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
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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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A) "For a client who has Clostridium difficile, I will cleanse my hands with an alcohol-based rub.":
This statement is incorrect. When caring for a client with Clostridium difficile (C. diff), hand hygiene must be performed using soap and water, not an alcohol-based rub. Alcohol does not effectively kill C. diff spores. Handwashing with soap and water is essential to reduce the spread of this infection, as alcohol-based hand sanitizers are ineffective against C. diff spores.
B) "Droplet precautions require that I wear a gown and gloves when providing client care.":
This statement is incorrect. Droplet precautions require wearing a surgical mask to protect against large respiratory droplets that may be expelled during coughing or sneezing. Gowns and gloves are not routinely necessary unless there is a risk of contact with body fluids or secretions. Contact precautions, not droplet precautions, would require a gown and gloves.
C) "Following a blood spill, I should use a bleach solution with a ratio of 1 to 20.":
This statement is partially correct but not fully optimal. For blood spills, the correct bleach solution ratio for disinfection is typically 1 part bleach to 9 parts water (a 1:10 ratio) rather than 1:20. The bleach solution must be strong enough to effectively kill pathogens and viruses, so a 1:9 dilution is preferred.
D) "Soiled dressings should be placed in a biohazard trash receptacle.":
This statement is correct. Soiled dressings, particularly those that are contaminated with blood, bodily fluids, or pathogens, should always be disposed of in a biohazard trash receptacle. This ensures the safe and appropriate handling of potentially infectious materials and helps prevent the spread of infection.
Correct Answer is A
Explanation
A) Request an x-ray of the neck: In cases of suspected epiglottitis, a lateral neck x-ray can help confirm the diagnosis by showing the classic "thumbprint sign," which indicates swelling of the epiglottis. This is a critical diagnostic step, but it should only be performed in a controlled setting where the child’s airway can be monitored closely. The priority is to avoid any procedures that may cause irritation or further compromise the airway.
B) Monitor urine for protein: Monitoring urine for protein is not relevant to the management of epiglottitis. This condition is related to inflammation and obstruction of the upper airway, and the focus should be on respiratory management rather than renal function.
C) Obtain a nasopharyngeal swab: While obtaining a nasopharyngeal swab can help identify the organism causing an infection (often bacterial), it is not the immediate priority in a child with suspected epiglottitis. The child’s airway is the most critical concern, and diagnostic interventions that could potentially cause further distress or obstruction (such as swabbing) should be avoided until airway management is stable.
D) Administer fluconazole: Fluconazole is an antifungal medication, and its use is not appropriate for epiglottitis. Epiglottitis is most often caused by a bacterial infection, particularly Haemophilus influenzae type b (Hib), which requires antibiotic therapy, not antifungals.
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