A nurse is caring for a client who just had a left long-arm plaster cast applied after experiencing a musculoskeletal trauma. Which of the following actions should the nurse take?

Position the cast on a plastic-covered pillow.

Perform neurovascular checks every 2 hr.

Instruct the client to avoid moving the fingers on the left hand.

Touch the cast with the palms of the hands when moving the client.

Answer and Explanation

The Correct Answer is B

A) Position the cast on a plastic-covered pillow:
Positioning the cast on a plastic-covered pillow is not recommended because the plastic can trap moisture and heat, potentially affecting the cast's integrity as it dries. Instead, a soft, absorbent material should be used to support the cast.

B) Perform neurovascular checks every 2 hr:
Frequent neurovascular checks are essential to monitor for complications such as compartment syndrome, nerve damage, or impaired circulation. This action helps ensure that any changes in sensation, movement, or circulation are identified and addressed promptly.

C) Instruct the client to avoid moving the fingers on the left hand:
Encouraging the client to move their fingers is important to prevent stiffness and swelling and to promote circulation. Instructing the client to avoid moving their fingers is not appropriate and could lead to complications.

D) Touch the cast with the palms of the hands when moving the client:
Handling a wet plaster cast with the palms of the hands is correct to prevent indentations and pressure points that could cause skin irritation or pressure sores. However, this action is not as critical as performing frequent neurovascular checks to ensure the client's safety and monitor for complications.

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Free Nursing Study Resources

Correct Answer is D

Explanation

A) Painful vesicles along a dermatome:
This finding is typically associated with herpes zoster (shingles), not scabies. Shingles causes painful vesicles that follow the path of a nerve and are confined to one side of the body, which does not align with the presentation of scabies.

B) Acneiform nodules on the face:
Acneiform nodules are related to conditions such as acne vulgaris, not scabies. Scabies does not typically present with acne-like lesions on the face but rather with intense itching and a specific rash.

C) Wheals surrounding raised bite marks:
Wheals and bite marks are more indicative of insect bites or conditions like urticaria (hives). Scabies is caused by mites that burrow under the skin, leading to a different type of rash.

D) Raised, linear burrows:
Raised, linear burrows are characteristic of scabies. These burrows are caused by the female mite as it tunnels just under the skin to lay eggs, resulting in a distinctive rash and intense itching, especially at night.

A. Place the client in a supine position for the first 12 hr postoperative. B. Pack the open wound with a dry gauze dressing. C. Administer naproxen orally for pain 30 min prior to ambulation. D. Maintain an NG tube on low intermittent suction until bowel sounds return.

Correct Answer is D

Explanation

A) Place the client in a supine position for the first 12 hr postoperative: Following surgery for a ruptured appendix, placing the child in a supine position for the first 12 hours can be inappropriate. It may be more beneficial to position the child in a semi-Fowler's position to promote drainage of any remaining infection and reduce the risk of respiratory complications.

B) Pack the open wound with a dry gauze dressing: For a postoperative wound following a ruptured appendix, using a dry gauze dressing might not be the best practice. A moist dressing can promote better healing and reduce the risk of infection. Wet-to-dry or other appropriate dressings are typically recommended based on the surgeon's instructions.

C) Administer naproxen orally for pain 30 min prior to ambulation: While managing pain is important, naproxen is a nonsteroidal anti-inflammatory drug (NSAID) that is typically not the first choice for postoperative pain management in children. Additionally, oral medication might not be recommended immediately post-surgery, especially if the child has an NG tube or other contraindications for oral intake.

D) Maintain an NG tube on low intermittent suction until bowel sounds return: This is a standard postoperative practice for children who have had surgery for a ruptured appendix. The NG tube helps to decompress the stomach, preventing vomiting and aspiration, and helps manage bowel function until normal activity resumes, which is crucial for postoperative recovery.

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