What is the most important nursing care aspect for a client with a new long leg cast?

Check the circulation and movement of toes frequently

Place the casted leg in traction for 8 hours daily

Alternate heat and cold therapy on the cast

Put the patient on complete bed rest immediately

Answer and Explanation

The Correct Answer is A

Rationale:
A. Frequent neurovascular assessments—checking circulation, movement, and sensation in the toes—are essential to detect early signs of complications such as compartment syndrome, impaired perfusion, or nerve damage. This is the priority nursing action.
B. Traction is not routinely applied with a long leg cast unless specifically ordered for a separate condition.
C. Heat and cold therapy should not be applied directly to a cast due to risk of skin injury and inability to accurately assess temperature through the cast material.
D. Complete bed rest is not necessary for most clients with a leg cast and can increase the risk of complications such as deep vein thrombosis and deconditioning.

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Correct Answer is C

Explanation

Rationale:
A. Deep breathing and coughing exercises are important but ensuring catheter patency is more critical immediately post-prostatectomy to prevent urinary retention and bladder distention.
B. Strict bed rest is generally not required; early ambulation is encouraged to reduce complications.
C. Maintaining a patent indwelling catheter is essential after prostatectomy to prevent urinary obstruction, bladder distension, and potential damage to the surgical site.
D. Monitoring for infection is important but is a routine ongoing assessment rather than the immediate priority.

A. Pain that radiates to the left shoulder and worsens with deep breathing B. Generalized abdominal pain that improves with eating C. Left lower quadrant pain with rebound tenderness D. Right lower quadrant pain at McBurney's point with rebound tenderness

Correct Answer is D

Explanation

Rationale:
A. Pain radiating to the left shoulder and worsening with deep breathing (Kehr’s sign) is more indicative of splenic injury, not appendicitis.
B. Pain from appendicitis typically worsens with movement and does not improve with eating; improvement with food is more characteristic of peptic ulcer disease.
C. Left lower quadrant pain is more consistent with diverticulitis, not appendicitis.
D. Right lower quadrant pain at McBurney's point with rebound tenderness is a hallmark sign of acute appendicitis, making this the most indicative finding.

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What is the most important nursing care aspect for a client with a new long leg cast?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client has just undergone a prostatectomy for benign prostatic hyperplasia (BPH). Which of the following nursing interventions is most important in the immediate post-operative period?

Correct Answer is C

Explanation

A 20-year-old client presents to the emergency department with abdominal pain. Which assessment finding is most indicative of acute appendicitis?

Correct Answer is D

Explanation

A nurse is planning care for a client who has diverticulitis. Which of the following menu guidance should the nurse include in the plan?

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A nurse is creating a teaching plan for a client who has thrombocytopenia. Which of the following instructions should the nurse include?

A nurse is caring for a client who is 5 hours postoperative following a transurethral resection of the prostate (TURP). The nurse notes that the client's indwelling urinary catheter has not drained in the past hour. Which of the following actions should the nurse take first?