A nurse is assessing a client who has a cast in place for a fractured tibia. Which of the following actions should the nurse take first?

Performing range of motion

Managing pain

Checking capillary refill

Discussing cast care

Answer and Explanation

The Correct Answer is C

A. Performing range of motion:
Explanation: Range of motion exercises are important for preventing joint stiffness and muscle atrophy, especially in clients with casts. However, this is not the first priority. Ensuring adequate circulation and perfusion is crucial before initiating any exercises or movements, as compromised circulation could lead to serious complications.

B. Managing pain:
Explanation: Pain management is important for the client's comfort, but it is not the first priority in this context. Assessing circulation and ensuring there are no signs of compromised perfusion takes precedence. Pain management can follow once circulation has been confirmed as adequate.

C. Checking capillary refill:
Explanation: Checking capillary refill is the first priority when assessing a client with a cast. Capillary refill assesses peripheral circulation by pressing on the nail bed and observing how quickly color returns. Delayed capillary refill could indicate compromised blood flow, which is a serious concern and requires immediate intervention.

D. Discussing cast care:
Explanation: Educating the client about cast care is important, but it is not the first priority. Ensuring proper circulation and ruling out any signs of impaired perfusion must be addressed before discussing cast care instructions.

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Correct Answer is B

Explanation

A. There is no need for the client to lie flat for an extended period after a DEXA scan. The procedure is non-invasive and does not require immobilization.

B. Emptying the bladder before the test is essential to ensure a clear and accurate scan of the pelvis and lower spine. A full bladder might obstruct the view and affect the accuracy of the results.

C. DEXA scans do not typically require the use of IV dye. It is a simple X-ray procedure that measures bone density, and no contrast material is usually needed.

D. Fasting is not necessary for a DEXA scan. The procedure does not involve ingesting or injecting any substances that require fasting.

A. "Pyelonephritis increases a person's risk for kidney damage." B. "Pyelonephritis is an infection of the lower urinary tract." C. "Pyelonephritis often causes no symptoms in affected clients." D. "Pyelonephritis is most often caused by Staphylococcus saprophyticus."

Correct Answer is A

Explanation

A. "Pyelonephritis increases a person's risk for kidney damage." - Pyelonephritis is a bacterial infection of the renal parenchyma and renal pelvis, typically caused by the ascent of bacteria from the lower urinary tract into the kidneys. If left untreated, it can lead to kidney damage, including scarring of the renal tissue and impaired kidney function.

B. "Pyelonephritis is an infection of the lower urinary tract." - This statement is incorrect. Pyelonephritis specifically involves the upper urinary tract, affecting the kidneys. In contrast, infections of the lower urinary tract (such as cystitis) affect the bladder and urethra.

C. "Pyelonephritis often causes no symptoms in affected clients." - This statement is incorrect. Pyelonephritis typically presents with symptoms such as fever, chills, flank pain, painful urination (dysuria), and frequent urination. Clients with pyelonephritis usually experience noticeable symptoms.

D. "Pyelonephritis is most often caused by Staphylococcus saprophyticus." - This statement is incorrect. While Staphylococcus saprophyticus is a common cause of urinary tract infections, pyelonephritis is more commonly caused by gram-negative bacteria, such as Escherichia coli, which often ascend from the lower urinary tract into the kidneys.

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A nurse is assessing a client who has a cast in place for a fractured tibia. Which of the following actions should the nurse take first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is A

Explanation

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