Question 1

The nurse admits a client from the emergency department (ED)with a newly placed leg cast.Which actions would the nurse perform to prevent neurovascular impairment?

Accepted Answer

B,C,D,E

Question 2

The nurse is caring for a client who is in skin traction.Which nursing actions are appropriate for this client?

Accepted Answer

A) Assessing neurovascular status every 4 hours is important to ensure proper circulation and prevent complications such as compartment syndrome.
B) Placing sheepskin under pressure areas helps prevent skin breakdown and pressure ulcers.
C) Massaging the skin with lotion or alcohol can increase skin irritation and should be avoided.
D) When removing nonadhesive traction, it is important to remove the weight first to prevent pulling on the client's skin and causing discomfort.
E) Using a slipper bedpan minimizes movement during elimination and helps maintain proper traction.

Question 3

The nurse working in the emergency department (ED)is assisting the health care provider with cast application.Which nursing action is the most appropriate after the health care provider completes application of the cast?

Accepted Answer

Using the palm of the hand to support the casted area while it dries helps avoid indentations or pressure points that could lead to discomfort or impaired circulation. Placing the arm on pillows also aids in elevation and comfort.

Question 4

The nurse is caring for a client with a fracture of cervical vertebrae 4.Which piece of equipment connects the client to traction for this type of injury?

Accepted Answer

Crutchfield tongs are the piece of equipment that is used to connect the client to traction for cervical vertebrae 4 fracture. They are attached to the skull to maintain cervical traction for severe neck injuries. Pearson attachment is used for femur or tibia fractures, Buck's extension is used for femur fractures, and Thomas splint is used for femur fractures as well as immobilizing the hip and knee after surgery.

Question 5

The nurse is providing care to a client who has a short arm cast.Which areas does the nurse assess to determine if irritation is occurring?

Accepted Answer

The nurse should assess the radial styloid process, ulnar styloid process, and joint at the base of the thumb for irritation, as these are common pressure points in a short arm cast.

Question 6

The nurse working in an orthopedic clinic received a call from a client complaining of itching under the cast and asking for advice on how to relieve the discomfort.Which instruction will the nurse provide to this client?

Accepted Answer

Using a back scratcher or wooden spoon to scratch inside the cast can damage the skin, while taking an antihistamine will not address the root cause of the itching. Blowing cool air under the cast, or applying ice, can provide relief without risking skin damage. Therefore, the best choice is to advise the client to blow air from a hair dryer set to cool under the cast or apply ice.

Question 7

The nurse would anticipate a plaster cast would be used for which client?

Accepted Answer

A plaster cast is commonly used for clients with fractures, particularly those that are more severe such as a compound fracture with multiple lacerations. It is not typically used for clients with muscle wasting or neurological disorders like ALS. Additionally, a client with a fractured femur who plans to return to construction work before cast removal would require a cast that allows for weight-bearing, which may not be possible with a plaster cast.

Question 8

The nurse is caring for a client who uses an orthotic device.Four days later,the client is noted to have a red area at the edge of the device which is padded and observed for 3 more days.Despite this intervention,the area is growing in size and is now open.Which nursing action is most appropriate in this situation?

Accepted Answer

The red area on the client's skin has progressed to an open sore despite padding and monitoring. This indicates a possible pressure injury and should be reported to both the healthcare provider and the orthotist. Removing the orthotic device completely may not be necessary and reshaping the device or using a thicker pad may not address the underlying issue of pressure on the skin. It is important to involve the healthcare team and the orthotist in order to determine the best course of action and avoid further damage to the client's skin.

Question 9

The nurse observes the health care provider apply a cast made of strips of open-weave cotton saturated with powdered calcium sulfate crystals.When documenting this procedure,which term will the nurse use for this type of cast?

Accepted Answer

The cast made of strips of open-weave cotton saturated with powdered calcium sulfate crystals is commonly referred to as a plaster cast.

Question 10

The adolescent client newly placed in traction says,"Laying in this bed all the time is going to turn my body into mush.Is there any way I could exercise while I'm in traction?" Which response by the nurse is the most appropriate?

Accepted Answer

The nurse's response in option A is appropriate as it acknowledges the client's concern and provides a practical solution by suggesting exercises that can be done while in traction, such as range of motion and isometric exercises.

Question 11

The nurse caring for a client with a plaster cast applied several days ago notes crumbs of plaster on the skin just under the edge of the cast.Which action by the nurse is the most appropriate?

Accepted Answer

Using a damp cloth to remove the crumbs can help prevent skin irritation or infection from crumbs rubbing against the skin. Feeling for rough edges while removing the crumbs can also help identify any potential pressure points or areas of discomfort for the client. However, it is important to avoid wetting the cast excessively.

Question 12

The nurse caring for a pediatric client who requires orthoses teaches the parent that which is a unique aspect of orthoses for children?

Accepted Answer

Orthoses for children require periodic adjustment due to the child's growth and development, unlike those for adults which may not need adjustments as frequently. This ensures the device continues to fit properly and function effectively as the child grows.

Question 13

The nurse caring for a client in traction inspects the apparatus and determines all is well when noting which finding?

Accepted Answer

All ropes being intact and connected with slipknots, and short ends being taped indicate that the traction apparatus is secure and functioning properly. The weight being on the floor could indicate that the weights are not properly suspended, the rope being on the side of the pulley could indicate improper placement, and the knots being positioned 5 inches from the pulley could indicate incorrect alignment.

Question 14

Which task could be safely delegated by the nurse to the unlicensed assistive personnel (UAP)?

Accepted Answer

Caring for a client with a stable cast can be safely delegated to UAP as long as the cast is not newly placed and there are no complications. UAP can assist with activities of daily living, turning and positioning, and monitoring for skin breakdown, among other tasks. However, caring for a client with a newly placed cast or caring for the insertion site for Crutchfield tongs requires specialized knowledge and skills that only a licensed nurse can provide. Explaining how to respond to itching under the cast also requires a nurse's assessment and intervention to prevent complications.

Question 15

The nurse working in the emergency department (ED)is providing discharge teaching for a client with a newly applied cast to the left arm.Which statement by the client indicates additional teaching is required?

Accepted Answer

Covering cold fingers with a blanket is not an appropriate action to take. It is possible that the cast is too tight, which can lead to circulation problems. The client should contact their doctor if they experience this symptom.

Quiz 32: Orthopedic Care

The nurse admits a client from the emergency department (ED) with a newly placed leg cast.Which actions would the nurse perform to prevent neurovascular impairment?