Following discharge teaching, the nurse realizes that additional instruction is needed when the patient says what?

Correct Answer: B

Rationale: In this NCLEX question on the neurological system, the correct answer is B) "When I begin to feel better." This response indicates a misunderstanding of the discharge teaching. Here's the detailed rationale: Correct Answer (B): The statement "When I begin to feel better" suggests that the patient plans to stop the treatment or follow-up care once they start feeling improved. This response is incorrect because neurological conditions often require ongoing management and adherence to treatment regimens even when symptoms improve. This highlights the importance of emphasizing the need for continuity in care and following through with the prescribed treatment plan. Incorrect Answers: A) "It is important for me to avoid exposure to people with upper respiratory infections": This statement shows an understanding of the importance of infection control measures to prevent complications, which is relevant to neurological conditions that may be exacerbated by infections. Therefore, this is a correct statement and does not indicate a need for additional instruction. C) "I should stop taking the prednisone to prevent side effects": Stopping prednisone suddenly can lead to adverse effects and complications. Patients should be advised on proper tapering schedules and the importance of not discontinuing medications abruptly to prevent rebound symptoms or side effects. This response is incorrect and could lead to harm. D) "I plan to use vitamin supplements and a high-protein diet to help manage my condition": While nutrition and supplements can play a supportive role in managing certain conditions, solely relying on these measures without following the prescribed medical treatment can be detrimental. This response indicates a lack of understanding of the primary treatment plan and the necessity of medical interventions in managing neurological conditions. Educational Context: This question underscores the importance of patient education and the nurse's role in ensuring that patients comprehend and adhere to their treatment plans. It highlights the potential consequences of misconceptions or non-adherence to medical advice in the context of neurological conditions. Nurses must provide clear, concise, and repeated instructions to facilitate patient understanding and promote optimal outcomes in managing neurological disorders.

Correct Answer: A

Rationale: Rationale: The correct answer is option A) The fracture heals in an unsatisfactory position. Malunion is a complication that occurs when a fracture heals in a position that is not anatomically correct or functional. In this case, the fractured femur has healed in a way that results in misalignment or improper positioning, leading to potential long-term consequences such as altered limb function, pain, and decreased mobility. Option B) The fracture fails to heal properly despite treatment is incorrect because malunion specifically refers to a situation where the fracture does heal, but in an unsatisfactory position. It is not about the failure of the fracture to heal at all. Option C) Fracture healing progresses more slowly than expected is incorrect as it describes delayed union, which is a separate complication where the fracture takes longer to heal than normal, but does not necessarily result in malalignment. Option D) Loss of bone substances occurs as a result of immobilization is incorrect because it describes disuse osteoporosis, a condition where bone loss occurs due to lack of weight-bearing activity, rather than the specific complication of malunion. In an educational context, understanding complications like malunion is crucial for nurses caring for patients with fractures. Recognizing the signs and symptoms of malunion can prompt timely interventions such as surgical correction to optimize outcomes and prevent long-term complications associated with improper bone healing. This knowledge is essential for providing comprehensive and effective care to patients with musculoskeletal injuries.

Correct Answer: A

Rationale: In the context of NCLEX questions on the neurological system, understanding the types of hip fractures and their respective treatments is crucial. The correct answer is A) Intracapsular. Intracapsular hip fractures occur within the capsule of the hip joint and are often repaired with a hip prosthesis due to the compromised blood supply to the femoral head. This type of fracture typically affects the neck of the femur. Extracapsular (Option B), subtrochanteric (Option C), and intertrochanteric (Option D) hip fractures involve areas outside the hip joint capsule. Extracapsular fractures occur below the neck of the femur, while subtrochanteric fractures occur just below the lesser trochanter, and intertrochanteric fractures happen between the greater and lesser trochanters. These fractures are usually treated with other methods such as internal fixation devices like screws, plates, or nails. Understanding the specific characteristics and treatments for each type of hip fracture is crucial for nurses as they care for patients with these injuries. It helps in providing appropriate care, understanding postoperative management, and recognizing potential complications. This knowledge also aids in patient education and rehabilitation guidance post-surgery.

Correct Answer: B

Rationale: The correct answer is B) Abduction and extension. After a total hip arthroplasty with a posterior approach, maintaining the affected extremity in abduction helps prevent dislocation of the hip prosthesis. Extension is important to keep the hip from flexing beyond 90 degrees, which could also lead to dislocation. Option A) Adduction and flexion would increase the risk of hip dislocation as it brings the hip into a position that could easily pop the prosthesis out of place. Option C) Abduction and internal rotation could lead to impingement or instability of the hip joint. Option D) Adduction and external rotation also increase the risk of hip dislocation. In an educational context, understanding the proper positioning after hip arthroplasty is crucial for nursing practice to prevent complications and promote patient safety and recovery. Nurses must be knowledgeable about postoperative care interventions to provide optimal care for patients undergoing orthopedic surgeries like hip arthroplasty.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Urinary incontinence. The nurse should be most concerned about urinary incontinence post laminectomy and spinal fusion surgery due to the potential for nerve damage during the procedure. The nerves controlling bladder function could be affected, leading to urinary incontinence. This finding could indicate nerve damage or compression, which needs immediate attention to prevent long-term complications. Option A) Paralytic ileus is not the most concerning finding in this situation as it is a common complication postoperatively but not directly related to the surgical site or procedure. Option C) Greater pain at the graft site than at the lumbar incision site may be expected due to the nature of the surgery involving fusion, but it is not the most concerning finding. Option D) Leg and arm movement and sensation unchanged from preoperative status would actually be a positive finding, indicating that there was no neurological damage during the surgery. Educationally, it is crucial for nurses to understand the potential complications following neurosurgical procedures to provide optimal care for their patients. Recognizing the most concerning findings postoperatively allows for timely interventions and prevents further complications. Understanding the implications of each finding helps nurses prioritize care and collaborate effectively with the healthcare team to ensure positive patient outcomes.