A client with a right tibial fracture is being discharged home after having a cast applied. What instruction should the nurse provide about the client's cast care?
"Use a clean object to scratch itches inside the cast
"Keep your right leg elevated above heart level"
"Cover the cast with a blanket until the cast dries"
"A foul smell from the cast is normal after the first few days."
The Correct Answer is B
Rationale:
A. Inserting objects into the cast to relieve itching can damage the skin and lead to infection. It should be strictly avoided.
B. Elevating the leg above heart level helps reduce swelling and promotes venous return, especially in the first 24–48 hours after cast application. This is an important self-care instruction.
C. Covering the cast can trap moisture and heat, delaying drying and increasing the risk of skin irritation or infection.
D. A foul odor from the cast may indicate infection and should be reported immediately—it is not a normal finding.
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Related Questions
Correct Answer is D
Explanation
Rationale:
A. Encouraging internal and external rotation of the affected leg increases the risk of dislocating the hip and should be avoided post-fracture or post-surgery.
B. Prone positioning is rarely used and can increase discomfort or stress on the hip joint, potentially worsening outcomes.
C. While administering analgesics is important for comfort, it does not directly prevent hip displacement.
D. Placing a pillow between the client’s legs when turning helps maintain proper hip alignment and prevents adduction, which can lead to hip dislocation. This is a key nursing intervention to prevent complications after a hip fracture.
Correct Answer is B
Explanation
Rationale:
A. Adults with a long history of smoking (especially those aged 50–80 with a 20 pack-year history) should have annual low-dose CT scans for early lung cancer detection.
B. The statement “I do not need to apply sunscreen every day” reflects a lack of understanding. Daily sunscreen use is recommended to reduce the risk of skin cancer, even on cloudy days or in indirect sunlight.
C. Pap smear guidelines recommend screening every 3 years starting at age 21, assuming normal results—this is correct.
D. Colonoscopy screening for average-risk adults is recommended to begin at age 45, with a repeat every 10 years if results are normal.
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