A nurse evaluates a client for postoperative complications following joint replacement surgery. Upon discharge, the nurse teaches the client that the risk of infection is present for how long after surgery?

Correct Answer: D

Rationale: The correct answer is D) Six months. After joint replacement surgery, the risk of infection persists for an extended period due to the presence of foreign material in the body, such as prosthetic implants. This foreign material increases the risk of bacterial colonization and infection. Option A) Two weeks is too short a duration for the risk of infection to completely subside after joint replacement surgery. Infections can manifest even beyond this timeframe. Option B) One month is also not a sufficient duration for monitoring the risk of infection post joint replacement surgery. The risk extends beyond this period due to the nature of the surgical procedure. Option C) Three months is closer to the correct answer, but infections can still occur beyond this timeframe, especially given the presence of prosthetic material which can serve as a site for bacterial growth and subsequent infection. Educationally, it is crucial for healthcare providers to educate clients about the prolonged risk of infection post joint replacement surgery to ensure early detection and prompt treatment of any potential complications. This knowledge empowers clients to monitor their recovery effectively and seek medical attention if they experience any signs of infection, such as increased pain, swelling, redness, or drainage at the surgical site.

Correct Answer: C

Rationale: In this scenario, the correct answer is C: Applies ice and gentle massage to the patient's lower extremities. Paget's disease is a chronic bone disorder that involves abnormal bone remodeling, leading to soft, deformed bones that can cause pain and deformities. Ice and massage can exacerbate the condition by potentially causing microfractures in the already weakened bones, making this intervention inappropriate. Option A, administering ibuprofen, is not necessarily contraindicated in Paget's disease as it can help manage the pain associated with the condition. Option B, encouraging the patient to perform physical therapy exercises, is beneficial in maintaining mobility and function. Option D, reminding the patient to consume dairy products, is also appropriate as adequate calcium intake is crucial for maintaining bone health. Educationally, this question highlights the importance of understanding the specific care needs of patients with Paget's disease. It emphasizes the need for nurses to be cautious about interventions that may pose a risk of further harm to the patient. Understanding the pathophysiology of conditions like Paget's disease is essential for providing safe and effective care to patients with complex health issues.

Correct Answer: A

Rationale: In this scenario, the correct answer is A) The patient complains of pressure and pain. This finding should be reported immediately because it could indicate compartment syndrome, a serious condition where increased pressure within a muscle compartment compromises blood flow and can lead to tissue damage. Prompt intervention is crucial to prevent long-term complications. Option B) The cast being dry and intact is a positive finding but not as urgent as the patient's complaint of pressure and pain. It indicates proper initial care of the fractures. Option C) The skin being pink and warm to touch is a good sign of adequate circulation, but it does not address the patient's complaint of pressure and pain, which takes precedence. Option D) The patient being able to move all fingers and thumb is also a positive finding but does not address the immediate concern of pressure and pain, which could signal a serious complication. In an educational context, this question highlights the importance of prioritizing patient assessments based on potential complications. Understanding the signs and symptoms of conditions like compartment syndrome is crucial for nurses to provide timely and appropriate care to prevent further harm to the patient. This knowledge is essential for nurses preparing for the NCLEX exam and in their clinical practice to ensure patient safety and well-being.

Correct Answer: B

Rationale: The correct answer is B) Administration of a histamine antagonist (Pepcid) as a gastrointestinal preventative measure for a client with intracranial pressure. This intervention helps reduce the risk of stress ulcers by decreasing gastric acid secretion. Stress ulcers can develop due to increased intracranial pressure and stress response in neurologically compromised patients. Option A) Insertion of an NG tube is not primarily used as a gastrointestinal preventative measure for intracranial pressure but rather for decompression or feeding purposes. Option C) Sips of clear fluid may not be sufficient to prevent gastrointestinal complications in a client with intracranial pressure. In fact, excessive fluid intake can sometimes exacerbate intracranial pressure. Option D) Insertion of a rectal tube is not a standard intervention for preventing gastrointestinal issues related to intracranial pressure and would not address the underlying cause of stress ulcers in this context. Educationally, understanding the rationale behind using a histamine antagonist to reduce gastric acid secretion in patients with increased intracranial pressure is crucial for nursing practice. It highlights the importance of preventive measures in managing complications associated with neurological conditions, promoting critical thinking and evidence-based interventions in patient care.

Correct Answer: B

Rationale: Intracranial pressure management is a critical aspect of postoperative care following intracranial surgery. Mannitol is the correct drug choice to decrease intracranial pressure in this scenario. Mannitol is an osmotic diuretic that works by drawing fluid out of brain tissue and into the bloodstream, thereby reducing cerebral edema and intracranial pressure. Benadryl (A) is an antihistamine and is not indicated for reducing intracranial pressure post-surgery. Prednisone (C) and corticosteroids (D) are anti-inflammatory drugs that are not primarily used to decrease intracranial pressure in this context. Educationally, understanding the rationale behind the choice of Mannitol reinforces the pharmacological principles of osmotic diuretics and their application in managing intracranial pressure. This knowledge is crucial for nursing practice, especially in neurosurgical and critical care settings where prompt and accurate interventions are essential for patient outcomes.