A nurse is evaluating a client's understanding of postoperative instructions after a total hip replacement surgery. Which of the following statements by the client indicates a need for further teaching? (Select all that apply.)

"I will use a walker or crutches to avoid putting too much weight on my new hip.”

"I will keep my legs crossed when I sit or lie down to prevent dislocation.”

"I will avoid bending my hip more than 90 degrees when I get dressed or use the toilet.”

"I will take antibiotics as prescribed to prevent infection.”

"I will report any signs of bleeding, swelling, redness or drainage from my incision."

Answer and Explanation

Correct Answer : B

Choice A reason:

This statement is correct and does not indicate a need for further teaching. The client should use a walker or crutches to avoid putting too much weight on the new hip and prevent dislocation or damage to the prosthesis.

Choice B reason:

This statement is incorrect and indicates a need for further teaching. The client should not keep the legs crossed when sitting or lying down, as this can cause dislocation of the new hip joint. The client should keep the affected leg in abduction at all times.

Choice C reason:

This statement is correct and does not indicate a need for further teaching. The client should avoid bending the hip more than 90 degrees when getting dressed or using the toilet, as this can also cause dislocation of the new hip joint. The client should use assistive devices such as a long-handled reacher or a raised toilet seat.

Choice D reason:

This statement is correct and does not indicate a need for further teaching. The client should take antibiotics as prescribed to prevent infection, which can be a serious complication of hip replacement surgery. The client should also report any signs of fever, chills, or increased pain.

Choice E reason:

This statement is correct and does not indicate a need for further teaching. The client should report any signs of bleeding, swelling, redness or drainage from the incision, as these can also indicate infection or hematoma formation. The client should keep the incision clean and dry and change the dressing as instructed.

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Correct Answer is C

Explanation

Choice A reason:

Covering the wound with sterile gauze moistened with normal saline is a correct nursing intervention for wound evisceration, but it is not the priority action. The priority is to get immediate help and inform the surgeon of the situation.

Choice B reason:

Placing the patient in low Fowler's position with knees bent is another correct nursing intervention for wound evisceration, as it reduces tension on the abdominal muscles and prevents further protrusion of the bowel. However, it is not the priority action either.

Choice C reason:

Calling for assistance and notifying the surgeon is the priority nursing intervention for wound evisceration, as this is a surgical emergency that requires prompt intervention to prevent complications such as infection, necrosis, or shock. The nurse should also monitor the patient's vital signs and prepare for possible surgery.

Choice D reason:

Applying pressure to the wound edges is an incorrect nursing intervention for wound evisceration, as it can cause further damage to the bowel and increase the risk of infection. The nurse should avoid touching or manipulating the wound or the bowel.

A. "General anesthesia will make you unconscious and unable to feel any pain during the surgery.” B. "General anesthesia will numb your lower body and allow you to remain awake during the surgery.” C. "General anesthesia will block pain signals from reaching your brain and make you sleepy during the surgery.” D. "General anesthesia will relax your muscles and reduce your awareness of what is happening during the surgery."

Correct Answer is A

Explanation

Choice A reason:

General anesthesia will make you unconscious and unable to feel any pain during the surgery. This is true because general anesthesia affects the whole body and brain, blocking the sensation of pain and awareness of the surroundings. General anesthesia is used for almost all laparoscopic hysterectomies and is often used for abdominal and vaginal hysterectomies. General anesthesia also impairs your breathing, so a breathing tube, ventilator, and inhalation anesthetic may be used.

Choice B reason:

General anesthesia will numb your lower body and allow you to remain awake during the surgery. This is false because general anesthesia does not numb only a part of the body, but rather affects the whole body and brain. Numbing only a part of the body is called regional anesthesia, which involves injecting an anesthetic near a cluster of nerves to block pain signals from that area. Regional anesthesia can be used for some types of hysterectomies, but not for abdominal hysterectomy.

Choice C reason:

General anesthesia will block pain signals from reaching your brain and make you sleepy during the surgery. This is partially true but incomplete. General anesthesia does block pain signals from reaching your brain, but it also makes you unconscious, not just sleepy. You will not be aware of anything that is happening during the surgery or remember anything afterwards. General anesthesia also affects other functions of your body, such as breathing, blood pressure, and heart rate.

Choice D reason:

General anesthesia will relax your muscles and reduce your awareness of what is happening during the surgery. This is also partially true but incomplete. General anesthesia does relax your muscles and reduce your awareness, but it also makes you completely unconscious and unable to feel any pain. You will not have any memory of the surgery or be able to respond to any stimuli. General anesthesia also has other effects on your body, such as lowering your body temperature and slowing down your digestion.

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A nurse is evaluating a client's understanding of postoperative instructions after a total hip replacement surgery. Which of the following statements by the client indicates a need for further teaching? (Select all that apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a patient who underwent surgery for appendicitis and has developed wound dehiscence with evisceration on postoperative day 3. What is the priority nursing intervention?

Correct Answer is C

Explanation

A nurse is caring for a client who is scheduled for an abdominal hysterectomy under general anesthesia. The client asks what type of anesthesia will be used and how it will affect her. Which of the following responses should the nurse give?

Correct Answer is A

Explanation

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