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Nursing Students NCLEX

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Hey there. I came across this nclex type question and its confused me. Of course it's from a book with no answer key. I believe the answer would be 2 do to the knee gatch. However answer 1 seems like it might be the answer to prevent DVTs but I keep thinking it was only arthroplasty not a replacement. And he is ambulatory since he's at the office. Any help would be appreciated. Thanks in advance.

During a visit to the medical office a nurse collects data from a client who had a knee arthroplasty 1 week ago. Which of the following statements made by the client should concern the nurse most?

1. "I am so glad to off those blood thinners."

2. "I will keep a pillow under my knee when I am in bed."

3. "I am planing to use my wheelchair to help me get around."

4. "I plan to take Motrin instead of the prescribed Lortab for pain control."

Specializes in PACU, pre/postoperative, ortho.

OP, it really is too bad that your source did not give you an answer with rationale. 50% or more of our TKR are dc on aspirin & fish oil; coumadin only if a home med & xarelto if they have a significant hx of dvt.

Sure, get your pt to take 3 more days of whichever med was rx but are they gonna get their butt up from the wc? If not, 10 days of anticoag is not going to benefit them in the long run.

Not to mention, they may as well set a date for a knee manipulation & injection. But that could just be "real world" thinking. 😆

OP, it really is too bad that your source did not give you an answer with rationale. 50% or more of our TKR are dc on aspirin & fish oil; coumadin only if a home med & xarelto if they have a significant hx of dvt.

Sure, get your pt to take 3 more days of whichever med was rx but are they gonna get their butt up from the wc? If not, 10 days of anticoag is not going to benefit them in the long run.

Not to mention, they may as well set a date for a knee manipulation & injection. But that could just be "real world" thinking. [emoji38]

I agree with you but you know the NCLEX world is different from the real world.

Those test takers who usually over analyze the NCLEX questions have a hard time with the exam.

My top 1 student in my class failed the NCLEX the first time and it took her the entire 4-5 hrs what ever the max hrs is. I on the other hand is not even on top 10 but passed the NCLEX first time in less than an hour.

This is a hard one. My answer is 1. Option 4 is psychosocial (pain) so cross that off. Option 3 states that the client is "planning" it did not mention anything about the client currently using a wheelchair. Further teaching would be required. 2 can certainly pose a threat to circulation, and this is where the NCLEX will have you thinking. You want to think expected outcomes. Knee surgery -> blood clot formation. Altered circulation from a pillow will not cause a clot. Not taking your blood thinner medication post surgery will. Especially only 1 week after.

Yeah I agree now. This was an ati question from a book. It doesn't give the answer though. But thank you to everyone for the clarification!

How can you study if it doesn't give you the right answer? How can it develop your critical thinking skills if it doesn't give you rationales? Hope you can come up with the right answer with the rationale

I used ATI throughout nursing school and my ATI book and ATI online always give us the answer.

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