A nurse is caring for a preschool-age child who has a short-leg plaster cast applied 1 hr ago. Which of the following is an appropriate intervention

Restrict movement of the toes of the affected leg

Dry the cast with a hair dryer set on a warm setting

Reposition the affected leg using fingertips

Support the affected leg on a pillow

Answer and Explanation

The Correct Answer is D

A. Restrict movement of the toes of the affected leg: Limiting toe movement is not necessary unless the toes are being injured. Encouraging gentle movement of the toes can promote circulation and prevent stiffness while the cast sets. Restricting toe motion unnecessarily can increase the risk of complications like decreased perfusion.

B. Dry the cast with a hair dryer set on a warm setting: Using a hair dryer on a warm setting can cause burns or damage the cast material before it fully sets. Casts should be allowed to dry naturally, and heat sources should be avoided during the initial hardening period to prevent injury.

C. Reposition the affected leg using fingertips: Touching or pressing on a newly applied plaster cast can cause indentations, leading to pressure points that may result in skin breakdown or impaired circulation. The cast should be handled minimally and supported rather than manipulated directly.

D. Support the affected leg on a pillow: Elevating and supporting the leg on a pillow helps reduce edema, provides comfort, and promotes proper alignment while the cast sets. This intervention is safe and appropriate during the immediate postoperative or post-cast application period.

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Correct Answer is D

Explanation

A. Verify the narcotic inventory count every 8 hr: Narcotic counts are typically verified at the beginning and end of each shift or according to facility policy, not strictly every 8 hours. This statement is partially correct but not comprehensive for safe practice.

B. Dispose of unused medication in the sharps container: Unused narcotics must be disposed of according to controlled substance regulations, usually requiring a witness and proper documentation. Disposal in a sharps container alone is inappropriate and unsafe.

C. Request an AP to witness the disposal of wasted medication: Witnessing narcotic disposal requires another licensed nurse, not an assistive personnel. Regulations mandate accountability by trained healthcare professionals to prevent diversion.

D. Report discrepancies in the narcotic inventory to the nurse manager: Any discrepancies in narcotic counts must be reported immediately to maintain compliance with controlled substance regulations, ensure patient safety, and prevent diversion. This is a primary responsibility of nurses handling narcotics.

A. Urine specific gravity of 1.028 (1.005 to 1.03) B. Urine output of 250 mL/hr C. Serum sodium of 115 mEq/L (136 mEq/L to 145 mEq/L) D. Blood glucose of 198 mg/dL (less than 200 mg/dL)

Correct Answer is B

Explanation

A. Urine specific gravity of 1.028 (1.005 to 1.03): A urine specific gravity in this range is within normal limits, indicating concentrated urine. In diabetes insipidus, urine is typically very dilute with a specific gravity below 1.005, reflecting excessive water loss, so this finding does not indicate DI.

B. Urine output of 250 mL/hr: Excessive urine output is a hallmark of diabetes insipidus, especially in the context of a recent head injury. High-volume, dilute urine (polyuria) occurs due to a deficiency of antidiuretic hormone or kidney insensitivity to it. This finding alerts the nurse to the early development of DI and the need for intervention.

C. Serum sodium of 115 mEq/L (136 mEq/L to 145 mEq/L): Low sodium indicates hyponatremia, which is not typical of DI. In fact, DI usually causes hypernatremia due to free water loss, making this finding inconsistent with the expected laboratory changes in DI.

D. Blood glucose of 198 mg/dL (less than 200 mg/dL): Mildly elevated blood glucose may indicate stress hyperglycemia but is unrelated to the pathophysiology of diabetes insipidus. Glucose levels do not provide a reliable indication of DI development.

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A nurse is caring for a preschool-age child who has a short-leg plaster cast applied 1 hr ago. Which of the following is an appropriate intervention

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is B

Explanation

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