The nurse is continuing to care for the child.

Exhibits

After reviewing the discharge instructions with the family, which of the following statements by a parent indicate an understanding of the teaching?
For each statement by the parent, click to specify if the statement reflects an understanding or indicates a need for reinforcement of the discharge teaching.

"We should notify the provider if the cast becomes loose over time."

"We should expect the swelling and tingling to worsen before it gets better."

"We need to be very careful about how we handle the cast for the first 2 days while it dries."

"It is important that our child avoids placing anything inside the cast.

"We should prop the casted arm on pillows for the next 24 hours."

Answer and Explanation

The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"B"},"C":{"answers":"A"},"D":{"answers":"A"},"E":{"answers":"A"}}

Rationale:

• "We should notify the provider if the cast becomes loose over time.": A loose cast can fail to immobilize the fracture properly, risking displacement or delayed healing. Recognizing this and contacting the provider demonstrates proper understanding of cast care.

• "We should expect the swelling and tingling to worsen before it gets better.": While mild swelling and tingling may occur, increasing or worsening neurovascular symptoms can indicate complications such as compartment syndrome. The parent needs reinforcement that any worsening sensation or cold fingers should prompt immediate provider notification rather than being expected.

• "We need to be very careful about how we handle the cast for the first 2 days while it dries.": Handling a wet cast improperly can deform it and compromise fracture stabilization. Awareness of this indicates correct knowledge of initial cast care.

• "It is important that our child avoids placing anything inside the cast.": Inserting objects into the cast can cause skin irritation, pressure ulcers, or infection. Avoiding this demonstrates understanding of safe cast management.

• "We should prop the casted arm on pillows for the next 24 hours.": Elevation of the casted limb reduces swelling and promotes comfort. This reflects correct knowledge of post-cast care.

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Free Nursing Study Resources

Correct Answer is A

Explanation

Rationale:
A. Creatinine: Serum creatinine is a key indicator of renal function. Cyclosporine is nephrotoxic, so monitoring both BUN and creatinine helps detect early signs of kidney impairment or transplant rejection.

B. Alkaline phosphatase: This enzyme primarily reflects liver and bone activity, not renal function. It is not routinely used to evaluate kidney status.

C. Bilirubin: Bilirubin levels are used to assess liver function and hemolytic disorders, not kidney function.

D. Amylase: Amylase is an enzyme related to pancreatic function and used to diagnose pancreatitis, not renal impairment.

A. Hypovolemia B. Hypotension C. Left ventricular failure D. Cardiogenic shock

Correct Answer is C

Explanation

Rationale:
A. Hypovolemia: Hypovolemia causes a decrease in PAWP due to reduced circulating blood volume and inadequate venous return to the heart. A low PAWP reflects decreased left ventricular preload, not an elevated value.

B. Hypotension: Hypotension alone does not directly increase PAWP. In fact, low blood pressure often accompanies decreased cardiac filling pressures. Elevated PAWP typically occurs with fluid overload or impaired ventricular function rather than simple hypotension.

C. Left ventricular failure: An elevated PAWP indicates increased left-sided heart pressures due to ineffective left ventricular pumping. Blood backs up into the pulmonary circulation, leading to pulmonary congestion and edema.

D. Cardiogenic shock: In cardiogenic shock, PAWP can be elevated due to impaired contractility, but it is accompanied by low cardiac output and hypotension. While related, the elevated PAWP in cardiogenic shock results from the underlying left ventricular failure, which is the primary cause of the pressure increase.

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Naxlex Comprehensive Predictor Exams

A nurse is reviewing the BUN result of a client who is taking cyclosporine following a kidney transplant. Which of the following laboratory studies should the nurse recognize as another renal function study that should be monitored?

Correct Answer is A

Explanation

A nurse is assessing a client's pulmonary artery wedge pressure (PAWP). The nurse should recognize that an elevated PAWP indicates which of the following complications?

Correct Answer is C

Explanation

A nurse is planning care for a client who is Chinese American and reports adhering to Chinese cultural postpartum practices. Which of the following should the nurse anticipate?

A nurse is reviewing the laboratory results for a female client who is receiving furosemide and digoxin. Which of the following findings should the nurse recognize increases the client's risk for developing digoxin toxicity?

A nurse is planning care for a client who has reduced visual sensory perception. Which of the following interventions should the nurse include in the plan of care?

A nurse is providing teaching to the guardian of a toddler about discipline techniques. Which of the following statements by the guardian indicate an understanding of the teaching?

A nurse in an emergency department is receiving report for four clients. Which of the following clients should the nurse see first?

A nurse is teaching a client who has an ileostomy about the care of their stoma site. Which of the following statements made by the client indicates the teaching was effective?

A nurse on a medical-surgical unit is performing medication reconciliation for a newly admitted client. Which of the following actions should the nurse take?