🌬️ Using a cool hair dryer is a safe method to relieve itching inside a fiberglass cast.

🌬️ Children should never insert objects such as pencils, rulers, or hangers into the cast because this can injure the skin and increase the risk for infection.

🌬️ Fiberglass casts are lighter and dry faster than plaster casts, but proper cast care is still essential to prevent complications.

🌬️ The nurse should teach the child and parents to monitor for swelling, numbness, discoloration, foul odor, or increased pain because these may indicate impaired circulation or infection.

🌬️ Keeping the extremity elevated during the first 24–48 hours helps reduce swelling and discomfort.

🌬️ This statement demonstrates correct understanding of safe cast care management.

❌ “I should expect full range of motion in the first few days.”

❌ Full range of motion is not expected immediately after a fracture because swelling, pain, and immobilization limit movement.

❌ Recovery of motion usually occurs gradually as healing progresses.

❌ The cast is intended to stabilize the fracture and temporarily restrict movement for proper bone healing.

❌ “I should expect the cast to be dry in 2 days.”

❌ Fiberglass casts generally dry within a much shorter period, often within about 30 minutes to 1 hour.

❌ Waiting 2 days is more consistent with plaster cast drying times.

❌ Understanding drying times is important to prevent damage to the cast structure.

❌ “I can let my arm hang down for 1 hour at a time every 4 hours.”

❌ Allowing the arm to hang down for long periods increases swelling and pain.

❌ The affected extremity should be elevated above heart level during the first days after cast application.

❌ Elevation promotes venous return and helps reduce edema around the fracture site.

🩸 Decreased or absent pulses following an open reduction and internal fixation (ORIF) of a fractured femur indicate impaired circulation and possible vascular compromise.

🩸 This finding may suggest a serious complication such as compartment syndrome, arterial obstruction, or severe swelling that is reducing blood flow to the extremity.

🩸 Neurovascular assessments are a priority after orthopedic surgery and include checking pulses, skin color, temperature, capillary refill, movement, and sensation.

🩸 Inadequate blood supply can quickly lead to tissue ischemia, nerve damage, and permanent loss of limb function if not treated immediately.

🩸 The nurse should notify the healthcare provider immediately because absent or weak pulses are considered an emergency finding.

🩸 Early recognition and intervention are essential to prevent irreversible complications.

❌ Pain 3/10 scale

❌ Mild postoperative pain is expected after orthopedic surgery and does not usually indicate a complication.

❌ Pain becomes more concerning when it is severe, sudden, increasing, or not relieved by prescribed medication.

❌ A pain score of 3/10 is considered relatively controlled postoperative discomfort.

❌ Dry, clean wound dressing

❌ A dry and clean dressing is an expected postoperative finding and suggests proper wound management.

❌ It indicates there is no excessive bleeding or drainage at the surgical site.

❌ This assessment finding supports normal postoperative recovery.

❌ Oral temperature of 100°F

❌ A slight temperature elevation can occur after surgery due to the inflammatory response associated with tissue trauma.

❌ Temperatures become more concerning when significantly elevated or accompanied by redness, drainage, or other infection signs.

❌ A temperature of 100°F alone is not the priority complication in this situation.

🔴 Warmth and redness around skeletal traction pin sites can indicate local inflammation and possible pin-site infection.

🔴 Skeletal traction uses pins or wires inserted through the bone, creating an opening where microorganisms can enter.

🔴 The nurse should also assess for purulent drainage, swelling, tenderness, foul odor, fever, or increased pain around the pin site.

🔴 Pin-site infection is important to identify early because it can spread deeper into the bone and lead to osteomyelitis.

🔴 Proper pin care, sterile technique, and frequent assessment help reduce infection risk.

🔴 This finding should be reported and managed promptly to prevent worsening complications.

❌ A negative wound culture

❌ A negative wound culture means no infectious organism was identified in the sample.

