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

A. Ultrasound: Ultrasound can be used to visualize soft tissue injuries and fluid accumulation but is not typically the first choice for long-term joint issues.
B. Arthroscopy: Arthroscopy is a minimally invasive procedure that allows direct visualization and treatment of joint problems. It is likely to be prescribed because it can help diagnose persistent pain and swelling in the knee.
C. Serum Alkaline Phosphatase Test: This blood test is used to evaluate bone growth and liver function. It is not specific for diagnosing joint pain or swelling.
D. Bone Biopsy: A bone biopsy is used to diagnose bone infections or cancer, which are not indicated in this scenario of persistent knee pain and swelling after an injury.

A. Explain the use of assistive devices. B. Clean skin with antibacterial skin cleaning cloths. C. Teach postoperative exercises. D. Ask if a consent form was signed.

Correct Answer is B

Explanation

A. Explain the use of assistive devices. While explaining the use of assistive devices is important, it is not the primary preoperative care focus.

B. Clean skin with antibacterial skin cleaning cloths. Correct. Preoperative skin cleaning with antibacterial cloths is crucial to reduce the risk of postoperative infections.

C. Teach postoperative exercises. Teaching postoperative exercises is important but is typically part of preoperative education rather than immediate preoperative care.

D. Ask if a consent form was signed. Ensuring that consent forms are signed is necessary but is not the primary preoperative care focus.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is B

Explanation

The nurse is providing preoperative care for a patient who is scheduled for joint replacement the next day. What should the nurse include with care?

Correct Answer is B

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?

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?

A nurse is monitoring a client who has a cast on her right ankle following an open reduction and internal fixation procedure. The nurse should monitor for which of the following findings to identify compartment syndrome?

A nurse is reinforcing teaching with a client who has rheumatoid arthritis. Which of the following statements by the client indicates understanding of the information?

A nurse is reinforcing teaching with a client that has osteomyelitis of an open wound on his heel. Which of the following information should the nurse include?

The nurse is caring for a patient with external fixation for a fracture involving severe bone damage. Which is the most important focus for the nurse during care of this patient?

Which medical condition increases the risk of osteomyelitis?