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 C

Explanation

This question is related to the responsibilities and scope of practice of a practical nurse (PN) and a medication aide. A medication aide is a certified nursing assistant (CNA) who is responsible for administering daily medication to patients under the supervision of a licensed nurse, such as a PN or a registered nurse (RN). A PN is a licensed nurse who can provide routine care, observe patients’ health, assist doctors and RNs, and communicate instructions to patients regarding medication, home-based care, and preventative lifestyle changes.

Based on this information, the best action that the PN should take in this situation is c. Assign the remainder of medication administration to another PN who is performing treatments. This is because it would ensure that the medication administration is completed by another licensed nurse who has the knowledge, skills, and authority to do so. The PN who is performing treatments may have some spare time or be able to rearrange their schedule to accommodate the additional task. The PN should also communicate with the other PN and the medication aide about the situation and document the change of assignment in the patients’ records.

Option a is not a good choice, because it would be unfair and unethical to deny the medication aide’s request to leave if they are sick. The medication aide’s health and well-being are also important, and forcing them to stay and work could compromise their safety and the quality of care they provide to the patients.

Option b is not a good choice, because it would be outside the scope of practice of the UAPs to give medications to the patients. UAPs are not trained or certified to administer medications, and doing so could pose serious risks to the patients’ health and safety. The PN would also be liable for any errors or adverse outcomes that may result from the UAPs’ actions.

Option d is not a good choice, because it would not solve the problem of the medication administration being incomplete. Documenting why the medications were not given is important, but it is not enough to ensure that the patients receive their prescribed drugs and treatments. The PN still has the responsibility to find a way to complete the medication administration or delegate it to another qualified and available person.

A. Asks how long he has been in the hospital B. Drinking broth C. States he is hungry D. Clawing at the air E. Keeps trying to get out of bed to find the swimming pool F. Recognizes his daughter G. Oriented to time, place, and self H. Oxygen saturation on 0.5L of 100%

Correct Answer is ["A","B","C","F","G"]

Explanation

Based on the given information, the statements that indicate the client's confusion is resolving are:

Asks how long he has been in the hospital: This shows cognitive awareness and the ability to ask relevant and coherent questions.
States he is hungry: This indicates a return to normal appetite and the ability to recognize and express basic needs.
Recognizes his daughter: This demonstrates the ability to recognize and identify a familiar individual, suggesting an improved level of cognitive functioning.
Oriented to time, place, and self: Being aware of the current time, location, and personal identity reflects an improved level of orientation and mental clarity.
The statement "Drinking broth" does reflect the client's willingness and ability to consume food.

The following statements suggest ongoing confusion or potential issues:

Clawing at the air: This behavior may indicate restlessness, agitation, or disorientation.
Keeps trying to get out of bed to find the swimming pool: This behavior may indicate confusion or an altered perception of reality.

The statement "Oxygen saturation on 0.5L of 100%" provides information about the client's oxygen saturation level but does not specifically address the resolution of confusion.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The medication aide at a long-term care facility is sick and requests to go home before all medications are administered. Which action should the practical nurse (PN) take in this situation?

Correct Answer is C

Explanation

Chest x-ray: Consolidation in the right lower lobe consistent with pneumonia Review H and P, nurse's notes, flow sheet, doctor's order, and Imaging studies. What statements indicate the client's confusion is resolving? Select all that apply.

Correct Answer is ["A","B","C","F","G"]

Explanation

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