A nurse in an emergency department is caring for a client who has a compound fracture of the right tibia. Which of the following actions should the nurse take?

Keep client in semi-Fowler's position with right extremity flat.

Manage pain with oral opioids every 6 hr.

Check capillary refill hourly for the first 24 hr.

Apply a compression dressing over the fracture site.

Answer and Explanation

The Correct Answer is D

A) Keep client in semi-Fowler's position with right extremity flat: Keeping the client in a semi-Fowler's position with the extremity flat is not appropriate for managing a compound fracture. Elevating the affected limb, if possible, helps reduce swelling and pain, but the position should also consider overall stability and comfort.

B) Manage pain with oral opioids every 6 hr: Oral opioids are not the best choice for immediate pain management in an emergency setting, especially with a compound fracture. Intravenous pain medications are typically more effective for acute, severe pain in such situations and can provide quicker relief.

C) Check capillary refill hourly for the first 24 hr: Checking capillary refill is important to assess blood flow and perfusion, but hourly checks for 24 hours may not be necessary and can be overly frequent unless specific concerns arise. Monitoring should be based on clinical judgment and the client's condition.

D) Apply a compression dressing over the fracture site: Applying a compression dressing over the fracture site can help control bleeding and stabilize the area. Compound fractures involve an open wound, so controlling bleeding while minimizing the risk of infection is crucial. This intervention is essential in managing the initial trauma before more definitive surgical treatment.

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Correct Answer is D

Explanation

A) Contact dermatitis: This condition results from an allergic reaction or irritation caused by contact with a substance, such as chemicals, detergents, or allergens. It is not a communicable skin infection and does not spread from person to person.

B) Actinic keratoses: These are rough, scaly patches on the skin caused by prolonged exposure to ultraviolet (UV) rays. They are considered precancerous lesions and are not contagious. They result from environmental factors rather than person-to-person transmission.

C) Psoriasis: This is a chronic autoimmune condition that leads to the rapid buildup of skin cells, causing scaling on the skin's surface. It is not contagious and does not spread through person-to-person contact. Psoriasis is an inherited condition influenced by immune system triggers.

D) Herpes zoster: Also known as shingles, this condition is caused by the reactivation of the varicella-zoster virus (the same virus that causes chickenpox). While shingles itself is not spread from person to person, the virus can be transmitted from a person with shingles to someone who has never had chickenpox, potentially causing chickenpox in the latter individual. The virus is spread through direct contact with the fluid from the blisters.

A. "What are you looking forward to each day?" B. "Can you tell me about your sleep patterns?" C. "Have you ever felt like you don't want to live anymore?" D. "Are you taking any medications at this time?"

Correct Answer is C

Explanation

A) "What are you looking forward to each day?": While asking about daily expectations can provide insight into the client's coping mechanisms and hopefulness, it does not immediately address potential safety concerns. It is a helpful question for assessing the client's adjustment but not the priority if there is a concern about suicidal ideation.

B) "Can you tell me about your sleep patterns?": Sleep patterns are important for understanding overall well-being, especially during grief. However, this question is secondary to addressing the immediate risk of self-harm. Assessing sleep can come after determining if the client is having suicidal thoughts.

C) "Have you ever felt like you don't want to live anymore?": This question is crucial because it directly assesses the client's risk of suicidal ideation or self-harm. Given the client's recent loss and current symptoms, it is important to evaluate if there is a risk to their safety, making this the priority question.

D) "Are you taking any medications at this time?": While it is important to know about the client's medication use, this question does not address the immediate risk of self-harm or assess the psychological impact of the recent loss. Medication information is less urgent compared to evaluating suicidal thoughts.

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A nurse in an emergency department is caring for a client who has a compound fracture of the right tibia. Which of the following actions should the nurse take?

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