A nurse is caring for a toddler who had a cast applied 2 hr ago due to multiple fractures of the right hand. Which of the following findings should the nurse report immediately to the charge nurse?

The parent reports the child will not keep the arm elevated on the pillow.

The fingers on the right hand have a capillary refill of 4 seconds.

The fingertips of the right hand are swollen and bruised.

The child is not attempting to move her right arm or fingers.

Answer and Explanation

The Correct Answer is B

A. The parent reports the child will not keep the arm elevated on the pillow: Not a priority. While elevation is important, it is not immediately concerning.

B. The fingers on the right hand have a capillary refill of 4 seconds: Correct. A capillary refill time of more than 2 seconds indicates poor perfusion, which can be a sign of compartment syndrome, a serious complication.

C. The fingertips of the right hand are swollen and bruised: Concerning, but swelling and bruising can be normal post-injury. Immediate concern is perfusion.

D. The child is not attempting to move her right arm or fingers: Concerning, but can be due to pain or fear. Poor perfusion (B) is a more immediate threat.

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Correct Answer is D

Explanation

A. "I will provide low-fat meals for my child.": Children with cystic fibrosis need a high-calorie, high-fat diet to meet their increased energy needs and to help with growth and development due to malabsorption issues.

B. "I will restrict the amount of salt in my child's meals.": Children with cystic fibrosis tend to lose more salt through sweat and often require additional salt in their diet.

C. "I will put my child in daycare to ensure that she socializes with other children.": While socialization is important, children with cystic fibrosis are at higher risk for respiratory infections and should avoid environments where they are more likely to be exposed to pathogens.

D. "I will make sure my child washes her hands before eating.": Hand hygiene is crucial for preventing infections, which are a significant risk for children with cystic fibrosis due to their compromised lung function.

A. "Sweating can occur with hypoglycemia." B. "My son might have nausea and vomiting with hypoglycemia." C. "My son might complain of feeling shaky when he has a low blood glucose level." D. "The onset of low blood glucose usually occurs rapidly."

Correct Answer is B

Explanation

A. ``Sweating can occur with hypoglycaemia." Sweating is a common symptom of hypoglycemia due to the activation of the sympathetic nervous system. This statement is accurate and does not require clarification.

B. "My son might have nausea and vomiting with hypoglycemia." Nausea and vomiting are typically associated with hyperglycemia and diabetic ketoacidosis (DKA), not hypoglycaemia. Hypoglycaemia usually presents with symptoms like sweating, shakiness, confusion, and hunger. This statement indicates a misunderstanding that needs to be clarified.

C. ``My son might complain of feeling shaky when he has a low blood glucose level." Feeling shaky is a common symptom of hypoglycemia due to the body's response to low blood glucose levels. This statement is correct and does not need clarification.

D. "The onset of low blood glucose usually occurs rapidly." Hypoglycaemia often has a rapid onset, particularly when caused by factors like excessive insulin or missed meals. This statement is accurate and does not require clarification.

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A nurse is caring for a toddler who had a cast applied 2 hr ago due to multiple fractures of the right hand. Which of the following findings should the nurse report immediately to the charge nurse?

Nursing Test Bank

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