NCSBN ON-LINE REVIEW 1.A client has been hospitalized after an automobile accident. A full leg cast was applied in the emergency room. The most important reason for the nurse to elevate the casted leg is to A) Promote the client's comfort B) Reduce the drying time C) Decrease irritation to the skin D) Improve venousreturn D: Improve venousreturn. Elevating the leg both improves venousreturn and reducesswelling. Client comfort will be improvedas well. 2. The nurse is reviewing with a client how to collect a clean catch urine specimen. What is the appropriate sequence to teach the client? A) Clean the meatus, begin voiding, then catch urine stream B) Void a little, clean the meatus, then collect specimen C) Clean the meatus, then urinate into container D) Void continuously and catch some of the urine A: Clean the meatus, begin voiding, then catch urine stream. A clean catch urine is difficult to obtain and requires cleardirections. Instructing the client to carefully clean the meatus, then void naturally with a steady stream prevents surface bacteriafrom contaminating the urine specimen. Asstarting and stopping flow can be difficult, once the client begins voiding it’s best tojust slip the container into the stream. Other responses do not reflect correct technique 3. Following change-of-shift report on an orthopedic unit, which client should the nurse see first? A) 16 year-old who had an open reduction of a fractured wrist 10 hours ago B) 20 year-old in skeletal traction for 2 weekssince a motor cycle accident C) 72 year-old recovering from surgery after a hip replacement 2 hours ago D) 75 year-old who is in skin traction prior to planned hip pinning surgery. C: Look for the client who has the most imminent risks and acute vulnerability. The client who returned from surgery 2 hoursago is at risk for life threatening hemorrhage and should be seen first. The 16 yearold should be seen next because it isstill thefirst post-op day. The 75 year-old is potentially vulnerable to age-related physical and cognitive consequences in skin tractionshould be seen next. The client who can safely be seen last is the 20 year-old who is 2 weeks post-injury.