A client with a compound fracture of the left ankle is being discharged with a below-the-knee cast. Which
instruction should the practical nurse (PN) provide to the client prior to discharge?
Apply a cold pack to any "hot spots" on the cast.
Keep the left leg in a dependent position.
Expect some increase in pain.
Never scratch under the cast.
The Correct Answer is D
When providing instructions to a client with a below-the-knee cast for a compound fracture of the left ankle, it is important to prioritize their safety and proper care of the cast. The instruction to never scratch under the cast is crucial for preventing complications and maintaining the integrity of the cast.
Let's evaluate the other options:
a) Apply a cold pack to any "hot spots" on the cast.
Applying a cold pack to any "hot spots" on the cast may help alleviate discomfort or itching, but it is not the highest priority instruction. Preventing scratching under the cast is more important to avoid skin damage or infection.
b) Keep the left leg in a dependent position.
Keeping the left leg in a dependent position (hanging down) is not the appropriate instruction for a client with a below-the-knee cast. It is generally recommended to elevate the injured limb to reduce swelling and promote proper blood flow. Elevating the leg would involve keeping it raised above the level of the heart.
c) Expect some increase in pain.
While it is possible for the client to experience some increase in pain after the application of a cast, this instruction alone is not comprehensive or specific enough for proper discharge education. Providing information about pain management strategies or when to seek medical atention for excessive pain would be more appropriate.
In summary, when discharging a client with a compound fracture of the left ankle and a below-the-knee cast, the practical nurse (PN) should provide the instruction to never scratch under the cast. This helps prevent complications and maintain the integrity of the cast, promoting proper healing of the fracture.
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Naxlex Comprehensive Predictor Exams
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Correct Answer is B
Explanation
Choice A reason: Developing a survey on teen pregnancies is not an appropriate action by the nurse because it does not address the issue of influenza A outbreak in the school, which can affect students of any age or gender.
Choice B reason: Holding a focus group to discuss immunizations is an appropriate action by the nurse because it can educate and inform parents and students about the benefits and risks of influenza vaccination, as well as encourage them to get vaccinated before or during flu season.
Choice C reason: Running a mandatory flu clinic is not an appropriate action by the nurse because it can violate the rights and autonomy of parents and students who may have medical or personal reasons for refusing influenza vaccination, as well as create resentment and resistance among them.
Choice D reason: Closing the school for 6 weeks is not an appropriate action by the nurse because it can disrupt the education and socialization of students, as well as cause economic and logistic problems for parents and teachers. The recommended duration of school closure for influenza A outbreak is 5 to 7 days, which is the typical incubation period of the virus.
Correct Answer is D
Explanation
Choice A reason: A public health nurse is a nurse who works to promote and protect the health of populations and communities, not specific workplaces.
Choice B reason: A community nurse specialist is a nurse who has advanced education and training in a specific area of community health, such as mental health, gerontology, or maternal-child healtH.
Choice C reason: A nurse clinician is a nurse who has expertise in a clinical area of nursing practice, such as critical care, oncology, or wound carE.
Choice D reason: An occupational health nurse is a nurse who works to prevent and treat work-related injuries and illnesses, as well as promote the health and safety of workers and the environment.
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