a client is in skeletal traction with the nurses assessment it is noted that the pairs appear red swollen and there is purulent drainage what action d
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Nursing Elites

ATI RN

Multi Dimensional Care | Exam | Rasmusson

1. A client is in skeletal traction. With the nurse's assessment, it is noted that the pairs appear red, swollen and there is purulent drainage. What action does the nurse take first?

Correct answer: A

Rationale:

2. A nurse assesses an area of skin over a bony prominence. What finding would be most concerning?

Correct answer: A

Rationale:

3. The medical record for a client states that the client has hemiplegia. What does this mean?

Correct answer: D

Rationale: Hemiplegia refers to paralysis on one side of the body, affecting either the right or left side. Choice A is incorrect because it describes selective paralysis of specific limbs, not one side of the body. Choice B is incorrect as hemiplegia does not involve paralysis of all four extremities. Choice C is also incorrect as decreased vision in one eye is not indicative of hemiplegia.

4. What activities should the client avoid after cataract surgery? (Select all that apply)

Correct answer: D

Rationale: After cataract surgery, the client should avoid activities that can increase intraocular pressure. Blowing one’s nose and bearing down during defecation can raise the pressure inside the eye, which can be harmful during the healing process. Lifting items heavier than 10 pounds can also lead to an increase in intraocular pressure. Therefore, all the activities mentioned in the choices (nose blowing, bearing down during defecation, and lifting heavy items) should be avoided after cataract surgery to promote proper healing and reduce the risk of complications.

5. A client recently had an above the knee amputation and complains of pain distal to the amputation. What type of pain is the client experiencing?

Correct answer: A

Rationale:

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