Nokea
The nurse completes teaching the client who has a plaster cast following a right wrist fracture. Which statement, if made by the client, indicates the need for additional teaching?
- A. I should keep my cast uncovered while drying so that moisture can evaporate.'
- B. My cast initially may smell musty. When dry, it should be odorless and shiny white.'
- C. My cast may feel sticky and very warm initially, but it will dry in about 30 minutes.'
- D. I should avoid sharp or hard surfaces while drying because it causes dents in the cast.'
Correct Answer: C
Rationale: C. Although the cast will feel very warm for about 15 to 20 minutes, a plaster cast requires 24 to 72 hours (not 30 minutes) to dry completely.
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The nurse is caring for clients on an orthopedic floor. Which client should be assessed first?
- A. The client diagnosed with back pain who is complaining of a '4' on a 1-to-10 scale.
- B. The client who has undergone a myelogram who is complaining of a slight headache.
- C. The client two (2) days post-disk fusion who has T 100.4, P 96, R 24, and BP 138/78.
- D. The client diagnosed with back pain who is being discharged and whose ride is here.
Correct Answer: C
Rationale: Fever, tachycardia, and tachypnea post-disk fusion suggest infection or complications, requiring urgent assessment. Mild pain, headache, and discharge are lower priority.
When assessing the characteristics of pain in a client with a herniated disk, the nurse would expect to document increased intensity of pain during which activity?
- A. Eating
- B. Coughing
- C. Sleeping
- D. Urinating
Correct Answer: B
Rationale: Coughing increases intraspinal pressure, exacerbating pain from a herniated disk by compressing the affected nerve root. Other activities are less likely to intensify disk-related pain.
Which illustration demonstrates abduction for a 10-year-old who had an SCI?
- A. ROM-1.png
- B. ROM-2.png
- C. ROM-3.png
- D. ROM-4.png
Correct Answer: A
Rationale: Abduction involves moving a limb away from the body's midline, as shown in the correct illustration.
After assessing the client's cast, what action should the nurse take next?
- A. Document the finding in the medical record.
- B. Call the physician and report the finding.
- C. Check the nurse, then record the nurse.
- D. Apply an ice bag over the drainage area.
Correct Answer: B
Rationale: Bloody drainage seeping through a cast suggests potential complications like infection or tissue damage, requiring immediate physician notification for evaluation. Documentation and ice application are secondary, and the third option is unclear.
Which statement should the nurse include in the instructions for parents of an infant with osteogenesis imperfecta (OI)?
- A. "Check the color of your infant's nailbeds and mucous membranes for signs of circulatory impairment."
- B. "If you note signs of infection, bring your infant to the clinic because the infant has a significant immune dysfunction."
- C. "Protect your infant from injury and handle your baby carefully because your infant's bones can break very easily."
- D. "Notify your physician if your infant does not respond to sound because the infant's CNS fails to develop completely."
Correct Answer: C
Rationale: OI causes brittle bones, so careful handling is essential to prevent fractures.