A nurse is assisting in the use of a fracture bedpan for a client who is immobile due to a cast. Which of the following actions should the nurse take?

Hyperextend the client's back while the fracture pan is in place.

Keep the bed flat while the client is on the fracture pan.

Encourage the client to try to defecate for 20 min while on the fracture pan.

Place the shallow end of the fracture pan under the client's buttocks

Answer and Explanation

The Correct Answer is D

A. Hyperextend the client's back while the fracture pan is in place: Hyperextending the client's back is not necessary and can cause discomfort or strain. The client's back should be kept in a neutral position.
B. Keep the bed flat while the client is on the fracture pan: Raising the head of the bed slightly can facilitate the client's positioning and defecation. It is not necessary to keep the bed completely flat.
C. Encourage the client to try to defecate for 20 minutes while on the fracture pan: Encouraging the client to try to defecate for a specific time frame is not necessary and may lead to discomfort or straining. The client should be allowed to take the time they need and not be rushed during this process.
D. Place the shallow end of the fracture pan under the client's buttocks: When using a fracture bedpan, the shallow end should be placed under the client's buttocks to allow for proper positioning. The higher, deeper end of the bedpan is positioned under the client's lower back.

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Correct Answer is C

Explanation

Choice A reason:
Palpation can help assess for tenderness, rigidity, or masses in the abdomen, which might indicate infection, bleeding, or other complications. However, palpation could potentially worsen a condition such as an evisceration or dehiscence, or cause additional pain. Therefore, palpation should be done only after the visual inspection and with great caution in the presence of severe pain.
Choice B reason:
Percussion is useful for assessing the presence of gas, fluid, or solid masses in the abdomen. Resonance might indicate normal air-filled intestines, while dullness could suggest fluid or mass. However, percussion is not the first action in an acute setting of sudden severe pain because it does not provide immediate information that could be life-saving. It is a later step in the physical examination.
Choice C reason:
Visual inspection is the first step because it can quickly reveal critical signs such as swelling, distention, redness, or evidence of wound complications like dehiscence or evisceration. Identifying these signs early allows for rapid intervention, which could be life-saving. This is why exposing and inspecting the abdomen is the priority in the context of sudden severe pain following surgery.
Choice D reason:
Listening for bowel sounds can provide information about the function of the gastrointestinal system. Absence of bowel sounds might suggest a paralytic ileus, while hyperactive sounds could indicate a bowel obstruction. However, in the context of sudden, severe abdominal pain postoperatively, auscultation is not the first priority.

A. Dilated pupils B. Physical exhaustion C. Bradycardia D. Depression

Correct Answer is A

Explanation

Choice A reason:
A. Dilated pupils
During the alarm reaction stage of the general adaptation syndrome (GAS), the body's initial response to stress triggers the "fight or flight" response. This response is characterized by the release of stress hormones, increased sympathetic nervous system activity, and various physiological changes to prepare the body to respond to the stressor. Dilated pupils are one of the manifestations of the fight or flight response, allowing for improved visual acuity and awareness of the environment.
Choice B reason:
Physical exhaustion is inappropriate. This is typically associated with the exhaustion stage of GAS, which follows the alarm reaction stage.
Choice C reason:
Bradycardia is inappropriate. Bradycardia (slow heart rate) is not a typical manifestation during the alarm reaction stage. Increased heart rate (tachycardia) is more common during this stage.
Choice D reason:
Depression is inappropriate. Depression is not a direct manifestation of the alarm reaction stage. It is a psychological response that may occur during or after prolonged stress and may be associated with the later stages of GAS.

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A nurse is assisting in the use of a fracture bedpan for a client who is immobile due to a cast. Which of the following actions should the nurse take?

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