The nurse is continuing to care for the child.
After reviewing the discharge instructions with the family, which of the following statements by a parent indicate an understanding of the teaching?
For each statement by the parent, click to specify if the statement reflects an understanding or indicates a need for reinforcement of the discharge teaching.
"We should notify the provider if the cast becomes loose over time."
"We should expect the swelling and tingling to worsen before it gets better."
"We need to be very careful about how we handle the cast for the first 2 days while it dries."
"It is important that our child avoids placing anything inside the cast.
"We should prop the casted arm on pillows for the next 24 hours."
The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"B"},"C":{"answers":"A"},"D":{"answers":"A"},"E":{"answers":"A"}}
Rationale:
• "We should notify the provider if the cast becomes loose over time.": A loose cast can fail to immobilize the fracture properly, risking displacement or delayed healing. Recognizing this and contacting the provider demonstrates proper understanding of cast care.
• "We should expect the swelling and tingling to worsen before it gets better.": While mild swelling and tingling may occur, increasing or worsening neurovascular symptoms can indicate complications such as compartment syndrome. The parent needs reinforcement that any worsening sensation or cold fingers should prompt immediate provider notification rather than being expected.
• "We need to be very careful about how we handle the cast for the first 2 days while it dries.": Handling a wet cast improperly can deform it and compromise fracture stabilization. Awareness of this indicates correct knowledge of initial cast care.
• "It is important that our child avoids placing anything inside the cast.": Inserting objects into the cast can cause skin irritation, pressure ulcers, or infection. Avoiding this demonstrates understanding of safe cast management.
• "We should prop the casted arm on pillows for the next 24 hours.": Elevation of the casted limb reduces swelling and promotes comfort. This reflects correct knowledge of post-cast care.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Rationale:
A. Transfer on the client's weaker side when moving a client from a bed to a chair: Clients should be moved toward their stronger side to facilitate participation and reduce strain on both the client and the nurse. Transferring toward the weaker side increases risk of injury and reduces stability.
B. Raise the head of the bed when transferring a client from a bed to a stretcher: Raising the head of the bed does not directly enhance safe body mechanics or ergonomic principles during a transfer. Proper lifting techniques and devices are more critical for preventing injury.
C. Use a lateral transfer device when moving a client from a bed to a stretcher: Using a lateral transfer device, such as a sliding board or transfer sheet, minimizes manual lifting, reduces musculoskeletal strain, and follows ergonomic principles. It is a key safety strategy for both the client and healthcare staff.
D. Use a pillow underneath the client's head when repositioning a client in bed: Placing a pillow under the head supports comfort and alignment but does not relate to ergonomic principles or safe lifting techniques. Ergonomics focuses on body mechanics, positioning, and injury prevention for caregivers.
Correct Answer is B
Explanation
Rationale:
A. "Massage the ointment into the skin.": The ointment should not be massaged into the skin because doing so alters the absorption rate and can cause unpredictable vasodilation and hypotension.
B. "Spread the ointment in a thin, even layer.": The nurse should instruct the client to apply the prescribed amount of nitroglycerin ointment in a thin, even layer to a hairless area of the upper body or chest. This ensures consistent absorption of the medication.
C. "Apply the ointment to the forearm.": The forearm is not a recommended site for application. The preferred areas are the chest, back, or upper arm where the skin is less likely to be disturbed and has better absorption.
D. "Apply the ointment to the skin every 4 hr.": Nitroglycerin ointment is usually applied every 6 to 12 hours depending on the prescription, with a nitrate-free interval to prevent tolerance. Every 4 hours is not standard practice.
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