A nurse is preparing to assist with applying a cast to a preschooler's arm. Which of the following actions should the nurse take?

Place a heated fan at the bedside to facilitate drying.

Support the casted arm with a firm grasp.

Tell the child, "This will make your arm feel better."

Wrap the arm of the child's doll or toy prior to the procedure.

Answer and Explanation

The Correct Answer is D

A. Place a heated fan at the bedside to facilitate drying: Using a heated fan can increase the risk of burns to the child's skin underneath the cast. The drying process for a cast should occur naturally, and artificial heat sources should not be used.

B. Support the casted arm with a firm grasp: While it's important to support the child's arm during the casting procedure, doing so with a firm grasp may not be necessary or appropriate. The nurse should follow the orthopedic surgeon's instructions regarding the positioning and support of the arm during casting.

C. Tell the child, "This will make your arm feel better": This statement may not accurately reflect the purpose of the cast, as casting is typically done to immobilize and protect the injured limb during the healing process. It's important to provide developmentally appropriate explanations to children about medical procedures, but this particular statement may not be helpful or accurate in this context.

D. Wrap the arm of the child's doll or toy prior to the procedure: This action helps familiarize the child with the procedure and can serve as a form of therapeutic play. By involving the child's toy or doll, the nurse can help reduce anxiety and fear associated with the casting procedure. It also provides an opportunity for the child to understand what will happen to their own arm, promoting a sense of familiarity and control over the situation.

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Correct Answer is C

Explanation

A. "You have a great deal to live for."

While this response is supportive and positive, it may not effectively address the client's feelings of worthlessness. It may come across as dismissive or invalidating of the client's emotions.

B. "It's not unusual for depressed people to feel that way."

This response acknowledges the commonality of feeling worthless among individuals with depression. While it normalizes the client's experience, it doesn't directly address the client's statement or offer support.

C. "You've been feeling that your life has no meaning."

This response reflects active listening and demonstrates empathy by paraphrasing the client's statement to show understanding. It acknowledges the client's feelings and opens the door for further exploration of the underlying issues contributing to their sense of worthlessness.

D. "Why do you feel you are worthless?"

While this response seeks to explore the underlying reasons for the client's feelings, it may come across as confrontational or judgmental. It puts the client on the spot to justify their emotions, which could make them feel defensive or invalidated.

A. Projectile vomiting B. Ridged abdomen C. Distended neck veins D. Red currant jelly stools

Correct Answer is A

Explanation

A. Projectile vomiting: Pyloric stenosis is a condition characterized by the narrowing of the pylorus, the opening between the stomach and the small intestine. This narrowing leads to obstruction of the gastric outlet, causing the stomach to become distended with food. When the infant feeds, the stomach fills up, but the food cannot pass through the narrowed pylorus efficiently. As a result, the infant forcefully expels the contents of the stomach in a characteristic manner known as projectile vomiting. Projectile vomiting is forceful, often occurring shortly after feeding, and the vomited material is usually not bile-stained.

B. Ridged abdomen: While abdominal distension can occur due to the buildup of gastric contents in pyloric stenosis, the term "ridged abdomen" is not typically associated with this condition. Instead, clinicians may palpate an olive-shaped mass in the right upper quadrant of the abdomen, which represents the hypertrophied pylorus. The ridged appearance may be more indicative of conditions such as peritonitis or muscular rigidity, rather than pyloric stenosis.

C. Distended neck veins: Distended neck veins are not typically associated with pyloric stenosis. This symptom is more commonly observed in conditions affecting the cardiovascular system, such as congestive heart failure. In pyloric stenosis, the primary manifestations are related to gastrointestinal obstruction, particularly projectile vomiting, rather than signs of circulatory compromise.

D. Red currant jelly stools: Red currant jelly stools are a characteristic finding in intussusception, a condition where one portion of the intestine telescopes into another, causing obstruction and compromise of the blood supply. This leads to the passage of stools containing blood and mucus, resembling red currant jelly in appearance. Pyloric stenosis primarily affects gastric emptying and does not typically result in bloody stools. Instead, the hallmark symptom is projectile vomiting due to gastric outlet obstruction.

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A nurse is preparing to assist with applying a cast to a preschooler's arm. Which of the following actions should the nurse take?

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