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 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."
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Rationale:
A. Assist the adolescent in applying for Medicaid: Medicaid can provide essential prenatal care, delivery services, and pediatric coverage for low-income individuals. Helping the adolescent apply addresses both her financial and health concerns, supporting positive outcomes.
B. Refer the adolescent to local mental health clinic: While emotional support is important, this action doesn’t directly address her stated concern about affording and caring for the baby. It may be appropriate later but is not the immediate priority.
C. Contact the adolescent parent for assistance: Contacting family may be helpful if the adolescent consents, but it must respect her autonomy and confidentiality. It is not the nurse’s first step without permission or expressed need for family involvement.
D. Advise the adolescent to place the newborn for adoption: Suggesting adoption without the adolescent initiating that discussion may be inappropriate and coercive. Nurses should provide options neutrally and supportively, not direct decisions about parenting or adoption.
Correct Answer is A
Explanation
Rationale:
A. The client has a wound dressing saturated with sanguinous drainage after it was reinforced: Continued sanguineous drainage that saturates reinforced dressings just 2 hours post-op may indicate active bleeding or hemorrhage. This is an urgent finding that requires immediate provider notification for assessment and possible intervention.
B. The client reports a pain level of 2 on a 0 to 10 scale after administration of pain medication: A pain score of 2 reflects adequate pain control following intervention. This is an expected and desirable outcome and does not require provider notification.
C. The client has a urine output of 50 mL/hr after removal of the indwelling urinary catheter: A urine output of 50 mL/hr is within normal limits and suggests appropriate renal perfusion. No immediate action or provider notification is required based on this finding.
D. The client has an oxygen saturation level of 96% after oxygen 2 L/min via nasal cannula was applied: This oxygen saturation level indicates adequate oxygenation with supplemental oxygen and is within expected postoperative parameters.
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