A nurse is caring for a 13-year-old with a tibia, fibula fracture, what is the priority assessment after a cast has been applied?

Assess the client's ability to use crutches

Assess the client's body image

Assess for worsening pain in the affected limb

Assess range of motion of the knee and hip

Answer and Explanation

The Correct Answer is C

A.   This is important for mobility, but after casting, the priority is to monitor for complications such as compartment syndrome, which can be life-threatening if not addressed.
B.   While body image and emotional well-being are important, the priority immediately following a fracture and cast placement is physical monitoring for complications.
C.   Worsening pain after a fracture or cast placement may indicate complications such as compartment syndrome, a medical emergency that requires prompt intervention. Monitoring for signs of increased pain is crucial.
D.   Range of motion is a later consideration after ensuring the child does not have complications such as compartment syndrome. The priority is evaluating the affected limb for issues like worsening pain or signs of nerve damage.

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Correct Answer is ["B","C","E"]

Explanation

A. Clear bilateral breath sounds are not typical in PDA; instead, crackles or signs of respiratory distress may be present.
B. Dyspnea (difficulty breathing) is common due to the increased pulmonary blood flow from the PDA.
C. A machine-like murmur heard at the right upper sternal border is characteristic of PDA.
D. Cyanosis is typically not present in isolated PDA unless the PDA is large and leads to right-to-left shunting.
E. Difficulty feeding is a common symptom because the newborn may tire easily due to inefficient circulation and increased work of breathing.

Correct Answer is []

Explanation

Absence Seizures:

The infant’s clinical presentation, including shaking of the arms and legs, lack of response to touch or voice, and the brief episodes of unconsciousness (lasting around 5 minutes), is consistent with absence seizures (also known as petit mal seizures). These seizures typically involve brief episodes of altered consciousness with subtle motor activity like shaking or jerking, and the child resumes normal activity afterward. The child’s seizure episodes seem to stop on their own, and the child appears to sleep soundly after the episodes, which further points to absence seizures.

Actions to Take:

Initiate seizure precautions:

Seizure precautions are essential to ensure the infant’s safety during and after a seizure episode. This includes making sure the environment is free from hazards and that the infant is being closely monitored.

Keep infant NPO until they are fully awake and alert:

Keeping the infant NPO (nothing by mouth) is essential to prevent aspiration risk during and after the seizure. Once the infant is fully awake and alert, they can resume normal feeding.

Parameters to Monitor:

Level of consciousness:

Monitoring the infant’s level of consciousness is crucial because the primary concern during absence seizures is the alteration of consciousness. After the seizure, assessing their responsiveness and mental state will help evaluate the resolution of the episode.

Motor ability:

The motor ability should be monitored to check for any residual effects from the seizure, such as weakness or abnormal movements, and to assess for any motor symptoms during the seizure.

Explanation of Incorrect Choices:

Akinetic seizures:

Akinetic seizures involve loss of muscle tone and are often associated with sudden collapse or "drop attacks." This is not consistent with the infant’s symptoms, which include shaking rather than sudden loss of muscle tone.

Tonic-clonic seizures:

Tonic-clonic seizures (grand mal seizures) typically involve both tonic (muscle stiffening) and clonic (jerking) movements with a loss of consciousness. While the infant is having shaking episodes, the description does not indicate the full tonic-clonic presentation.

Focal seizures with impaired awareness:

Focal seizures typically involve abnormal activity in one part of the brain and often manifest with

symptoms localized to one area of the body. This infant’s symptoms are more generalized, with shaking

in the arms and legs, and a lack of response, which aligns better with absence seizures.

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A nurse is caring for a 13-year-old with a tibia, fibula fracture, what is the priority assessment after a cast has been applied?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a newborn with suspected Patent Ductus Arteriosus (PDA). What signs and symptoms should the nurse expect to find when assessing the newborn? (Select All That Apply).

Correct Answer is ["B","C","E"]

Explanation

Correct Answer is []

Explanation

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