A client is reporting pain in her casted leg and the nurse notes some swelling distal to the cast. The nurse has administered analgesics and elevated the limb. Thirty minutes after administering the analgesics, the client states the pain is unrelieved. The nurse should identify the warning signs of what complication?

Compartment syndrome

Muscle wasting

Skin breakdown

Joint Stiffness

Answer and Explanation

The Correct Answer is A

A. Compartment syndrome. The client’s unrelieved pain, despite analgesics, and the presence of swelling distal to the cast are warning signs of compartment syndrome. This is a medical emergency that occurs when increased pressure within a closed muscle compartment reduces blood flow, leading to tissue damage and pain.

B. Muscle wasting. Muscle wasting typically occurs over time due to disuse and is not a sudden, acute complication like compartment syndrome.

C. Skin breakdown. Skin breakdown could occur from improper cast fitting or prolonged pressure, but it would not cause unrelieved pain in the same way as compartment syndrome.

D. Joint stiffness. Joint stiffness can occur in casted limbs after removal, but it is not an acute complication like compartment syndrome.

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Correct Answer is B

Explanation

A. Aspirin 325 mg PO: Aspirin is important for preventing clot formation but should not be administered until a hemorrhagic stroke is ruled out.

B. Non-contrast computed tomography (CT) scan: This is the priority because it determines whether the stroke is ischemic or hemorrhagic, guiding further treatment.

C. Electrocardiogram (ECG): While assessing cardiac rhythm is important, it is not the immediate priority in the presence of stroke symptoms.

D. Simvastatin (Zocor) 80 mg PO: Statins are used for long-term management but are not urgent in this acute scenario.

A. Start CPR B. Prepare for radiofrequency catheter ablation C. Prepare for defibrillation D. Prepare for cardioversion

Correct Answer is D

Explanation

A. Start CPR: CPR is indicated if the client is unresponsive and pulseless, which is not the case here as the client is alert.

B. Prepare for radiofrequency catheter ablation: This is a long-term treatment for recurrent VT but not appropriate for acute management.

C. Prepare for defibrillation: Defibrillation is used for pulseless VT or ventricular fibrillation, not for a stable VT with a pulse.

D. Prepare for cardioversion: Synchronized cardioversion is the appropriate intervention for a stable VT with a pulse to restore normal rhythm.

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Naxlex Comprehensive Predictor Exams

A client with new onset right-sided weakness is admitted to the emergency department and the following orders are received. Which order should the nurse implement first?

Correct Answer is B

Explanation

A nurse is caring for an alert client who reports heart palpitations, nausea, and dizziness. An electrocardiogram (EKG) confirms the client is experiencing vector tachycardia (VT). The nurse should anticipate which action?

Correct Answer is D

Explanation

A nurse is caring for client with increased intracranial pressure What is an appropriate nursing intervention for the client?

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