This is the edited text:

A client is experiencing numbness and tingling distal to a new arm cast with no increase in pain. The nurse assesses that the client's fingers are pale, cool, and swollen. What action does the nurse take next?

Encourage range of motion

Apply heat to the affected hand

Remove the cast to decrease pressure

Raise the arm above the level of the heart

Answer and Explanation

The Correct Answer is C

Choice A reason: This is not the best action because encouraging range of motion can worsen the symptoms and cause more damage to the nerves and blood vessels. Range of motion is the movement of the joints and muscles through their normal extent. Range of motion can help to prevent stiffness, contractures, and muscle atrophy, but it can also increase the swelling and pressure in the affected area, which can impair the circulation and sensation.

Choice B reason: This is not the best action because applying heat to the affected hand can worsen the symptoms and cause more damage to the tissues. Heat is the transfer of thermal energy from a warmer object to a cooler one. Heat can help to relax the muscles, reduce the pain, and increase the blood flow, but it can also increase the inflammation and edema in the affected area, which can compromise the oxygen and nutrient delivery to the tissues.

Choice C reason: This is the best action because removing the cast can decrease the pressure and restore the circulation and sensation to the affected area. A cast is a rigid device that immobilizes and protects a fractured or injured body part. A cast can help to align the bones, prevent displacement, and promote healing, but it can also cause complications, such as compartment syndrome, infection, or nerve damage. Compartment syndrome is a condition where the pressure inside the muscles increases to dangerous levels, causing severe pain, reduced blood flow, and tissue death. The nurse should remove the cast immediately and notify the physician if the client shows signs of compartment syndrome, such as numbness, tingling, pallor, coolness, or swelling.

Choice D reason: This is not the best action because raising the arm above the level of the heart can worsen the symptoms and cause more damage to the nerves and blood vessels. Raising the arm above the level of the heart can help to reduce the swelling and pain in the affected area, but it can also reduce the blood flow and oxygenation to the area, which can lead to ischemia, necrosis, or gangrene. The nurse should elevate the arm at or below the level of the heart and monitor the pulse, color, temperature, and sensation of the fingers.

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Correct Answer is A

Explanation

Choice A reason: Shearing or friction is the force that caused the injury, because it occurs when the skin and underlying tissues move in opposite directions, such as when the client slides down in bed. Shearing or friction can damage the blood vessels and reduce blood flow to the skin, resulting in tissue ischemia, necrosis, and ulceration.

Choice B reason: Pressure or gravity is not the force that caused the injury, because it occurs when the skin and underlying tissues are compressed between a bony prominence and an external surface, such as when the client lies on his back. Pressure or gravity can impair blood flow and oxygen delivery to the skin, resulting in tissue damage and ulceration.

Choice C reason: Chemical or pressure is not the force that caused the injury, because it occurs when the skin is exposed to a substance that causes irritation, inflammation, or corrosion, such as when the client has a wound dressing that contains an antiseptic or a topical agent. Chemical or pressure can damage the skin barrier and increase the risk of infection and delayed wound healing.

Choice D reason: Twisting and bending is not the force that caused the injury, because it occurs when the skin and underlying tissues are stretched or distorted, such as when the client twists his ankle or bends his knee. Twisting and bending can cause sprains, strains, or tears of the ligaments, tendons, or muscles.

A. Opioids B. Anticoagulants C. Nonsteroidal antiinflammatory drugs (NSAIDs) D. Narcotics

Correct Answer is C

Explanation

Choice A reason: This is not the correct answer because opioids are a class of medications that act on the opioid receptors in the brain and spinal cord to reduce pain perception and emotional response. Opioids do not have a direct effect on tissue inflammation or bone healing, but they can cause side effects such as constipation, nausea, sedation, respiratory depression, and addiction.

Choice B reason: This is not the correct answer because anticoagulants are a class of medications that prevent or reduce the formation of blood clots by interfering with the clotting factors or platelets. Anticoagulants do not have a direct effect on tissue inflammation or bone healing, but they can increase the risk of bleeding and hematoma formation, which can impair the blood supply and oxygen delivery to the injured tissues.

Choice C reason: This is the correct answer because NSAIDs are a class of medications that inhibit the enzyme cyclooxygenase (COX), which is involved in the synthesis of prostaglandins, which are inflammatory mediators that cause pain, swelling, and fever. NSAIDs can decrease tissue inflammation and pain, but they can also delay bone healing by reducing the formation of osteoblasts, which are cells that build new bone tissue.

Choice D reason: This is not the correct answer because narcotics are another term for opioids, which are a class of medications that act on the opioid receptors in the brain and spinal cord to reduce pain perception and emotional response. Narcotics do not have a direct effect on tissue inflammation or bone healing, but they can cause side effects such as constipation, nausea, sedation, respiratory depression, and addiction.

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This is the edited text:A client is experiencing numbness and tingling distal to a new arm cast with no increase in pain. The nurse assesses that the client's fingers are pale, cool, and swollen. What action does the nurse take next?

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This is the edited text:

A client is experiencing numbness and tingling distal to a new arm cast with no increase in pain. The nurse assesses that the client's fingers are pale, cool, and swollen. What action does the nurse take next?