Which instruction is the most important for the practical nurse (PN) to reinforce in the discharge teaching of a 16-year-old who had an above-the-knee amputation (AKA)?

Do not use lotion on the residual limb.

Inspect the residual limb every day.

Lay prone for 30 minutes 3 or 4 times every day.

Air dry the residual limb for 20 minutes after washing it.

Answer and Explanation

The Correct Answer is C

A. Do not use lotion on the residual limb: Avoiding lotion is appropriate initially because it may cause skin softening or irritation before full healing occurs. However, this is not the most important teaching point related to long-term functional recovery and prevention of complications.

B. Inspect the residual limb every day: Daily inspection is essential for detecting irritation or infection, especially once the client begins prosthesis use. However, in the early postoperative phase, preventing contractures is a higher priority to preserve mobility and facilitate prosthetic fitting.

C. Lay prone for 30 minutes 3 or 4 times every day: Lying prone several times daily helps prevent hip flexion contractures, a common complication after an above-the-knee amputation. This position stretches the hip muscles, maintains joint extension, and promotes proper alignment, making it the most critical instruction for long-term rehabilitation success.

D. Air dry the residual limb for 20 minutes after washing it: Allowing the limb to air dry helps maintain skin integrity, but it is a basic hygiene measure rather than a primary preventive strategy. Preventing contractures takes precedence in discharge teaching.

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Correct Answer is A

Explanation

A. Dorsal recumbent with the right leg elevated on two pillows: Elevating the injured leg above the level of the heart in the dorsal recumbent position promotes venous return, reduces edema, and relieves pain. This position also helps minimize tissue swelling and prevents complications such as compartment syndrome.

B. Supine with a foot board and a trochanter roll to the right leg: A foot board and trochanter roll are used to prevent foot drop and maintain hip alignment. This position does not facilitate venous drainage and may contribute to fluid accumulation in the injured limb.

C. Left lateral recumbent position with the right leg supported in proper alignment: While maintaining alignment is important, this position does not promote elevation of the leg, which is essential for decreasing swelling and improving comfort in the early stages of a fracture.

D. Right lateral with a pillow between the legs: The right lateral position places pressure on the injured leg and may worsen pain and swelling. Even with a pillow between the legs, this posture is not therapeutic for edema control or comfort following a tibia-fibula fracture.

A. Gently pull the upper aspect of the ear lobe upwards and backwards. B. Gently pull the lower aspect of the ear lobe downwards and forward. C. Hold the upper aspect of the ear lobe downwards and against the skull. D. Instill one drop q5 minutes with the child in a Trendelenburg position.

Correct Answer is A

Explanation

A. Gently pull the upper aspect of the ear lobe upwards and backwards: For children older than 3 years, this straightens the ear canal to allow proper delivery of the medication into the external auditory canal.

B. Gently pull the lower aspect of the ear lobe downwards and forward: This technique is appropriate for infants and children younger than 3 years, as their ear canal angles differently.

C. Hold the upper aspect of the ear lobe downwards and against the skull: This position would obstruct the ear canal rather than open it, preventing proper medication flow.

D. Instill one drop q5 minutes with the child in a Trendelenburg position: Trendelenburg positioning is unnecessary and unsafe for ear drop administration; the child should simply remain with the affected ear upward for several minutes.

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Which instruction is the most important for the practical nurse (PN) to reinforce in the discharge teaching of a 16-year-old who had an above-the-knee amputation (AKA)?

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Naxlex Comprehensive Predictor Exams

The practical nurse (PN) is caring for a client who has a fractured right tibia and fibula. To reduce swelling and promote comfort, the PN should place the client in which position?

Correct Answer is A

Explanation

The healthcare provider prescribed ear drops for a 5-year-old girl with otitis externa. Which technique should the practical nurse (PN) advise the mother to use when administering the ear drops?

Correct Answer is A

Explanation

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The practical nurse (PN) and unlicensed assistive personnel (UAP) enter a client's room and find the client lying on the bed. The PN determines that the client is unresponsive. Which instruction should the PN give the UAP first?