A nurse is providing discharge teaching to a client who has a Plaster of Paris walking cast on his left lower leg. Which of the following instructions should the nurse include?

There is no need to cover the cast when showering.

Apply ice to your foot after walking.

A musty odor is normal as the cast ages.

Report any numbness or pain in your toes.

Answer and Explanation

The Correct Answer is D

Choice A reason:
It is important to keep a Plaster of Paris cast dry because moisture can weaken the cast and irritate the skin underneath. Therefore, the cast should be covered while showering to prevent it from getting wet.

Choice B reason:
Applying ice to the foot after walking can help reduce swelling and provide pain relief. It is a common recommendation for managing discomfort associated with a walking cast. The ice should be applied over the cast at the level of the injury for 15-30 minutes, repeating every few hours for the first few days.

Choice C reason:
While a musty odor can develop over time due to sweat and lack of air circulation, it is not necessarily normal and could indicate a problem such as an infection. If there is a persistent unpleasant odor, it should be evaluated by a healthcare provider.

Choice D reason:
Numbness or pain in the toes can be a sign of compromised circulation or nerve compression and should be reported immediately. It is crucial to monitor for any changes in sensation or increased pain, as these could indicate a serious issue that requires medical attention.

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Correct Answer is B

Explanation

Choice A reason:
Decreased hemoglobin (Hgb) levels can be indicative of anemia or blood loss, but they are not typically associated with fluid volume deficit. In cases of fluid volume deficit, the Hgb concentration may actually appear elevated due to hemoconcentration as the plasma volume decreases.

Choice B reason:
Increased blood urea nitrogen (BUN) levels are expected in a fluid volume deficit because as the blood volume decreases, the concentration of solutes like urea can increase. This is often due to decreased renal perfusion and subsequent reduced renal function, leading to less urea being excreted through the kidneys.

Choice C reason:
Increased urine ketones are typically associated with diabetic ketoacidosis or starvation, not directly with fluid volume deficit. Ketones are produced when the body breaks down fats for energy, which is not a process directly related to fluid volume status.

Choice D reason:
Decreased urine specific gravity would not be expected in fluid volume deficit; in fact, one would expect the opposite. Specific gravity measures the kidney's ability to concentrate urine. In fluid volume deficit, the urine specific gravity would likely be increased as the body attempts to conserve water.

A. The lesions are contagious to others only if they are draining. B. Vesicles will appear followed by pain and/or itching. C. Many clients experience pain in the affected area for weeks after the lesions have resolved. D. Herpes zoster is easily spread to family and friends who have had chickenpox in the past.

Correct Answer is ["A","B","C"]

Explanation

Choice A reason:
Herpes zoster lesions are indeed contagious if they are draining. The virus can spread through direct contact with the fluid from the blisters. It is crucial to cover the lesions to prevent spreading the virus to others, especially to those who have never had chickenpox or the vaccine.

Choice B reason:
The development of vesicles, which are small fluid-filled blisters, is a hallmark of herpes zoster. These vesicles typically appear in a band-like pattern on one side of the body and are often accompanied by pain, itching, or tingling before they are visible.

Choice C reason:
Postherpetic neuralgia is a condition where the pain persists in the area of the herpes zoster rash even after the lesions have healed. This can last for weeks, months, or even years and is more common in older adults.

Choice D reason:
Herpes zoster itself is not spread like chickenpox. It occurs when the varicella-zoster virus, which has been lying dormant in the nerve cells, reactivates. While it is possible for someone who has never had chickenpox to develop chickenpox after direct contact with a shingles rash, herpes zoster is not "easily spread" to others in the same way that chickenpox is.

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A nurse is providing discharge teaching to a client who has a Plaster of Paris walking cast on his left lower leg. Which of the following instructions should the nurse include?

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Naxlex Comprehensive Predictor Exams

A nurse is assessing a client who has a fluid volume deficit. The nurse should expect which of the following findings?

Correct Answer is B

Explanation

A nurse is formulating a teaching plan about herpes zoster for a group of older adults at a community center. The nurse should include which of the following information in the plan?

Correct Answer is ["A","B","C"]

Explanation

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