A nurse is caring for a child following an open reduction and internal fixation of a fractured femur and application of a cast. The cast has a window cut in it for viewing of the incision. Which of the following actions should the nurse take first?

Turn the client so the cast will dry on all sides.

Remove the window and view the incision.

Medicate the client for pain.

Perform neurovascular checks of the affected extremity.

Answer and Explanation

The Correct Answer is D

a. Turn the client so the cast will dry on all sides: While ensuring the cast is dry is important, the first priority following a surgical procedure is to assess neurovascular status to detect any

complications.

b. Remove the window and view the incision: Removing the window may compromise the cast's integrity, and the priority is to assess neurovascular status before inspecting the incision.

c. Medicate the client for pain: Pain management is important, but assessing neurovascular status is the initial priority to ensure there are no complications affecting circulation.

d. Perform neurovascular checks of the affected extremity: Neurovascular checks are the priority to detect any signs of impaired circulation or nerve function.

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Correct Answer is A

Explanation

a. Provide humidified oxygen: Humidification helps prevent the drying of mucous membranes, making secretions more manageable and less tenacious. This is an acceptable method to thin

secretions in a client with a tracheostomy.

b. Prelubricate the suction catheter tip with sterile saline when suctioning the airway: While lubrication with sterile saline is a common practice during suctioning to reduce trauma to the airway, it does not directly address the tenacity of secretions.

c. Perform chest physiotherapy prior to suctioning: Chest physiotherapy is a technique used to mobilize respiratory secretions, but it may not directly address the tenacity of secretions.

d. Hyperventilate the client with 100% oxygen before suctioning the airway: Hyperventilation with 100% oxygen is not a routine practice and may lead to respiratory alkalosis. Providing

humidified oxygen is a more appropriate approach.

A. “I can take these pills with my meals.” B. “It’s okay to crush a tablet as long as I make sure it dissolves completely in water before swallowing it.” C. “I am taking this type of medication so it dissolves in my intestine, not my stomach.” D. “I might not get relief from my pain for 3 to 4 weeks.”

Correct Answer is B

Explanation

Rationale for A: Taking enteric-coated pills with meals is generally acceptable as food does not affect the integrity of the enteric coating. The coating is designed to withstand the acidic environment of the stomach and dissolve in the more neutral pH of the intestine.
Rationale for B: Enteric-coated tablets should not be crushed as this destroys the coating designed to protect the stomach lining from the medication's potentially irritating effects, ensuring the medication is released in the intestine.
Rationale for C: This statement is correct; enteric-coated medications are formulated to bypass the stomach and dissolve in the intestine, which can help minimize gastric side effects and irritation.
Rationale for D: It is common for anti-inflammatory medications like naproxen to take several weeks to reach full efficacy. This statement reflects a correct understanding of the medication's expected onset of action.

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A nurse is caring for a child following an open reduction and internal fixation of a fractured femur and application of a cast. The cast has a window cut in it for viewing of the incision. Which of the following actions should the nurse take first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is postoperative following a tracheostomy and has copious and tenacious secretions. Which of the following is an acceptable method for the nurse to use to thin this client's secretions?

Correct Answer is A

Explanation

A nurse is reinforcing teaching with a client who is to start taking enteric-coated naproxen for rheumatoid arthritis. Which of the following client statements by the client indicates a need for further teaching?

Correct Answer is B

Explanation

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