A nurse cares for a client who had a wrist cast applied 3 days ago. The client states, “The cast is loose enough to slide off.” How would the nurse respond?
Keep your arm above the level of your heart.
As your muscles atrophy, the cast is expected to loosen.
I will wrap a bandage around the cast to prevent it from slipping.
You need a new cast now that the swelling is decreased.
The Correct Answer is D
Choice A reason: Elevating the arm reduces edema but does not address a loose cast, which can fail to immobilize the fracture. Inadequate immobilization risks malunion or delayed healing, as the cast must maintain stable alignment of the fractured bones.
Choice B reason: Muscle atrophy occurs over weeks, not 3 days, and is not the primary cause of a loose cast. Initial swelling reduction post-fracture causes the looseness, requiring cast replacement to ensure proper immobilization and fracture stability.
Choice C reason: Wrapping a bandage around a loose cast is inadequate, as it does not provide the rigid support needed for fracture healing. Improper immobilization can lead to bone misalignment, delayed union, or soft tissue injury, necessitating a new cast.
Choice D reason: A loose cast 3 days post-application indicates reduced swelling, common after initial trauma. A new, properly fitted cast is needed to ensure immobilization, as loose casts fail to stabilize the fracture, risking malunion or nonunion of the wrist bones.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Vitamin D enhances calcium absorption in the intestines, critical for bone mineralization during fracture healing. Baked fish (rich in protein) and orange juice (vitamin C source) support collagen formation, making this a comprehensive choice for bone repair and tissue recovery.
Choice B reason: Vitamin B supports energy metabolism but has no direct role in bone healing. A bacon, lettuce, and tomato sandwich lacks significant calcium or vitamin D, essential for osteoblast activity and bone matrix formation, making it less effective for fracture recovery.
Choice C reason: Vitamin A supports epithelial tissue but is less critical for bone healing than vitamin D or calcium. Vegetable lasagna and salad provide some nutrients but lack the specific bone-supporting elements like calcium, making this choice suboptimal.
Choice D reason: Vitamin C aids collagen synthesis, and low-fat milk provides calcium, both beneficial for fracture healing. However, it lacks vitamin D, which is essential for calcium absorption, making it less comprehensive than the vitamin D-inclusive option for optimal bone repair.
Correct Answer is D
Explanation
Choice A reason: Removing traction during repositioning disrupts the continuous pull needed to maintain bone alignment in fractures. This could lead to misalignment, delayed healing, or increased pain, as traction counteracts muscle spasms and stabilizes the fracture site.
Choice B reason: While skin assessment during a bed bath is important to detect pressure injuries, it is a general nursing responsibility, not specific to traction care. Traction-specific teaching focuses on maintaining the system’s integrity, such as ensuring proper weight function, over general hygiene tasks.
Choice C reason: Using alcohol wipes for pin care in skeletal traction is inappropriate, as it may not adequately prevent infection. Pin sites require sterile technique with solutions like chlorhexidine to minimize osteomyelitis risk, making this an incorrect teaching point.
Choice D reason: In traction, weights must hang freely to maintain consistent force for bone alignment and fracture stabilization. Obstructed weights reduce traction effectiveness, potentially causing misalignment, delayed healing, or increased pain, making this a critical teaching point for safe traction care.
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