Patient Data

Complete the diagram by dragging from the choices area to specify which type of exercises the client needs, two actions the nurse should take to facilitate the exercises, and two parameters the nurse should monitor to assess the client's progress.

Answer and Explanation

The Correct Answer is []

Potential Exercise Type: Isometric Exercises

Isometric exercises involve muscle contraction without movement, which is beneficial for clients with fractures and those who need to maintain muscle strength while limiting joint movement.

After a right femur fracture and intermedullary rod placement, weight-bearing is likely restricted, making isometric exercises ideal for preventing muscle atrophy and promoting circulation without stressing the healing bone.

Actions to Take:

Have the client contract muscle group for ten seconds and then release: This is a core principle of isometric exercises, helping to engage muscles while minimizing movement.

Strengthens the quadriceps and hamstrings without putting pressure on the femur.

Have client conduct quad sets four times: Quadriceps setting exercises ("quad sets") involve contracting the quadriceps for a few seconds and then releasing, helping maintain muscle tone and circulation in the affected limb. Important for early rehab and preventing complications like deep vein thrombosis (DVT).

Parameters to Monitor:

Number of muscle group contraction and relaxation repetitions: Tracking frequency and consistency of isometric exercises ensures muscle engagement and rehabilitation progress. Helps evaluate compliance with therapy.

Pain level: Pain can limit participation in exercises and may indicate complications such as muscle strain or improper technique. Managing pain effectively ensures continued participation in rehabilitation.

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Correct Answer is C

Explanation

A. The observed spacing is correct (2-3 finger-widths), so there is no need to consult the physical therapist.

B. No adjustment is needed because the crutches are already at the correct length.

C. Since the crutch height is appropriate, the nurse should move forward with gait training to ensure safe crutch use.

D. Circulatory issues would not result from properly fitting crutches but could occur if the client is improperly bearing weight through the axilla.

A. Assess the position of the mask on the client's face. B. Release and reinsert the flowmeter in the wall outlet. C. Attach the flowmeter to a humidification canister. D. Adjust the flow rate to the prescribed liters per minute.

Correct Answer is B

Explanation

A. While important, this does not address the cause of the loud hissing sound, which suggests an issue with the flowmeter connection.

B. A loud hissing sound may indicate that the flowmeter is not securely attached, causing an oxygen leak. The nurse should remove and correctly reinsert the flowmeter to ensure a proper seal.

C. Humidification is beneficial for high-flow oxygen therapy but does not resolve the hissing noise, which indicates a gas leak.

D. The hissing sound needs to be addressed before adjusting the flow rate.

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Patient Data Complete the diagram by dragging from the choices area to specify which type of exercises the client needs, two actions the nurse should take to facilitate the exercises, and two parameters the nurse should monitor to assess the client's progress.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with a sprained ankle is seen at the clinic and is given a pair of crutches. When the client stands with the aid of the crutches, the nurse notes a space of three finger-widths between the top of the crutch and the client's axilla. Which action should the nurse take?

Correct Answer is C

Explanation

When initiating oxygen per mask to a client who is short of breath, the nurse hears a loud hissing sound after inserting the flowmeter into the wall outlet. Which should the nurse do next?

Correct Answer is B

Explanation

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Patient Data

Complete the diagram by dragging from the choices area to specify which type of exercises the client needs, two actions the nurse should take to facilitate the exercises, and two parameters the nurse should monitor to assess the client's progress.