❌ This finding does not support the presence of infection.

❌ The nurse would continue routine monitoring, but this is not an abnormal infection finding.

❌ Cap refill less than 3 seconds

❌ Capillary refill less than 3 seconds is a normal neurovascular finding.

❌ It indicates adequate peripheral perfusion to the affected extremity.

❌ This finding is important in traction care, but it does not indicate infection.

❌ Positive pedal pulses

❌ Positive pedal pulses indicate blood flow is present in the lower extremity.

❌ This is an expected circulation finding during neurovascular assessment.

❌ It does not suggest infection at the pin sites.

💊 Alendronate is a bisphosphonate used to treat or prevent osteoporosis by slowing bone resorption.

💊 It should be taken first thing in the morning on an empty stomach with a full glass of plain water.

💊 Food, calcium, antacids, coffee, juice, and other medications can greatly reduce absorption of alendronate.

💊 The client should remain upright for at least 30 minutes after taking it to reduce the risk of esophageal irritation.

💊 Taking the medication correctly improves absorption and helps reduce the risk of esophagitis or esophageal ulcers.

💊 This statement shows the client understands the most important administration instruction.

❌ “I will lie down for 30 minutes after taking this.”

❌ The client should not lie down after taking alendronate because it can irritate the esophagus.

❌ The client should sit or stand upright for at least 30 minutes.

❌ Remaining upright helps the medication pass into the stomach and lowers the risk of esophageal injury.

❌ “I will take calcium at the same time with this medication.”

❌ Calcium should not be taken at the same time because it decreases alendronate absorption.

❌ Calcium supplements may be prescribed, but they should be taken later in the day.

❌ Separating calcium from alendronate helps the medication work effectively.

❌ “I will take this medication after a full meal.”

❌ Alendronate should not be taken after a full meal because food reduces absorption.

❌ It is best taken before any food or drink other than plain water.

❌ Taking it with meals can make the medication much less effective.

🦵 A patient with a hip fracture often presents with the affected leg shortened and externally rotated.

🦵 External rotation occurs because the fractured femoral head or neck disrupts normal alignment of the hip joint.

🦵 The client may also have severe hip or groin pain, inability to move the leg, and difficulty bearing weight.

🦵 The nurse should avoid unnecessary movement of the affected extremity to prevent further injury.

🦵 Neurovascular status should be assessed because swelling or trauma can affect circulation and sensation.

🦵 External rotation is a classic assessment finding associated with hip fracture.

❌ Able to bear weight

❌ Clients with a hip fracture are usually unable or unwilling to bear weight on the affected leg.

❌ Weight bearing can worsen pain and may increase displacement of the fracture.

❌ The affected extremity should be protected until evaluated and treated.

❌ Calf atrophy

❌ Calf atrophy develops over time from prolonged immobility or disuse.

❌ It is not an expected immediate finding of an acute hip fracture.

❌ The question asks for an expected assessment finding at the time of injury.

❌ Leg lengthening

❌ Hip fractures commonly cause shortening, not lengthening, of the affected leg.

❌ Muscle spasms and displacement can pull the fractured limb upward.

❌ Lengthening does not match the typical presentation of a fractured hip.

🚶 Early ambulation after ORIF helps prevent postoperative complications such as venous thromboembolism, atelectasis, pneumonia, constipation, and muscle weakness.

🚶 Older adults are at high risk for complications from immobility, so movement should begin as soon as the provider allows and safety measures are in place.

🚶 Ambulation promotes circulation, improves lung expansion, supports bowel motility, and helps preserve functional independence.

🚶 After femur repair, the nurse should follow the prescribed weight-bearing status and assistive-device plan, such as walker use or physical therapy support.

🚶 The client should be assessed for pain, dizziness, orthostatic hypotension, and neurovascular status before and after activity.

🚶 This intervention supports safe recovery while reducing immobility-related complications.

