The nurse is caring for a client who had a left total hip replacement three days ago. The client suddenly has severe left hip pain and the nurse notes a shortening of the left lower extremity. What complication does the nurse suspect?
The hip has dislocated
The incision has dehisced
There is bleeding at the operative site
An infection has developed suddenly
The Correct Answer is A
A. A sudden onset of severe hip pain with observable shortening and external rotation of the affected extremity is a hallmark sign of hip dislocation, a serious complication after hip replacement surgery. This requires immediate intervention to prevent neurovascular damage.
B. Incision dehiscence involves the surgical wound opening but does not typically cause leg shortening or severe sudden hip pain.
C. Bleeding at the operative site may lead to swelling, bruising, or decreased hemoglobin, but it does not cause limb shortening or abrupt severe pain localized to the hip joint.
D. Infection usually develops gradually with fever, redness, warmth, or drainage at the surgical site, not a sudden severe pain with extremity shortening.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is {"A":{"answers":"B"},"B":{"answers":"A"},"C":{"answers":"A"},"D":{"answers":"B"},"E":{"answers":"C"},"F":{"answers":"C"}}
Explanation
- Assess for symptoms of hyperglycemia – Non-essential: The client’s presentation is consistent with fluid overload and hypertension, not hyperglycemia. Assessing for hyperglycemia may be done but is not a priority.
- Assess for bilateral peripheral edema – Essential: Bilateral edema is a key indicator of fluid overload and cardiovascular compromise, requiring immediate assessment.
- Measure intake and output every hour – Essential: Accurate I&O monitoring is critical for managing fluid status in clients with edema and hypertension.
- Review the client's most recent CBC results – Non-essential: While helpful for general assessment, CBC does not directly address the acute fluid overload and cardiovascular status.
- Hold furosemide – Contraindicated: Furosemide, a loop diuretic, is typically indicated for fluid overload. Holding it could worsen edema and hypertension.
- Place the client in Trendelenburg position – Contraindicated: Trendelenburg can increase venous return and worsen pulmonary edema or hypertension, making it unsafe for this client.
Correct Answer is ["A","D"]
Explanation
A. Keeping immunizations up to date, especially pneumococcal and influenza vaccines, helps prevent recurrent ear infections that can lead to complications.
B. Bottles in bed increase the risk of otitis media due to pooling of formula in the nasopharynx and eustachian tube, and should be avoided.
C. Tubes are expected to fall out spontaneously within 6–12 months; this is not an emergency. Parents should simply notify the provider at the next follow-up.
D. Purulent drainage may indicate an infection and should be reported promptly to the health care provider for evaluation and possible treatment.
E. Leftover antibiotics should never be saved or reused without medical direction, as improper use can lead to resistance or ineffective treatment.
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