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A patient has a hip spica cast and will be discharged home to family. The nurse would include in the home education plan information relative to: (Select all that apply.)

using the spreader bar to turn the patient.

protecting the cast from soiling.

grasping the cast over the leg to help in turning.

easing itching under the cast by scratching with a bent coat hanger.

turning frequently to the prone position.

Answer and Explanation

Correct Answer : B,E

A. Using the spreader bar to turn the patient.

The spreader bar is not designed for lifting or turning; it maintains cast shape and stability.

B. Protecting the cast from soiling.

Soiling the cast can lead to skin irritation and infection, especially in the perineal area.

C. Grasping the cast over the leg to help in turning.

This can cause pressure points or cast damage; turning should be done using proper support techniques.

D. Easing itching under the cast by scratching with a bent coat hanger.

This is unsafe and can cause skin injury or infection under the cast.

E. Turning frequently to the prone position.

Frequent position changes, including prone if tolerated, help prevent pressure sores and promote circulation.

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Correct Answer is ["A","B","C"]

Explanation

A. Muscle atrophy

Lack of movement leads to wasting of muscle tissue over time, a common consequence of immobility.

B. Venous pooling

Immobility causes reduced venous return, leading to venous stasis or pooling, increasing the risk of DVT.

C. Urinary stasis

Lying flat for extended periods contributes to bladder emptying issues, increasing risk for UTIs and renal calculi.

D. Increased depth of respirations

Immobility leads to shallow breathing and reduced lung expansion, not deeper respirations.

E. Increased metabolic rate

Immobility generally results in a decreased metabolic rate due to lower energy needs.

A. Abducting the arm to a 90-degree angle from the side of the body B. Adducting the arm so that is lies next to the client's side C. Flexing the shoulder by raising the arm from a side position to a 180-degree angle D. Circumducting the shoulder in a 180-degree half circle

Correct Answer is C

Explanation

A. Abducting the arm to a 90-degree angle from the side of the body

This is only partial abduction; full ROM involves more than 90 degrees.

B. Adducting the arm so that it lies next to the client's side

Adduction is part of the range, but not a complete indicator of full shoulder ROM.

C. Flexing the shoulder by raising the arm from a side position to a 180-degree angle

This demonstrates full shoulder flexion, from rest to above the head.

D. Circumducting the shoulder in a 180-degree half circle

Circumduction is a circular movement, but a 180° half-circle isn’t a full demonstration of the shoulder’s capacity.

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A patient has a hip spica cast and will be discharged home to family. The nurse would include in the home education plan information relative to: (Select all that apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is collecting data from a client who has had paraplegia for several years. Which of the following physiologic changes due to immobility should the nurse consider when evaluating this client's overall status? (Select all that apply.)

Correct Answer is ["A","B","C"]

Explanation

A nurse is caring for a client who has been hospitalized and is performing active range-of-motion exercises. Which of the following body movements should indicate to the nurse that the client has full range of motion of the shoulder?

Correct Answer is C

Explanation

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