A nurse is caring for an older adult client who has had a total hip arthroplasty.

Exhibits

For each potential precaution, click to specify if the precaution is indicated or contraindicated for a client who has had a total hip arthroplasty.

Request an antiemetic medication.

Encourage the client to cough and deep breathe every 2 hr.

Ensure an abductor pillow is in place while the client is in bed.

Anticipate the administration of antibiotics.

Obtain a culture of the drainage from the surgical site.

Answer and Explanation

The Correct Answer is {"A":{"answers":"B"},"B":{"answers":"A"},"C":{"answers":"A"},"D":{"answers":"A"},"E":{"answers":"A"}}

Request an antiemetic medication: Contraindicated
- Rationale: Antiemetic medications are not typically required unless the client is experiencing nausea or vomiting, which is not indicated in this scenario.
Encourage the client to cough and deep breathe every 2 hr: Indicated
- Rationale: Encouraging coughing and deep breathing helps prevent respiratory complications such as pneumonia, which is important postoperatively.
Ensure an abductor pillow is in place while the client is in bed: Indicated
- Rationale: An abductor pillow helps maintain proper hip alignment and prevents dislocation of the hip joint after surgery.
Anticipate the administration of antibiotics: Indicated
- Rationale: Administering antibiotics helps prevent infection, which is a common concern after surgical procedures.
Obtain a culture of the drainage from the surgical site: Indicated
- Rationale: Obtaining a culture of the drainage can help identify any potential infections and guide appropriate treatment.

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Correct Answer is B

Explanation

A. Ensuring adequate nutrition is important, but the priority is preventing aspiration, as the client may have difficulty swallowing or clearing the airway due to the intermaxillary fixation. Aspiration could lead to serious complications like pneumonia.
B. Preventing aspiration is the priority because the client may have difficulty swallowing or controlling their airway due to the surgical procedure and fixation of the jaw. The nurse should ensure the client's airway is clear and that they are positioned appropriately to prevent aspiration.
C. Pain relief is important for comfort and recovery, but it is secondary to ensuring the client's airway is protected and preventing aspiration, which could lead to more severe complications.
D. Promoting oral hygiene is important, but it is not the priority in the immediate postoperative period. The focus should be on ensuring the airway is clear and preventing aspiration, especially if the client is unable to properly swallow or manage secretions.

A. Muffled heart sound B. Narrow pulse pressure C. Pulses paradoxus D. Pericardial friction rub

Correct Answer is D

Explanation

A. Muffled heart sounds are more commonly associated with pericardial effusion or cardiac tamponade, where fluid accumulation in the pericardial sac muffles the heart sounds. Acute pericarditis, however, typically does not cause muffled heart sounds.
B. Narrow pulse pressure (a small difference between systolic and diastolic blood pressure) is not a typical finding in acute pericarditis. It is more commonly seen in conditions such as cardiac tamponade or severe heart failure.
C. Pulses paradoxus, a significant decrease in systolic blood pressure during inspiration, is more commonly associated with conditions like cardiac tamponade, not acute pericarditis.
D. A pericardial friction rub is a hallmark sign of acute pericarditis. It occurs due to the inflammation of the pericardial layers, which rub against each other, producing a characteristic high-pitched, scratchy sound heard on auscultation.

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A nurse is caring for an older adult client who has had a total hip arthroplasty. Exhibits For each potential precaution, click to specify if the precaution is indicated or contraindicated for a client who has had a total hip arthroplasty.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has returned from the surgical suite following surgery for a fractured mandible. The client had intermaxillary fixation to repair and stabilize the fracture. Which of the following actions is the priority for the nurse to take?

Correct Answer is B

Explanation

Which assessment finding would the nurse expect in a patient diagnosed with acute pericarditis?

Correct Answer is D

Explanation

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A nurse is caring for an older adult client who has had a total hip arthroplasty.

Exhibits

For each potential precaution, click to specify if the precaution is indicated or contraindicated for a client who has had a total hip arthroplasty.