A nurse is caring for a 25yearold male quadriplegic client. Which of the following treatments would the nurse perform to decrease the risk of joint contracture and promote joint mobility?
Provide active range of motion (ROM)
Provide passive range of motion (ROM)
Turn the client every 2 hours
Administer glucosamine supplements
The Correct Answer is B
Choice A reason: Providing active range of motion (ROM) is not a treatment that the nurse can perform for a quadriplegic client. Active ROM means that the client moves their own joints without assistance. A quadriplegic client has paralysis of all four limbs and cannot move their joints voluntarily.
Choice B reason: Providing passive range of motion (ROM) is a treatment that the nurse can perform for a quadriplegic client. Passive ROM means that the nurse moves the client's joints through their full range of motion without resistance. This helps prevent joint contracture, which is the loss of joint movement and flexibility due to muscle shortening and stiffness. It also helps maintain joint mobility, which is the ability of the joint to move smoothly and freely.
Choice C reason: Turning the client every 2 hours is not a treatment that the nurse can perform to decrease the risk of joint contracture and promote joint mobility. Turning the client every 2 hours is a preventive measure to avoid pressure ulcers, which are skin injuries caused by prolonged pressure on the skin. It does not directly affect the joint function or movement.
Choice D reason: Administering glucosamine supplements is not a treatment that the nurse can perform to decrease the risk of joint contracture and promote joint mobility. Glucosamine supplements are dietary supplements that may help reduce the pain and inflammation of osteoarthritis, which is a degenerative joint disease that causes the breakdown of the cartilage and bone in the joints. It does not affect the muscle or nerve function or movement.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: "I will use a humidifier during the winter months." is not the correct answer, because it indicates a good understanding of dry skin. Using a humidifier during the winter months is a helpful measure to prevent or treat dry skin, as it can increase the moisture level in the air, which can hydrate the skin and reduce the loss of natural oils.
Choice B reason: "I will shower every day in hot water." is the correct answer, because it indicates a need for further teaching about dry skin. Showering every day in hot water is a harmful practice that can worsen dry skin, as it can strip the skin of its natural oils, damage the skin barrier, and cause irritation and inflammation.
Choice C reason: "I will avoid tight belts." is not the correct answer, because it indicates a good understanding of dry skin. Avoiding tight belts is a helpful measure to prevent or treat dry skin, as it can reduce the friction and pressure on the skin, which can prevent skin breakdown and infection.
Choice D reason: "I will drink at least 3000 mL of water daily." is not the correct answer, because it indicates a good understanding of dry skin. Drinking at least 3000 mL of water daily is a helpful measure to prevent or treat dry skin, as it can hydrate the body and the skin, and flush out toxins and waste products.
Correct Answer is C
Explanation
Choice A reason: A bone fragment has injured the nerve supply in the area is not the best response by the nurse. This may be a possible complication of a fracture, but it does not explain the mechanism of compartment syndrome. Compartment syndrome is a condition where the pressure within a closed space (such as a muscle compartment) exceeds the perfusion pressure and causes ischemia and necrosis of the tissues. A bone fragment may damage the nerve, but it does not cause increased pressure in the compartment.
Choice B reason: An injured artery causes impaired arterial perfusion through the compartment is not the best response by the nurse. This may be a possible cause of compartment syndrome, but it is not the most common one. Compartment syndrome is more often caused by venous obstruction than arterial obstruction. An injured artery may reduce the blood flow to the compartment, but it does not cause increased pressure in the compartment.
Choice C reason: Bleeding and swelling cause increased pressure in an area that cannot expand is the best response by the nurse. This is the most common cause of compartment syndrome and explains the pathophysiology of the condition. Bleeding and swelling are the result of inflammation and tissue injury that occur after a fracture. They increase the volume of fluid in the compartment, which cannot expand due to the rigid fascia that surrounds it. This leads to increased pressure in the compartment, which compresses the blood vessels, nerves, and muscles and causes ischemia and necrosis of the tissues.
Choice D reason: The fascia expands with injury, causing pressure on underlying nerves and muscles is not the best response by the nurse. This is not a correct statement, as the fascia does not expand with injury. The fascia is a tough connective tissue that encloses the muscle compartments and limits their expansion. The fascia is part of the problem, not the cause, of compartment syndrome. The fascia prevents the compartment from accommodating the increased volume of fluid and causes increased pressure in the compartment.
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