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 C

Explanation

A. Deep Tissue Injury. Deep tissue injuries appear as intact or discolored skin (purple or maroon) due to underlying soft tissue damage. This wound is already open with slough, so it does not fit this category.

B. Stage III Pressure Ulcer. A Stage III pressure ulcer involves full-thickness skin loss with visible subcutaneous tissue, but the wound depth must be assessable. Since the slough covers the wound, the depth cannot be determined.

C. Unstageable Pressure Ulcer. An unstageable pressure ulcer is one where the base of the wound is covered with slough or eschar, preventing assessment of the full depth of tissue damage. Until the slough is removed, the stage cannot be determined.

D. Stage II Pressure Ulcer. A Stage II ulcer has partial-thickness skin loss with exposed dermis, often appearing as an open blister or shallow wound. The presence of thick slough suggests deeper involvement, making this an incorrect classification.

A. Impetigo B. Scabies C. Herpes simplex virus D. Tinea corporis

Correct Answer is A

Explanation

A. Impetigo. Impetigo is a highly contagious bacterial skin infection, often caused by Staphylococcus aureus or Streptococcus pyogenes. It is characterized by honey-colored crusted lesions, especially around the mouth and extremities.

B. Scabies. Scabies presents as intensely itchy burrows or papules, often in the web spaces of the fingers, wrists, and axillae, rather than honey-colored crusts.

C. Herpes simplex virus. Herpes simplex virus (HSV) typically causes grouped vesicular lesions on an erythematous base, not crusted honey-colored lesions.

D. Tinea corporis. Tinea corporis (ringworm) presents as red, scaly, annular lesions with central clearing, not honey-colored crusts.

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Naxlex Comprehensive Predictor Exams

A nurse is assessing a patient with a pressure ulcer on the heel (as shown in the image). The wound is covered with thick yellow slough, making it difficult to determine the depth of tissue damage. How should the nurse classify this wound?

Correct Answer is C

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?

Correct Answer is A

Explanation

A nurse is explaining the pathophysiology of pneumonia to a group of nursing students. Which statement by one of the students indicates a correct understanding of the condition?

A nurse is providing teaching for a client who is postoperative following below-the-knee amputation. The nurse should instruct the client that which of the following nutrients is necessary for wound healing?

A nurse is assessing a patient who sustained partial-thickness burns to the anterior chest and anterior left arm. Using the Rule of Nines, what percentage of total body surface area (TBSA) is affected?

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

Which of the following actions should the nurse take immediately to prevent complications?

A nurse is caring for a client who has a new short-leg cast on his lower leg to treat an ankle fracture. Which of the following findings requires immediate notification of the provider?

A nurse is caring for a patient post-total hip arthroplasty. Which of the following findings requires immediate intervention?

A nurse is caring for an adolescent client who has a newly applied fiberglass cast for a fractured tibia. Which of the following is the priority action for the nurse to take?