A client is in Buck's traction after fracturing his right hip. Which action should the nurse include in the care plan?
Maintaining the bed in the knee gatch position
Removing the weights once every shift
Maintaining correct body alignment
Keeping the client in semi-Fowler's positions
The Correct Answer is C
Rationale:
A. Elevating the knee gatch (bending the knee portion of the bed) can interfere with the effectiveness of traction and should be avoided.
B. Weights should never be removed unless prescribed by the healthcare provider, as doing so can disrupt traction and harm the patient.
C. Maintaining correct body alignment ensures the traction is effective and helps prevent complications, such as muscle spasm or nerve compression. This is a key part of Buck's traction care.
D. Prolonged semi-Fowler's position can promote hip flexion and compromise the effectiveness of traction. Flat or low Fowler’s position is generally preferred.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Rationale:
A. While keeping a toothbrush clean is important, running it in the dishwasher monthly is not an effective or necessary method of infection prevention. A soft-bristled toothbrush should be rinsed and replaced regularly.
B. Excessive menstrual bleeding can indicate thrombocytopenia, a serious side effect of chemotherapy, and should be reported immediately. This statement shows appropriate understanding.
C. Clients with neutropenia should avoid crowds to protect themselves from infection, not to prevent spreading it to others.
D. Antiemetics are most effective when taken before chemotherapy begins, not after the infusion is complete.
Correct Answer is C
Explanation
Rationale:
A. Tamsulosin is an alpha-1 blocker that can cause blood pressure to decrease, not increase, due to vasodilation.
B. Tamsulosin does not shrink the prostate; it relaxes the muscles in the prostate and bladder neck to improve urine flow.
C. Tamsulosin can cause orthostatic hypotension (sudden drops in blood pressure when standing), so avoiding sudden position changes is important to prevent dizziness and falls.
D. While the medication does improve urinary flow, patient safety regarding blood pressure changes is the priority teaching point.
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