Care Manager Certification Practice Exam

Upon assessing a client with a cast for a fractured tibia, what should the nurse check first?

1. Checking capillary refill.

2. Discussing cast care.

3. Managing pain.

4. Performing range of motion.

The correct answer is: Checking capillary refill.

The priority in assessing a client with a cast for a fractured tibia is checking capillary refill. This assessment is crucial because it provides immediate insight into the perfusion and circulation in the affected limb. A delay in capillary refill can indicate compromised blood flow, potentially leading to complications such as compartment syndrome or necrosis due to the pressure the cast may exert on the blood vessels. While managing pain, discussing cast care, and performing range of motion are important aspects of overall patient care, they do not take precedence over ensuring that the limb has adequate circulation. Checking capillary refill allows the nurse to promptly identify any urgent issues that need to be addressed regarding the integrity of the blood flow, setting a foundation for further interventions or assessments related to the client's recovery process.