The practical nurse (PN) assesses a child in 90-90 skeletal traction. It is most important for the PN to assess for signs of inflammation at which location?

A
B
C
D
The Correct Answer is A
A. Based on the understanding of 90-90 skeletal traction and the common complications associated with pin sites, the practical nurse should focus on assessing the areas around the pin insertion sites in the femur and possibly the tibia for any signs of inflammation.
B. the back is not the correct location
C. The sole of the foot is not the correct location
D. The unaffected limb is not the appropriate location.
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Related Questions
Correct Answer is B
Explanation
A. Breast tenderness is a common side effect of oral contraceptives and is generally not a cause for immediate concern unless accompanied by other symptoms.
B. Left calf pain is a significant finding that could indicate deep vein thrombosis (DVT), a serious condition requiring prompt evaluation and potential treatment to prevent complications such as pulmonary embolism.
C. A change in menstrual flow can occur with oral contraceptives but is usually less critical than other symptoms. It should be monitored but does not indicate an immediate problem.
D. A weight gain of 5 pounds is a relatively minor side effect and not as urgent as symptoms suggestive of a serious condition like DVT.
Correct Answer is B
Explanation
A. Move away from the overbed table: This action can be done after the gloves are completely removed and disposed of. Moving away too early increases the risk of bumping into something and contaminating the gloves.
B. Sterile gloves are contaminated on the outside after performing a procedure like a dressing change. Pulling the glove down and everting it (turning it inside out) confines the contamination to the inside of the glove, reducing the risk of transferring germs to the hands or surrounding surfaces. This maintains a sterile field and minimizes the risk of healthcare-associated infections (HAIs).
C. Loosen the glove from the fingers: This might be the initial step while grasping the glove for removal, but the key is to maintain aseptic technique by keeping the outside of the glove contained throughout removal.
D. Raise the hands above waist level: Raising hands above the waist level increases the risk of contaminating the sterile field or nearby surfaces if the glove integrity is compromised.
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