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 C

Explanation

Rationale:

A. "Rinse your mouth with an alcohol-based mouthwash.": Alcohol-based mouthwashes can further irritate the mucous membranes, worsen oral discomfort, and dry the oral tissues, especially in clients with mucositis or candidiasis common in AIDS.

B. "Eat foods served at hot temperatures.": Hot foods can aggravate oral sores and cause more pain or tissue damage. Cool or room-temperature foods are typically better tolerated when the mouth is sore.

C. "Use ice chips to numb your mouth.": Ice chips can provide temporary relief by numbing oral tissues, reducing inflammation, and making eating more comfortable. This is a helpful, non-pharmacologic intervention for oral pain.

D. "Add salt to season foods.": Salt can irritate open or inflamed oral tissues and worsen the discomfort. Bland, soft foods without strong seasonings are usually better tolerated in cases of mouth soreness.

A. "Opioids should not be given to older adults." B. "Pain perception is decreased in older adult clients." C. "Older adults report pain less frequently than younger clients." D. "Older adults require higher doses of pain medication."

Correct Answer is C

Explanation

Rationale:

A. "Opioids should not be given to older adults.": Opioids can be given to older adults when necessary, but with caution. The dose may need adjustment due to age-related changes in metabolism and increased sensitivity, not outright avoidance.

B. "Pain perception is decreased in older adult clients.": Pain perception does not decrease with age. Older adults may have conditions that affect communication or cognition, but their ability to feel pain remains intact, and they can still experience significant discomfort.

C. "Older adults report pain less frequently than younger clients.": Older adults often underreport pain due to beliefs that pain is a normal part of aging or fear of treatment consequences. This makes active assessment and trust-building essential in managing their pain effectively.

D. "Older adults require higher doses of pain medication.": Older adults typically require lower or more carefully titrated doses due to slower metabolism, decreased renal clearance, and heightened drug sensitivity, especially to central nervous system effects.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has AIDS. The client states, "My mouth is sore when I eat." Which of the following instructions should the nurse provide?

Correct Answer is C

Explanation

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?

Correct Answer is C

Explanation

A nurse is caring for a client who has type 1 diabetes mellitus. The client reports that she is not feeling well. Which of the following findings should indicate to the nurse that the client is hypoglycemic? (Select all that apply.)

A nurse is providing teaching at a community health fair about electrical fire prevention. Which of the following information should the nurse Include in the teaching?

A nurse is caring for a client who has lung cancer and has a sealed radiation implant. Which of the following actions should the nurse take? (Select all that apply.)

A nurse in a pediatric clinic is reviewing the laboratory results of a school-age child. Which of the following findings indicates the child may have a potential bacterial infection?

A nurse is caring for a client who is seeking information about end-of-life decisions. According to the Patient Self-Determination Act, which of the following applies to medical decisions that can be made within organizations that receive Medicare and Medicaid reimbursements?

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?

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