A nurse is caring for an adolescent client whose right leg is in Buck's traction. Which of the following interventions should the nurse implement to promote the client's mobility?
Active range-of-motion exercises of the left leg
Log rolling every 2 hr
Passive range of motion to the right leg
Isometric exercises of both legs
The Correct Answer is D
A. Active range-of-motion exercises of the left leg promote mobility in the unaffected limb but do not fully address the need for maintaining muscle strength in both legs.
B. Log rolling every 2 hours is a technique used for clients who require spinal precautions or have limited movement due to back injuries. It does not promote mobility for a client in Buck's traction.
C. Passive range of motion to the right leg may prevent joint stiffness but does not actively maintain or improve muscle strength. Additionally, movement of the affected limb should be minimized to maintain the alignment of the traction.
D. Isometric exercises of both legs are appropriate for promoting mobility and maintaining muscle strength without disrupting the traction. These exercises involve contracting the muscles without moving the joints, which is safe for the affected limb in Buck's traction.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Inhaling and exhaling quickly through pursed lips does not achieve the intended purpose of pursed-lip breathing. This technique is designed to promote slower, controlled breathing to prevent airway collapse and improve oxygen exchange.
B. Exhaling quickly through pursed lips negates the benefits of pursed-lip breathing. The purpose of this technique is to prolong exhalation, reducing air trapping and improving ventilation.
C. Inhaling deeply through the nose and exhaling slowly through pursed lips is the correct technique for pursed-lip breathing. This method helps maintain open airways, reduces dyspnea, and promotes relaxation.
D. Inhaling deeply through pursed lips and exhaling quickly through the nose is not consistent with proper pursed-lip breathing. The inhalation should be through the nose, and exhalation should be slow and controlled through pursed lips.
Correct Answer is D
Explanation
A. Tidal fluctuation in the water seal chamber is an expected finding in a chest tube drainage system. It indicates that the pleural space is still connected to the atmosphere, and the lungs are expanding and contracting normally.
B. Continuous bubbling in the suction control chamber is normal when the chest tube is connected to suction. This shows that the suction system is functioning properly.
C. Chest tube eyelets not being visible is expected when the chest tube is properly positioned inside the pleural space. This finding does not require immediate notification.
D. Development of subcutaneous emphysema (air trapped under the skin) may indicate an air leak or improper chest tube placement. This finding requires immediate notification of the provider to address the underlying cause and prevent complications.
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