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.

Answer and Explanation

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.

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Correct Answer is C

Explanation

A. Rather than helping the child accept a loss of control, atraumatic care focuses on empowering the child and promoting a sense of control through participation in care and decision-making.

B. While pain management is crucial, the goal is not to have the child "accept" pain but to minimize it through interventions like distraction, pharmacologic pain relief, and comfort measures.

C. Preparing the child for unfamiliar treatments or procedures aligns with the principles of atraumatic care, which aim to reduce fear, anxiety, and physical and emotional distress. By offering developmentally appropriate explanations, the nurse helps the child feel more in control and reduces the traumatic impact of the experience.

D. Atraumatic care emphasizes maintaining parental involvement during hospitalization whenever possible. Preparing the child for separation does not align with atraumatic care principles, as separation is a source of stress that should be minimized.

A. A WBC of 6,000/mm3 B. Purulent nasogastric drainage C. Passage of dark red stool with mucus D. Absence of peristalsis

Correct Answer is D

Explanation

A. A WBC of 6,000/mm³ is within the normal range (4,500-11,000/mm³), and a postoperative infection is more likely to result in an elevated WBC count.

B. Purulent nasogastric drainage is more suggestive of a gastrointestinal issue unrelated to a perforated appendix and is not a common finding post-surgery.

C. Passage of dark red stool with mucus could suggest gastrointestinal bleeding or infection, but it is not typical postoperatively after a perforated appendix.

D. After surgery for a perforated appendix, peristalsis may be absent initially due to the effects of anesthesia, bowel manipulation, or inflammation from the infection. This is a normal postoperative finding.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which intervention would the nurse include when providing atraumatic care?

Correct Answer is C

Explanation

A nurse is assessing a school-age child immediately postoperative following a perforated appendix. Which of the following finding should the nurse expect?

Correct Answer is D

Explanation

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