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 expect the swelling and tingling to worsen before it gets better."

"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."

"We should notify the provider if the cast becomes loose over time.

"We need to be very careful about how we handle the cast for the first 2 days while it dries."

Answer and Explanation

The Correct Answer is {"A":{"answers":"B"},"B":{"answers":"A"},"C":{"answers":"A"},"D":{"answers":"A"},"E":{"answers":"A"}}

Rationale:

"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.

"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 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.
"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.
"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.

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Correct Answer is D

Explanation

Rationale:

A. A client who has decreased interleukin-6 levels: Interleukin-6 is a pro-inflammatory cytokine that may be elevated in depression, but its decrease is not an indicator for antidepressant use. It’s not routinely used to determine the need for antidepressant therapy in clinical practice.

B. A client who has decreased urine cortisol levels: Depression is more commonly associated with increased cortisol levels due to stress responses. Low cortisol may be seen in conditions like Addison's disease but does not typically guide antidepressant use.

C. A client who has decreased C-reactive protein levels: CRP is a nonspecific inflammatory marker. While elevated CRP has been observed in some individuals with depression, a decreased CRP level would not indicate the need for antidepressant therapy.

D. A client who has decreased serotonin levels: Low serotonin levels are closely linked to depression pathophysiology. Many antidepressants, such as SSRIs, target serotonin levels to relieve depressive symptoms, making this the most relevant indicator for antidepressant therapy.

A. Sudden muscular contractions B. Orthostatic hypotension C. Anticholinergic effects D. Tremors E. Sedation F. Increased urination

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

Explanation

Rationale:

A. Sudden muscular contractions: Antipsychotics like haloperidol and chlorpromazine can cause extrapyramidal symptoms (EPS), including acute dystonia, which manifests as sudden, involuntary muscle contractions typically affecting the face, neck, or back.

B. Orthostatic hypotension: Chlorpromazine, a low-potency typical antipsychotic, often causes orthostatic hypotension due to its alpha-adrenergic blockade, increasing fall risk, especially in older adults or those new to therapy.

C. Anticholinergic effects: These include dry mouth, blurred vision, constipation, and urinary retention. Chlorpromazine is particularly known for its anticholinergic side effects due to its action on muscarinic receptors.

D. Tremors: Tremors are part of parkinsonian side effects, another form of EPS commonly caused by haloperidol. They result from dopamine blockade in the nigrostriatal pathway.

E. Sedation: Both haloperidol and chlorpromazine can cause sedation. Chlorpromazine is especially sedating due to its histamine (H1) receptor blockade, which depresses the CNS.

F. Increased urination: Not typically associated with these medications. In fact, anticholinergic effects from chlorpromazine more often lead to urinary retention, not increased urination.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is discussing antidepressants with a newly licensed nurse. Which of the following clients should the nurse identify as being a candidate for antidepressant therapy?

Correct Answer is D

Explanation

The nurse continues to care for the client.Exhibits The nurse administers the client's scheduled medication. Which of the following adverse effects of the medication should the nurse monitor the client for? Select all that apply.

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

Explanation

A nurse is supervising an assistive personnel (AP) who is caring for a client with an indwelling urinary catheter. Which of the following actions taken by the AP indicates proper technique?

A nurse manager is teaching a newly licensed nurse about pain management for an older adult client. Which of the following statements by the nurse indicates an understanding of the teaching?

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

A charge nurse in a newborn nursery is providing information to a group of nurses about risk factors for hypoglycemia. Which of the following risk factors should the charge nurse include? (Select all that apply.)

A nurse is caring for a client who has a closed wound drainage system. Which of the following interventions should the nurse include in the plan of care?

A nurse is planning care for a client who is Chinese American and reports adhering to Chinese cultural postpartum practices. Which of the following should the nurse anticipate?

A nurse is caring for an adolescent who has sickle-cell anemia. Which of the following manifestations indicates acute chest syndrome and should be immediately reported to the provider?

A nurse is teaching a client who has multiple sclerosis. Which of the following instructions should the nurse include in the teaching?