Two weeks after cast application, a client with a fractured right arm returns to the clinic for evaluation. The client seems upset and tells the practical nurse (PN) that the healthcare provider said a callus has formed on the bone. Which action should the PN take?

Prepare to assist in applying a new cast to reduce pressure points.

Report the client's concern to the healthcare provider.

Explain this is an expected part of the bone healing process.

Teach the client strategies to prevent further calluses.

Answer and Explanation

The Correct Answer is C

A callus is a normal response of the body during bone healing, where new bone tissue forms around the fracture site to provide stability and support. It helps in the process of bridging the fracture and promoting healing.
The PN can provide reassurance to the client by explaining that the presence of a callus indicates that the bone is healing and progressing toward recovery. It is important to educate the client about the expected timeline for bone healing and the need for continued follow-up with the healthcare provider.
Incorrect:

A. Prepare to assist in applying a new cast to reduce pressure points: This choice assumes that the client's concern is related to discomfort or pressure points caused by the current cast.
However, the client's concern is about the formation of a callus, which is a normal part of bone healing. There is no indication that a new cast is necessary at this point.
B. Report the client's concern to the healthcare provider: While it's important to address client concerns and communicate any changes in their condition to the healthcare provider, in this case, the formation of a callus is an expected part of the bone healing process. It is not necessary to report this concern to the healthcare provider as it is a normal occurrence.
D. Teach the client strategies to prevent further calluses: The formation of a callus in this context is a natural response of the body to promote bone healing. It is not necessary to teach the client strategies to prevent further calluses, as callus formation is a temporary and beneficial part of the healing process.

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Correct Answer is D

Explanation

Regular insulin is the medication of choice for treating DKA. Its main action is to lower blood glucose levels by promoting the uptake of glucose into cells and inhibiting the production of glucose by the liver. Therefore, checking the fingerstick blood glucose level is an important indicator of the effectiveness of the insulin treatment.
A decrease in the blood glucose level indicates that the insulin is working to lower the high blood sugar associated with DKA. This measurement helps the PN assess the response to treatment and adjust the insulin dosage if necessary.
The other actions mentioned are also important assessments in the care of a client with DKA, but they do not specifically evaluate the effectiveness of the insulin dosage:
A. Smelling the client's breath for resolution of a fruity odor is important as it indicates a decrease in ketone production, which is a marker of improving DKA. However, it does not directly evaluate the effectiveness of the insulin dosage.
B. Determining the client's orientation to time and space is part of assessing their neurological status, which is crucial in managing DKA. However, it does not specifically assess the effectiveness of the insulin dosage.
C. Measuring the client's urinary output for an increased volume is important to monitor hydration status and renal function, but it does not directly evaluate the effectiveness of the insulin dosage.

A. The client will use self-affirmation statements to decrease fear. B. The client will ambulate with assistance for q4 hours. C. The physical therapist will instruct the client in the use of a walker. D. The PN will place a gait belt on the client prior to ambulation.

Correct Answer is B

Explanation

While all of the options address the issue of impaired mobility related to fear of falling, the desired outcome of ambulating with assistance q4 hours is the most specific and measurable goal. This outcome focuses on promoting mobility and addressing the client's fear of falling by providing the necessary assistance during ambulation. It ensures that the client is engaging in regular activity and working towards regaining mobility.
The other options address different aspects of the nursing problem:

A. "The client will use self-affirmation statements to decrease fear" is a potential intervention that can be used to address the client's fear of falling, but it does not directly address the issue of impaired mobility.
C. "The physical therapist will instruct the client in the use of a walker" is an intervention that can be helpful in improving mobility, but it does not specify the frequency or timing of ambulation.
D. "The PN will place a gait belt on the client prior to ambulation" is a specific intervention that ensures the safety of the client during ambulation, but it does not address the frequency or timing of ambulation.

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Two weeks after cast application, a client with a fractured right arm returns to the clinic for evaluation. The client seems upset and tells the practical nurse (PN) that the healthcare provider said a callus has formed on the bone. Which action should the PN take?

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Naxlex Comprehensive Predictor Exams

A client with diabetic ketoacidosis (DKA) is receiving regular insulin. Which action should the practical nurse (PN) implement to evaluate the effectiveness of the insulin dosage?

Correct Answer is D

Explanation

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Correct Answer is B

Explanation

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