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Question 1 of 5

A client has had a long leg cast removed after eight weeks. Which of the following actions is the correct method of cleansing the skin after cast removal?

Correct Answer: B

Rationale: Soaking in a tub and washing with a washcloth (
B) gently removes dead skin and debris without irritation. A bath brush (
A) or hot water (
D) may be too harsh, and enzyme wash (
C) is unnecessary.

Question 2 of 5

The nurse is caring for a client scheduled for a surgical repair of a sacular abdominal aortic aneurysm. Which assessment is most crucial during the preoperative period?

Correct Answer: C

Rationale: Identifying peripheral pulses is critical to assess baseline circulation, as an abdominal aortic aneurysm can affect distal blood flow.

Question 3 of 5

A client is given morphine 6 mg IV push for postoperative pain. Following administration of this drug, the nurse observes the following: pulse 68, respirations 8, BP 100/68, client sleeping quietly. Which of the following nursing actions is MOST appropriate?

Correct Answer: C

Rationale: IV naloxone (Narcan) should be given to reverse respiratory depression; respiratory rate of 8 is too low and necessitates a nursing action

Question 4 of 5

A client with a T6 injury 6 months ago develops facial flushing and a BP of 210/106. After elevating the head of the bed, which is the most appropriate nursing action?

Correct Answer: B

Rationale: The symptoms suggest autonomic dysreflexia, often triggered by a distended bladder in spinal cord injury patients. Assessing and relieving the bladder is the priority after elevating the bed.

Question 5 of 5

Which of the following descriptions is typical of a Parkinsonian gait?

Correct Answer: C

Rationale: Parkinsonian gait is characterized by decreased speed, poor balance, flexed posture, and shuffling steps (
C). Other descriptions (A, B,
D) do not fully capture this gait.

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