A nurse is assessing a client who has a newly applied cast on their right arm. Which of the following findings should the nurse identify as an indication the client is experiencing paresthesia?
The client's right radial pulse is+1.
The client reports the analgesics are not working.
The client describes a tingling sensation.
The client's extremity below the cast has reduced pigmentation.
The Correct Answer is C
A. The client's right radial pulse is +1: A diminished pulse can indicate compromised circulation, such as arterial compression or compartment syndrome, but it does not specifically reflect paresthesia, which is a sensory symptom. Circulatory assessment is important but assesses perfusion rather than nerve sensation.
B. The client reports the analgesics are not working: Inadequate pain control may indicate severe pain or early compartment syndrome, but it does not specifically identify paresthesia. Pain and paresthesia are related but distinct; paresthesia refers to abnormal sensations like tingling or numbness rather than general pain intensity.
C. The client describes a tingling sensation: Paresthesia is characterized by abnormal sensations such as tingling, numbness, or “pins and needles.” The client’s report of tingling below or around the cast is a direct indication of nerve irritation or compression and warrants prompt assessment to prevent permanent nerve damage.
D. The client's extremity below the cast has reduced pigmentation: Changes in skin color can indicate compromised circulation, such as cyanosis or ischemia, but reduced pigmentation is not a primary symptom of paresthesia. Sensory symptoms are the hallmark of paresthesia rather than visual changes in skin color.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. A client who has measles: Measles is a highly contagious viral infection transmitted via airborne droplets that can remain suspended in the air for long periods. Implementing airborne precautions, including placing the client in a negative-pressure room and using an N95 or higher-level respirator, is essential to prevent transmission to others.
B. A client who has vancomycin-resistant enterococcus: VRE is transmitted primarily via contact with contaminated surfaces or direct contact with infected persons. Contact precautions, including gloves and gowns, are appropriate, but airborne precautions are not necessary.
C. A client who has pertussis: Pertussis (whooping cough) is transmitted through respiratory droplets, so droplet precautions, including a surgical mask for staff and visitors, are indicated. Airborne precautions are not required.
D. A client who has respiratory syncytial virus: RSV is primarily spread via contact with respiratory secretions and droplets. Contact and droplet precautions are recommended, but airborne precautions are not needed unless an aerosol-generating procedure is being performed.
Correct Answer is C
Explanation
A. Transdermal patch: Combined hormonal contraceptives, such as the transdermal patch, contain both estrogen and progestin. Estrogen increases the risk of thromboembolic events, particularly in clients over 35 who smoke, making it contraindicated for this client due to increased risk of deep vein thrombosis, pulmonary embolism, stroke, and myocardial infarction.
B. Vaginal ring: The vaginal ring also delivers combined estrogen and progestin. Although it is administered locally, systemic absorption still occurs, and the associated estrogen exposure poses similar cardiovascular risks to smokers over 35, making it inappropriate for this client.
C. Cervical cap: The cervical cap is a barrier method of contraception that does not involve hormones. It physically prevents sperm from entering the cervix and does not carry the cardiovascular risks associated with estrogen-containing methods. This makes it a safe and effective contraceptive choice for a 37-year-old client who smokes.
D. Oral contraception: Combined oral contraceptives contain estrogen and progestin. Estrogen exposure in smokers over 35 significantly increases the risk of cardiovascular events, including thrombosis, stroke, and myocardial infarction. Therefore, oral contraceptives are contraindicated for this client.
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