Twelve hours following a unilateral total knee replacement, a client reports being unable to sleep because of severe incisional pain. What is the best initial nursing action?

Instruct the client in use of the prescribed patient-controlled analgesia (PCA) pump.

Assist the client in assuming a lateral recumbent position for comfort.

Initiate continuous passive motion (CPM) to relieve muscle spasms.

Apply ice to the incision for twenty minutes prior to joint flexion exercises.

Answer and Explanation

The Correct Answer is A

A. Instructing the client in the use of the PCA pump directly addresses the severe pain by allowing the client to self-administer analgesia as needed, which provides immediate relief and is crucial for effective pain management post-surgery.
B. Assisting the client in changing positions may offer temporary relief but does not address the underlying pain, which should be managed primarily through medication.
C. Initiating CPM is not an appropriate first step for managing severe pain. CPM is used for improving joint mobility and should only be considered after effective pain management is established.
D. Applying ice might provide some temporary relief, but it is not a substitute for effective pain control through medication. Addressing the pain with PCA is the priority.

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Correct Answer is ["20"]

Explanation

To calculate the total daily dose, we first need to determine the dose per administration:

Desired dose = 200 mg/dose
Concentration = 100 mg/5 mL

Volume (mL) = Desired dose (mg) / Concentration (mg/mL)

Volume = 200 mg / (100 mg/5 mL) = 10 mL

Now, calculate the total daily volume:

10 mL/dose 2 doses/day = 20 mL/day

A. The technique is intended to maintain straight spinal alignment. B. Working together can decrease the risk of back injury to the nurses. C. Using two or three people increases client safety. D. Turning instead of pulling reduces the likelihood of skin damage.

Correct Answer is A

Explanation

A. The log rolling technique is specifically intended to maintain straight spinal alignment, which is essential for preventing further injury or complications, particularly for patients with spinal injuries or undergoing post-surgical care. Proper spinal alignment is crucial during the turning process.
B. While working together can help decrease the risk of back injury for nurses, the primary purpose of the log rolling technique is to ensure the client’s spinal alignment.
C. Although using multiple people can enhance safety during the turning process, the main goal of the log rolling technique is to maintain spinal alignment rather than just increasing client safety.
D. Turning instead of pulling helps to reduce skin damage, but the primary reason for using the log rolling technique is to keep the spine aligned, not solely to address skin integrity.

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Twelve hours following a unilateral total knee replacement, a client reports being unable to sleep because of severe incisional pain. What is the best initial nursing action?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The healthcare provider prescribes cefixime oral suspension 200 mg by mouth twice a day for an older adult who has difficulty swallowing pills. The bottle is labeled, "Cefixime for Oral Suspension, USP 100 mg per 5 mL." How many mL should the nurse administer daily? (Enter numerical value only.)

Correct Answer is ["20"]

Explanation

Which explanation is best for the nurse to provide a client who asks the purpose of using the log rolling technique for turning?

Correct Answer is A

Explanation

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