A nurse is caring for a 9-year-old client at a clinic.

Exhibits

After reviewing the discharge instructions with the family, which of the following statements by a parent indicate an understanding of the teaching?

For each statement by the parent, click to specify if the statement reflects an understanding or indicates a need for reinforcement of the discharge teaching.

“We should prop the casted arm on pillows for the next 24 hours.”

“It is important that our child avoids placing anything inside the cast.”

“We need to be very careful about how we handle the cast for the first 2 days while it dries.”

“We should notify the provider if the cast becomes loose over time.”

“We should expect the swelling and tingling to worsen before it gets better.”

Answer and Explanation

The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"A"},"D":{"answers":"A"},"E":{"answers":"B"}}

Parent Statements Reflecting Understanding:

“We should prop the casted arm on pillows for the next 24 hours.” This demonstrates understanding because elevating the casted arm helps reduce swelling, improve circulation, and increase comfort during the initial period after casting. Proper elevation is an essential part of post-cast care.

“It is important that our child avoids placing anything inside the cast.” This shows correct understanding because inserting objects inside the cast can damage the skin, cause irritation, or lead to infection. Avoiding insertion of objects helps protect the skin and maintain safe healing conditions.

“We need to be very careful about how we handle the cast for the first 2 days while it dries.” This reflects understanding because a cast is still soft and vulnerable immediately after application. Gentle handling ensures the cast maintains proper alignment, which is critical for proper bone healing.

“We should notify the provider if the cast becomes loose over time.” This demonstrates understanding because a loose cast can compromise immobilization, potentially leading to improper healing or displacement of the fracture. Notifying the provider ensures timely correction.

Parent Statements Needing Reinforcement:

“We should expect the swelling and tingling to worsen before it gets better.” This statement indicates a misunderstanding. In a properly casted limb, swelling and tingling should gradually improve, not worsen. Worsening symptoms may suggest neurovascular compromise, which is an urgent condition requiring immediate evaluation by a healthcare provider. Parents need reinforcement that persistent or increasing tingling, numbness, pain, or changes in color of the fingers are warning signs and should not be ignored.

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Correct Answer is B

Explanation

A. Disulfiram is started after the client abstains from alcohol for at least 12 hours to prevent a severe reaction.

B. Avoiding all products containing alcohol (e.g., cough syrups, mouthwash, aftershave) prevents a dangerous disulfiram–alcohol reaction, which can cause flushing, nausea, hypotension, and even cardiovascular collapse.

C. Disulfiram is used short-term to support abstinence; it is not typically taken for years unless directed by a provider.

D. Disulfiram is taken orally once daily, not by injection.

A. Encourage the client and partner to avoid expressing negative feelings about the colostomy. B. Transfer the client to a rehabilitation facility for instruction about self-management of the colostomy. C. Suggest the client join a support group for people who have colostomies. D. Instruct the client's partner to assume care of the colostomy for the client.

Correct Answer is C

Explanation

A. Encourage the client and partner to avoid expressing negative feelings about the colostomy: Suppressing emotions can hinder psychological adaptation. The nurse should encourage open discussion to promote emotional healing.

B. Transfer the client to a rehabilitation facility for instruction about self-management of the colostomy: This step is unnecessary and premature; the nurse should first focus on emotional readiness and gradual teaching during hospitalization.

C. Suggest the client join a support group for people who have colostomies: Clients with new ostomies often experience body image disturbance and emotional adjustment issues. Support groups provide peer encouragement, education, and normalization of the experience, which helps improve acceptance and self-care confidence.

D. Instruct the client's partner to assume care of the colostomy for the client: This reinforces avoidance behavior and delays the client’s adjustment and independence.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing medication teaching about disulfiram for a client who has alcohol use disorder. Which of the following statements by the client indicates an understanding of the teaching?

Correct Answer is B

Explanation

A nurse is caring for a client who has a newly created colostomy. The client's partner tells the nurse that the client refuses to look at the stoma. Which of the following actions should the nurse take?

Correct Answer is C

Explanation

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