Which nursing intervention is appropriate for a client with skeletal traction?
Pin site care
Five-pound weight lifting restriction
Prone positioning
Intermitent weights
The Correct Answer is A
Choice A reason: Pin site care is essential for a client with skeletal traction to prevent infection and ensure proper healing.
Choice B reason: A five-pound weight lifting restriction is not related to the care of a client with skeletal traction.
Choice C reason: Prone positioning is not typically recommended for clients with skeletal traction as it may interfere with the traction setup.
Choice D reason: Intermitent weights are not a standard intervention for skeletal traction, which requires consistent and controlled application of force.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Urine output is important but not the priority after administration of fibrinolytic medication.
Choice B reason: Vital signs are routinely monitored but the priority is assessing for any signs of complications from the medication, such as bleeding or stroke.
Choice C reason: The name of the patient's dog is irrelevant to the patient's medical care and assessment.
Choice D reason: Neurological status is the priority to monitor for signs of intracranial hemorrhage, a potential complication of fibrinolytic therapy.
Correct Answer is D
Explanation
Choice A reason: While it is useful to know the patient's current pain management strategies, new onset severe back pain could indicate a serious complication such as a spinal fracture or compression, which requires immediate attention.
Choice B reason: Reassuring the patient is not appropriate without further assessment, as new onset severe pain could signify a serious issue that needs to be addressed.
Choice C reason: Suggesting a back brace may be part of the management plan, but it should not precede notifying the healthcare provider of new severe pain.
Choice D reason: Notifying the healthcare provider is the correct action because new onset severe back pain in a patient with multiple myeloma could indicate a serious condition such as a spinal fracture or compression, which requires prompt evaluation and treatment.
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