The nurse is providing care for a patient after an above-the-knee amputation due to diabetes complications. Which nursing care is essential for promoting ambulation?

Lying prone as prescribed.

Promoting coordination exercises.

Building upper body strength.

Maintaining residual limb elevation.

Answer and Explanation

The Correct Answer is C

Choice A reason: Lying prone may be part of the care plan but is not specifically aimed at promoting ambulation.

Choice B reason: Coordination exercises are important but secondary to building the strength necessary for using mobility aids.

Choice C reason: Building upper body strength is essential for a patient who has had an above-the-knee amputation to be able to use assistive devices for ambulation effectively.

Choice D reason: Maintaining residual limb elevation is important for reducing swelling but does not directly promote ambulation.

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Correct Answer is A

Explanation

Choice A reason: A urine output of 18 mL/hr is significantly lower than the normal range (typically around 0.5-1 mL/kg/hr), indicating possible renal hypoperfusion, an early sign of shock.

Choice B reason: While blood pressure is an important indicator, it may not drop until later stages of shock.

Choice C reason: Lethargy can be a sign of shock, but it is a more subjective and later symptom compared to the objective measure of urine output.

Choice D reason: An elevated pulse is a compensatory mechanism in shock, but it is not as specific an early indicator as a decrease in urine output.

A. "I should hold my insulin the day before surgery." B. "I should take a vitamin with zinc and vitamin C after surgery." C. "I don't have to quit smoking before surgery." D. "I should eat a meal high in fat 2 hours before surgery."

Correct Answer is B

Explanation

Choice A reason: Patients should not hold their insulin unless instructed by a physician, as it can lead to uncontrolled blood sugar levels.

Choice B reason: Taking vitamins with zinc and vitamin C can help with wound healing and immune function after surgery.

Choice C reason: Smoking should be stopped before surgery as it can impair wound healing and increase the risk of complications.

Choice D reason: Patients are typically advised to fast before surgery to reduce the risk of aspiration during anesthesia.

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The nurse is providing care for a patient after an above-the-knee amputation due to diabetes complications. Which nursing care is essential for promoting ambulation?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

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