a nurse is caring for a client who is postoperative following a hip arthroplasty which of the following interventions should the nurse include in the
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Nursing Elites

ATI RN

ATI Exit Exam 2024

1. A client is postoperative following a hip arthroplasty. Which of the following interventions should the nurse include in the plan of care?

Correct answer: C

Rationale: Using an abduction pillow between the client's legs is essential in maintaining proper alignment and preventing dislocation of the hip joint following a hip arthroplasty. Encouraging the client to lie flat in bed (Choice A) is not recommended as early mobilization is crucial for preventing complications. Applying heat to the incision site (Choice B) is not typically done immediately postoperatively. Placing a trochanter roll under the client's knees (Choice D) is not as beneficial as using an abduction pillow to maintain proper positioning.

2. A nurse is providing discharge teaching to a client who has a new prescription for albuterol. Which of the following instructions should the nurse include?

Correct answer: C

Rationale: The correct answer is C: 'You should rinse your mouth after using this medication.' When providing discharge teaching for a client prescribed albuterol, the nurse should include the instruction to rinse the mouth after each use. This is important to prevent dry mouth and oral infections. Choice A is incorrect as albuterol is usually taken during the day to manage symptoms, not at bedtime. Choice B is incorrect as palpitations are not a common side effect of albuterol. Choice D is incorrect as there is no specific requirement to avoid eating before taking albuterol.

3. A client is being taught how to perform self-catheterization. Which of the following instructions should the nurse include?

Correct answer: C

Rationale: The correct answer is C: 'Use a new catheter each time you perform self-catheterization.' It is essential to use a new, sterile catheter each time to prevent infection during the procedure. Choice A is incorrect because cleaning the catheter with alcohol may not be sufficient to prevent infection. Choice B is incorrect because self-catheterization is typically done in a clean, private area, not necessarily on the toilet. Choice D is incorrect because lubricating the catheter tip with petroleum jelly is a common practice but not as crucial as using a new catheter each time to prevent infection.

4. A nurse is caring for a client who is postoperative following a thyroidectomy. The nurse should identify that which of the following client reports is an indication of hypocalcemia?

Correct answer: C

Rationale: The correct answer is C: 'Numbness and tingling of the fingers.' Post-thyroidectomy, hypocalcemia is a concern due to potential damage to the parathyroid glands that regulate calcium levels. Numbness and tingling of the fingers are classic signs of hypocalcemia. Constipation (Choice A) is not typically associated with hypocalcemia. Frequent urination (Choice B) is more indicative of conditions like diabetes or a urinary tract infection. Increased thirst (Choice D) is commonly seen in conditions such as diabetes insipidus or uncontrolled diabetes mellitus, not specifically related to hypocalcemia.

5. A nurse is caring for a client who is 12 hours postoperative following abdominal surgery. Which of the following findings should the nurse report to the provider?

Correct answer: D

Rationale: A WBC count of 15,000/mm3 is elevated, which may indicate infection, a common concern postoperatively. An elevated WBC count suggests the body is fighting an infection, and prompt reporting to the provider is essential for further evaluation and treatment. Serosanguineous drainage on the surgical dressing is expected in the immediate postoperative period, respiratory rate of 16/min is within the normal range, and a heart rate of 90/min is also within an acceptable range postoperatively. Therefore, these findings do not raise immediate concerns that necessitate reporting to the provider.

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