A nurse is caring for a client who was in a MVA (motor vehicle accident) two days ago and sustained fractures to his tibia. ulna and ribs. The client is disoriented to time and place, has Sa02 of 87% and the nurse notices general petechiae over the client's chest. Which complication should the nurse suspect?

Hypovolemic shock

Fat embolism

Thrombophlebitis

Osteomyelitis

Answer and Explanation

The Correct Answer is B

A. Hypovolemic shock: While disorientation and low SaO2 could be signs of hypovolemic shock, the presence of petechiae is not a typical symptom. Hypovolemic shock is usually associated with blood loss and does not present with petechiae.

B. Fat embolism: Fat embolism syndrome (FES) is a common complication after fractures, especially long bones like the tibia. The classic triad includes respiratory distress, neurological symptoms, and petechiae, making this the most likely diagnosis.

C. Thrombophlebitis: Thrombophlebitis involves inflammation of a vein due to a blood clot, typically presenting with localized pain, swelling, and redness, not petechiae or disorientation.

D. Osteomyelitis: Osteomyelitis is an infection of the bone. Symptoms include pain, fever, and redness over the infected area, but it does not typically present with disorientation, low SaO2, or petechiae.

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Correct Answer is A

Explanation

A. There is numbness and tingling sensations in the surgical limb. Numbness and tingling may indicate neurovascular compromise, such as compartment syndrome or nerve damage, requiring immediate medical attention.

B. Surgical pain is a 4 on a scale 0-10. Pain at a level 4 postoperatively is generally manageable and expected. It does not indicate an immediate complication.

C. The foot on the surgical limb is slightly cooler than the other limb. While a slightly cooler foot could be a concern, it is less urgent than numbness and tingling. Monitoring and comparing with other symptoms are necessary.

D. There are +2 pulses and the surgical limb is pink in color. This indicates good circulation and is a positive sign, not requiring immediate reporting.

A. Uric acid levels drop and calcium forms precipitate. B. Articular cartilage thins, leading to splitting and fragmentation. C. Uric acid crystal deposit(s) causing inflammation. D. Tophi form in the kidneys and impair the excretion of uric acid.

Correct Answer is C

Explanation

A. Uric acid levels drop and calcium forms precipitate. Incorrect. Gout is caused by elevated levels of uric acid, not a drop. Calcium precipitates are associated with other conditions such as kidney stones, not gout.
B. Articular cartilage thins, leading to splitting and fragmentation. Incorrect. This describes osteoarthritis, not gout.
C. Uric acid crystal deposit(s) causing inflammation. Correct. Gout occurs due to the deposition of uric acid crystals in joints, leading to inflammation and pain.
D. Tophi form in the kidneys and impair the excretion of uric acid. Incorrect. Tophi are deposits of uric acid crystals found in the joints and other tissues, not specifically in the kidneys.

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Naxlex Comprehensive Predictor Exams

The nurse is providing care for a patient following an open reduction surgery of a fracture. Which finding should the nurse report immediately to the HCP?

Correct Answer is A

Explanation

A nurse is reinforcing teaching with a client who has a new diagnosis of gout. The client asks the nurse how she got the disorder. Which of the following information should the nurse include in the teaching?

Correct Answer is C

Explanation

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