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 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.

A. Applying a cast B. Performing physical therapy C. Taking antibiotics D. Using heat therapy

Correct Answer is A

Explanation

A. Applying a cast: Casting is a common treatment to immobilize the fracture and allow proper healing.
B. Performing physical therapy: Physical therapy is part of the rehabilitation process but not an immediate treatment for stabilizing a fracture.
C. Taking antibiotics: Antibiotics are not standard treatment for fractures unless there is an associated open wound or infection.
D. Using heat therapy: Heat therapy is not recommended immediately after a fracture as it can increase swelling and pain.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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

A nurse is reviewing the treatment for an ankle fracture. Which of the following is a treatment option for fractures?

Correct Answer is A

Explanation

Which of the following is a common symptom of osteomyelitis?

A nurse is caring for a client who is postoperative following shoulder surgery. The client has a prescription to keep the affected arm adducted. Which of the following instructions should the nurse provide the client?

A nurse is taking care of a client with a displaced fracture. The nurse knows a displaced fracture is best described as?

A patient experiences a fracture of the lower leg and undergoes a closed reduction and placement of a fiberglass cast. The patient is 65 years old and has a medical 30-year history of diabetes mellitus. Which condition does the nurse recognize as a possible complication for this patient?

A nurse is contributing to the plan of care for a client to achieve the outcome of functional healing of a fracture. Which of the following nursing interventions is the HIGHEST priority to assist in meeting this outcome?

Which of the following statements about rhabdomyolysis is true?

The nurse is assisting with the care of a patient with rheumatoid arthritis (RA). The nurse must remember in which way RA care is different from osteoarthritis care. What type of nursing care does the nurse specifically provide for the patient with RA?