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) Arterial blood gases: Arterial blood gas (ABG) tests are typically used to assess respiratory and metabolic function, including the balance of oxygen and carbon dioxide in the blood. While important in many clinical situations, ABGs are not specifically relevant for monitoring a client on levothyroxine, as it does not directly affect gas exchange or acid-base balance.

B) Thyroid stimulating hormone (TSH): TSH is the most important laboratory test to monitor in a client taking levothyroxine, as this medication is used to replace or supplement thyroid hormone levels. Levothyroxine directly affects thyroid hormone levels in the body, so monitoring TSH levels is essential for determining whether the medication dosage needs to be adjusted. Elevated TSH levels may indicate that the dose is too low, while low levels may suggest an overdose.

C) Prothrombin time: Prothrombin time (PT) is used to assess blood clotting and coagulation status. While certain thyroid conditions can influence coagulation, PT is not a routine test to monitor in clients on levothyroxine therapy unless there are specific concerns related to bleeding or clotting. It is not the most relevant test for monitoring thyroid function in this context.

D) Blood urea nitrogen (BUN): Blood urea nitrogen (BUN) levels reflect kidney function and hydration status. While kidney function is always important to monitor, BUN is not specifically used to assess the effects of levothyroxine therapy. It would not provide direct information regarding the effectiveness of the medication or the thyroid status of the client.

A. Patient Health Questionnaire -9 B. Abnormal involuntary Movement Scale C. Mental Status Examination D. Brief Psychiatric Rating Scale

Correct Answer is B

Explanation

A) Patient Health Questionnaire - 9:
The Patient Health Questionnaire-9 (PHQ-9) is a screening tool used to assess the severity of depression in a client. It is not specific to detecting tardive dyskinesia, which is a movement disorder caused by long-term use of antipsychotic medications. Therefore, this tool is not appropriate for assessing tardive dyskinesia.

B) Abnormal Involuntary Movement Scale:
The Abnormal Involuntary Movement Scale (AIMS) is the correct tool to screen for tardive dyskinesia. It is specifically designed to assess involuntary movements, such as those seen in tardive dyskinesia, which is a common side effect of long-term use of antipsychotic medications. The AIMS evaluates the presence and severity of abnormal movements, making it the most appropriate tool for this purpose.

C) Mental Status Examination:
The Mental Status Examination (MSE) is a broad assessment used to evaluate a client’s cognitive and emotional functioning. It includes aspects such as appearance, behavior, mood, thoughts, and perception but does not specifically assess for movement disorders like tardive dyskinesia. While it can provide useful information about a client's mental state, it is not focused on detecting motor side effects of antipsychotic medications.

D) Brief Psychiatric Rating Scale:
The Brief Psychiatric Rating Scale (BPRS) is used to assess the severity of psychiatric symptoms, including delusions, hallucinations, and mood disturbances, primarily in individuals with schizophrenia or other psychiatric disorders. It does not specifically assess for tardive dyskinesia, so it is not the most appropriate screening tool for identifying this condition.

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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?

Nursing Test Bank

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