A nurse is reinforcing teaching with a client who is to have a plaster cast applied to his right arm. Which of the following information should the nurse include in the teaching?
- A. The client's extremity should be elevated after the cast is applied.
- B. The client should use a hair dryer on a warm setting to relieve itching inside the cast.
- C. The client should keep the cast covered until it is dry.
- D. The client can shower with the cast after 24 hr.
Correct Answer: A
Rationale: Elevating the extremity reduces swelling post-cast application.
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A nurse is reinforcing dietary teaching with a client who has constipation about appropriate food choices. Which of the following food selections by the client demonstrates an understanding of the teaching?
- A. Puffed rice cereal
- B. Tomato juice
- C. Bran muffin
- D. Cottage cheese
- E. None
- F. None
Correct Answer: C
Rationale: Bran muffins are high in fiber, which promotes bowel regularity and indicates understanding.
The client expresses anxiety about exercising in the outdoor courtyard.
A nurse in a mental health facility is caring for a client who expresses anxiety about exercising in the outdoor courtyard. The nurse promises to walk with the client in the courtyard each day. Which of the following ethical principles is the nurse demonstrating?
- A. Fidelity
- B. Justice
- C. Nonmaleficence
- D. Autonomy
Correct Answer: A
Rationale: Fidelity is demonstrated by keeping the promise to walk with the client.
A nurse is providing care to a client who is preparing to undergo surgery. The client inquires about advance directives. Which of the following statements should the nurse make?
- A. Advance directives are the same as a consent form for health care treatment.
- B. Advance directives protect your right to make your own health care decisions.
- C. Advance directives must be approved by your lawyer.
- D. Advance directives are for clients who have life-threatening conditions.
Correct Answer: B
Rationale: Advance directives ensure client autonomy in health care decisions.
The client states that she slipped on some water outside of the shower.
A nurse enters a client's room and finds her sitting on the floor next to the shower. The client states that she slipped on some water outside of the shower. Which of the following actions should the nurse take first?
- A. Notify the client's provider.
- B. Measure the client's vital signs.
- C. Document the fall in the client's medical record.
- D. Complete an incident report.
Correct Answer: B
Rationale: Measuring vital signs assesses for immediate injury, the priority action.
A nurse is assisting with teaching a class about the importance of fire safety. Which of the following hazards should the nurse include as an example of the leading cause of residential fires?
- A. Placing a space heater 5 ft from bed
- B. Smoking in bed
- C. Leaving the stove on
- D. Lack of smoke detectors
Correct Answer: B
Rationale: Smoking in bed is a leading cause of residential fires.
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