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2024 EVOLVE NCLEX REVIEW EXAM QUESTIONS- CHAPTER 63 WITH CORRECT ANSWERS
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2024 EVOLVE NCLEX REVIEW EXAM QUESTIONS- CHAPTER 63 WITH CORRECT ANSWERS
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2024 EVOLVE NCLEX REVIEWEXAM QUESTIONS- CHAPTER 63
WITH CORRECT ANSWERS
The nurse is completing a neurovascular assessment on the patient with a
tibial fracture and a cast. The feet are pulseless, pale, and cool. The patient
says they are numb. What should the nurse suspect is occurring?
a.Paresthesia
b.Pitting edema
c.Poor venous return
d.Compartment syndrome - CORRECT ANSWERS-D. Compartment syndrome
The nurse should suspect compartment syndrome with one or more of the
following six Ps: paresthesia, pallor, pulselessness, pain distal to the injury
and unrelieved with opioids, pressure increases in the compartment, and
paralysis. Although paresthesia and poor venous return are evident, these
are just some of the manifestations of compartment syndrome.
An injured soldier had an amputation of his left leg and is reporting shooting
pain and heaviness in the area of his missing leg. What would be the best
response by the nurse for this patient?
a.Use mirror therapy.
b.Give opioid analgesics.
c.Rebandage the residual limb.
d.Show the patient the leg is gone. - CORRECT ANSWERS-A. Use mirror
therapy.
Mirror therapy has been shown to reduce phantom limb pain in some
patients. Opioid analgesics, rebandaging the residual limb, and showing the
patient that the leg is gone will not decrease phantom limb pain.
While completing an admission history for a 73-year-old man with
osteoarthritis admitted for knee arthroplasty, the nurse asks about the
patient's perception of the reason for admission. The nurse expects the
patient to relate which response to this question?
a.Recent knee trauma
b.Debilitating joint pain
c.Repeated knee infections
d.Onset of "frozen" knee joint - CORRECT ANSWERS-B. Debilitating joint pain
The most common reason for knee arthroplasty is debilitating joint pain
despite attempts to manage it with exercise and drug therapy. Recent knee
trauma, repeated knee infections, and onset of "frozen" knee joint are not
primary indicators for a knee arthroplasty.
, The nurse is caring for a patient with osteoarthritis who is about to undergo
total left knee arthroplasty. The nurse assesses the patient carefully to be
sure that there is no evidence of what in the preoperative period?
a.Pain
b.Left knee stiffness
c.Left knee infection
d. Left knee instability - CORRECT ANSWERS-C. Left knee infection
It is critical that the patient be free of infection before a total knee
arthroplasty. An infection in the joint could lead to even greater pain and
joint instability, requiring extensive surgery. For this reason, the nurse
monitors the patient for signs of infection, such as redness, swelling, fever,
and elevated white blood cell count. Pain, knee stiffness, or instability may
be present with osteoarthritis.
The nurse formulates a nursing diagnosis of impaired physical mobility
related to decreased muscle strength for a 78-year-old patient following left
total knee replacement. What would be an appropriate nursing intervention
for this patient?
a.Promote vitamin C and calcium intake in the diet.
b.Provide passive range of motion to all of the joints q4hr.
c.Encourage isometric quadriceps-setting exercises at least qid.
d.Keep the left leg in extension and abduction to prevent contractures. -
CORRECT ANSWERS-C. Encourage isometric quadriceps-setting exercises at
least qid.
Emphasis is placed on postoperative exercise of the affected leg, with
isometric quadriceps setting beginning on the first day after surgery along
with a continuous passive motion (CPM) machine. Vitamin C and calcium do
not improve muscle strength, but they will facilitate healing. The patient
should be able to do active range of motion to all joints. Keeping the leg in
one position (extension and abduction) potentially will result in contractures.
The nurse is caring for a 76-year-old man who has undergone left knee
arthroplasty with prosthetic replacement of the knee joint to relieve the pain
of severe osteoarthritis. Postoperatively the nurse expects what to be
included in the care of the affected leg?
a.Progressive leg exercises to obtain 90-degree flexion
b.Early ambulation with full weight bearing on the left leg
c.Bed rest for 3 days with the left leg immobilized in extension
d.Immobilization of the left knee in 30-degree flexion for 2 weeks to prevent
dislocation - CORRECT ANSWERS-A. Progressive leg exercises to obtain 90-
degree flexion
Although early ambulation is not done, the patient is encouraged to engage
in progressive leg exercises until 90-degree flexion is possible. Because this
is painful after surgery, the patient requires good pain management and
often the use of a CPM machine. The patient's knee is unlikely to dislocate.
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