The nurse turns a 2-day postoperative patient with a right total hip replacement using pillows between the legs. The nurse later returns and finds the patient lying supine with legs crossed. Which of the following should the nurse immediately observe to determine whether a complication has developed?

The right leg for shortening

The left leg for internal rotation

The left leg for loss of function

The right knee for crepitation

Answer and Explanation

The Correct Answer is A

Correct answer: A
A. The right leg for shortening: This is the most critical observation because crossing the legs after a hip replacement can cause hip dislocation. A shortened leg can be a sign of dislocation, which is a serious complication that requires immediate attention.
B. The left leg for internal rotation: Internal rotation is more of a concern for the operated leg (the right leg), not the left leg, in this context.
C. The left leg for loss of function: This is less relevant unless there is concern about a complication in the left leg, which is not directly related to the issue of crossing legs post-surgery.
D. The right knee for crepitation: Crepitation refers to a crackling sound and is more associated with joint issues rather than an indicator of hip dislocation.

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Correct Answer is C

Explanation

A. You can start taking sildenafil (Viagra): this should fix the problem.: This is inappropriate advice for the nurse to give. The use of medications like sildenafil should be discussed with the physician, especially considering potential interactions with hypertension medications.
B. This is a normal side effect of the medication and you will get used to it.: While erectile dysfunction can be a side effect of hypertension medications, telling the patient they will "get used to it" is dismissive and not supportive.
C. I will talk to your doctor to see if adjustments can be made.: This is appropriate as it acknowledges the patient's concern and involves the healthcare provider to explore potential medication adjustments or alternatives.
D. You should stop taking this medication immediately.: This is incorrect and potentially dangerous. Stopping hypertension medication abruptly can lead to uncontrolled blood pressure and other serious issues.

A. "Permanent structural changes in my kidneys and eyes have already occurred." B. "My blood pressure can return to normal with treatment of my kidney disease." C. "I don't know the cause of my hypertension." D. "My essential hypertension must be treated with medications."

Correct Answer is B

Explanation

A. "Permanent structural changes in my kidneys and eyes have already occurred.": This statement is more indicative of the complications of chronic, uncontrolled hypertension, whether primary or secondary. It does not reflect understanding that secondary hypertension is due to a specific, often treatable cause.
B. "My blood pressure can return to normal with treatment of my kidney disease.": This statement correctly reflects an understanding of secondary hypertension, which is caused by an underlying condition (like kidney disease). Treating the underlying condition can potentially normalize blood pressure.
C. "I don't know the cause of my hypertension.": This statement reflects primary (essential) hypertension, where the cause is generally unknown.
D. "My essential hypertension must be treated with medications.": This statement describes essential hypertension, not secondary. Essential hypertension typically requires lifelong medication management.

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Naxlex Comprehensive Predictor Exams

A patient tells the nurse he has started experiencing erectile dysfunction since beginning treatment for hypertension. Which statement by the nurse is most appropriate?

Correct Answer is C

Explanation

The LPN/LVP is discussing types of hypertension with a patient. Which statement by the patient would reflect understanding of secondary hypertension?

Correct Answer is B

Explanation

The nurse is providing education about the warning signs of stroke to a nursing student. Which information would be appropriate for the nurse to include in the teaching?

The nurse is planning care for patients with hypertension. What side effect should be included with teaching about the beta blocker propranolol (Inderal)?

The nurse is caring for a group of patients. Which patient is the priority?

The nurse is providing care for a patient with expressive aphasia. Which intervention does the nurse expect to find in the patient's plan of care? (Select all that apply.)

The nurse is assisting with patients in an orthopedic unit. Which is an important factor to remember when caring for patients after a total hip replacement?

A nurse is reinforcing teaching with a client who has peripheral vascular disease (PVD). The nurse should recognize which of the following statements by the client indicates a need for further teaching?

On which lifestyle modifications would the nurse reinforce teaching with the patient to reduce the risk of hypertension? Select all that apply.

Which risk factors would be considered modifiable in the prevention of stroke? Select all that apply.