A nurse is assessing a patient who has been immobilized in a full-body cast for 3 weeks following a spinal fracture. The patient reports nausea, abdominal discomfort, and bloating. The nurse also notes progressive weight boss and decreased appetite.
Which complication should the nurse suspect based on these findings?

Fat embolism syndrome

Deep vein thrombosis (DVT)

Compartment syndrome

Cast syndrome (Superior Mesenteric Artery Syndrome - SMAS)

Answer and Explanation

The Correct Answer is D

A. Fat embolism syndrome: Fat embolism syndrome (FES) typically presents with respiratory symptoms, such as dyspnea, petechiae, and confusion. Gastrointestinal symptoms like nausea and bloating are not characteristic of FES.

B. Deep vein thrombosis (DVT): DVT primarily presents with unilateral leg swelling, pain, and warmth, rather than gastrointestinal symptoms. While immobilization increases the risk of DVT, the patient’s symptoms do not align with this condition.

C. Compartment syndrome: Compartment syndrome involves severe pain, pallor, paresthesia, pulselessness, and paralysis in an affected limb. Gastrointestinal symptoms are not associated with compartment syndrome.

D. Cast syndrome (Superior Mesenteric Artery Syndrome - SMAS): SMAS occurs when the full-body cast compresses the superior mesenteric artery, leading to nausea, bloating, abdominal pain, and weight loss due to gastric obstruction. This condition is common in patients immobilized for prolonged periods.

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Correct Answer is B

Explanation

A. Tophi deposits and podagra: These findings are associated with gout, not osteoarthritis. Tophi are urate crystal deposits, and podagra refers to gout affecting the big toe.

B. Heberden's nodes and Bouchard's nodes: Heberden’s nodes are bony growths at the distal interphalangeal (DIP) joints, while Bouchard’s nodes affect the proximal interphalangeal (PIP) joints. These are characteristic of osteoarthritis.

C. Ulnar deviation and joint subluxation: Ulnar deviation and joint subluxation are commonly seen in rheumatoid arthritis, not osteoarthritis.

D. Swan-neck deformity and Boutonnière deformity: These deformities are typical of rheumatoid arthritis, not osteoarthritis.

A. Administer antibiotics to the client. B. Teach relaxation breathing to reduce the client's pain. C. Increase the client's protein intake. D. Provide the client with antipyretic therapy.

Correct Answer is A

Explanation

A. Administer antibiotics to the client. Osteomyelitis is a severe bone infection that requires immediate antibiotic therapy to eliminate the infection and prevent complications such as sepsis or bone necrosis.

B. Teach relaxation breathing to reduce the client’s pain. Pain management is important, but it does not address the underlying cause of osteomyelitis. Treating the infection is the priority.

C. Increase the client’s protein intake. A high-protein diet can promote healing, but it does not directly treat the infection and is not the priority intervention.

D. Provide the client with antipyretic therapy. Fever management is beneficial, but treating the underlying infection with antibiotics is more important than simply reducing fever.

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Naxlex Comprehensive Predictor Exams

Correct Answer is B

Explanation

A nurse is caring for a client who has acute osteomyelitis. Which of the following interventions is the nurse's priority?

Correct Answer is A

Explanation

A school nurse is assessing a child who has honey-colored crusted lesions around their mouth and on their arms. The nurse should recognize this as a characteristic of which of the following skis infections?

A nurse is performing a skin assessment on a patient and suspects basal cell carcinoma (BCC). Which of the following findings would support this suspicion?

A nurse is assessing a bedridden patient and notes a reddened area on the sacrum that does not blanch when pressed. The skin is intact. Based on this finding, which stage of pressure ulcer should the nurse document?

A nurse is discussing the differences between skeletal and skin traction with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates understanding?

The nurse is evaluating a patient's understanding of cast care before discharge. Which statement by the patient indicates the need for further teaching?

A nurse is providing initial emergency care for a client with extensive burns. Which of the following interventions should the nurse perform first?

A nurse is reviewing the diagnostic test results of an older adult female client who is preoperative for a knee arthroplasty. The nurse should notify the surgeon of which of the following results?

A patient with chronic gout is prescribed allopurinol. Which statement by the patient indicates a correct understanding of the medication's purpose?