NCLEX-RN Exam Pack Set 9 (75 Questions & Answers Updated 2023) VERIFIED PASS
• 3. Question
A client with a fractured tibia has a plaster-of-Paris
... [Show More] cast applied to immobilize the fracture. Which action by the nurse indicates an understanding of a plaster-of-Paris cast? The nurse:
o A. Handles the cast with the fingertips
o B. Petals the cast
o C. Dries the cast with a hair dryer
o D. Allows 24 hours before bearing weight
about 10 to 15 minutes. The temperature of the skin might rise as the plaster is drying because of a chemical reaction that occurs. When plaster is used, it can take from 1 to 2 days for the cast to harden completely.
o Option A: The cast should be handled with the palms, not the fingertips. Use the palm of hand to apply, hold, or move cast and support on pillows after application. Uneven plaster is irritating to the skin and may result in abrasions.
o Option B: Petaling a cast is covering the end of the cast with cast batting or a sock, to prevent skin irritation and flaking of the skin under the cast. Trim excess plaster from edges of the cast as soon as casting is completed; prevents skin breakdown caused by prolonged moisture trapped under the cast.
o Option C: The client should be told not to dry the cast with a hair dryer because this causes hot spots and could burn the client. This also causes unequal drying. Promote cast drying by removing bed linen, exposing it to circulating air; pressure can cause ulcerations, necrosis, or nerve palsies. Pad (petal) the edges of the cast with waterproof tape; provides an effective barrier to cast flaking and moisture. Helps prevent the breakdown of cast material at the edges and reduce skin irritation and excoriation.
• 4. Question
The teenager with a fiberglass cast asks the nurse if it will be okay to allow his friends to autograph his cast. Which response would be best?
o A. "It will be alright for your friends to autograph the cast."
o B. "Because the cast is made of plaster, autographing can weaken the cast."
o C. "If they don’t use chalk to autograph, it is okay."
o D. "Autographing or writing on the cast in any form will harm the cast."
Correct Answer: A. “It will be alright for your friends to autograph the cast.”
There is no reason that the client’s friends should not be allowed to autograph the cast; it will not harm the cast in any way, so answers B, C, and D are . Fiberglass has several advantages compared to plaster. It weighs less, so the cast made from it will be lighter. More durable and porous, fiberglass allows air to flow in and out. Fiberglass is the better choice in case the limb must be X-rayed during the healing process. It is also available in a variety of colors.
o Option B: Plaster costs less than fiberglass and is more malleable (is more easily shaped) than fiberglass in certain cases. Plaster comes in strips or rolls that are moistened and rolled on over the padding. Plaster materials are made from dry muslin that is treated with starch or dextrose and calcium sulfate.
o Option C: Keep the cast clean and dry. A hair dryer with a cool setting may be used to dry a fiberglass cast if it becomes damp. Call a doctor if the cast does not dry or if the skin under the cast becomes wet. Avoid placing pressure or weight on the cast. If you have a leg injury and have a walking cast, make sure that the cast has hardened completely before you attempt to walk on it.
o Option D: Like plaster, fiberglass materials come in rolls. Strips are moistened and applied to form the cast. The cast will appear rough after it has dried. Do not place any objects inside the cast. Avoid using lotions or powders on skin underneath the cast.
• 5. Question
The nurse is assigned to care for the client with a Steinmann pin. During pin care, she notes that the LPN uses sterile gloves and Q- tips to clean the pin. Which action should the nurse take at this time?
o A. Assisting the LPN with opening sterile packages and peroxide.
o B. Telling the LPN that clean gloves are allowed.
o C. Telling the LPN that the registered nurse should perform pin care.
o D. Asking the LPN to clean the weights and pulleys with peroxide.
Correct Answer: A. Assisting the LPN with opening sterile packages and peroxide
The nurse is performing the pin care correctly when she uses sterile gloves and Q-tips. All pins and wire sites must be cleaned daily. Basic pin care will be performed once daily by the hospital nursing staff prior to discharge from the hospital. Following discharge, the patient and family will go to the clinic for pin care teaching and instructions.
o Option B: During pin care, the sterile technique is utilized and sterile gloves are needed. The approach to pin care should occur in a stepwise fashion. If step one is effective there is no need to go further and pins can be wrapped with gauze. If step one is not effective, please continue until effective pin care has been achieved.
o Option C: A licensed practical nurse can perform pin care. Pin care is recommended during showers, after pool therapy, or swimming in the pool or ocean (ocean saltwater is good for pin sites). Ideally, pin sites are cleaned when the surrounding skin and gauze are soft. This should make removal of gauze and cleaning of pins less painful.
o Option D: There is no need to clean the weights. The purpose of the cleaning is to prevent the skin from attaching to the pins and wires and to clean and inspect the [Show Less]