A nurse is caring for a client following application of a cast. Which of the following actions should the nurse take first?

Palpate the pulse distal to the cast.

Position the casted extremity on a pillow.

Place an ice pack over the cast.

Teach the client to keep the cast clean and dry.

Answer and Explanation

The Correct Answer is A

Rationale:

A. Palpate the pulse distal to the cast: Assessing neurovascular status is the priority immediately after cast application. Palpating the distal pulse helps determine adequate circulation and can detect complications like compartment syndrome early, which can lead to permanent damage if untreated.

B. Position the casted extremity on a pillow: Elevating the extremity helps reduce swelling and pain, but it is a secondary action. Ensuring perfusion through a pulse check takes precedence before supportive comfort measures are initiated.

C. Place an ice pack over the cast: Cold therapy can help minimize swelling and pain in the initial hours after casting, but it should only be done after confirming that circulation is intact. Ice packs should also be used carefully to prevent moisture from damaging the cast.

D. Teach the client to keep the cast clean and dry: Education is important for long-term cast care, but it is not the immediate priority after application. Early assessment for circulation, sensation, and movement must occur first to ensure the cast has not compromised perfusion.

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Correct Answer is A

Explanation

Rationale:

A. Assess the client's peripheral pulses every 15 min: Frequent assessment of peripheral pulses is essential to monitor for signs of arterial obstruction, bleeding, or hematoma formation at the femoral site. This helps ensure adequate perfusion and detect complications early.

B. Elevate the head of the client's bed to 45°: After femoral catheterization, the head of the bed should be elevated no more than 30° to reduce pressure at the puncture site and prevent bleeding. A 45° angle may increase the risk of hemorrhage.

C. Change the client's dressing 4 hr following the procedure: The dressing should remain in place and be monitored for signs of bleeding or saturation. Routine dressing changes shortly after the procedure are not recommended unless soiled or ordered.

D. Instruct the client to flex the right knee every 30 min: Flexing the leg increases the risk of dislodging the clot or reopening the arterial puncture site. The affected leg should remain straight and immobilized for several hours post-procedure.

A. Phlebitis B. Peripheral neuropathy C. Osteoarthritis D. Abdominal aortic aneurysm

Correct Answer is B

Explanation

Rationale:

A. Phlebitis: Heat therapy is often used to treat phlebitis because it promotes vasodilation and increases blood flow, which can help reduce inflammation and pain at the site of vein irritation.

B. Peripheral neuropathy: Clients with peripheral neuropathy have decreased sensation, putting them at risk for burns or tissue injury because they may not perceive excessive heat. This makes heat therapy unsafe in these individuals.

C. Osteoarthritis: Heat is commonly used to relieve joint stiffness and muscle spasms in osteoarthritis. It helps increase circulation and reduce discomfort in affected joints, especially before physical activity.

D. Abdominal aortic aneurysm: While an abdominal aortic aneurysm is a serious condition, it is not directly impacted by localized heat therapy to a foot. However, heat should still not be applied near the aneurysm site. For distal injuries, it’s not a specific contraindication.

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A nurse is caring for a client following application of a cast. Which of the following actions should the nurse take first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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