A nurse at a rehabilitation facility is contributing to the plan of care for a client who has had a below-the-knee amputation. Which of the following interventions should the nurse include in the plan of care? (Select all that apply.)

Restrict visitors to family members until the client is able to wear a prosthesis.

Encourage the client to talk with another client who completed rehabilitation for amputation.

Instruct the client to ignore phantom pain sensations.

Suggest that family members bring clothing for the client from home.

Ask the client to describe her feelings about the loss of the affected limb.

Answer and Explanation

Correct Answer : B,D,E

A. Restrict visitors to family members until the client is able to wear a prosthesis: Restricting visitors may increase isolation and hinder emotional support.
B. Encourage the client to talk with another client who completed rehabilitation for amputation: Peer support can provide emotional reassurance and motivate the client in their recovery process.
C. Instruct the client to ignore phantom pain sensations: Phantom pain is real and should not be dismissed; it requires management through medication or other interventions.
D. Suggest that family members bring clothing for the client from home: Familiar clothing can improve self-esteem and promote adjustment to body image changes.
E. Ask the client to describe her feelings about the loss of the affected limb: Exploring the client’s feelings helps address emotional and psychological aspects of coping with amputation.

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Correct Answer is A

Explanation

A. Ginkgo biloba: Ginkgo biloba increases the risk of bleeding when taken with anticoagulants like enoxaparin, as it inhibits platelet aggregation.
B. Flaxseed powder: While flaxseed may have mild anticoagulant properties, it is less likely to pose a significant risk compared to ginkgo biloba.
C. Probiotics: Probiotics do not interact with anticoagulants or increase bleeding risk.
D. Echinacea: Echinacea is primarily used to boost immunity and does not increase bleeding risk.

A. "Do you have any pain this morning?" B. "Is your pain the same as it has been?" C. "Could you rate your pain on a scale from 0 to 10?" D. "What does your pain feel like?"

Correct Answer is D

Explanation

A. "Do you have any pain this morning?": This is a yes/no question that doesn't provide information about the pain's quality.
B. "Is your pain the same as it has been?": This assesses changes in pain, not its quality.
C. "Could you rate your pain on a scale from 0 to 10?": This measures the intensity of pain, not its quality.
D. "What does your pain feel like?": Asking about the quality of pain focuses on its nature (e.g., sharp, dull, throbbing, or burning). This helps determine the pain's characteristics.

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A nurse at a rehabilitation facility is contributing to the plan of care for a client who has had a below-the-knee amputation. Which of the following interventions should the nurse include in the plan of care? (Select all that apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is collecting data from a client who is taking enoxaparin. The client reports starting the use of dietary supplements. The nurse should report the use of which of the following supplements to the provider?

Correct Answer is A

Explanation

A nurse is collecting data from a client about her current pain status. Which of the following questions should the nurse ask to determine the quality of the client's pain?

Correct Answer is D

Explanation

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