A nurse is caring for a client who is postoperative following a below-the knee-amputation and will soon undergo fitting for a leg prosthesis. Which of the following is an appropriate nursing intervention for this client at this time?

Wrap the residual limb with an elastic bandage in a figure-eight configuration.

Wrap the residual limb with an elastic bandage in a proximal-to-distal direction.

Remove the elastic bandage and re-wrap the residual limb once a day.

Secure the elastic bandage to the lowest joint.

Answer and Explanation

The Correct Answer is A

A. Wrapping the residual limb in a figure-eight configuration provides compression and support, shaping the limb for prosthesis fitting, and promoting proper circulation.

B. Wrapping in a proximal-to-distal direction can restrict blood flow and does not provide the appropriate support needed for prosthetic shaping.

C. The bandage should be rewrapped more frequently than once a day to maintain compression and limb shape.

D. Securing the bandage at the lowest joint is inadequate as it may allow loosening and improper shaping of the residual limb.

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Correct Answer is A

Explanation

A. Hypoxemia is an early sign of fat embolism syndrome due to the presence of fat globules in the pulmonary circulation.

B. Headache can be associated with hypoxemia but is not as specific or immediate as hypoxemia itself.

C. Petechiae, while a classic sign, usually appear later in the progression of fat embolism syndrome.

D. Precordial chest pain may occur but is not typically the first sign; hypoxemia is usually noted first.

A. Raise the foot of the bed to a 90° angle. B. Prepare to insert a central line. C. Remove the dressing to inspect the wound. D. Administer oxygen via nasal cannula.

Correct Answer is D

Explanation

A. Raising the foot of the bed to a 90° angle is not an appropriate intervention for a chest wound as it may impair respiratory function further.

B. Preparing to insert a central line is not a priority action in managing a sucking chest wound and may delay more immediate life-saving interventions.

C. Removing the dressing to inspect the wound can worsen the condition by allowing more air to enter, increasing the risk of a tension pneumothorax.

D. Administering oxygen via nasal cannula provides essential oxygen support, addressing hypoxia caused by the impaired respiratory function from the chest wound.

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A nurse is caring for a client who is postoperative following a below-the knee-amputation and will soon undergo fitting for a leg prosthesis. Which of the following is an appropriate nursing intervention for this client at this time?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has a femur fracture. The nurse suspects that the client has fat embolism syndrome. Which of the following findings should the nurse identify as an early manifestation of fat embolism syndrome?

Correct Answer is A

Explanation

A nurse in an emergency department is caring for a client who has a sucking chest wound resulting from a gunshot. The client has a blood pressure of 100/60 mm Hg, a weak pulse rate of 118/min, and a respiratory rate of 40/min. Which of the following actions should the nurse take?

Correct Answer is D

Explanation

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