A nurse is caring for an older adult client who had a femoral head fracture 24 hours ago and is in skin traction. The client reports shortness of breath and dyspnea. The nurse should suspect that the client has developed which of the following complications?
Pneumothorax
Pneumonia
Airway obstruction
Fat embolism
The Correct Answer is D
Choice A reason:
Pneumothorax, a collapsed lung, can indeed cause shortness of breath and dyspnea. However, it is typically associated with a sudden onset of these symptoms following a chest injury or spontaneously in the case of a ruptured air blister. In the context of a femoral head fracture, pneumothorax is less likely unless there was additional trauma to the chest area.
Choice B reason:
Pneumonia is an infection of the lungs that leads to inflammation of the air sacs, causing them to fill with fluid or pus. Symptoms include cough with phlegm, fever, chills, and difficulty breathing. While pneumonia could cause dyspnea, it usually develops due to an infectious process rather than directly from a femoral head fracture.
Choice C reason:
Airway obstruction involves a blockage that prevents air from passing freely to the lungs. It can be caused by foreign objects, swelling due to allergic reactions, or other medical conditions. The symptoms of airway obstruction include difficulty breathing, wheezing, and potential changes in skin color. However, airway obstruction is not commonly a direct complication of a femoral head fracture.
Choice D reason:
Fat embolism syndrome is a serious condition that occurs when fat globules enter the bloodstream and lodge within the pulmonary vasculature, leading to respiratory distress. It is a known complication following long bone fractures, such as the femur, and presents with symptoms like shortness of breath, hypoxemia, and neurological manifestations. Given the recent femoral head fracture and the symptoms reported, fat embolism syndrome is the most likely diagnosis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason:
Hypertension is not typically an early manifestation of fat embolism syndrome (FES). FES is more commonly associated with hypoxemia, which can lead to hypotension rather than hypertension².
Choice B reason:
While a swollen calf may indicate deep vein thrombosis, it is not an early sign of FES. FES primarily affects the lungs and neurological systems early on, rather than causing localized swelling such as in a calf².
Choice C reason:
Tachypnea, or rapid breathing, is indeed an early sign of FES. This symptom usually develops before others and is due to the fat globules causing respiratory distress by blocking the pulmonary microcirculation²³⁴.
Choice D reason:
Bradycardia, or a slower than normal heart rate, is not an early sign of FES. Instead, patients may experience tachycardia as a response to hypoxemia and respiratory distress².
Correct Answer is B
Explanation
Choice A reason:
Malignant melanoma typically presents as a mole that changes in color, size, or feel and has irregular edges. It may also itch, ooze, or bleed. A raised, flesh-colored lesion with pearly white borders is not characteristic of malignant melanoma.
Choice B reason:
Basal cell carcinoma often appears as a raised, pearly bump, sometimes with visible blood vessels, which may have a central depression. The description of the lesion as raised, flesh-colored with pearly white borders aligns with the common presentation of basal cell carcinoma.
Choice C reason:
Squamous cell carcinoma usually presents as a firm, red nodule, or a flat lesion with a scaly, crusted surface. The lesion described does not match the typical appearance of squamous cell carcinoma.
Choice D reason:
Actinic keratosis is characterized by rough, scaly patches on sun-exposed areas of the skin, which may be precancerous. They are not typically described as raised, flesh-colored lesions with pearly borders.
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