RN VATI Adult Medical Surgical LATEST (2023) QUESTIONS AND ANSWERS GRADED A

RN VATI Adult Medical Surgical 2019 CLOSE Question 1 loaded rationals provided Question: 1 of 90 CORRECT FLAG • Time Remaining: 00:28:06 • Pause Remaining: 00:05:00 PAUSE A nurse is caring for a client who is 24 hr postoperative following a total hip arthroplasty. Which of the following actions should the nurse take? Place the affected leg in external rotation. The nurse should keep the affected extremity in a neutral position to prevent dislocation. Manifestations of a dislocation of the hip include inward rotation of the affected leg, sudden severe pain, and shortening of the surgical extremity. Encourage the client to use the incentive spirometer every shift. The nurse should encourage the client to cough, breathe deeply, and use the incentive spirometer every 2 hr to prevent pneumonia and atelectasis, which is the collapse of alveoli. Atelectasis can lead to poor oxygen exchange and pneumonia. Instruct the client to lean forward when rising from a chair. To prevent dislocation of the hip, the client should not flex the hip more than 90º at any time. Leaning forward when rising from a chair flexes the hip more than 90º. Maintain abduction of the affected extremity. MY ANSWE R The nurse should ensure that the affected extremity is in a position of abduction to prevent hip dislocation. The nurse should place an abductor pillow or several pillows between the client's legs to keep the affected extremity in abduction while the client is in bed.