A nurse is providing discharge instructions to an older adult client who had a hip replacement surgery.

Which of the following statements by the client indicates a need for further teaching?

“I will use a walker until I can walk without pain.”.

“I will avoid crossing my legs or bending my hip more than 90 degrees.”.

“I will sleep on my back with a pillow between my legs.”.

“I will apply ice to my hip if it becomes swollen or inflamed.”.

Answer and Explanation

The Correct Answer is A

The correct answer is A.

“I will use a walker until I can walk without pain.” This statement indicates a need for further teaching because the client should use a walker or other assistive device until they have regained their balance, flexibility and strength, not just until the pain subsides. Using a walker too long or too little can affect the healing process and the stability of the new hip joint.

Choice B is correct because the client should avoid crossing their legs or bending their hip more than 90 degrees to prevent dislocating the new hip joint.

Choice C is correct because the client should sleep on their back with a pillow between their legs to keep the hip in a neutral position and prevent excessive internal or external rotation.

Choice D is correct because the client should apply ice to their hip if it becomes swollen or inflamed to reduce pain and inflammation. The client should also elevate their leg and notify their healthcare provider if they notice any signs of infection, such as fever, chills, redness, warmth or drainage from the incision site.

Normal ranges for hip replacement surgery recovery vary depending on the individual and the type of surgery, but some general guidelines are:.

• The client should be able to walk with a cane or crutches within 2 to 4 weeks after surgery.

• The client should be able to resume most daily activities within 6 to 12 weeks after surgery.

• The client should avoid high-impact activities, such as running, jumping or contact sports, for at least 6 months after surgery.

• The client should have regular follow-up visits with their healthcare provider and physical therapist to monitor their progress and adjust their treatment plan as needed.

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Correct Answer is C

Explanation

The correct answer is C.

Living arrangements and social support.

This is because living arrangements and social support are some of the environmental factors that can influence the psychosocial changes in older adults.Psychosocial changes refer to the changes in mental and emotional well-being, social relationships, and roles that occur as people age.Environmental factors are the external conditions or circumstances that affect a person’s life.

Choice A is wrong because physical health and functional status are not environmental factors, but rather biological factors that affect the aging process.Physical health and functional status can influence the psychosocial changes in older adults, but they are not part of the environment.

Choice B is wrong because cognitive conditions and memory loss are also not environmental factors, but rather neurological factors that affect the brain function of older adults.Cognitive conditions and memory loss can also influence the psychosocial changes in older adults, but they are not part of the environment.

Choice D is wrong because hormonal changes and sensory impairments are also not environmental factors, but rather physiological factors that affect the body function of older adults.Hormonal changes and sensory impairments can also influence the psychosocial changes in older adults, but they are not part of the environment.

Living arrangements and social support are environmental factors because they depend on the availability, accessibility, and quality of housing, transportation, community services, family networks, and social interactions that older adults have in their surroundings.Living arrangements and social support can influence the psychosocial changes in older adults by affecting their sense of independence, identity, belonging, security, and satisfaction.

Therefore, living arrangements and social support are some of the environmental factors that can influence the psychosocial changes in older adults.

A. The client reports an improvement in mood, energy, appetite and sleep. B. The client scores lower on the Geriatric Depression Scale (GDS) or the Patient Health Questionnaire (PHQ-9). C. The client shows more interest and participation in social activities and hobbies. D. All of the above.

Correct Answer is D

Explanation

The correct answer is D.

All of the above.

This is because all of these findings indicate that the client has experienced an improvement in mood, energy, appetite, sleep, interest and participation in social activities and hobbies, which are common signs of depression recovery.

Choice A is wrong because it only covers some of the symptoms of depression, such as mood, energy, appetite and sleep, but not others, such as interest and participation in social activities and hobbies.

Choice B is wrong because it only measures the client’s depression level using standardized scales, such as the Geriatric Depression Scale (GDS) or the Patient Health Questionnaire (PHQ-9), but not their actual functioning and quality of life.

Choice C is wrong because it only reflects the client’s interest and participation in social activities and hobbies, which are important aspects of depression recovery, but not their mood, energy, appetite, sleep or depression level.

The GDS and the PHQ-9 are both valid and reliable tools for screening and measuring depression in older adults.

The GDS is a 15-item questionnaire that asks the client to answer yes or no to questions about their mood, satisfaction, hopelessness, helplessness, worthlessness, guilt, agitation, withdrawal and suicidal thoughts.

The PHQ-9 is a 9-item questionnaire that asks the client to rate how often they have experienced symptoms of depression in the past two weeks, such as depressed mood, anhedonia, insomnia or hypersomnia, fatigue, appetite or weight changes, concentration problems, feelings of worthlessness or guilt.

A. The client reports an improvement in mood, energy, appetite and sleep B.

The client scores lower on the Geriatric Depression Scale (GDS) or the Patient Health Questionnaire (PHQ-9) C.

The client shows more interest and participation in social activities and hobbies D.

All of the above

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A nurse is providing discharge instructions to an older adult client who had a hip replacement surgery. Which of the following statements by the client indicates a need for further teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

What are some of the environmental factors that can influence the psychosocial changes in older adults?

Correct Answer is C

Explanation

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Correct Answer is D

Explanation

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A nurse is providing discharge instructions to an older adult client who had a hip replacement surgery.

Which of the following statements by the client indicates a need for further teaching?