The nurse is assessing the respiratory status of a client who has suffered a fractured rib. Which observation, if made by the nurse, would not be directly related to the fractured rib?

Pleural effusion on the unaffected side

Shallow breathing due to pain

Guarding behavior when taking deep breaths

Localized chest pain on inspiration

Answer and Explanation

The Correct Answer is A

A. Pleural effusion on the unaffected side is not directly related to a fractured rib. While rib fractures can lead to complications such as pneumothorax or hemothorax, pleural effusion on the opposite side is likely caused by another condition, such as infection or malignancy, and should be investigated separately.

B. Shallow breathing due to pain is a common response to a fractured rib, as the client may avoid deep breaths to minimize discomfort.

C. Guarding behavior when taking deep breaths is directly related to the pain caused by the fractured rib and is an expected observation.

D. Localized chest pain on inspiration is a hallmark symptom of a fractured rib, as the injury causes discomfort with chest wall movement during breathing.

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Correct Answer is A

Explanation

A. Administering pain medication is the priority action in this scenario. The patient is experiencing significant post-surgical pain, which can impair their ability to breathe deeply and effectively. Addressing pain will improve comfort and facilitate better respiratory effort.

B. Notifying the healthcare provider immediately is not warranted based on the current findings. The amount of drainage (50 mL) is within expected limits for the first hour after surgery, and fluctuation in the water seal chamber indicates the chest tube is functioning properly.

C. Repositioning the patient to the unaffected side may help with comfort but is not the most appropriate action to address the pain or improve respiratory status in this situation.

D. Documenting the findings and continuing to monitor the drain is important but does not address the patient’s immediate need for pain relief.

A. "Fragments of bone have splintered into the surrounding tissue." B. "The sharp edge of the bone has broken through the skin." C. "The bone ends have been forced toward each other." D. "The bone is broken on one side and bent on the other side."

Correct Answer is D

Explanation

A. This description refers to a comminuted fracture, where the bone is broken into multiple fragments. It is not characteristic of a greenstick fracture.

B. This description refers to a compound or open fracture, where the bone breaks through the skin. A greenstick fracture typically does not involve the bone piercing the skin.

C. This description refers to a compression or impacted fracture, where the bone ends are driven into each other. This is not the nature of a greenstick fracture.

D. A greenstick fracture occurs when the bone breaks on one side but bends on the other, similar to how a green twig might break. This is common in children due to the flexibility of their bones.

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The nurse is assessing the respiratory status of a client who has suffered a fractured rib. Which observation, if made by the nurse, would not be directly related to the fractured rib?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is A

Explanation

A nurse is caring for a child who has a fracture of the forearm. The parent tells the nurse that the provider said it was a greenstick fracture and asks what that means. Which of the following statements should the nurse make?

Correct Answer is D

Explanation

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