Question：
A client has had a total hip replacement. Which of the following signs most likely indicates that the hip has dislocated?
1. Abduction of the affected leg.
2. Loosening of the prosthesis.
3. External rotation of the affected leg.
4. Shortening of the affected leg.

Answer：4
The most likely indication of a dislocated hip is a shortening of the affected leg. Other indications of dislocation include increasing pain, loss of function to the extremity and deformity. Abduction of the leg after total hip replacement is a desirable position to prevent dislocation.
Loosening of the prosthesis does not necessarily indicate that the hip has dislocated. External rotation of the hip can occur without the hip’s being dislocated. However, a neutral position of rotation is the desired position.
CN: Physiological adaptation; CL: Analyze

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ISPN模拟试题之每日一练（2）

Question：
A client with paranoid schizophrenia is withdrawn, suspicious of others and projects blame. The client’s behavior reflects problems in which of the following stages of development as identified by Erikson?
1. Trust versus mistrust.
2. Autonomy versus shame and doubt.
3. Initiative versus guilt.
4. Intimacy versus isolation.

Answer：5
The client who is withdrawn, is suspicious, and projects blame is exhibiting problems in trust versus mistrust. Shame and doubt would be reflected as low self-esteem and suspiciousness.
Guilt would be reflected in self-blame for all problems. Isolation would be reflected in a lack of long-term relationships.
CN: Psychosocial adaptation; CL: Analyze
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Question：
During the initial interview, a client with a compulsive eating disorder remarks, “I can’t stand myself and the way I look.” Which of the following statements by the nurse is most therapeutic?
1. “Everyone who has the same problem feels like you do.”
2. “I don’t think you look bad at all.”
3. “Don’t worry. You’ll soon be back in shape.”
4. “Tell me more about your feelings.”

Answer：6
The nurse needs to explore more about the client’s feelings to assess what underlies the eating disorder. The nurse also needs to evaluate the client’s suicide risk. The other statements are not therapeutic because they minimize the client’s feelings.
CN: Psychosocial adaptation; CL: Synthesize

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ISPN模拟题之每日一练（4）

Question：
A client with a new ileal conduit asks the nurse when to wear his appliance. Which of the following responses by the nurse is best?
1. “You need to wear your appliance all the time.”
2. “You need to wear your appliance after you irrigate.”
3. “It is only necessary to wear your appliance at night.”
4. “The appliance must be worn after your meals.”