Nokea
A client's cast is removed. The client is worried because the skin appears mottled and is covered with a yellowish crust. What advice should the nurse give the client to address the skin problem?
- A. Consult a skin specialist.
- B. Scrub the area vigorously to remove the crust.
- C. Apply lotions and take warm baths or soaks.
- D. Avoid exposure to direct sunlight.
Correct Answer: C
Rationale: The client should be advised to apply lotions and take warm baths or soaks. This will help in softening the skin and removing debris. The client usually sheds this residue in a few days so the client need not consult a skin specialist. It is not advisable to scrub the area vigorously. The client need not avoid exposure to direct sunlight because the area is not photosensitive.
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A client sustained a stable fracture of the cervical spine and is having skeletal traction applied. What type of traction does the nurse educate the client about?
- A. Kirschner wires
- B. Thomas splint
- C. Steinmann pins
- D. Crutchfield tongs
Correct Answer: D
Rationale: Crutchfield tongs are used for skeletal traction in the case of a cervical spine fracture to stabilize the spine and maintain alignment. Kirschner wires and Steinmann pins are typically used for skeletal traction in other areas, such as limbs. A Thomas splint is used for femoral fractures and is a form of skin traction, not skeletal traction.
The nurse is caring for a client who sustained rib fractures in an automobile accident. What symptoms does the nurse recognize as a complication of rib fractures and should immediately be reported to the physician?
- A. Blood pressure of 140/90 mm Hg
- B. Crackles in the lung bases
- C. SUBJECT: Client complains of pain in the affected rib area when taking a deep breath
- D. Heart rate of 94 beats/minute
Correct Answer: B
Rationale: Crackles in the lung bases can be an indicator that the client has developed pneumonia from shallow respirations. The blood pressure is high but may be due to pain. It is expected that the client will have pain in the rib area when taking deep breaths. A heart rate of 94 beats/minute is within normal range.
A client has had a knee replacement and will be discharged in the morning. What does the nurse understand is the goal for bending the knee by discharge?
- A. 15?°
- B. 30?°
- C. 60?°
- D. 90?°
Correct Answer: D
Rationale: The goal for the client to have the ability to bend the knee 90?° by discharge. The other answers are incorrect.
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.
The nurse is caring for a client who has had a fracture reduction using a cast. What would be most important for the nurse to assess?
- A. Cardiac and respiratory status
- B. Renal and hepatic function
- C. Sleep status
- D. Sensation and mobility status
Correct Answer: D
Rationale: After cast application, the nurse should assess circulation, sensation, and mobility in exposed fingers and toes every 1 to 2 hours. Assessment of cardiac, respiratory, hepatic, and renal status would be priorities if the client experienced multiple fractures or had an open reduction. The client's sleep status would be a low priority.