A nurse is assessing a client who is 24 hours postoperative following an open reduction and internal fixation to repair a fracture of the femur. Which of the following assessment findings is an early manifestation of fat embolism syndrome (FES)?

Headache

Dyspnea

Red-brown petechiae

Altered mental status

Answer and Explanation

The Correct Answer is B

Choice A reason: Headache can be associated with FES; however, it is not typically considered an early sign. It may occur as a part of the broader spectrum of symptoms.

Choice B reason: Dyspnea, or difficulty breathing, is one of the earliest signs of FES. Patients may experience shortness of breath due to fat globules obstructing pulmonary vessels.

Choice C reason: Red-brown petechiae, which are small, pinpoint hemorrhages, can appear on the skin and are a classic sign of FES, often found in the axillary region or on the chest.

Choice D reason: Altered mental status, including confusion and drowsiness, can occur early in FES due to fat emboli traveling to the cerebral circulation.

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Correct Answer is C

Explanation

Choice A reason: This choice is incorrect as painless, raised purple nodules on the hard palate are not typically indicative of squamous cell carcinoma.

Choice B reason: This choice is incorrect because a small macule with a yellow-brown scale does not describe squamous cell carcinoma, which often presents as a firm nodule with a scaly crust.

Choice C reason: This choice is correct. Squamous cell carcinoma can present as a firm nodule with a hard, scaly crust on the skin.

Choice D reason: Yellow white patches of growth on the tongue are more indicative of conditions such as oral leukoplakia, not squamous cell carcinoma.

A. pH 7.30, HCO3 26 mEq/L, PaCO2 50 mm Hg B. pH 7.50, HCO3 20 mEq/L, PaCO2 32 mm Hg C. pH 7.55, HCO3 30 mEq/L, PaCO2 31 mm Hg D. pH 7.25, HCO3 19 mEq/L, PaCO2 30 mm Hg

Correct Answer is A

Explanation

Choice A reason: This set of values is indicative of metabolic acidosis with respiratory compensation, which is common in chronic kidney disease due to the accumulation of acids in the blood and the lungs' attempt to compensate by retaining CO2.

Choice B reason: This choice suggests respiratory alkalosis, which is less likely in chronic kidney disease unless there is a secondary respiratory condition causing hyperventilation.

Choice C reason: This choice indicates metabolic alkalosis, which is not typical for chronic kidney disease, as the kidneys are unable to excrete acid effectively.

Choice D reason: While this set of values does indicate acidosis, the expected compensatory response in chronic kidney disease would be an elevated PaCO2, not a normal or low value.

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A nurse is assessing a client who is 24 hours postoperative following an open reduction and internal fixation to repair a fracture of the femur. Which of the following assessment findings is an early manifestation of fat embolism syndrome (FES)?

Nursing Test Bank

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Correct Answer is A

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