A client with a compound fracture of the left ankle is being discharged with a below-the-knee cast. Which
instruction should the practical nurse (PN) provide to the client prior to discharge?
Apply a cold pack to any "hot spots" on the cast.
Keep the left leg in a dependent position.
Expect some increase in pain.
Never scratch under the cast.
The Correct Answer is D
When providing instructions to a client with a below-the-knee cast for a compound fracture of the left ankle, it is important to prioritize their safety and proper care of the cast. The instruction to never scratch under the cast is crucial for preventing complications and maintaining the integrity of the cast.
Let's evaluate the other options:
a) Apply a cold pack to any "hot spots" on the cast.
Applying a cold pack to any "hot spots" on the cast may help alleviate discomfort or itching, but it is not the highest priority instruction. Preventing scratching under the cast is more important to avoid skin damage or infection.
b) Keep the left leg in a dependent position.
Keeping the left leg in a dependent position (hanging down) is not the appropriate instruction for a client with a below-the-knee cast. It is generally recommended to elevate the injured limb to reduce swelling and promote proper blood flow. Elevating the leg would involve keeping it raised above the level of the heart.
c) Expect some increase in pain.
While it is possible for the client to experience some increase in pain after the application of a cast, this instruction alone is not comprehensive or specific enough for proper discharge education. Providing information about pain management strategies or when to seek medical atention for excessive pain would be more appropriate.
In summary, when discharging a client with a compound fracture of the left ankle and a below-the-knee cast, the practical nurse (PN) should provide the instruction to never scratch under the cast. This helps prevent complications and maintain the integrity of the cast, promoting proper healing of the fracture.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Decreasing bright lights is not the first action that the nurse should perform because it does not address the priority problem of potential infection and inflammation of the meninges, which can cause serious complications such as brain damage or deatH. Decreasing bright lights can help reduce photophobia and headache, but it is not an urgent intervention.
Choice B reason: Initiating IV access is not the first action that the nurse should perform because it does not address the priority problem of potential infection and inflammation of the meninges, which can cause serious complications such as brain damage or deatH. Initiating IV access can facilitate fluid and medication administration, but it is not an immediate intervention.
Choice C reason: Administering antibiotics is not the first action that the nurse should perform because it requires a physician's order and confirmation of the diagnosis and causative organism by laboratory tests such as blood culture or cerebrospinal fluid (CSF) analysis. Administering antibiotics can treat bacterial meningitis, but it is not a priority intervention.
Choice D reason: Implementing droplet precautions is the first action that the nurse should perform because it addresses the priority problem of potential infection and inflammation of the meninges, which can cause serious complications such as brain damage or deatH. Implementing droplet precautions can prevent transmission of meningitis to other clients or staff, as meningitis can be spread by respiratory droplets from coughing, sneezing, or talkinG.
Correct Answer is ["C","D"]
Explanation
Choice A reason: Inability to take risks is not a quality of an effective nurse leader because it can limit the nurse's creativity, innovation, and problem-solving skills, as well as prevent the nurse from exploring new opportunities and learning from mistakes.
Choice B reason: Never considers being a follower is not a quality of an effective nurse leader because it can isolate the nurse from the team, hinder collaboration and communication, and create a sense of superiority and arrogancE.
Choice C reason: Ability to set priorities is a quality of an effective nurse leader because it can help the nurse manage time, resources, and tasks efficiently and effectively, as well as focus on the most important and urgent goals and outcomes.
Choice D reason: Integrity is a quality of an effective nurse leader because it can foster trust, respect, and honesty among the team, as well as demonstrate the nurse's adherence to ethical principles and professional standards.
Choice E reason: Critical care certification is not a quality of an effective nurse leader because it is a credential that reflects the nurse's knowledge and competence in a specific area of practice, but not necessarily their leadership skills or abilities.
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