A 24-year-old man with a tibial fracture is suspected of having compartment syndrome. Which assessment findings most closely align with acute compartment syndrome?
Pain with active movement, inability to perform passive movements, pallor
Pain with active movement, inability to perform passive movements, weakness
Pain, pulselessness, paresthesia, paralysis, and pallor
Pain with passive movement, inability to perform active movement, weakness
The Correct Answer is C
Choice A reason: While pain and pallor are features of compartment syndrome, the inability to perform passive movements is not a hallmark sign. In fact, pain with passive movement is more indicative of increased intracompartmental pressure. This choice omits critical signs such as paresthesia and pulselessness, which are essential for diagnosis.
Choice B reason: This option includes pain and weakness, which may be present, but again lacks the specificity of pain with passive movement and the full spectrum of neurovascular compromise. Weakness alone is not sufficient to confirm compartment syndrome, and the absence of paresthesia and pulselessness makes this choice incomplete.
Choice C reason: This choice correctly lists the classic “5 P’s” of acute compartment syndrome: pain, pulselessness, paresthesia, paralysis, and pallor. These signs reflect severe neurovascular compromise due to increased pressure within the compartment. Pain is typically out of proportion to the injury and worsens with passive stretch. Pulselessness and paralysis are late findings, indicating advanced ischemia.
Choice D reason: Pain with passive movement is a key early sign of compartment syndrome, but the inability to perform active movement and weakness alone do not encompass the full clinical picture. This option lacks paresthesia and pulselessness, which are critical for diagnosis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Carcinomas are typically hard, irregular, immobile, and may be associated with skin changes or nipple retraction. While breast cancer must always be ruled out, the described mass lacks the suspicious features of malignancy.
Choice B reason: A clogged duct is usually painful and associated with lactation. It presents as a tender, localized area of swelling and is not typically rubbery or mobile. This patient is nulligravid and not lactating, making this diagnosis unlikely.
Choice C reason: Fibroadenomas are common benign breast tumors in young women. They are typically smooth, round, rubbery, mobile, and nontender. The location in the upper outer quadrant and the described characteristics strongly suggest a fibroadenoma.
Choice D reason: Duct ectasia involves dilation of the milk ducts and may present with nipple discharge, tenderness, or inflammation. It is more common in older women and does not typically present as a discrete, mobile mass.
Correct Answer is D
Explanation
Choice A reason: Trichomonas is a sexually transmitted infection that typically causes vaginal discharge, itching, and irritation. It does not cause uterine tenderness or systemic symptoms like fever and flu-like illness in the postpartum period.
Choice B reason: A urinary tract infection may cause fever and abdominal discomfort, but it does not typically result in a tender, subinvoluted uterus or foul-smelling lochia. The symptoms described are more consistent with a uterine infection.
Choice C reason: Endometriosis is a chronic condition involving ectopic endometrial tissue, causing pelvic pain and infertility. It is not an acute postpartum infection and does not present with fever or foul-smelling discharge.
Choice D reason: Endometritis is an infection of the uterine lining, commonly occurring postpartum, especially after prolonged labor or cesarean delivery. Symptoms include uterine tenderness, fever, subinvolution, and malodorous lochia. This diagnosis best fits the clinical presentation.
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