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?
Compartment syndrome
Deep vein thrombosis
Disseminated intravascular coagulopathy
Fat embolism
The Correct Answer is D
Choice A reason: Compartment syndrome involves increased pressure within a muscle compartment, causing pain, swelling, and neurovascular compromise. It typically presents with localized symptoms like severe pain and paresthesia, not systemic signs like tachycardia, pallor, or confusion. These findings in a humerus fracture suggest a broader complication, making this less likely.
Choice B reason: Deep vein thrombosis (DVT) causes localized swelling, pain, and redness, primarily in the lower limbs. Systemic symptoms like tachycardia or confusion are rare unless DVT progresses to pulmonary embolism. A humerus fracture is less associated with DVT, and the patient’s symptoms point to a more acute, systemic issue.
Choice C reason: Disseminated intravascular coagulopathy (DIC) involves widespread clotting and bleeding, often triggered by sepsis or trauma. While possible in severe trauma, it typically presents with bleeding or bruising, not primarily tachycardia, pallor, and confusion. These symptoms align more closely with fat embolism in the context of a long bone fracture.
Choice D reason: Fat embolism syndrome, common in long bone fractures like the humerus, occurs when fat globules enter the bloodstream, obstructing pulmonary or cerebral vessels. This causes tachycardia, pallor (from hypoxia), and confusion (from cerebral hypoxia). These systemic symptoms match the patient’s presentation, making fat embolism the most likely complication requiring urgent intervention.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Ankylosis, fusion of spinal joints, is associated with ankylosing spondylitis, not osteoporosis. Osteoporosis causes bone density loss, leading to fractures and deformities like kyphosis, not joint fusion. Expecting ankylosis misaligns assessment, potentially overlooking osteoporosis-related vertebral compression fractures critical for managing mobility and pain in older adults.
Choice B reason: Kyphosis, an exaggerated thoracic spine curvature, is common in osteoporosis due to vertebral compression fractures from weakened bones. These fractures collapse anteriorly, causing a hunchback appearance, affecting posture and balance. Recognizing kyphosis guides interventions like bracing or bisphosphonates to prevent further fractures and improve quality of life.
Choice C reason: Scoliosis, lateral spine curvature, is typically congenital or idiopathic, not directly caused by osteoporosis. While osteoporosis may exacerbate existing scoliosis through fractures, it’s not a primary deformity. Expecting scoliosis risks misdiagnosis, diverting focus from osteoporosis-related kyphosis and its management, like calcium supplementation or physical therapy.
Choice D reason: Lordosis, exaggerated lumbar curvature, is not typical in osteoporosis. Osteoporosis primarily affects thoracic vertebrae, causing kyphosis from compression fractures. Lordosis may occur in other conditions like muscular imbalances, but expecting it in osteoporosis misguides assessment, delaying interventions for fracture prevention and spinal stability in older adults.
Correct Answer is B
Explanation
Choice A reason: Complications of immobility, like muscle atrophy or thromboembolism, occur with both ORIF and closed reduction, as both may require immobilization post-procedure. ORIF involves surgery, but modern protocols emphasize early mobilization, similar to closed reduction. This disadvantage is not unique to ORIF, making it an incorrect choice.
Choice B reason: ORIF involves surgical incision and hardware placement, increasing infection risk at the surgical site or deep tissues (osteomyelitis). Closed reduction is non-invasive, avoiding this risk. Infections can delay healing, require antibiotics, or necessitate hardware removal, making this a significant disadvantage of ORIF compared to closed reduction.
Choice C reason: Skin irritation can occur with both ORIF (from incisions or hardware) and closed reduction (from casts or splints). It is not a distinct disadvantage of ORIF, as both methods involve external or internal devices that may irritate skin. This choice is incorrect, as it is not unique to ORIF.
Choice D reason: Nerve impairment risks exist in both ORIF (from surgical manipulation) and closed reduction (from fracture displacement or cast pressure). Neither method uniquely predisposes to nerve damage, and careful technique minimizes this risk. This disadvantage is not specific to ORIF, making it an incorrect choice.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.