A nurse is instructing a client on the maintenance of their cast. Which of the following instructions should be given to the client?
"You might feel tightness and pain with the cast and that is a normal feeling."
Trim off the rough edges of the cast if it bothers you in order to promote comfort."
"You might feel itchy under the cast, and it is okay to scratch under the cast with a very slim tool."
"Once the cast is dry, you can shower if you cover it with a plastic covering."
The Correct Answer is D
A. Tightness and pain can indicate complications such as impaired circulation or compartment syndrome and should not be considered normal. These symptoms should be reported immediately.
B. Clients should not trim or alter their cast. Doing so can compromise the integrity of the cast and increase the risk of injury or skin damage.
C. Inserting objects under the cast to relieve itching is unsafe and can cause skin injury or infection. Instead, clients should be advised to blow cool air under the cast or tap on the cast to relieve itching.
D. It is appropriate to shower with a cast if it is completely dry and covered with a waterproof plastic covering, which helps protect the cast from moisture and potential skin breakdown.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Applying mitten restraints may be appropriate if the client is at risk of removing essential medical devices, as long as it meets facility policy and safety standards.
B. An abduction pillow is a standard intervention for clients who have had hip surgery, especially total hip arthroplasty, to prevent hip dislocation—this is appropriate.
C. Applying a vest restraint daily at bedtime as a standing order is not appropriate. Restraints should never be used routinely or as a convenience; they require a specific indication, ongoing assessment, and frequent reevaluation. This prescription should be verified with the provider.
D. Soft heel protectors are a non-restrictive, comfort-based intervention used to prevent pressure injuries, and they are appropriate for clients in bed for extended periods.
Correct Answer is C
Explanation
A. Elevated temperature is not a typical sign of dialysis disequilibrium. Fever suggests infection (e.g., access-site infection or bacteremia), not fluid shifts.
B. Malaise is nonspecific and not a classic symptom of dialysis disequilibrium. It is common after dialysis due to fatigue, fluid shifts, and electrolyte changes.
C. Headache is a common symptom of dialysis disequilibrium syndrome, caused by rapid changes in fluid and solute balance during dialysis. Indicates increased intracranial pressure from cerebral edema. Requires immediate assessment and provider notification.
D. Nosebleed is not associated with dialysis disequilibrium. It suggests platelet dysfunction, anticoagulation effects, or hypertension.
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