A nurse is caring for a client who has a fractured arm in a cast. Which of the following findings about the affected arm should the nurse report to the provider?

Active movement is present

Pain is 4 on scale of 0 to 10

Capillary refit is less than 2 seconds

Skin is cool to the touch

Answer and Explanation

The Correct Answer is D

A. Active movement is present: The presence of active movement in the fingers and toes of the affected arm indicates that nerve and muscle function are intact, which is a positive finding. It indicates there is no impairment in function of the affected arm.

B. Pain is 4 on scale of 0 to 10: A pain level of 4 is moderate pain and might be expected after a fracture. As long as pain is being managed appropriately with prescribed medications and no other concerning symptoms are present, it does not necessarily require immediate reporting.

C. Capillary refill is less than 2 seconds: A capillary refill time of less than 2 seconds is normal. This suggests good blood flow to the affected arm and is not an issue that needs reporting.

D. Skin is cool to the touch: A cool skin temperature on the affected arm could indicate impaired circulation, possibly due to swelling or tightness of the cast, which could lead to compartment syndrome—a serious condition that requires immediate intervention. Therefore, this finding should be reported to the provider immediately.

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Correct Answer is A

Explanation

A. Drink high-protein nutritional supplements between meals: Clients with COPD often experience anorexia due to fatigue, difficulty breathing while eating, and early satiety. High-protein, high-calorie supplements between meals help meet nutritional needs without overwhelming them during main meals, supporting energy levels and respiratory muscle strength.

B. Eat more hot foods than cold foods at mealtime: Hot foods can produce stronger odors that may worsen appetite loss. Cold foods tend to have milder smells and may be better tolerated by clients with anorexia, making cold foods preferable rather than focusing on hot foods.

C. Eat low-calorie foods first at mealtime: Clients with anorexia and COPD should prioritize high-calorie, nutrient-dense foods first to maximize intake before feeling full. Eating low-calorie foods first could reduce overall calorie intake, worsening weight loss and malnutrition risks.

D. Increase liquids during meals: Consuming large amounts of liquid during meals can cause early satiety, making it harder for clients to consume enough food. It is better to encourage drinking fluids between meals to optimize food intake during eating times.

A. The client recently received a pay raise at work B. The client is married and has children C. The client has a strong religious affiliation D. The client has a history of chronic back pain

Correct Answer is D

Explanation

A. The client recently received a pay raise at work: Receiving a pay raise is generally considered a positive life event that can improve self-esteem and financial security. Positive achievements like this are not associated with increased suicide risk and may actually serve as protective factors against depressive symptoms.

B. The client is married and has children: Being married and having children are typically viewed as protective factors against suicide. Strong familial bonds and social connections provide emotional support, a sense of responsibility, and a buffer against feelings of isolation or hopelessness that often contribute to suicidal ideation.

C. The client has a strong religious affiliation: Strong religious beliefs can serve as a significant protective factor against suicide by providing hope, purpose, community support, and moral objections to self-harm. Clients with strong spiritual ties often demonstrate greater resilience during periods of emotional distress.

D. The client has a history of chronic back pain: Chronic pain is a known risk factor for suicide because it can lead to feelings of hopelessness, helplessness, and a diminished quality of life. Clients with long-term physical pain often experience comorbid depression and are at higher risk for suicidal thoughts and behaviors.

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A nurse is caring for a client who has a fractured arm in a cast. Which of the following findings about the affected arm should the nurse report to the provider?

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