A nurse in an emergency department is caring for a client who has a compound fracture of the right tibia. Which of the following actions should the nurse take?

Keep client in semi-Fowler's position with right extremity flat.

Manage pain with oral opioids every 6 hr.

Check capillary refill hourly for the first 24 hr.

Apply a compression dressing over the fracture site.

Answer and Explanation

The Correct Answer is D

A) Keep client in semi-Fowler's position with right extremity flat: Keeping the client in a semi-Fowler's position with the extremity flat is not appropriate for managing a compound fracture. Elevating the affected limb, if possible, helps reduce swelling and pain, but the position should also consider overall stability and comfort.

B) Manage pain with oral opioids every 6 hr: Oral opioids are not the best choice for immediate pain management in an emergency setting, especially with a compound fracture. Intravenous pain medications are typically more effective for acute, severe pain in such situations and can provide quicker relief.

C) Check capillary refill hourly for the first 24 hr: Checking capillary refill is important to assess blood flow and perfusion, but hourly checks for 24 hours may not be necessary and can be overly frequent unless specific concerns arise. Monitoring should be based on clinical judgment and the client's condition.

D) Apply a compression dressing over the fracture site: Applying a compression dressing over the fracture site can help control bleeding and stabilize the area. Compound fractures involve an open wound, so controlling bleeding while minimizing the risk of infection is crucial. This intervention is essential in managing the initial trauma before more definitive surgical treatment.

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Correct Answer is C

Explanation

A. Discuss events with the child that have led to anxiety in the past.: While understanding past anxiety triggers can be helpful, focusing on specific strategies and action plans is more effective for managing current anxiety.

B. Assure the child that he is in control of the situation.: This might not always be accurate or helpful. Reassuring the child may not address the underlying anxiety or provide practical strategies for managing it.

C. Provide the child with a detailed action plan when he becomes anxious.: This approach is beneficial as it gives the child a structured plan to follow, which can help manage anxiety and provide a sense of control. Specific actions can help the child cope with anxiety in real-time.

D. Leave the child alone when he is exhibiting signs of anxiety.: Avoiding the child during episodes of anxiety can increase feelings of isolation and might not address the child's needs for support and guidance during these times.

A. Painful vesicles along a dermatome B. Acneiform nodules on the face C. Wheals surrounding raised bite marks D. Raised, linear burrows

Correct Answer is D

Explanation

A) Painful vesicles along a dermatome:
This finding is typically associated with herpes zoster (shingles), not scabies. Shingles causes painful vesicles that follow the path of a nerve and are confined to one side of the body, which does not align with the presentation of scabies.

B) Acneiform nodules on the face:
Acneiform nodules are related to conditions such as acne vulgaris, not scabies. Scabies does not typically present with acne-like lesions on the face but rather with intense itching and a specific rash.

C) Wheals surrounding raised bite marks:
Wheals and bite marks are more indicative of insect bites or conditions like urticaria (hives). Scabies is caused by mites that burrow under the skin, leading to a different type of rash.

D) Raised, linear burrows:
Raised, linear burrows are characteristic of scabies. These burrows are caused by the female mite as it tunnels just under the skin to lay eggs, resulting in a distinctive rash and intense itching, especially at night.

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A nurse in an emergency department is caring for a client who has a compound fracture of the right tibia. Which of the following actions should the nurse take?

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