The nurse is continuing to care for the child.
Elevate the affected forearm with pillows.
Administer Ibuprofen 200 mg PO.
Place a non adherent dressing on the right knee abrasion.
Review cast care instructions with the child's parents.
Explain the cast application procedure to the child.
Apply ice packs to the fingers and along the right forearm.
Correct Answer : A,B,F
Rationale:
A. Elevate the affected forearm with pillows: Elevation helps reduce swelling and promotes venous return, which is critical in the immediate management of a fracture to prevent complications such as increased edema or impaired circulation.
B. Administer Ibuprofen 200 mg PO: The child reports pain at a level of 5, meeting the prescription threshold. Administering analgesia promptly helps manage discomfort and supports cooperation with further interventions, such as casting.
C. Place a nonadherent dressing on the right knee abrasion: While wound care is important, the abrasion is minor and not the most urgent concern. Prioritization focuses on the fractured limb and pain management.
D. Review cast care instructions with the child's parents: Education is important but is not the immediate priority before the cast is applied. It can be provided after the child is stabilized and pain is managed.
E. Explain the cast application procedure to the child: While preparing the child psychologically is important, immediate interventions to reduce pain and swelling take precedence over anticipatory teaching.
F. Apply ice packs to the fingers and along the right forearm: Ice helps reduce swelling and pain in the acute phase of the fracture. Applying ice in combination with elevation supports circulation and comfort while awaiting casting.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Rationale:
A. "Massage the ointment into the skin.": The ointment should not be massaged into the skin because doing so alters the absorption rate and can cause unpredictable vasodilation and hypotension.
B. "Spread the ointment in a thin, even layer.": The nurse should instruct the client to apply the prescribed amount of nitroglycerin ointment in a thin, even layer to a hairless area of the upper body or chest. This ensures consistent absorption of the medication.
C. "Apply the ointment to the forearm.": The forearm is not a recommended site for application. The preferred areas are the chest, back, or upper arm where the skin is less likely to be disturbed and has better absorption.
D. "Apply the ointment to the skin every 4 hr.": Nitroglycerin ointment is usually applied every 6 to 12 hours depending on the prescription, with a nitrate-free interval to prevent tolerance. Every 4 hours is not standard practice.
Correct Answer is B
Explanation
Rationale:
A. Tell the client they can continue to drink cranberry juice while taking warfarin: Cranberry juice can potentiate the effects of warfarin, increasing the risk of bleeding. Clients should be cautioned to avoid interactions that affect anticoagulation.
B. Consult the pharmacist about potential interactions between the client's regular medications and warfarin: Warfarin has numerous drug and food interactions that can significantly alter its effectiveness. Consulting a pharmacist ensures safe management of concurrent medications and reduces the risk of adverse effects.
C. Recommend the client take warfarin at the same time as other medications: While consistent dosing is important, the priority is verifying potential interactions with other medications rather than simply synchronizing administration times.
D. Advise the client that over-the-counter medications remain safe to consume as needed: Many OTC medications, such as NSAIDs, can increase bleeding risk when taken with warfarin. Clients should always check with their provider or pharmacist before using OTC products.
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