A patient is brought to the ED by a friend who states that a tree fell on the patient’s leg and crushed it while they were cutting firewood. What priority actions should the nurse perform? (Select all that apply.)

Elevating the site to limit the accumulation of fluid in the interstitial spaces

Performing a fasciotomy

Applying a clean dressing to protect the wound

Inserting an indwelling catheter

Splinting the wound in a position of rest to prevent motion

Answer and Explanation

Correct Answer : C,E

A. Elevating the site is incorrect because in crush injuries, elevation can worsen ischemia by reducing arterial perfusion.
B. Performing a fasciotomy is incorrect because this is a surgical procedure that must be performed by a physician when compartment syndrome is diagnosed.
C. Applying a clean dressing to protect the wound is correct as it prevents contamination and infection.
D. Inserting an indwelling catheter is incorrect unless there is concern for shock or fluid balance issues, which are not immediately indicated in the question.
E. Splinting the wound in a position of rest to prevent motion is correct as immobilization reduces pain and prevents further injury.

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Correct Answer is A

Explanation

A. Respiratory acidosis is correct because the patient has a low pH (acidosis) and elevated PaCO₂, indicating hypoventilation as the primary cause.
B. Metabolic alkalosis is incorrect because bicarbonate is within the normal range, and there is no metabolic compensation.
C. Respiratory alkalosis is incorrect because alkalosis would present with a high pH and low PaCO₂, the opposite of this scenario.
D. Metabolic acidosis is incorrect because bicarbonate is normal, ruling out a metabolic cause.

A. Fidelity B. Nonmaleficence C. Beneficence D. Veracity

Correct Answer is D

Explanation

A. Fidelity refers to being loyal, faithful, and keeping promises, but it is not the primary principle when obtaining informed consent.
B. Nonmaleficence means "do no harm," which is important in healthcare but does not directly relate to the process of informed consent.
C. Beneficence involves promoting good and acting in the best interest of the patient but is secondary to ensuring informed consent is given.
D. Veracity is the ethical principle of truth-telling. It is most important when obtaining informed consent because the patient must fully understand the information about the procedure, including the risks and benefits, before giving consent.

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A patient is brought to the ED by a friend who states that a tree fell on the patient’s leg and crushed it while they were cutting firewood. What priority actions should the nurse perform? (Select all that apply.)

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Naxlex Comprehensive Predictor Exams

Correct Answer is A

Explanation

Which ethical principle is most important when soliciting informed consent from a patient?

Correct Answer is D

Explanation

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