A nurse is caring for a child who has a hip spica cast. Which of the following actions should the nurse take?
Place the child in a semi-sitting position for meals.
Maintain the child’s lower extremities in a dependent position.
Provide a bedside commode for toileting.
Turn the child every 2 hours.
The Correct Answer is D
Choice A reason: A semi-sitting position for meals is impractical in a hip spica cast, risking discomfort or aspiration; turning every 2 hours prevents pressure injuries. Assuming semi-sitting is correct risks complications, critical to avoid in ensuring safe positioning and care for children in spica casts.
Choice B reason: Maintaining dependent lower extremities increases edema risk in a hip spica cast; turning every 2 hours promotes circulation. Assuming dependent positioning is correct risks swelling, critical to prevent in ensuring proper cast care and comfort for children with hip spica casts.
Choice C reason: A bedside commode is unsuitable for a hip spica cast, which covers the pelvis; bedpans are used. Turning every 2 hours is key. Assuming a commode is appropriate risks impracticality, critical to avoid in ensuring proper toileting and care in spica cast management.
Choice D reason: Turning every 2 hours prevents pressure ulcers and promotes circulation in a child with a hip spica cast, critical for skin integrity and comfort. This ensures proper cast care, reducing complications, supporting healing, and maintaining safety in pediatric orthopedic management.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Alone time for reflection may increase rumination in alcohol use disorder, not fostering self-control; positive feedback reinforces coping. Assuming alone time helps risks isolation, potentially worsening stress, critical to avoid in supporting adaptive behaviors and recovery in clients with alcohol use disorders.
Choice B reason: Gradual alcohol reduction is not ideal for alcohol use disorder, where abstinence is often recommended; positive feedback supports coping. Assuming reduction is effective risks enabling continued use, delaying recovery, critical to prevent in fostering self-control and sobriety in clients with alcohol dependence.
Choice C reason: Having the partner monitor alcohol intake undermines client autonomy, not promoting self-control; positive feedback reinforces independence. Assuming partner responsibility risks dependency, potentially hindering personal accountability, critical to avoid in supporting self-managed recovery in clients with alcohol use disorder.
Choice D reason: Giving positive feedback for adaptive coping strategies reinforces healthy stress management, promoting self-control in alcohol use disorder. This builds confidence, critical for sustained sobriety, encouraging alternative coping mechanisms, and supporting long-term recovery, essential for effective behavioral change in clients managing stress without alcohol.
Correct Answer is C
Explanation
Choice A reason: Indirect lighting aids visual impairment, not hearing loss, where attention-getting is key. Assuming lighting is relevant risks ineffective communication, potentially frustrating the client, critical to avoid in ensuring clear, respectful interaction for clients with total hearing loss in care settings.
Choice B reason: Speech therapists address speech, not hearing loss communication, where attention-getting is essential. Assuming therapist collaboration is primary risks overlooking direct communication strategies, critical to prevent in ensuring effective, tailored interaction for clients with total hearing loss in healthcare settings.
Choice C reason: Getting the client’s attention before speaking (e.g., tapping or waving) ensures effective communication for total hearing loss, facilitating lip-reading or sign language. This is critical for clarity, promoting inclusion, and ensuring accurate information exchange, essential for care delivery in hearing-impaired clients.
Choice D reason: Using a loud tone is ineffective for total hearing loss, where visual cues are needed. Assuming loudness helps risks miscommunication, potentially isolating the client, critical to avoid in ensuring respectful, effective communication strategies for clients with complete hearing loss in care.
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