The nurse is providing discharge teaching to the 12-year-old with a fractured humerus and the parents. Which information should the nurse include regarding cast care?

Correct Answer: A

Rationale: The correct answer is A: Keep the fractured arm at heart level. This positioning helps reduce swelling and promote circulation, aiding in the healing process. Keeping the arm elevated can also help alleviate pain and discomfort. Choice B is incorrect because using a wire hanger to scratch inside the cast can lead to injury and complications. Choice C is incorrect because applying an ice pack to an itching area can cause skin damage and should be avoided. Choice D is incorrect because foul smells are not expected occurrences with cast care; any foul odor should be reported to the healthcare provider as it may indicate an infection.

Correct Answer: D

Rationale: The correct answer is D. Osteoporosis is more common in older individuals, especially postmenopausal women due to decreased estrogen levels. Smoking can lead to decreased bone density. Sedentary lifestyle also contributes to bone loss. Therefore, a sedentary 65-year-old woman who smokes cigarettes is at the highest risk. A: A 25-year-old woman who runs - Running is actually beneficial for bone health, so this individual is not at the greatest risk. B: A 36-year-old man who has asthma - Asthma does not directly increase the risk of osteoporosis compared to the other factors mentioned. C: A 70-year-old man who consumes excess alcohol - While excessive alcohol consumption can impact bone health, it is not as strong a risk factor as smoking and sedentary lifestyle.

Correct Answer: B

Rationale: The correct answer is B because participation in self-care activities indicates effective pain management and adaptation to pain. Engaging in self-care activities suggests that the client is able to maintain independence despite the pain, which is a positive outcome. Choices A, C, and D are incorrect. A decrease in medication use may not always be appropriate for acute pain management. Relaxation techniques can help manage pain but may not be the primary expected outcome. Repeating instructions about medications does not directly relate to the expected outcome of managing acute pain.

Correct Answer: C

Rationale: The correct answer is C: Chronic exposure to loud noises. Prolonged exposure to loud noises can damage the sensitive structures in the inner ear leading to hearing loss. The nurse should discuss this risk factor with the client to raise awareness on the importance of protecting their hearing. Incorrect Choices: A: Multiple piercings in the auricle - Piercings do not directly cause hearing loss. B: Use of nephrotoxic medications - Nephrotoxic medications can damage the kidneys, not the ears. D: Taking oral antihistamines daily - Antihistamines are not known to cause hearing loss.

Correct Answer: C

Rationale: The correct answer is C because assessing for visual acuity and proprioceptive deficits is essential in managing a client with vertigo to identify potential factors contributing to impaired balance. Visual acuity helps determine if vision issues are exacerbating vertigo symptoms, while proprioceptive deficits affect body awareness and balance. By assessing these factors, the nurse can tailor interventions to address specific needs, such as recommending corrective measures for vision problems or implementing balance exercises. A: Providing information about vertigo is important but does not directly address the specific issue of assessing visual acuity and proprioceptive deficits. B: Assessing for diversional activities is important for overall client well-being but does not directly address the balance issues related to vertigo. D: Referring the client to a support group and counseling may be beneficial for emotional support but does not directly address the physical factors contributing to impaired balance.