A patient recovering from aorto-femoral bypass surgery has developed edema, severe pain, paresthesia, and tightness of the operative limb.
The nurse recognizes that what post-operative complication is most likely causing the patient’s symptoms?

Wound infection.

Internal bleeding.

Graft rupture.

Compartment syndrome.

Answer and Explanation

The Correct Answer is D

Choice D rationale

The symptoms described - edema, severe pain, paresthesia, and tightness of the operative limb

- are indicative of Compartment Syndrome. This is a serious condition that can occur after surgery, where increased pressure within one of the body’s compartments results in insufficient blood supply to the area. It requires immediate treatment to prevent permanent damage.

Choice A rationale

While wound infection is a possible post-operative complication, it would typically present with symptoms such as redness, increased pain at the wound site, purulent discharge, and possibly fever. The symptoms described do not specifically indicate a wound infection.

Choice B rationale

Internal bleeding could cause pain and swelling, but it would likely also present with signs of shock, such as low blood pressure, increased heart rate, and altered mental status. The symptoms provided do not clearly indicate internal bleeding.

Choice C rationale

Graft rupture is a serious complication that could potentially cause severe pain and swelling. However, it would also likely cause significant hemodynamic instability, including hypotension and tachycardia. The symptoms described are more indicative of Compartment Syndrome.

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Correct Answer is C

Explanation

Choice A rationale

Placing the patient back on the heparin infusion and redrawing laboratory values would not be the appropriate next step. The INR of 1.9 is below the therapeutic range of 2.0 - 3.0 for most patients on warfarin. Therefore, the warfarin therapy is not yet fully effective, and there is no need to revert to heparin.

Choice B rationale

Asking the healthcare provider if the patient’s medication can be changed to rivaroxaban would not be the appropriate next step. Rivaroxaban is a different type of anticoagulant and would not necessarily be more effective in this situation.

Choice C rationale

Notifying the healthcare provider and asking if the dose of warfarin can be increased would be the appropriate next step. The INR of 1.9 is below the therapeutic range of 2.0 - 3.0 for most patients on warfarin. Therefore, an increase in the warfarin dose may be necessary to achieve therapeutic anticoagulation.

Choice D rationale

Preparing to administer a dose of Vitamin K subcutaneously would not be the appropriate next step. Vitamin K is used to reverse the effects of warfarin and would be counterproductive in this situation.

A. Trendelenburg with the stump supported on three pillows. B. Side lying with amputated leg flexed. C. Prone for 24 hours. D. Supine with the stump flat on the bed.

Correct Answer is D

Explanation

Choice A rationale

The Trendelenburg position, with the stump supported on three pillows, is not typically recommended following a below-the-knee amputation. This position could increase the risk of contractures.

Choice B rationale

Side lying with the amputated leg flexed is not typically recommended following a below-the- knee amputation. This position could increase the risk of contractures.

Choice C rationale

Lying prone for 24 hours is not typically recommended following a below-the-knee amputation. While some prone positioning may be beneficial to prevent hip flexion contractures, it should not be the only position used.

Choice D rationale

The supine position, with the stump flat on the bed, is often recommended following a below- the-knee amputation. This position helps to prevent contractures and promotes healing.

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A patient recovering from aorto-femoral bypass surgery has developed edema, severe pain, paresthesia, and tightness of the operative limb. The nurse recognizes that what post-operative complication is most likely causing the patient’s symptoms?

Choice D rationale

Choice A rationale

Choice B rationale

Choice C rationale

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Naxlex Comprehensive Predictor Exams

A patient has been receiving warfarin sodium 2.5 mg PO daily for four days and the International Normalized Ratio (INR) is 1.9. What should be the nurse’s next step?

Correct Answer is C

Explanation

Choice B rationale

Choice C rationale

Choice D rationale

The nurse is caring for a client who has just returned to the nursing unit following a below-the-knee amputation (BKA) of the right leg. How should this client be positioned?

Correct Answer is D

Explanation

Choice A rationale

Choice B rationale

Choice C rationale

Choice D rationale

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A patient recovering from aorto-femoral bypass surgery has developed edema, severe pain, paresthesia, and tightness of the operative limb.
The nurse recognizes that what post-operative complication is most likely causing the patient’s symptoms?