The triage nurse in the emergency department is assessing a client who reports pain and swelling in the right lower leg. The client's pain became much worse last night and appeared along with fever, chills, and sweating. The client states, "I hit my leg on the car door 4 or 5 days ago, and the sore is getting bigger" The client has a history of diabetes mellitus type 2. Which condition should the nurse anticipate for this client?
Venous thromboembolism (VTE)
Cellulitis
Arterial insufficiency
Thrombocytopenia
The Correct Answer is B
A. Venous thromboembolism (VTE) - While VTE can cause leg pain and swelling, the presence of fever, chills, and localized trauma history in this scenario points more toward cellulitis.
B. Cellulitis
The client's symptoms, including pain, swelling, fever, chills, and sweating, are indicative of cellulitis, which is a bacterial skin infection. The history of trauma to the leg (hitting the leg on the car door) could have introduced bacteria into the skin, leading to the infection. The client's diabetes mellitus type 2 also increases the risk of developing skin infections due to impaired immune function and circulation. Cellulitis often presents with localized pain, swelling, warmth, redness, and systemic symptoms like fever and chills. Immediate medical evaluation and appropriate antibiotic treatment are necessary for cellulitis.
C. Arterial insufficiency - Arterial insufficiency typically presents with symptoms like intermittent claudication, rest pain, and non-healing wounds due to poor circulation. The symptoms described in the scenario are more consistent with an acute infection (cellulitis) rather than chronic arterial insufficiency.
D. Thrombocytopenia - Thrombocytopenia is a condition characterized by low platelet count and does not directly cause localized pain, swelling, and redness in the leg as described in the scenario.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. "I will reduce my intake of sodium." - This statement is correct. High sodium intake can lead to increased calcium excretion through the urine, which can weaken bones. Reducing sodium intake can help prevent osteoporosis.
B. "I will limit my intake of soft drinks." - This statement is correct. Soft drinks, especially cola beverages, contain phosphoric acid, which can leach calcium from bones, leading to decreased bone density. Limiting soft drink consumption is advisable for bone health.
C. "I will decrease my intake of caffeine." - This statement is correct. Excessive caffeine consumption can interfere with calcium absorption and increase calcium excretion. It is advisable to limit caffeine intake to prevent osteoporosis.
D. "I will reduce my intake of vitamin K-rich foods." - This statement is incorrect. Vitamin K is essential for bone health as it helps in bone mineralization and reduces the risk of fractures. Foods rich in vitamin K, such as leafy green vegetables, are beneficial for bone health and should not be reduced unless there are specific medical reasons to do so.
Correct Answer is A
Explanation
A. Urine culture and sensitivity
Explanation: A urine culture and sensitivity test involves growing bacteria from a urine sample in a laboratory setting. Once the bacteria have grown, they are exposed to different antibiotics to see which one is most effective in inhibiting their growth. This helps healthcare providers identify the specific strain of bacteria causing the infection and choose the most appropriate antibiotic treatment.
B. Serum creatinine level
Explanation: Serum creatinine level is a blood test used to measure kidney function. It evaluates how well the kidneys are filtering waste from the blood. While important for assessing kidney health, it does not determine the specific bacteria causing a urinary tract infection or the appropriate antibiotic treatment.
C. Urinalysis
Explanation: Urinalysis is a broad screening test that assesses various components in the urine, such as red and white blood cells, protein, glucose, and bacteria. While it can detect signs of a urinary tract infection (such as the presence of bacteria and white blood cells), it does not identify the specific bacterial strain causing the infection or provide information about antibiotic sensitivity.
D. Kidney scan
Explanation: A kidney scan, also known as a renal scan, is a medical imaging technique used to assess the structure and function of the kidneys. It can help diagnose conditions like kidney stones, urinary obstruction, or kidney infections. However, it does not determine the strain of bacteria causing a urinary tract infection or guide antibiotic treatment.
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