The nurse is continuing to care for the child.
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."
"It is important that our child avoids placing anything inside the cast."
"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."
"We should prop the casted arm on pillows for the next 24 hours."
The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"A"},"E":{"answers":"A"}}
Rationale:
- "We should notify the provider if the cast becomes loose over time." A loose cast may no longer immobilize the fracture effectively and can allow excessive movement. It may also rub the skin, increasing the risk of irritation or breakdown.
- "It is important that our child avoids placing anything inside the cast." This statement reflects understanding because inserting objects inside the cast can break the skin and introduce bacteria, leading to infection. It may also damage the padding and compromise skin protection.
- "We should expect the swelling and tingling to worsen before it gets better." This statement needs reinforcement because worsening swelling and tingling can indicate early signs of compartment syndrome. These symptoms are not normal and should prompt immediate medical attention.
- "We need to be very careful about how we handle the cast for the first 2 days while it dries." This shows understanding because a plaster cast takes 24 to 48 hours to fully dry. Improper handling can cause pressure indentations, leading to skin damage and poor cast integrity
- "We should prop the casted arm on pillows for the next 24 hours." Elevating the limb helps reduce swelling and pain by improving venous return. Keeping the casted arm elevated is a standard part of cast care teaching after an injury.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Rationale:
A. "Store oxygen cylinders on their side.": Oxygen cylinders should always be stored upright and secured to prevent tipping, rolling, or falling, which could damage the valve and create a fire hazard. Storing cylinders on their side increases the risk of accidents and is unsafe in the home setting.
B. "Use two-prong electrical outlets in the room where oxygen is used.": Electrical safety requires that outlets and devices used near oxygen be in good condition and free of sparks. The number of prongs is not the key concern; rather, all electrical equipment should be properly grounded and well-maintained to prevent ignition in an oxygen-rich environment.
C. "You can adjust the flow of your oxygen as needed.": Oxygen flow should only be adjusted according to the provider’s prescription. Changing the flow without guidance can result in hypoxia if decreased or oxygen toxicity if increased, making this statement unsafe and incorrect.
D. "Notify your power company that oxygen is used in the home.": Informing the power company is an important safety measure because home oxygen use increases fire risk. Utility companies can provide guidance on electrical safety, and emergency responders will be aware of the presence of oxygen in case of power outages or accidents.
Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"C"}
Explanation
Rationale for correct choices
• heparin 30 units/kg IV bolus once: The diagnostic ultrasound confirms a thrombus in the right leg, indicating acute DVT. Anticoagulation with heparin is the first-line intervention to prevent clot extension and pulmonary embolism. The lab values (normal platelets, normal INR) show no contraindication to starting anticoagulation.
• acetaminophen 650 mg PO every 4 hr PRN: Acetaminophen is appropriate for managing the client’s pain (rated 6/10) without increasing bleeding risk. NSAIDs such as ibuprofen are avoided in DVT because they can impair platelet function and increase bleeding risk once anticoagulation is initiated.
Rationale for incorrect choices
• initiating fluid restriction: Fluid restriction is typically used in conditions like heart failure or hyponatremia, not DVT. Adequate hydration is beneficial in DVT because it helps maintain blood viscosity and supports circulation without affecting clot stability.
• maintaining the extremity below the level of the heart: Lowering the extremity increases venous pressure and can worsen swelling. For DVT, the extremity is usually elevated to promote venous return and reduce edema, so this option does not align with recommended care.
• administering cold packs to the extremity: Cold therapy can cause vasoconstriction and slow venous blood flow, which may worsen thrombosis. Warm compresses improve circulation but are used cautiously and only with provider guidance.
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