A mother whose 7-year-old child has been placed in a cast for a fractured right arm reports he will not stop crying even after taking Tylenol with codeine. He also will not straighten the fingers on his right arm. The best response by the nurse is?
Take him to the emergency department.
Put ice on the injury.
Avoid letting him get so tired.
Wait another hour. If he is still crying, call back.
The Correct Answer is A
A. The child is exhibiting signs of possible compartment syndrome, a medical emergency. Key indicators include unrelieved pain despite analgesics, inability to move fingers, and persistent crying, which may signal nerve or vascular compromise. Immediate assessment and intervention are necessary to prevent permanent nerve or tissue damage. The nurse should instruct the mother to seek emergency care immediately rather than waiting.
B. While ice can help reduce swelling in minor injuries, it is not sufficient for managing potential compartment syndrome. Delaying emergency evaluation could worsen tissue damage and lead to permanent functional loss.
C. Fatigue management does not address the acute, serious risk of neurovascular compromise in this situation. This advice would not resolve the underlying problem.
D. Waiting is unsafe because persistent pain and inability to move the fingers are red flags for compartment syndrome
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. This is more characteristic of thalassemia major, where extramedullary hematopoiesis occurs in the facial bones and skull due to chronic severe anemia. Sickle-cell anemia does not typically cause this finding.
B. Skin depigmentation is not a typical manifestation of sickle-cell anemia. Skin changes may occur secondary to ischemia (ulcers) or infection, but generalized depigmentation is unrelated.
C. Children with SCA may experience delayed growth and short stature due to chronic anemia, poor oxygenation, and nutritional deficits, not increased growth.
D. Mild jaundice (yellowing of the sclera) is a common finding in sickle-cell anemia due to chronic hemolysis. Destruction of sickled red blood cells releases bilirubin, which can accumulate in the skin and eyes, leading to scleral icterus. This is a hallmark clinical indicator of ongoing hemolysis.
Correct Answer is ["1650"]
Explanation
Step 1: Add segmented + bands
30% + 25% = 55%
Step 2: Convert percentage to decimal
55% = 0.55
Step 3: Calculate ANC
ANC = WBC × (% neutrophils + % bands)
ANC = 3,000 × 0.55 = 1650
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