A nurse is caring for a client with a herniated disc who has undergone a lumbar laminectomy and diskectomy at L4-5. When assisting the client to move in bed, the nurse should include what specific technique?

Bend the knees and support the back.

Move the hips and legs first, then the upper body.

Have the client help by pulling on the side rail.

Turn the client as one unit without twisting the spine

Answer and Explanation

The Correct Answer is D

A. While bending the knees helps with body mechanics, twisting the spine should still be avoided.

B. Moving the hips and legs first could lead to twisting the spine if not done correctly, so the spine must be kept aligned during all movements.

C. The client should avoid pulling on side rails or assisting with movement until fully cleared by the physician, as this could put unnecessary strain on the spine.

D. It is essential to maintain spinal alignment and prevent twisting of the spine during repositioning. The client should be turned as one unit to minimize strain on the healing vertebrae.

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Correct Answer is D

Explanation

A. Measuring drainage from the Jackson-Pratt drain is important, but this is not the primary intervention to address post-laminectomy complications.

B. The patient should generally be positioned in a neutral, stable position, but not specifically prone with knees elevated, which may be uncomfortable or inappropriate for the cervical region.

C. Narcotics may be required for pain control, especially postoperatively, so advising the patient to avoid them is inappropriate.

D. Following a cervical spine laminectomy, the nurse should assess the client for any signs of nerve or spinal cord injury, such as difficulty speaking or breathing. These symptoms may indicate spinal cord compression or other complications.

A. "I would suggest the use of any available remedy that might give you some comfort. B. "Let's discuss some of your concerns." C. "The changes will be subtle at first, so they won't be noticeable to others." D. "It is hard to predict what the disease process has in store for any one individual."

Correct Answer is B

Explanation

A. Suggesting remedies prematurely without fully understanding the client’s concerns might not address their specific needs.

B. The best response is to encourage open communication by acknowledging the client’s concerns and fostering a discussion. This approach helps the nurse understand the client’s worries and provide tailored information about rheumatoid arthritis and its potential impact on daily life.

C. The progression of rheumatoid arthritis is variable and can affect activities of daily living more noticeably over time; it’s not always subtle.

D. While predicting disease outcomes can be difficult, giving a more open response like option B will foster better communication and support.

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A nurse is caring for a client with a herniated disc who has undergone a lumbar laminectomy and diskectomy at L4-5. When assisting the client to move in bed, the nurse should include what specific technique?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client diagnosed with cervical spine degeneration has undergone a laminectomy. Which intervention should the nurse implement?

Correct Answer is D

Explanation

The client has been diagnosed with rheumatoid arthritis and asks, "What impact will this have on my activities of daily living in the years to come?" What is the best response by the nurse?

Correct Answer is B

Explanation

Which of these deformities is associated with osteoarthritis? (SELECT ALL THAT APPLY).

A nurse is teaching a client who has osteoporosis and a new prescription for the biphosphonate alendronate. Which of the following instructions should the nurse provide? (SELECT ALL THAT APPLY)

A client with newly diagnosed rheumatoid arthritis asks the nurse what happens to the joint with this disease. Which explanation by the nurse is most accurate?

A nurse is caring for a client postoperative closed reduction of the left ankle with a short cast in place. Which assessments of the client's affected leg should the nurse make? (SELECT ALL THAT APPLY)

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Which interventions should be included in discharge teaching for a client who has had a total hip replacement? (SELECT ALL THAT APPLY)

A client describes low back pain that radiates down one leg. Which factors that aggravate the pain increase the likelihood that this client has a herniated disc? (SELECT ALL THAT APPLY)

A nurse is assessing a client on the first post-operative day after a L3-4 laminectomy and diskectomy. The client now complains of numbness and tingling in the left leg. What is the nurse's first priority?