A nurse is assessing a client who has a cast in place for a fractured tibia. Which of the following actions should the nurse take first?

Performing range of motion

Managing pain

Checking capillary refill

Discussing cast care

Answer and Explanation

The Correct Answer is C

A. Performing range of motion:
Explanation: Range of motion exercises are important for preventing joint stiffness and muscle atrophy, especially in clients with casts. However, this is not the first priority. Ensuring adequate circulation and perfusion is crucial before initiating any exercises or movements, as compromised circulation could lead to serious complications.

B. Managing pain:
Explanation: Pain management is important for the client's comfort, but it is not the first priority in this context. Assessing circulation and ensuring there are no signs of compromised perfusion takes precedence. Pain management can follow once circulation has been confirmed as adequate.

C. Checking capillary refill:
Explanation: Checking capillary refill is the first priority when assessing a client with a cast. Capillary refill assesses peripheral circulation by pressing on the nail bed and observing how quickly color returns. Delayed capillary refill could indicate compromised blood flow, which is a serious concern and requires immediate intervention.

D. Discussing cast care:
Explanation: Educating the client about cast care is important, but it is not the first priority. Ensuring proper circulation and ruling out any signs of impaired perfusion must be addressed before discussing cast care instructions.

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Free Nursing Study Resources

Correct Answer is A

Explanation

A. "Pyelonephritis increases a person's risk for kidney damage." - Pyelonephritis is a bacterial infection of the renal parenchyma and renal pelvis, typically caused by the ascent of bacteria from the lower urinary tract into the kidneys. If left untreated, it can lead to kidney damage, including scarring of the renal tissue and impaired kidney function.

B. "Pyelonephritis is an infection of the lower urinary tract." - This statement is incorrect. Pyelonephritis specifically involves the upper urinary tract, affecting the kidneys. In contrast, infections of the lower urinary tract (such as cystitis) affect the bladder and urethra.

C. "Pyelonephritis often causes no symptoms in affected clients." - This statement is incorrect. Pyelonephritis typically presents with symptoms such as fever, chills, flank pain, painful urination (dysuria), and frequent urination. Clients with pyelonephritis usually experience noticeable symptoms.

D. "Pyelonephritis is most often caused by Staphylococcus saprophyticus." - This statement is incorrect. While Staphylococcus saprophyticus is a common cause of urinary tract infections, pyelonephritis is more commonly caused by gram-negative bacteria, such as Escherichia coli, which often ascend from the lower urinary tract into the kidneys.

A. Restrict calcium intake to one serving per day. B. Take 3.000 mg of vitamin C daily. C. The nurse should instruct the client to limit foods high in purines. D. Eat 12 oz of animal protein daily.

Correct Answer is C

Explanation

A. Restrict calcium intake to one serving per day:
This statement is not accurate. Adequate calcium intake is essential for bone health. Calcium-rich foods are important for maintaining strong bones and are not directly related to gout or uric acid kidney stones. It's crucial to differentiate between dietary recommendations for different health conditions.

B. Take 3,000 mg of vitamin C daily:
High doses of vitamin C can increase urinary oxalate and uric acid levels, which might contribute to the formation of kidney stones. It is generally not recommended for individuals with a history of uric acid kidney stones.

C. The nurse should instruct the client to limit foods high in purines.
Dietary changes are important in managing gout and preventing uric acid kidney stones. Purines are natural substances found in many foods, especially animal products, and purine-rich foods can contribute to increased uric acid levels, leading to gout attacks and kidney stones.

D. Eat 12 oz of animal protein daily:
Consuming excessive amounts of animal protein, particularly red meat, can lead to higher purine intake, which is not advisable for individuals prone to gout and uric acid kidney stones. High animal protein intake can increase uric acid production and may exacerbate these conditions. Moderation in protein intake, especially from animal sources, is recommended.

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A nurse is assessing a client who has a cast in place for a fractured tibia. Which of the following actions should the nurse take first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is teaching a group of nursing students about pyelonephritis. Which of the following statements should the nurse include in the teaching?

Correct Answer is A

Explanation

A nurse is providing dietary teaching to a client who has a history of gout and recurring uric acid kidney stones. Which of the following instructions should the nurse include in the teaching?

Correct Answer is C

Explanation

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