A 28-year-old man with a fractured humerus calls the nurse into his room. Upon assessment, the nurse finds the patient to be tachycardic, pale, and confused. The nurse suspects the patient may be experiencing which of the following complications?

Choice A reason: Using a blow dryer to dry a fiberglass cast is inappropriate, as casts should be kept dry to prevent skin maceration or infection. Fiberglass is water-resistant but not waterproof, and heat can damage the cast or skin. This instruction risks complications, misguiding patients on proper cast care and hygiene.

Choice B reason: Using a cotton swab under the cast to relieve itching is unsafe, as it may introduce debris or cause skin injury, increasing infection risk. Itching should be managed with elevation or antihistamines. This advice misaligns with cast care, potentially leading to complications like dermatitis or bacterial infection under the cast.

Choice C reason: Avoiding all movement of the affected leg is impractical and harmful. Controlled movement, as advised, prevents stiffness and muscle atrophy while maintaining circulation. Complete immobilization risks complications like contractures. This instruction misguides recovery, delaying rehabilitation and functional restoration in patients with a tibial fracture.

Choice D reason: Reporting worsening or unrelieved pain is critical, as it may indicate complications like compartment syndrome, infection, or cast pressure. Pain assessment ensures timely intervention, preventing serious outcomes like tissue necrosis or delayed healing. This instruction aligns with safe cast care, promoting patient safety and effective fracture management.

Choice A reason: Duchenne muscular dystrophy (DMD) is an X-linked recessive disorder. Males (XY) pass their Y chromosome to sons and X to daughters, not the DMD gene. Females (XX) can pass the mutated X to offspring. This statement is incorrect, as males cannot pass the DMD gene to their children.

Choice B reason: DMD primarily affects males, as it is X-linked recessive, and males lack a second X chromosome to mask the mutation. Females are rarely affected, typically as carriers or in rare cases with skewed X-inactivation. This statement is incorrect, as patients are predominantly male, not female.

Choice C reason: Genetic testing identifies DMD gene mutations, confirming diagnosis and guiding treatment, such as corticosteroids to slow muscle degeneration or emerging gene therapies. It informs prognosis, carrier status, and family planning, making it critical for tailoring interventions and counseling families about the disease’s progression and management.

Choice D reason: Not all daughters of a carrier female will be carriers. A carrier mother has a 50% chance of passing the mutated X chromosome to each daughter, making half likely carriers. This statement is incorrect, as it overstates the genetic transmission probability for female offspring.