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 B
Explanation
Choice A rationale:
Planning to have the client lay down for 1 hour after meals is not an appropriate intervention for a client with COPD. It may increase the risk of aspiration and worsen their breathing difficulties.
Choice C rationale:
Encouraging the client to use the upper chest for respiration is not the best approach for a client with COPD. Pursed-lip breathing helps improve oxygen exchange and decreases air trapping, which is more effective in managing COPD.
Choice D rationale:
Restricting the client's fluid intake to less than 1 Vday is not a suitable intervention for a client with COPD. Dehydration can lead to thicker mucus, making it harder to breathe
Correct Answer is ["B","C","D"]
Explanation
Choice A reason: Nurses performing duties outside of the nurses' typical job description is not a component of a disaster plan. Nurses should only perform tasks that are within their scope of practice, license, and competencE.
Choice B reason: A plan for comprehensive practice drills is a component of a disaster plan. Nurses should be involved in conducting regular drills to test and improve the preparedness and response of the staff and facility.
Choice C reason: Identification of resources to meet anticipated needs for food, water, and supplies is a component of a disaster plan. Nurses should be involved in assessing and securing the necessary resources to provide adequate care and support for the clients and staff during a disaster.
Choice D reason: An internal and external communication plan is a component of a disaster plan. Nurses should be involved in establishing and maintaining effective communication channels with other health care providers, agencies, authorities, media, and community during a disaster.
Choice E reason: Discharge all surgical clients who are one day or more post-op is not a component of a disaster plan. Nurses should not discharge clients without proper assessment, documentation, education, and follow-up arrangements.
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