A nurse is reinforcing teaching with a client who is 24 hr postoperative following a total hip arthroplasty. Which of the following instructions should the nurse include in the teaching?
Perform range of motion by adducting the hip.
Sit in a straight-backed chair.
Cleanse the surgical incision with hydrogen peroxide.
Apply moist heat to the incision while in bed.
The Correct Answer is B
Choice A reason: Performing range of motion by adducting the hip is an incorrect instruction for a client who had a total hip arthroplasty. Adduction is moving the leg toward the midline of the body, which can cause dislocation of the prosthesis. The nurse should instruct the client to perform range of motion by abducting (moving away from midline), flexing (bending), and extending (straightening) the hip as prescribed by physical therapy.
Choice B reason: Sitting in a straight-backed chair is a correct instruction for a client who had a total hip arthroplasty. This position helps to maintain proper alignment and stability of the hip joint and prevents excessive flexion or rotation that can cause dislocation. The nurse should also instruct the client to avoid crossing legs, bending forward more than 90 degrees, or twisting at the waist.
Choice C reason: Cleansing the surgical incision with hydrogen peroxide is an incorrect instruction for a client who had a total hip arthroplasty. Hydrogen peroxide is a harsh agent that can damage healthy tissue and delay healing. The nurse should instruct the client to cleanse the incision with mild soap and water or as directed by the provider and keep it dry and covered with sterile dressing.
Choice D reason: Applying moist heat to the incision while in bed is an incorrect instruction for a client who had a total hip arthroplasty. Moist heat can increase swelling, inflammation, and infection risk at the incision site. The nurse should instruct the client to apply ice packs or cold compresses to the incision as needed to reduce pain and swelling.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: This is not an expected sensation during injection of the contrast medium because numbness in the fingertips can indicate peripheral nerve damage or ischemia, which are rare but serious complications of cardiac catheterization. The nurse should assess the client's peripheral pulses, capillary refill, and sensation and report any abnormalities.
Choice B reason: This is not an expected sensation during injection of the contrast medium because pain in the jawline can indicate angina or myocardial infarction, which are rare but serious complications of cardiac catheterization. The nurse should monitor the client's vital signs, electrocardiogram, and chest pain and report any changes.
Choice C reason: This is not an expected sensation during injection of the contrast medium because urge to urinate can indicate bladder distension or urinary tract infection, which are unrelated to cardiac catheterization. The nurse should encourage the client to empty their bladder before the procedure and check for urinary retention or dysuria after the procedure.
Choice D reason: This is an expected sensation during injection of the contrast medium because feeling of heat can occur as a result of vasodilation caused by the contrast medium, which increases blood flow to the skin and mucous membranes. The nurse should inform the client that this sensation is normal and temporary and will subside within a few minutes.
Correct Answer is D
Explanation
Choice A reason: This is not a therapeutic effect of aprepitant because aprepitant is not an analgesic drug that can relieve pain. Aprepitant is an antiemetic drug that can prevent nausea and vomiting caused by chemotherapy or surgery.
Choice B reason: This is not a therapeutic effect of aprepitant because aprepitant does not affect the balance or vestibular system that can cause dizziness. Aprepitant works by blocking the action of substance P, a neurotransmitter involved in nausea and vomiting.
Choice C reason: This is not a therapeutic effect of aprepitant because aprepitant does not affect the cardiac rhythm or conduction that can cause dysrhythmias. Aprepitant has a low risk of interacting with other drugs that can affect the heart, such as warfarin or digoxin.
Choice D reason: This is a therapeutic effect of aprepitant because aprepitant can prevent nausea and vomiting caused by chemotherapy or surgery by blocking the action of substance P, a neurotransmitter involved in nausea and vomiting. The nurse should monitor the client's oral intake, hydration status, and weight and report any signs of dehydration or malnutrition.
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