The nurse is continuing to care for the child.

Exhibits

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."

Answer and Explanation

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

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Naxlex Comprehensive Predictor Exams

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Free Nursing Study Resources

Correct Answer is ["A","B","D","E"]

Explanation

Rationale:
A. Obtain a culture specimen of the lochia from the client's perineal pad using a sterile swab: The client exhibits signs of postpartum infection, including foul-smelling lochia, fever, and elevated WBC count. Collecting a culture helps identify the causative organism and guide antibiotic therapy.

B. Instruct the client to wash her hands before and after changing her perineal pad: Hand hygiene reduces the risk of introducing additional pathogens to the uterine or perineal area, supporting infection control and client safety.

C. Initiate contact precautions: Contact precautions are typically used for highly contagious or multidrug-resistant infections. Standard precautions, including hand hygiene, are sufficient for most postpartum infections like endometritis.

D. Encourage the client to maintain a semi-Fowler's position to enhance uterine drainage: Semi-Fowler’s positioning promotes drainage of lochia, reduces uterine stasis, and helps prevent further infection or discomfort.

E. Monitor the height and tone of the client's fundus: Regular assessment of fundal height and tone is essential postpartum to detect uterine atony, retained tissue, or infection. Monitoring ensures early intervention if complications develop.

F. Request a prescription for terbutaline from the provider: Terbutaline is a tocolytic used to suppress preterm labor. There is no indication for its use in this postpartum client with uterine infection.

G. Inform the client she will need to formula feed her newborn until she has received antibiotics for 24 hr: Most antibiotics, including clindamycin, are compatible with breastfeeding. The client does not need to discontinue breastfeeding unless specifically contraindicated.

A. After inflation, deflate a blood pressure cuff on the client's arm while palpating their brachial pulse. B. Compare the client's carotid pulse while resting to their carotid pulse after standing for 1 min. C. Measure the client's apical pulse while another nurse measures their radial pulse. D. Assess both of the client's radial pulses at the same time and compare the quality of pulsations.

Correct Answer is C

Explanation

Rationale:
A. After inflation, deflate a blood pressure cuff on the client's arm while palpating their brachial pulse: This technique assesses blood pressure, not pulse deficit. Pulse deficit requires comparing simultaneous heartbeats at different sites rather than using a cuff for measurement.

B. Compare the client's carotid pulse while resting to their carotid pulse after standing for 1 min: This evaluates orthostatic changes in heart rate, not pulse deficit. Pulse deficit specifically identifies a difference between apical and peripheral pulses during the same cardiac cycle.

C. Measure the client's apical pulse while another nurse measures their radial pulse: A pulse deficit is determined by counting the apical pulse and comparing it to the radial pulse simultaneously. A difference indicates that some heartbeats are not producing a palpable peripheral pulse, which is important in conditions like atrial fibrillation.

D. Assess both of the client's radial pulses at the same time and compare the quality of pulsations: Comparing radial pulses on both sides evaluates for peripheral pulse equality or arterial obstruction, not pulse deficit.

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Naxlex Comprehensive Predictor Exams

A nurse reviews the provider prescriptions and reassesses the client. Exhibits The nurse is continuing to care for the client. Which of the following actions should the nurse take? Select all that apply.

Correct Answer is ["A","B","D","E"]

Explanation

A nurse is preparing to assess a client for pulse deficit. Which of the following actions should the nurse plan to take?

Correct Answer is C

Explanation

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