Which of the following interventions is essential for post-operative mastectomy care to maintain range of motion?
Assist with active or passive range of motion exercises at least three times daily
Apply pressure dressings to prevent contractures and scarring.
Monitor areas at high risk for pressure sores, heels, sacrum, back of the head
Use compression dressings for up to 4-6 months to increase mobility and reduce scarring
The Correct Answer is A
A. Assist with active or passive range of motion exercises at least three times daily: Early initiation of range of motion exercises is critical for preventing stiffness. These exercises help to improve circulation, reduce the risk of frozen shoulder, and maintain shoulder mobility.
B. Apply pressure dressings to prevent contractures and scarring: Pressure dressings are not used for preventing contractures or scarring after mastectomy. Scar management involves massage therapy or silicone sheets.
C. Monitor areas at high risk for pressure sores (heels, sacrum, back of the head): Monitoring for pressure sores is essential in general post-operative care but not specifically for mastectomy recovery. Pressure sores are more of a concern when patients are immobile for long periods.
D. Use compression dressings for up to 4-6 months to increase mobility and reduce scarring: Compression dressings are primarily used to manage swelling and prevent lymphedema after mastectomy. They do not directly help with mobility or range of motion.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Use an electric razor when shaving: With thrombocytopenia, the client is at an increased risk for bleeding due to low platelet counts. Using an electric razor reduces the risk of cuts and bleeding during shaving, which is critical in preventing injury.
B. Restrict visits from children under twelve-years-old: While avoiding exposure to illness is important in immunosuppressed patients, this is not as urgent a concern as preventing bleeding due to thrombocytopenia.
C. Incorporate rest periods throughout the day: Rest is important for overall well-being during chemotherapy, but it is not directly related to managing thrombocytopenia. The priority is preventing bleeding complications, such as using an electric razor.
D. Take your temperature daily: Taking temperature daily is helpful for detecting infection, but it is not the most important intervention for thrombocytopenia. Preventing bleeding should be the primary
Correct Answer is B
Explanation
A. 150 mL: This calculation is incorrect because the amount of fluid drained includes both the saline solution and the urine. The true urine output is the difference between what was drained and what was instilled.
B. 100 mL: The true urine output is calculated by subtracting the amount of saline instilled from the total output. In this case, 300 mL was drained, and 200 mL was saline. Therefore, 300 mL - 200 mL = 100 mL of true urine output.
C. 200 mL: This would be the amount of saline instilled, not the urine output. The true urine output needs to account for the saline volume that was used in the irrigation process.
D. 50 mL: The correct calculation subtracts the 200 mL of saline from the total 300 mL drained, which gives 100 mL of true urine output, not 50mL.
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