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."

"It is important that our child avoids placing anything inside the cast."

"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."

"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":"A"},"C":{"answers":"B"},"D":{"answers":"A"},"E":{"answers":"A"}}

Rationale:

"We should notify the provider if the cast becomes loose over time." A loose cast may no longer immobilize the fracture effectively and can allow excessive movement. It may also rub the skin, increasing the risk of irritation or breakdown.

"It is important that our child avoids placing anything inside the cast." This statement reflects understanding because inserting objects inside the cast can break the skin and introduce bacteria, leading to infection. It may also damage the padding and compromise skin protection.
"We should expect the swelling and tingling to worsen before it gets better." This statement needs reinforcement because worsening swelling and tingling can indicate early signs of compartment syndrome. These symptoms are not normal and should prompt immediate medical attention.
"We need to be very careful about how we handle the cast for the first 2 days while it dries." This shows understanding because a plaster cast takes 24 to 48 hours to fully dry. Improper handling can cause pressure indentations, leading to skin damage and poor cast integrity
"We should prop the casted arm on pillows for the next 24 hours." Elevating the limb helps reduce swelling and pain by improving venous return. Keeping the casted arm elevated is a standard part of cast care teaching after an injury.

Nursing Test Bank

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Correct Answer is D

Explanation

Rationale:

A. Instruct the client to bend at the waist to put on slippers: Bending at the waist increases the risk of hip dislocation after total hip arthroplasty. Clients should avoid flexing the hip beyond 90 degrees and use adaptive equipment for dressing to maintain safety.

B. Keep the client's heels elevated while in bed: Elevating the heels is not routinely indicated and may cause hip or knee strain. Proper positioning focuses on maintaining hip alignment and preventing dislocation or pressure injuries rather than heel elevation.

C. Massage the client’s affected leg three times daily: Massaging the leg after hip surgery is contraindicated due to the risk of dislodging a deep vein thrombus (DVT). Gentle range-of-motion exercises are preferred, but direct massage should be avoided until clotting risk is ruled out.

D. Maintain slight abduction of the client’s affected hip: Keeping the hip in slight abduction with pillows or abduction devices helps prevent dislocation of the prosthetic joint. Proper positioning is essential for safe recovery following total hip arthroplasty.

A. Forearm B. Ventrogluteal C. Outer posterior aspect of upper arm D. Vastus lateralis

Correct Answer is C

Explanation

Rationale:

A. Forearm: The forearm is not a recommended site for subcutaneous injections because it has limited subcutaneous tissue and is typically reserved for intradermal injections, such as allergy testing or tuberculosis screening.

B. Ventrogluteal: The ventrogluteal site is preferred for intramuscular injections due to the large muscle mass and low risk of nerve injury. It is not suitable for subcutaneous injections, which require fatty tissue rather than muscle.

C. Outer posterior aspect of upper arm: This site contains adequate subcutaneous tissue, is easily accessible, and is commonly used for subcutaneous injections such as insulin or heparin. It allows for proper absorption and minimizes the risk of intramuscular administration.

D. Vastus lateralis: The vastus lateralis is part of the thigh and is primarily used for intramuscular injections, especially in infants or adults needing large-volume IM medications. It is not a typical site for subcutaneous injections.

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Body System	Findings
Neurological	Reports that dizziness and palpitations started 2 months ago. Alert and oriented to person, place, and time
Cardiovascular	Pedal pulses +1 bilaterally, Pedal edema +1 bilaterally. Capillary refill time 5 seconds for all extremities. Reports no pain with palpation of thorax.
Respiratory	Fatigue and dyspnea with exertion started 1 week ago. Lungs clear to auscultation bilaterally
Vital Signs	Heart rate 105/min Respiratory rate 20/min Blood pressure 164/92 mm Hg Oxygen saturation 96% on room air

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who had total hip arthroplasty 2 days ago. Which of the following actions should the nurse take

Correct Answer is D

Explanation

A nurse is preparing to administer a subcutaneous injection to a client. Which of the following sites should the nurse choose?

Correct Answer is C

Explanation

A nurse is caring for a client who received 50, 000 units of IV heparin rather than the prescribed 5,000 units. Which of the following actions should the nurse take first?

A school nurse is assessing a child and notes various bruises on the child's body that are unexplained. Which of the following actions should the school nurse take?

A nurse is caring for a client who has vision loss. Which of the following actions should the nurse take? (Select all that apply)

A nurse is teaching a client about advance directives. Which of the following statements by the client indicates an understanding of the teaching?

Exhibits A nurse is reviewing the medical record of a client who has schizophrenia. Which of the following findings should the nurse report to the provider? (Click on the exhibit tabs for additional information about the client. There are three tabs that contain separate categories of data.)