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How can the nurse best support the wet cast while the physician wraps the arm with rolls of wet plaster?
- A. By using a soft mattress
- B. By resting it on a firm surface
- C. By using the client's knee on the fingers
- D. By using the palms of the hands
Correct Answer: D
Rationale: Using the palms of the hands to support the wet cast prevents indentations that could cause pressure points, ensuring the cast maintains its shape. A soft mattress or fingers may deform the cast, and a firm surface is less precise.
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Which nursing instruction about heating pads is essential to include in the client's teaching plan?
- A. Use the lowest setting on the heating pad.
- B. Place the heating pad directly on the skin.
- C. Cover the heating pad with plastic during use.
- D. Apply the heating pad for 2 hours at a time.
Correct Answer: A
Rationale: Using the lowest setting on the heating pad minimizes the risk of burns, especially in older clients with potentially reduced skin sensitivity. Direct skin contact, plastic covers, or prolonged use increase burn risk.
The clinic nurse completed teaching the client with a rotator cuff tear who is being treated conservatively. Which client statement indicates that further teaching is needed?
- A. I received a corticosteroid injection in my shoulder to reduce the inflammation and pain.'
- B. Now that the pain is controlled, I can do progressive stretching and strengthening exercises.'
- C. I will continue to take ibuprofen for pain control, but I should take it with food.'
- D. I will need an open acromioplasty to repair the torn cuff after the swelling is reduced.'
Correct Answer: D
Rationale: D. Conservative treatment for a rotator cuff tear typically involves non-surgical methods like corticosteroid injections, physical therapy, and NSAIDs. An open acromioplasty is a surgical procedure and not part of conservative management, indicating a misunderstanding by the client.
The physician directs the nurse to wrap the client's lower extremity with an elastic bandage. Where should the nurse begin applying the bandage?
- A. Below the knee
- B. Above the ankle
- C. Across the phalanges
- D. At the metatarsals
Correct Answer: D
Rationale: Starting the elastic bandage at the metatarsals (the foot's midsection) ensures distal-to-proximal compression, promoting venous return and reducing swelling effectively. Beginning higher up, such as below the knee or above the ankle, may not adequately address swelling in the foot, and starting at the phalanges is too distal.
The nurse is caring for a client who has just had a cast applied. Which statement best describes the expected client outcome relative to the circulatory system for a client with a cast?
- A. There will be no increase in pain in the extremity.
- B. The client will have no circulatory impairment.
- C. The integrity of the cast will be maintained.
- D. The client will report any feelings of skin irritation.
Correct Answer: B
Rationale: The primary circulatory outcome is preventing impairment, such as swelling or color changes. Pain relates to neurological issues, cast integrity is unrelated to circulation, and skin irritation is not a circulatory indicator.
If the client is in shock, how should the nurse position the client while continuing to assess and provide care?
- A. Prone with the arm supported
- B. In Fowler's position with the knees flexed
- C. Supine with the legs elevated
- D. Lateral with the back extended
Correct Answer: C
Rationale: Supine with legs elevated improves venous return in shock.