Patient Data

Exhibits

Click to indicate if the listed characteristic is consistent with a fat embolism or blood clot embolism. Each column must have at least one response option selected.

Chest pain

Petechiae

Origin typically long bone fracture

Altered mental status

Dyspnea

Origin typically deep vein thrombosis

Tachycardia

Answer and Explanation

The Correct Answer is {"A":{"answers":"B"},"B":{"answers":"A"},"C":{"answers":"A"},"D":{"answers":"A"},"E":{"answers":"B,B"},"F":{"answers":"B"},"G":{"answers":"A,B"}}

• Chest pain: Blood clot embolism, especially pulmonary embolism, typically causes sudden chest pain due to obstruction of the pulmonary arteries. Fat embolism rarely causes chest pain as the primary symptom, though hypoxia may lead to discomfort. Chest pain is therefore more indicative of thrombotic embolism.

• Petechiae: Petechiae on the neck, upper chest, and conjunctiva are hallmark signs of fat embolism. They result from occlusion of dermal capillaries by fat globules and platelet aggregation. Blood clot embolism does not usually cause petechiae.

• Origin typically long bone fracture: Fat emboli commonly originate from fractures of long bones such as the femur, tibia, or pelvis. Trauma forces fat from the bone marrow into the bloodstream, creating emboli. Blood clot emboli generally do not arise from bone fractures.

• Altered mental status: Fat embolism can impair cerebral oxygenation, leading to confusion, lethargy, or agitation. This neurological involvement is a distinguishing feature of fat embolism. Blood clot embolism rarely affects mental status unless there is severe hypoxia.

• Dyspnea: Dyspnea occurs in both fat and blood clot embolism due to impaired oxygen exchange in the lungs. In fat embolism, hypoxia may develop gradually, while blood clot embolism often causes sudden shortness of breath. Both conditions require prompt respiratory support.

• Origin typically deep vein thrombosis: Blood clot emboli usually originate from deep veins in the legs or pelvis and travel to the lungs. Fat emboli are not associated with venous thrombi. Identifying the source helps differentiate between the two embolism types.

• Tachycardia: Tachycardia is a compensatory response to hypoxia or stress in both fat and blood clot embolism. It helps maintain oxygen delivery to vital organs. While nonspecific, its presence supports the need for urgent intervention in either condition.

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Free Nursing Study Resources

Correct Answer is D

Explanation

A. Instruct the client to cough as the suction tip is removed: While encouraging coughing helps clear secretions, it is not safe to ask a client to cough before suctioning; suctioning should be done with the catheter in place to remove secretions effectively.

B. Apply a water soluble lubricant to the catheter: Lubrication is not recommended for tracheostomy suctioning because it can introduce infection or interfere with effective suctioning.

C. Instill 3 mL of 0.9% sodium chloride before suctioning: Routine saline instillation is no longer recommended as it may increase the risk of infection, hypoxia, and airway irritation without improving secretion clearance.

D. Wear protective goggles while performing the procedure: Protective eyewear is essential to prevent exposure to secretions and reduce the risk of infection or contamination during tracheostomy suctioning.

A. Noncompliance with treatment regimen. B. Disturbed Body Image. C. Interrupted Family Processes. D. Imbalanced Nutrition: less than body requirements.

Correct Answer is D

Explanation

A. Noncompliance with treatment regimen: While noncompliance can affect recovery, it is secondary to the immediate physiological risks posed by malnutrition. Addressing noncompliance becomes relevant after stabilizing the client’s health.

B. Disturbed Body Image: Distorted body image is a core psychological issue in anorexia nervosa, but it does not pose an immediate threat to the client’s life. Interventions targeting body image are important but not the first priority.

C. Interrupted Family Processes: Family dynamics may influence the client’s condition and recovery, yet they are not life-threatening. Family interventions are supportive and adjunctive to stabilizing the client’s nutritional status.

D. Imbalanced Nutrition: less than body requirements: Malnutrition directly threatens the adolescent’s physiological stability, affecting cardiovascular, gastrointestinal, and endocrine function. Correcting nutritional deficits and preventing complications such as electrolyte imbalance or organ failure is the highest priority in care planning.

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Patient Data Exhibits Click to indicate if the listed characteristic is consistent with a fat embolism or blood clot embolism. Each column must have at least one response option selected.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

When performing suctioning for a client with a tracheostomy, which action should the nurse include?

Correct Answer is D

Explanation

When planning care for an adolescent with anorexia nervosa, which nursing problem has the highest priority?

Correct Answer is D

Explanation

Patient Data Exhibits The nurse is reviewing the client's initial assessment findings. Which assessment findings require follow-up? Select all that apply.

The nurse is providing teaching to a client newly diagnosed with type 2 diabetes mellitus about disease management. Which response by the client indicates understanding?

The nurse is performing an admission assessment for a newborn who has asymmetrical buttocks. Which assessment test results should the nurse report to the healthcare provider?

Which client's vital signs indicating increased intracranial pressure (ICP) should the nurse report to the healthcare provider?

An older male client who is admitted to a rehabilitation facility manifests signs of acute dementia. The nurse observes the client repeatedly calling out for his deceased spouse to come and get him. Which intervention(s) should the nurse implement? Select all that apply.

Patient Data Exhibits Which laboratory test(s) would be helpful in determining the plan of care (POC) for this client? Select all that apply.

The nurse is caring for a client with chronic kidney disease (CKD). Which meal selection should the nurse recommend to the client?

Patient Data

Exhibits

Click to indicate if the listed characteristic is consistent with a fat embolism or blood clot embolism. Each column must have at least one response option selected.