VNSG 1323: Chapter 25 Prep U Questions

A nurse is helping a client while a fiberglass cast is drying. Approximately how many minutes will the nurse hold the client's arm in the drying position? Record your answer using a whole number.

15 Explanation: For a fiberglass cast, the nurse would hold the extremity in the drying position until the cast is dry (approximately 15 minutes).

The nurse is caring for a client who had a cast applied yesterday for a tibia fracture. When the client returns today with swelling in that extremity, for which procedure does the nurse prepare?

Bivalving of the cast Explanation: Bivalving can be done when the client had swelling that compresses tissue and interferes with circulation. This condition does not require surgery at this time; a functional brace is inappropriate; petals protect skin, but do not alleviate swelling.

A client reports pain in the casted leg. The nurse has administered analgesics and elevated the limb. Thirty minutes after administering the analgesics, the client states the pain is unrelieved. This may be a sign of:

Compartment Syndrome Explanation: Compartment syndrome may manifest as unrelenting, uncontrollable pain. Discomfort from edema may be relieved with elevation of the limb; pain from ulcers is usually relieved when ulceration occurs. Disuse syndrome may result in disuse atrophy.

While preparing a client with a forearm fracture for casting, the nurse washes and dries the skin. Which nursing action is next?

Covering arm with stockinette Explanation: The nurse will cover the arm with a stockinette, prepare the cast material, apply an arm sling after casting, and provide home care teaching.

A client with severe arthritis needs temporary immobilization of the wrist and hand. Which type of cast does the nurse anticipate will be ordered?

Cylinder Bivalve Explanation: A bivalve cylinder cast can be used for painful joints that need to be temporarily immobilized for clients with arthritis. A spica cast encircles one of both arms or legs, the chest, or trunk. Body casts encircle the trunk of the body instead of the extremity.

A nurse is assessing a client's neuromuscular status following recovery from a neck injury. Which findings would indicate intact function? Select all that apply.

Flex and extend the elbows and wrists. Elevate both shoulders. Spread the fingers. Generate a strong hand grip. Explanation: If neuromuscular function is intact, the client can do the following: elevate both shoulders, flex and extend the elbows and the wrists, generate a strong hand grip, spread the fingers, and touch the thumb to the little finger on each hand.

A client with an unstable patella has seen the health care provider to discuss options to provide stability to this joint. Which type of immobilizer does the nurse anticipate applying?

Functional Base Explanation: A functional brace is used to provide stability for an unstable joint. Other answers are incorrect.

A nurse is caring for a client with carpal tunnel syndrome who has been prescribed a mechanical immobilizing device. Which mechanical immobilizing device would be appropriate for this client?

Molded splints Explanation: Molded splints are used for clients with repetitive motion disorders, such as carpal tunnel syndrome. They provide prolonged support and limit movement to prevent further injury and pain. They maintain the body part in a functional position to prevent contractures and muscle atrophy during immobility. Inflatable splints are used to control bleeding and swelling. Immobilizers are not suitable because they are used for healing neck and knee injuries. Traction splints are metal devices that immobilize and pull on contracted muscles. Nurses require special training for the application of traction splints to prevent additional injuries.

The nurse is showing a client "petals" that will be applied to a forearm cast. When the client asks, "What are those for?" what teaching will the nurse provide?

Moleskin pieces that cover the cast's rough edges. Explanation: "Petals" are pieces of moleskin that cover rough edges of the cast. Other answers are incorrect.

A nurse is caring for a client with a cervical halter applied. Which intervention should the nurse perform when caring for this client?

Provide a trapeze or an overbed frame to the client. Explanation:When caring for a client applied with traction, nurses should provide a trapeze or an overbed frame to the client to facilitate mobility and self-care. Traction should be applied continuously to the client for better results unless there are medical orders. The traction weights should be hanging slightly above the floor to maintain traction effectively. The nurse should encourage the client to perform basic isometric, isotonic, and active range-of-motion exercises to maintain the tone, strength, and flexibility of the musculoskeletal system.

Which device is designed specifically to support and immobilize a body part in a desired position?

Splint Explanation: A splint may be applied to a fractured extremity initially until swelling subsides. A brace is an externally applied device to support a body part, control movement, and prevent injury. A CPM device is an instrument that moves a body part to promote healing and circulation. A trapeze is an overhead device to promote client mobility in bed.

The nurse is caring for a client who has had a shoulder spica made of plaster of Paris applied. Which teaching will the nurse provide to the client?

The client should expect to feel that the cast is hot and heavy. Explanation: A spica cast made from plaster of Paris will be hot and heavy, and will not flex or bend. It will be worn longer than 24-48 hours, and should not be gotten wet.

The urgent care nurse is assessing a client who had a plaster cast applied to the left ankle 4 hours ago. The client has come back to the urgent care with concerns. Which finding requires immediate nursing intervention?

Toes are dry and cool to touch. Explanation: Neurovascular complications are most likely to occur in the early hours after initial casting; cool toes may be an indication that circulation is impaired. All other findings are normal.

When the nurse is performing pin care, what would be most appropriate?

Use an applicator only once. Explanation :When performing pin care, the nurse should use at least one applicator per pin and not use an applicator more than once, cleaning the site from the pin outward. Unless there are obvious signs of infection, crusts are left intact to provide a normal protective barrier. Ointment is avoided unless it is specifically ordered.

The nurse is caring for a client who has a long leg cast applied after surgery yesterday. The client is using a patient-controlled analgesia (PCA) device appropriately. At 1700, the client reports pain of "8" on a 1-10 scale. At 1900, pain has decreased to a "7". At 2100, the client reports pain of a "6". Which nursing intervention is appropriate?

Utilize prn doses of pain control medication. Explanation: The nurse may utilize prn doses of pain control medication, if the client still is uncomfortable. Other answers are incorrect and do not address the problem.

The nurse is checking the traction apparatus for a client in skin traction. Which finding would require the nurse to intervene?

Weights hanging and touching the floor Explanation: When checking traction equipment, the weights should be freely hanging. Weights that touch the floor require the nurse to intervene. The body should be aligned in an opposite line to the pull of the traction. The ropes should be freely moving over unobstructed pulleys.