In caring for a client with Buck's traction, the practical nurse (PN) observes that the prescribed amount of weights are hanging freely and the traction rope is on the pulley. Which action should the PN implement next?
Document that the Buck's traction is being maintained.
Adjust the traction rope so it is free from the pulley.
Place the weights on blocks to increase their stability.
Contact the orthopedic technician to adjust the traction.
The Correct Answer is A
A. Document that the Buck's traction is being maintained: The weights are hanging freely and the rope is properly aligned on the pulley, indicating that Buck’s traction is functioning as prescribed. Accurate documentation confirms the traction setup is effective and the client’s treatment is being properly maintained.
B. Adjust the traction rope so it is free from the pulley: The rope should remain on the pulley to maintain continuous traction. Adjusting it unnecessarily could disrupt alignment, alter the amount of force applied, and compromise immobilization of the affected limb.
C. Place the weights on blocks to increase their stability: Weights should never rest on any surface, as doing so removes the continuous pulling force required for effective traction. Interfering with the weights’ free-hanging position can reduce traction effectiveness and cause complications.
D. Contact the orthopedic technician to adjust the traction: Since the traction setup is correct, there is no need to call for adjustment. The PN should continue to monitor the system for alignment, tension, and client comfort, documenting findings as part of routine care.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Tell the resident and the UAP that shouting is not permitted: While setting behavioral limits is important, addressing both parties simultaneously does not stop the immediate verbal conflict or protect the resident from potential emotional harm.
B. Enter the room and tell the UAP to leave the room immediately: The priority is to protect the resident from verbal abuse and de-escalate the confrontation. Removing the UAP stops the conflict, ensures the resident’s emotional safety, and allows the PN to assess the resident’s condition and provide reassurance.
C. Tell both of them to lower their voices in consideration of other residents: Asking them to quiet down minimizes the impact on others but fails to address the abusive nature of the exchange. The situation requires immediate intervention to stop the staff’s inappropriate behavior.
D. Report the incident and the UAP for further action by the nurse-manager: Reporting is necessary and should occur after the immediate threat has been resolved. The PN should first stop the confrontation and protect the resident before following up with appropriate documentation and notification to the nurse-manager.
Correct Answer is A
Explanation
A. Gravida 2, Para 1: Gravida refers to the total number of pregnancies a client has had, including the current one, so this client is gravida 2. Para refers to the number of pregnancies carried to viability (≥20 weeks), so having one previous child makes her para 1.
B. Gravida 2, Para 0: While the client is correctly identified as gravida 2, she has previously carried a pregnancy to viability, so para 0 is inaccurate.
C. Gravida 1, Para 1: Gravida 1 would indicate this is the client’s first pregnancy, which is inconsistent with her history of one prior child.
D. Gravida 1, Para 0: Both the gravida and para are incorrect because this is her second pregnancy and she has delivered one child previously.
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