The nurse is explaining the rationale for performing leg exercises after surgery. Which reason would the nurse include in the explanation?

Promote respiratory function

Maintain functional abilities

Provide diversional activities

Increase venous return

Answer and Explanation

The Correct Answer is D

After surgery, immobility increases the risk of venous stasis, leading to DVT and emboli. Preventive measures such as leg exercises, early ambulation, elastic stockings, and sequential compression devices are essential parts of postoperative nursing care.

Rationale for correct answer:

4. Increase venous return: Surgery and immobility increase the risk of venous stasis, which predisposes patients to deep vein thrombosis and pulmonary embolism. Leg exercises contract the muscles of the lower extremities, which act as a pump to improve circulation and venous return.

Rationale for incorrect answers:

1. Promote respiratory function: While respiratory function is an important concern postoperatively, leg exercises specifically target circulation in the lower extremities, not the lungs.

2. Maintain functional abilities: Early ambulation and mobility exercises are used to maintain muscle tone and prevent deconditioning.

3. Provide diversional activities: Leg exercises are not intended as recreation. While they may distract briefly, the primary purpose is physiological, not psychological.

Take home points:

Leg exercises after surgery prevent venous stasis and thrombus formation by promoting blood flow and venous return.
Patient education is critical - when patients understand why they need to do leg exercises, they are more likely to comply, reducing the risk of DVT and pulmonary embolism.

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Correct Answer is B

Explanation

Normal aging decreases lung elasticity, chest wall compliance, and vital capacity. These changes make older adults more prone to hypoventilation, atelectasis, and respiratory infections after anesthesia. Nursing care must focus on pulmonary hygiene: turning, coughing, deep breathing, and using incentive spirometry.

Rationale for correct answer:

2. Turn, cough, and deep breathe every 4 hours: Reduced vital capacity in older adults increases the risk of atelectasis and pneumonia postoperatively. Encouraging frequent deep breathing and coughing expands alveoli, promotes secretion clearance, and improves oxygenation.

Rationale for incorrect answers:

1. Take and record vital signs every shift: Vital signs help monitor overall stability but do not directly address the physiologic change of reduced vital capacity.

3. Encourage increased intake of oral fluids: Fluids are important for hydration and mucous membrane health, but they don’t directly improve vital capacity.

4. Assess bowel sounds daily: Monitoring bowel function is important after surgery, but it does not address the pulmonary risks related to decreased lung function.

Take home points:

Older adults have decreased lung reserve, making pulmonary complications more likely after surgery.
Frequent pulmonary exercises (turn, cough, deep breathe, incentive spirometry) are the most effective interventions to prevent atelectasis and pneumonia.

A. A 19-year-old woman who had a repair of large facial laceration B. A 42-year-old woman who has had gallbladder surgery C. A 14-year-old boy who underwent a repair of a fractured clavicle D. A 52-year-old man who has had an inguinal hernia repair

Correct Answer is A

Explanation

Body image refers to an individual’s perception of their physical self. Surgery that alters visible body parts (face, breasts, limbs) or sexual/reproductive organs carries the highest psychosocial impact. Nurses must anticipate these concerns, provide support, and involve counseling when needed.

Rationale for correct answer:

1. 19-year-old woman, facial laceration: Adolescents and young adults are particularly vulnerable to changes in body image because appearance and social acceptance are critical at this stage of psychosocial development.

Rationale for incorrect answers:

2. 42-year-old woman, gallbladder surgery: While scars may form, they are often small and hidden; adults in this age group generally have a more stable self-concept and body image compared to adolescents.

3. 14-year-old boy, fractured clavicle repair: Although body image is important in adolescence, clavicle repairs usually result in minimal visible long-term changes and full functional recovery.

4. 52-year-old man, inguinal hernia repair: Body image changes are minimal with this procedure, and psychosocial adaptation at this age tends to be less influenced by appearance.

Take home points:

Visible surgical changes (especially on the face or reproductive areas) increase risk for disturbed body image.
Age and developmental stage influence how strongly clients react to body image changes - adolescents and young adults are at greater risk.

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The nurse is explaining the rationale for performing leg exercises after surgery. Which reason would the nurse include in the explanation?

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Naxlex Comprehensive Predictor Exams

Older adults often have reduced vital capacity as a result of normal physiologic changes. Which nursing intervention would be most important for the postoperative care of an older surgical patient specific to this change?

Correct Answer is B

Explanation

Which of the following surgical patients is at a greater risk for alterations in body image?

Correct Answer is A

Explanation

The nurse is explaining the rationale for performing leg exercises after surgery. Which reason would the nurse include in the explanation?

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