A nurse is providing discharge teaching to a client who has a Plaster of Paris walking cast on his left lower leg. Which of the following instructions should the nurse include?

There is no need to cover the cast when showering.

Apply ice to your foot after walking.

A musty odor is normal as the cast ages.

Report any numbness or pain in your toes.

Answer and Explanation

The Correct Answer is D

Choice A reason:
It is important to keep a Plaster of Paris cast dry because moisture can weaken the cast and irritate the skin underneath. Therefore, the cast should be covered while showering to prevent it from getting wet.

Choice B reason:
Applying ice to the foot after walking can help reduce swelling and provide pain relief. It is a common recommendation for managing discomfort associated with a walking cast. The ice should be applied over the cast at the level of the injury for 15-30 minutes, repeating every few hours for the first few days.

Choice C reason:
While a musty odor can develop over time due to sweat and lack of air circulation, it is not necessarily normal and could indicate a problem such as an infection. If there is a persistent unpleasant odor, it should be evaluated by a healthcare provider.

Choice D reason:
Numbness or pain in the toes can be a sign of compromised circulation or nerve compression and should be reported immediately. It is crucial to monitor for any changes in sensation or increased pain, as these could indicate a serious issue that requires medical attention.

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Correct Answer is D

Explanation

Choice A reason:
Abdominal distention can be a sign of delayed return of peristalsis or ileus, especially when accompanied by other symptoms such as nausea, vomiting, or lack of bowel movement. It is not typically a sign that peristalsis is returning.

Choice B reason:
A request for a cup of tea and some toast may indicate that the client is feeling better and is hungry, which can be a good sign. However, it is not a definitive clinical indicator of the return of peristalsis. The desire to eat does not necessarily mean that the digestive system is ready to process food.

Choice C reason:
Hypoactive bowel sounds in two quadrants may indicate that peristalsis is present but weak. While this could be a sign that peristalsis is starting to return, it is not as strong an indicator as the passage of flatus or stool.

Choice D reason:
The passage of flatus is a clear sign that peristalsis is returning. It indicates that gas is moving through the intestines, which is a function of peristalsis. This is often one of the first signs that the gastrointestinal system is recovering after surgery.

A. "Dietary supplements have not been tested and approved by the government." B. "Dietary supplements can cause a drug-drug interaction with nitrates." C. "There is not enough evidence that dietary supplements are effective for erectile dysfunction." D. "Dietary supplements may be expensive and are not typically covered by insurance."

Correct Answer is B

Explanation

Choice A reason:
While it is true that many dietary supplements have not been tested and approved by the government, this is not the most critical information for a client taking nitroglycerin. The primary concern with dietary supplements is their potential interaction with other medications.

Choice B reason:
This is the most important statement for the nurse to include. Dietary supplements, especially those containing L-arginine or other compounds that affect blood flow, can have serious interactions with nitrates like nitroglycerin, potentially leading to dangerously low blood pressure.

Choice C reason:
The effectiveness of dietary supplements for erectile dysfunction varies, and there is indeed a lack of evidence for many of these products. However, the immediate concern for a client taking nitroglycerin is the risk of interaction, not the general effectiveness of supplements.

Choice D reason:
The cost and insurance coverage of dietary supplements can be a concern for clients, but it is not as critical as understanding the potential risks associated with their use alongside prescribed medications like nitroglycerin.

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A nurse is providing discharge teaching to a client who has a Plaster of Paris walking cast on his left lower leg. Which of the following instructions should the nurse include?

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Naxlex Comprehensive Predictor Exams

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