A nurse is caring for a client following application of a cast. Which of the following actions should the nurse take first?
Place an ice pack over the cast.
Position the casted extremity on a pillow.
Teach the client to keep the cast clean and dry.
Palpate the pulse distal to the cast.
The Correct Answer is D
A. Place an ice pack over the cast. While this can help reduce swelling and pain, it is a comfort measure, not the priority. Safety assessments must be completed first before implementing non-urgent interventions.
B. Position the casted extremity on a pillow. Elevation is important to reduce swelling, but it follows after ensuring that circulation to the extremity is intact and that there are no signs of vascular compromise.
C. Teach the client to keep the cast clean and dry. Education is essential for long-term cast care, but it is not the first action after cast application. Immediate post-procedural monitoring takes precedence.
D. Palpate the pulse distal to the cast. The nurse should first assess for adequate circulation by checking distal pulses. This helps identify early signs of complications like compartment syndrome or impaired blood flow, making it the highest priority.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is {"dropdown-group-1":"C","dropdown-group-2":"D"}
Explanation
- Dry skin and lips: This is a very common side effect of isotretinoin due to its drying effects on sebaceous glands. It is expected and manageable with regular moisturizing and is not considered an emergency.
- Increased appetite: Isotretinoin is not associated with increased appetite. Weight changes are not typical or concerning symptoms during therapy and do not warrant urgent provider notification.
- Depression: Isotretinoin has been associated with mood changes including depression, suicidal thoughts, and other psychiatric effects. These can emerge suddenly and must be reported immediately for prompt evaluation and intervention to ensure safety.
- Visual disturbances: Blurred vision or difficulty seeing, particularly at night, can indicate rare but serious complications such as increased intracranial pressure. Any change in vision during isotretinoin therapy requires immediate medical attention.
- Productive cough: This is not commonly linked with isotretinoin therapy. Unless respiratory symptoms worsen or are accompanied by fever or systemic signs, a productive cough alone is not a reason to stop treatment or alert the provider urgently.
Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"B"}
Explanation
An hCG level of 30,000 IU/L is significantly elevated and may suggest a molar pregnancy, especially when values are higher than expected for gestational age. In a molar pregnancy (hydatidiform mole), trophoblastic tissue proliferates abnormally, producing excessive hCG. This level, in combination with normal hemoglobin and hematocrit, makes other causes like spontaneous or induced abortion less likely.
Key Takeaways:
- Extremely elevated hCG levels can indicate gestational trophoblastic disease (molar pregnancy).
- Molar pregnancy is a nonviable pregnancy characterized by abnormal trophoblast proliferation.
- Normal hemoglobin and hematocrit reduce the likelihood of current bleeding or miscarriage.
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