Nokea
A client is seen in the emergency department for an injury acquired from falling off of a bicycle and fracturing the arm. The client also has a long laceration that has been sutured to the same area. The client asks the nurse why a splint is applied and not a cast. What is the best explanation by the nurse?
- A. We will need to monitor the status of the laceration to be sure it does not get infected.
- B. The arm does not require the same immobilization that a leg fracture would.
- C. You will be able to wear the splint longer than you would a cast.
- D. The splint is less expensive than the cast.
Correct Answer: A
Rationale: A splint would be used when there is special skin treatment or observation that is required. The arm fracture would require the same form of immobilization that a leg fracture does. The length of time the splint can be worn is equal to that
of a cast to immobilize the fracture. The cost of the splint and cast would be similar.
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A group of students is reviewing information about cast composition in preparation for a discussion on the advantages and disadvantages of each. The students demonstrate understanding of the topic when they cite what as an advantage of a plaster cast?
- A. Better molding to the client
- B. Quicker drying
- C. Longer lasting
- D. More breathable
Correct Answer: A
Rationale: Plaster casts require a longer time for drying but mold better to the client and are initially used until the swelling subsides. Fiberglass casts dry more quickly, are lighter in weight, longer lasting, and breathable.
A client has a cast that extends from below the elbow to the palmar crease and is secured around the base of the thumb. The thumb is also casted. The nurse identifies this as which type of cast?
- A. Short arm cast
- B. Gauntlet cast
- C. Body cast
- D. Spica cast
Correct Answer: B
Rationale: A gauntlet cast is a short arm cast that extends from below the elbow to the palmar crease and is secured around the base of the thumb, with the thumb also being casted. A short arm cast extends from below the elbow to the palmar crease and is secured around the base of the thumb. A body cast is a larger form of a cylinder cast that encircles the trunk from about the nipple line to the iliac crests. A hip spica cast surrounds one or both legs and the trunk.
The nurse is caring for a client who had a surgical amputation of the left leg related to complication from diabetes. The client asks the nurse: 'If my leg is really gone, then why am I having such bad pain?' What is an appropriate response by the nurse?
- A. You are only imagining that you are having pain.
- B. It is called phantom pain and may come and go.
- C. You will continue to have this pain, and you will have to learn to ignore it.
- D. This is called false pain and is a brain dysfunction.
Correct Answer: B
Rationale: Phantom pain is pain or other discomfort, such as burning, tingling, throbbing, or itching. Pain felt from the phantom limb can be an extremely serious problem in relation to the client's emotional status and ability to use prosthesis. The other responses are nontherapeutic.
A client is brought to the emergency department by a softball team member who states the client and another player ran into each other, and the client is having severe pain in the right shoulder. What symptoms of a fractured clavicle does the nurse recognize?
- A. Client complains of tingling and numbness in the right shoulder.
- B. Right shoulder is elevated above the left.
- C. Client complains of pain in the unaffected shoulder.
- D. Right shoulder slopes downward and droops inward.
Correct Answer: D
Rationale: The client with a fractured clavicle has restricted motion, and the affected shoulder appears to slope downward and droop inward. The client will have pain, not typically tingling and numbness in the right shoulder. Pain is not felt in the unaffected shoulder.
The nurse is caring for a client with an external fixator that requires pin care twice a day. The nurse observes that there is a new purulent drainage around one of the pins. What intervention should the nurse anticipate doing?
- A. Scrubbing the drainage from around the pin site
- B. Obtaining a culture
- C. Applying iodine-based solution
- D. Apply ointment to the pin site.
Correct Answer: B
Rationale: A culture should be obtained if purulent drainage is present. Drainage should be gently removed, not scrubbed. Iodine-based products interfere with tissue healing and are not recommended for cleaning pin sites. Ointment should not be applied to the pin site unless specifically ordered.