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.

Answer and Explanation

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.

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Correct Answer is B

Explanation

Choice A reason: Guiding a child to the floor during a seizure is unsafe, as it risks injury to both the child and nurse due to uncontrolled movements. Leaving to get help abandons the child, increasing injury risk during the seizure’s tonic-clonic phase.
Choice B reason: Moving objects away from a child during a tonic-clonic seizure prevents injury from striking hard surfaces. Generalized seizures cause uncontrolled muscle contractions, increasing the risk of trauma. Ensuring a safe environment is a priority to minimize harm during the seizure event.
Choice C reason: Inserting a tongue blade, even padded, risks dental injury or airway obstruction, as jaw clenching is common in tonic-clonic seizures. Current guidelines advise against placing objects in the mouth, as it does not prevent tongue biting and may cause harm.
Choice D reason: Restraining a child during a seizure can cause fractures or soft tissue injury due to forceful muscle contractions. It also increases stress and hypoxia risk. Allowing the seizure to occur while ensuring safety is the recommended approach to minimize complications.

A. Have adequate help to transfer the patient. B. Provide socks so the patient can slide easier. C. Tell the patient full weight bearing is allowed. D. Use a footstool to elevate the patient’s leg.

Correct Answer is A

Explanation

Choice A reason: Uncemented hip arthroplasty requires careful transfer to prevent dislocation of the new joint, which relies on bone ingrowth for stability. Adequate help (e.g., two staff members) ensures safe transfer, minimizing stress on the surgical site and reducing the risk of falls or prosthesis misalignment.
Choice B reason: Providing socks to “slide easier” increases the risk of slipping during transfer, which could lead to falls or hip dislocation. Non-slip footwear is preferred to ensure stability and safety during mobilization post-hip arthroplasty.
Choice C reason: Full weight bearing is typically restricted after uncemented hip arthroplasty to allow bone ingrowth into the prosthesis. Informing the patient that full weight bearing is allowed is incorrect and could lead to implant failure or dislocation.
Choice D reason: Using a footstool to elevate the leg during transfer is inappropriate, as it may cause hip flexion beyond 90 degrees, increasing the risk of dislocation. Elevation is used in specific positions but not during initial transfers.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

What is an appropriate nursing action when a child is experiencing a generalized tonic-clonic seizure?

Correct Answer is B

Explanation

A client is getting out of bed into a chair for the first time after an uncemented total hip arthroplasty. What action by the nurse is appropriate?

Correct Answer is A

Explanation

A nurse is caring for a client who is recovering from an above-the-knee amputation and reports pain in the limb that was removed. How would the nurse respond?

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