❌ Maintain the client on bedrest for 72 hours after surgery

❌ Prolonged bedrest increases the risk for blood clots, pneumonia, pressure injuries, constipation, and deconditioning.

❌ Unless specifically prescribed due to instability, clients are usually encouraged to mobilize early after orthopedic surgery.

❌ Bedrest for 72 hours would delay recovery and increase complications in an older adult.

❌ Change dressings every other day to examine the site

❌ Dressings should be changed according to the provider’s prescription or facility policy, not automatically every other day.

❌ Unnecessary dressing changes can increase contamination risk and disrupt healing tissue.

❌ The nurse should monitor the dressing for drainage, bleeding, odor, and signs of infection without removing it unnecessarily.

❌ Limit fluids to 200 mL per day

❌ Limiting fluids to 200 mL/day is extremely restrictive and can cause dehydration, poor perfusion, constipation, and impaired healing.

❌ Postoperative clients usually need adequate hydration unless a specific condition requires fluid restriction.

❌ Fluids support circulation, kidney function, bowel function, and tissue repair.

🦵 Elevating a newly casted leg helps improve venous return by assisting blood and fluid movement back toward the heart.

🦵 After a fracture and cast application, swelling is common because of tissue injury and inflammation.

🦵 Elevation reduces dependent edema, which helps decrease pain and pressure inside the cast.

🦵 Less swelling also lowers the risk of impaired circulation, nerve compression, and complications such as compartment syndrome.

🦵 The extremity is usually elevated above the level of the heart during the early period after cast placement.

🦵 This is one of the most important instructions because circulation and swelling control are priority concerns after casting.

❌ Decrease odor

❌ Elevation does not directly decrease cast odor.

❌ Odor is more related to moisture, drainage, hygiene issues, or possible infection.

❌ The priority purpose of elevation is circulation and swelling control.

❌ Prevent infection

❌ Elevation does not directly prevent infection inside or around the cast.

❌ Infection prevention focuses on keeping the cast dry, avoiding skin injury, and reporting drainage or foul odor.

❌ While swelling reduction supports tissue health, the main reason for elevation is improved venous return.

❌ Reduce drying time of the cast

❌ Elevation does not make the cast dry faster.

❌ Drying time depends on the cast material, such as fiberglass or plaster, and air exposure.

❌ The question asks the most important reason, which is circulation support.

⚠️ Severe pain unrelieved by medication is a classic early sign of compartment syndrome.

⚠️ Compartment syndrome occurs when swelling or bleeding increases pressure inside a closed muscle compartment.

⚠️ This pressure reduces blood flow and oxygen delivery to nerves and muscles, creating a limb-threatening emergency.

⚠️ Pain is often disproportionate to the injury and may worsen with passive stretching of the affected extremity.

⚠️ The nurse should assess neurovascular status, keep the extremity at heart level, and notify the provider immediately.

⚠️ Untreated compartment syndrome can lead to tissue necrosis, nerve damage, and permanent loss of function.

❌ Capillary refill of 3 seconds

❌ Capillary refill of 3 seconds is borderline but may still be considered acceptable in some settings.

❌ It is not as specific or urgent as severe pain that is not relieved by medication.

❌ In compartment syndrome, worsening findings may include delayed capillary refill, pallor, paresthesia, paralysis, and pulselessness.

❌ Dyspnea and tachypnea

❌ Dyspnea and tachypnea are respiratory findings, not classic signs of compartment syndrome.

❌ These symptoms may suggest complications such as pulmonary embolism or respiratory distress.

❌ The question focuses on a casted fractured tibia and limb pressure complication.

❌ Decreased level of consciousness

❌ Decreased level of consciousness is a neurological or systemic concern, not the expected local finding of compartment syndrome.

❌ It may occur with hypoxia, shock, medication effects, or neurologic injury.

❌ Compartment syndrome is primarily identified through severe limb pain and neurovascular changes.