.