The nurse assesses a client after a total hip arthroplasty. The client’s surgical leg is visibly shorter than the other one and the client reports extreme pain. While a co-worker calls the surgeon, what action by the nurse is appropriate?

Assess neurovascular status in both legs.

Elevate the surgical leg and apply ice.

Prepare to administer pain medication.

Try to place the surgical leg in abduction.

Answer and Explanation

The Correct Answer is A

Choice A reason: A visibly shorter leg and extreme pain post-hip arthroplasty suggest possible hip dislocation, a serious complication. Assessing neurovascular status (pulse, sensation, movement, color, temperature) in both legs is critical to detect compromised blood flow or nerve damage, which could lead to tissue ischemia or permanent injury if not addressed promptly.
Choice B reason: Elevating the leg and applying ice may reduce swelling but does not address the potential dislocation indicated by leg shortening and pain. These interventions could delay critical assessment and management of neurovascular compromise, potentially worsening outcomes in a suspected dislocation scenario.
Choice C reason: Administering pain medication may alleviate discomfort but does not address the underlying cause, such as a dislocated hip prosthesis. Pain relief is secondary to ensuring neurovascular integrity and confirming the surgical leg’s alignment, which are critical to prevent complications like tissue necrosis.
Choice D reason: Attempting to place the leg in abduction without confirming the cause of shortening and pain risks further damage, especially if the hip is dislocated. Manipulation could exacerbate neurovascular compromise or prosthesis misalignment, leading to prolonged recovery or additional surgical intervention.

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Correct Answer is D

Explanation

Choice A reason: Removing traction during repositioning disrupts the continuous pull needed to maintain bone alignment in fractures. This could lead to misalignment, delayed healing, or increased pain, as traction counteracts muscle spasms and stabilizes the fracture site.
Choice B reason: While skin assessment during a bed bath is important to detect pressure injuries, it is a general nursing responsibility, not specific to traction care. Traction-specific teaching focuses on maintaining the system’s integrity, such as ensuring proper weight function, over general hygiene tasks.
Choice C reason: Using alcohol wipes for pin care in skeletal traction is inappropriate, as it may not adequately prevent infection. Pin sites require sterile technique with solutions like chlorhexidine to minimize osteomyelitis risk, making this an incorrect teaching point.
Choice D reason: In traction, weights must hang freely to maintain consistent force for bone alignment and fracture stabilization. Obstructed weights reduce traction effectiveness, potentially causing misalignment, delayed healing, or increased pain, making this a critical teaching point for safe traction care.

A. Baked fish with orange juice and a vitamin D supplement. B. Bacon, lettuce, and tomato sandwich with a vitamin B supplement. C. Vegetable lasagna with a green salad and a vitamin A supplement. D. Roast beef with low-fat milk and a vitamin C supplement.

Correct Answer is A

Explanation

Choice A reason: Vitamin D enhances calcium absorption in the intestines, critical for bone mineralization during fracture healing. Baked fish (rich in protein) and orange juice (vitamin C source) support collagen formation, making this a comprehensive choice for bone repair and tissue recovery.
Choice B reason: Vitamin B supports energy metabolism but has no direct role in bone healing. A bacon, lettuce, and tomato sandwich lacks significant calcium or vitamin D, essential for osteoblast activity and bone matrix formation, making it less effective for fracture recovery.
Choice C reason: Vitamin A supports epithelial tissue but is less critical for bone healing than vitamin D or calcium. Vegetable lasagna and salad provide some nutrients but lack the specific bone-supporting elements like calcium, making this choice suboptimal.
Choice D reason: Vitamin C aids collagen synthesis, and low-fat milk provides calcium, both beneficial for fracture healing. However, it lacks vitamin D, which is essential for calcium absorption, making it less comprehensive than the vitamin D-inclusive option for optimal bone repair.

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The nurse assesses a client after a total hip arthroplasty. The client’s surgical leg is visibly shorter than the other one and the client reports extreme pain. While a co-worker calls the surgeon, what action by the nurse is appropriate?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse teaches assistive personnel about providing hygiene for a client in traction. Which statement would the nurse include as part of the teaching about this client’s care?

Correct Answer is D

Explanation

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Correct Answer is A

Explanation

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