The nurse is continuing to care for the child.
Administer Ibuprofen 200 mg PO.
Elevate the affected forearm with pillows.
Place a nonadherent dressing on the right knee abrasion.
Review cast care instructions with the child's parents.
Apply ice packs to the fingers and along the right forearm.
Explain the cast application procedure to the child.
Correct Answer : A,B,E
Rationale:
A. Administer Ibuprofen 200 mg PO: The child reports a pain score of 5/10 and is requesting pain medication. The provider has prescribed ibuprofen PRN for this level of pain. Prompt administration supports comfort and reduces inflammation associated with fracture and swelling.
B. Elevate the affected forearm with pillows: Elevation helps reduce edema by promoting venous return and lymphatic drainage. Given the child's worsening edema in the forearm and fingers, this is a priority to minimize complications like compartment syndrome.
C. Place a nonadherent dressing on the right knee abrasion: Although dressing the abrasion is a reasonable intervention, it is not a priority at this stage. The abrasion is not actively bleeding or infected, so attention should remain on managing neurovascular risk and pain.
D. Review cast care instructions with the child's parents: This is an important educational step, but it is not a current priority since the cast has not yet been applied. Priority actions should focus on pain, swelling, and circulation while awaiting casting.
E. Apply ice packs to the fingers and along the right forearm: Ice helps manage pain and inflammation by vasoconstriction, limiting fluid accumulation in tissues. Applying it early post-injury is crucial to controlling swelling in a fractured limb.
F. Explain the cast application procedure to the child: Preparing the child for a future procedure is helpful but not immediately necessary. At this point, pain control and reduction of swelling take precedence to prevent complications and stabilize the injury.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Rationale:
A. The person holding financial power of attorney will make health care decisions based on the client's advance directives: A financial power of attorney manages financial matters, not health care decisions. A separate designation such as a health care proxy or medical power of attorney is needed for making medical decisions.
B. The client has the right to refuse medical treatment, even if health care providers recommend it: Under the Patient Self-Determination Act (PSDA), clients have the legal right to make autonomous decisions about their care, including the right to refuse or discontinue treatment, regardless of medical advice.
C. The client's eldest adult child has the right to change advance directives in an end-of-life situation: Advance directives reflect the client’s own decisions. No family member, regardless of birth order, has the legal authority to change them unless specifically authorized as a health care proxy and even then, only if the client is incapacitated.
D. If the client's advance directives are in writing and notarized, the client cannot change it in the future: Clients can revise or revoke advance directives at any time, as long as they remain mentally competent. Notarization does not make the document legally fixed or unchangeable.
Correct Answer is A
Explanation
Rationale:
A. "Let's talk about what you already know about immunizing your baby.": This response uses open-ended, nonjudgmental communication to explore the parents' beliefs and knowledge. It encourages dialogue, builds trust, and opens the door for education about vaccine safety and benefits.
B. "Your baby's immunizations should be up to date before they are able to travel with you by airplane.": This statement may feel coercive or irrelevant if the parents are not currently planning to travel. It does not address their current concerns or promote open discussion.
C. "You don't have to immunize your baby against diseases that are no longer common.": Diseases like measles and pertussis can still occur and spread quickly in under-immunized communities. Vaccination remains essential to maintain herd immunity and prevent outbreaks.
D. "The provider can give you a referral for your baby to see an infectious disease provider.": Referring to a specialist at this stage may come across as dismissive or escalate the situation unnecessarily. Primary care providers and nurses can often address vaccine concerns effectively through discussion and education.
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