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 B

Explanation

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.

A. Apply heat during the first 24 hr. B. Place moderate weight on the affected leg when walking. C. Elevate the affected ankle to the level of the heart. D. Apply the elastic compression dressing tight enough so the toes and ankle become numb.

Correct Answer is C

Explanation

A. Apply heat during the first 24 hr. Applying heat can increase swelling and should be avoided initially. Ice is recommended to reduce swelling.

B. Place moderate weight on the affected leg when walking. The affected leg should not bear weight until the initial acute phase of the injury has passed and pain/swelling has decreased.

C. Elevate the affected ankle to the level of the heart. Correct. Elevating the ankle helps to reduce swelling and promote venous return.

D. Apply the elastic compression dressing tight enough so the toes and ankle become numb. The compression dressing should be snug but not so tight that it restricts blood flow, which can lead to numbness and further injury.

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Naxlex Comprehensive Predictor Exams

Correct Answer is B

Explanation

A nurse is reinforcing teaching with a client who has an ankle sprain. Which of the following instructions should the nurse include?

Correct Answer is C

Explanation

A nurse is collecting data from a client who has multiple fractures in his left leg and reports severe pain and tingling in the extremity. The nurse should suspect which of the following complications?

Which of the following is a manifestation of a soft tissue injury?

What is an appropriate nursing intervention for postoperative care of a patient with a fractured leg?

The nurse is collecting data on a patient with a left tibia fracture. Which of the following findings is a priority finding?

A nurse is caring for a client who is postoperative following a right total hip arthroplasty. In which of the following positions should the nurse place the client's right leg?

The nurse is providing care for a patient with an external fixation for a fracture involving severe bone damage. What is the priority of care?

A nurse is caring for a client with a hip fracture. The client is scheduled for surgery. When performing an ORIF procedure of a hip. what is the purpose of the internal fixation?

A nurse at an urgent care center is reinforcing information with a new employee about the difference between sprains and strains. Which of the following examples should the nurse include as a cause of sprain injury?