The nurse is conducting teaching to parents of a 7-year-old child who fractured an arm and is being discharged with a cast. Which instruction would be included in the teaching?
Elevate casted arm when resting and when sitting up.
Immobilize the shoulder to decrease pain in the arm.
Swelling of the fingers is to be expected for the next 48 hours.
Allow the affected limb to hang down for 1 hour each day.
The Correct Answer is A
A. Elevating the casted arm helps reduce swelling and promotes circulation. The arm should be elevated above the heart level when resting to minimize swelling.
B. Immobilizing the shoulder is unnecessary unless specifically instructed, as immobilizing the shoulder is not required for most arm fractures.
C. Swelling of the fingers can occur with a cast, but it should not last longer than 24 hours. Prolonged swelling should be reported.
D. Allowing the limb to hang down may increase swelling and should be avoided.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. The toddler’s behavior—sitting quietly and turning away from the nurse—suggests anxiety due to separation from the mother. This is typical of toddlers who experience distress when separated from caregivers.
B. Developing autonomy is a developmental task of toddlers, but the behavior described (turning away from the nurse and seeking comfort through thumb-sucking) indicates distress rather than an expression of independence.
C. Regression can occur in toddlers when they experience stress, but the behavior here seems more related to anxiety than a return to earlier developmental behaviors.
D. Resentment toward the mother is unlikely in this situation; the behavior is more indicative of separation anxiety.
Correct Answer is B
Explanation
A. Elevating the head of the bed may be useful after airway management but is not the priority in anaphylaxis.
B. Administering IM epinephrine is the priority action in anaphylaxis, as it works rapidly to reverse the symptoms by constricting blood vessels, relaxing smooth muscles, and improving breathing.
C. Determining the allergen is important for future prevention, but the immediate priority is treating the reaction.
D. While establishing IV access is important for fluid resuscitation, it is not the priority over administering epinephrine in anaphylaxis.
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