A nurse is providing discharge education to a client who is going home with a cast on his leg. What teaching point would be appropriate for the nurse to emphasize in the teaching session?

Report any pain that is uncontrolled by elevating the affected limb or by analgesic agents

May use intermittent heat packs as prescribed to control swelling

A small hair brush may be used to control any itching under the cast

Keep the affected extremity below the level of the heart to prevent swelling

Inspect the cast daily for cracks, breaks, or signs of infection

Answer and Explanation

The Correct Answer is A

Choice A reason: Reporting any pain that is uncontrolled by elevating the affected limb or by analgesic agents is an appropriate teaching point for the nurse to emphasize, as it may indicate a serious complication such as compartment syndrome, infection, or nerve damage. The nurse should instruct the client to notify the health care provider immediately if the pain persists or worsens.

Choice B reason: Using intermittent heat packs as prescribed to control swelling is not an appropriate teaching point for the nurse to emphasize, as it may increase the blood flow and inflammation in the affected area. The nurse should advise the client to avoid heat sources such as heating pads, hot water bottles, or electric blankets, as they may also damage the cast or cause burns.

Choice C reason: Using a small hair brush to control any itching under the cast is not an appropriate teaching point for the nurse to emphasize, as it may cause skin irritation, infection, or damage to the cast. The nurse should suggest the client to use a cool air dryer, a gentle tapping, or an antihistamine to relieve the itching, and to avoid inserting any objects under the cast.

Choice D reason: Keeping the affected extremity below the level of the heart to prevent swelling is not an appropriate teaching point for the nurse to emphasize, as it may impair the venous return and increase the edema. The nurse should recommend the client to elevate the affected extremity above the level of the heart to reduce the swelling and promote the healing.

Choice E reason: Inspecting the cast daily for cracks, breaks, or signs of infection is not an appropriate teaching point for the nurse to emphasize, as it is not a specific or relevant instruction for the client with a cast on his leg. The nurse should teach the client to keep the cast dry and clean, to cover it with a plastic bag when showering or bathing, and to report any foul odor, drainage, or fever.

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Correct Answer is E

Explanation

Choice A reason: Including an average daily intake of 300 mg of calcium is not a sufficient measure to prevent osteoporosis, as it is below the recommended dietary allowance (RDA) for calcium, which is 1000 mg for adults aged 19-50 years, and 1200 mg for adults aged 51 years and older. Calcium is an essential mineral for bone health, as it helps to build and maintain the bone density and strength.

Choice B reason: Walking 20-30 minutes three days a week is not an optimal measure to prevent osteoporosis, as it is below the recommended physical activity guidelines, which suggest at least 150 minutes of moderate-intensity aerobic exercise per week, and at least two sessions of muscle-strengthening activities per week. Physical activity is beneficial for bone health, as it stimulates the bone formation and reduces the bone loss.

Choice C reason: Engaging in isometric exercise 20-30 minutes weekly is not an effective measure to prevent osteoporosis, as it is not the best type of exercise for bone health, and it is not performed frequently enough. Isometric exercise is a form of exercise that involves contracting the muscles without moving the joints, such as holding a plank or a wall sit. Isometric exercise does not provide enough mechanical stress or load to the bones, which is needed to stimulate the bone remodeling and growth.

Choice D reason: Including adequate intake of vitamin E is not a relevant measure to prevent osteoporosis, as it is not a major nutrient for bone health, and it has no direct effect on the bone metabolism. Vitamin E is an antioxidant that helps to protect the cells from oxidative stress and inflammation, which may have some indirect benefits for the bone health, but it is not a key factor. Vitamin E is also not a common deficiency, and it can be obtained from various foods, such as vegetable oils, nuts, seeds, and green leafy vegetables.

A. Pain management B. Improvement of joint mobility C. Client will recover from osteoarthritis within 6 months D. Weight loss promotion E. The client will deny symptoms of osteoarthritis

Correct Answer is B

Explanation

Choice A reason: Pain management is an important goal for a client with osteoarthritis, but it is not the only one. The question asks for what goals the nurse should include, not what is the most essential or urgent goal.

Choice B reason: Improvement of joint mobility is a correct goal for a client with osteoarthritis, as it helps to prevent stiffness, contractures, and deformities of the affected joints. It also improves the client's function, quality of life, and independence.

Choice C reason: Client will recover from osteoarthritis within 6 months is not a realistic or attainable goal, as osteoarthritis is a chronic and progressive condition that has no cure. The nurse should focus on managing the symptoms and preventing complications, not on curing the disease.

Choice D reason: Weight loss promotion is a relevant goal for a client with osteoarthritis, especially if the client is obese, as it helps to reduce the stress and pressure on the weight-bearing joints. However, it is not a specific or measurable goal, as it does not indicate how much weight the client should lose or how the nurse will monitor the progress.

Choice E reason: The client will deny symptoms of osteoarthritis is not a desirable or appropriate goal, as it implies that the client is not honest or aware of their condition. The nurse should encourage the client to report any symptoms or changes in their joints, as it helps to assess the effectiveness of the treatment and to adjust the plan of care accordingly.

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A nurse is providing discharge education to a client who is going home with a cast on his leg. What teaching point would be appropriate for the nurse to emphasize in the teaching session?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which should the nurse include when instructing a client on the prevention of osteoporosis?

Correct Answer is E

Explanation

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Correct Answer is B

Explanation

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