A nurse on an orthopedic floor is completing the morning assessments on several clients. Which of the following clients has the greatest risk for fat embolism syndrome (FES)

A24-year-old male who has a casted femur fracture

A 10-year old female who has an ulnar fracture in an external fixator

A 45-year-old male who has multiple rib fractures

A 62-year-old female who has vertebral fractures due to osteoporosis

Answer and Explanation

The Correct Answer is A

A. A 24-year-old male who has a casted femur fracture: Long bone fractures, particularly of the femur, are the most common cause of fat embolism syndrome (FES). Fat globules can enter the bloodstream from the bone marrow, leading to respiratory, neurologic, and dermatologic manifestations. Young adults are at higher risk due to the frequency of high-energy trauma.

B. A 10-year-old female who has an ulnar fracture in an external fixator: FES is rare in small bone fractures such as the ulna, especially in children. The risk is minimal because less marrow fat is released into circulation compared with long bones like the femur.

C. A 45-year-old male who has multiple rib fractures: Rib fractures carry a low risk for FES because they involve flat bones with less marrow fat. The primary complications are respiratory in nature, such as pneumothorax or pulmonary contusion.

D. A 62-year-old female who has vertebral fractures due to osteoporosis: Vertebral fractures in older adults rarely result in FES because the marrow fat released is minimal, and low-energy trauma is usually involved. Other complications, such as spinal cord injury or chronic pain, are more likely.

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Correct Answer is C

Explanation

A. Blurred vision: Blurred vision can occur as a side effect of clozapine due to anticholinergic properties. While it may cause discomfort or temporary visual disturbances, it is not immediately life-threatening and does not require urgent reporting to the provider.

B. Dry mouth: Dry mouth is a common and expected anticholinergic side effect of clozapine. Although it can contribute to dental issues if persistent, it does not indicate a serious or emergent complication and can often be managed with hydration or saliva substitutes.

C. Fever: Fever is the highest priority symptom to report because it can indicate agranulocytosis, a rare but potentially life-threatening side effect of clozapine. Agranulocytosis compromises the immune system, increasing the risk of severe infections, making early detection and intervention critical.

D. Constipation: Constipation is a common side effect due to clozapine’s anticholinergic effects. While it should be monitored and managed to prevent complications such as bowel obstruction, it is not immediately life-threatening compared to signs of infection like fever.

A. Determine the client's airway patency B. Evaluate the client's level of consciousness. C. Auscultate the client's lung sounds. D. Ask the client to rate their pain.

Correct Answer is A,C,B,D

Explanation

A. Determine the client's airway patency: Ensuring the airway is patent is the highest priority in the immediate postoperative period because airway compromise can be life-threatening. This assessment is performed first to address the most critical physiological need.

B. Evaluate the client's level of consciousness: After airway and basic respiratory assessment, the nurse evaluates the client’s level of consciousness to detect neurological changes, sedation effects from anesthesia, or potential complications.

C. Auscultate the client's lung sounds: Respiratory assessment, including auscultation, identifies complications such as atelectasis or pneumonia. While vital, it follows confirming airway patency to prioritize immediate safety.

D. Ask the client to rate their pain: Pain assessment is important for comfort and recovery but is performed after addressing airway, breathing, and neurological status. It is lower priority compared with immediate physiological needs.

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A nurse on an orthopedic floor is completing the morning assessments on several clients. Which of the following clients has the greatest risk for fat embolism syndrome (FES)

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Naxlex Comprehensive Predictor Exams

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Correct Answer is C

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Explanation

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