A nurse is reinforcing teaching with a client who is to have plaster cast applied to his right arm. Which of the following information should the nurse include the teaching?

The client should use a hair dryer on a warm setting to relieve itching inside the cast.

The client can shower with the cast after 24 hr.

The client’s extremity should be elevated after the cast applied.

The client should keep the cast covered until it is dry

Answer and Explanation

The Correct Answer is C

A) "The client should use a hair dryer on a warm setting to relieve itching inside the cast.": Using a hair dryer on a warm setting to relieve itching inside the cast is not recommended because it could potentially lead to burns or skin irritation. The client should avoid inserting objects inside the cast to scratch, as this could damage the skin or cause an infection.

B) "The client can shower with the cast after 24 hr.": A plaster cast is not waterproof, and the client should avoid getting it wet. Although the cast may feel dry on the outside after 24 hours, it typically takes about 48 hours or longer for a plaster cast to fully dry and harden. Showering with a plaster cast is not safe, as moisture could cause skin irritation or lead to the development of sores or infection.

C) "The client’s extremity should be elevated after the cast is applied.": Elevating the extremity after a cast is applied is a key teaching point to help reduce swelling and improve circulation. This is especially important during the first 24 to 48 hours after cast application. Elevation helps to prevent or manage swelling, which can be a common complication after an injury and cast application.

D) "The client should keep the cast covered until it is dry.": While it is important to keep a cast clean and dry during the drying process, the cast should not be covered with plastic or other materials that could trap moisture. The cast needs air circulation to dry properly, and covering it could lead to the cast becoming too moist, increasing the risk of skin issues or infection.

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Correct Answer is B

Explanation

A) Increase in concentration: Chlorpromazine is an antipsychotic medication used to manage symptoms of schizophrenia and other psychotic disorders. While it may have some effects on cognition, an increase in concentration is not the primary therapeutic effect of chlorpromazine.

B) Decrease in delusions: Chlorpromazine is effective in reducing symptoms of psychosis, such as delusions and hallucinations, which are common in conditions like schizophrenia. A decrease in delusions is a direct indicator that the medication is having its intended therapeutic effect.

C) Increase in alertness: Chlorpromazine can cause sedation and drowsiness as side effects, particularly during the initial stages of treatment. An increase in alertness would not be a typical therapeutic outcome, and it may even suggest a side effect like overstimulation or anxiety rather than the intended effect.

D) Decrease in anxiety: While chlorpromazine may have some calming effects, it is primarily used to treat symptoms of psychosis, not anxiety disorders. A decrease in anxiety is not the main therapeutic effect of chlorpromazine. Other medications, such as benzodiazepines, are typically used for anxiety management.

A. Insert an oral airway into the client’s mouth B. Measure the duration of the seizure. C. Lower the side rails of the bed when the seizure begins. D. Restrain the client's arms and legs to prevent injury. E. None F. None

Correct Answer is B

Explanation

A. Attempting to force an object into the oral cavity during muscle contraction causes dental trauma or jaw fractures. It significantly increases the risk of aspiration if the object breaks or triggers a gag reflex. Modern clinical guidelines strictly prohibit the insertion of any device into the mouth during active convulsions. Airway patency is maintained by placing the client in a lateral position.

B. Tracking the exact duration of the ictal phase is a critical nursing responsibility for clinical assessment. This data determines the necessity for emergency benzodiazepines if the event lasts longer than 5 minutes. Precise timing helps differentiate between a self-limiting seizure and dangerous status epilepticus. The nurse must record the start and end times to guide medical intervention.

C. Lowering the side rails during a seizure increases the risk of the client falling from the height of the bed. Standard seizure precautions require that side rails remain raised and should be padded to prevent blunt force trauma. Ensuring the patient stays within the safe boundaries of the bed is a primary safety goal.

D. Physical restraints can cause severe musculoskeletal injuries such as fractures or dislocations during the forceful involuntary movements of the clonic phase. Restricting the extremities creates unnecessary resistance against powerful muscle contractions. The nurse should clear the immediate area of hard objects rather than holding the client down.

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A nurse is reinforcing teaching with a client who is to have plaster cast applied to his right arm. Which of the following information should the nurse include the teaching?

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Naxlex Comprehensive Predictor Exams

A nurse is assisting in the care of a client who is taking chlorpromazine. Which of the following findings indicates a therapeutic effect medication?

Correct Answer is B

Explanation

A nurse is caring for a client who is experiencing a tonic-clonic seizure. Which of the following action should the nurse take?

Correct Answer is B

Explanation

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