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Twelve hours after experiencing a traumatic closed fracture of the lower left tibia, a client reports pain, tingling, and diminished toe movement in the left foot. Which nursing problem has the highest priority based on this information?

Impaired comfort.

Impaired skin integrity.

Risk for infection related to traumatic fracture.

Risk for peripheral neurovascular dysfunction.

Answer and Explanation

The Correct Answer is D

A. While impaired comfort is a concern, the priority is to address potential neurovascular compromise.

B. Impaired skin integrity is a concern but not the most immediate issue given the symptoms described.

C. Risk for infection is important but secondary to the acute concern of neurovascular function.

D. Risk for peripheral neurovascular dysfunction is the highest priority as it indicates potential compartment syndrome or other serious complications requiring urgent intervention.

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Correct Answer is []

Explanation

The client has a history of chronic obstructive pulmonary disease (COPD) and is experiencing episodes of more forceful coughing. This history increases the risk of aspiration, especially when taking oral medications. Aspiration can occur if the medication is not swallowed properly, leading to potential respiratory complications.

Assess swallowing ability: Given the client’s COPD and increased coughing, assessing the swallowing ability is crucial before administering oral medications to ensure that the client can safely swallow the medication and reduce the risk of aspiration.

Place in Fowler’s position: Placing the client in Fowler’s position (or semi-Fowler's position) promotes proper swallowing and decreases the risk of aspiration. It also helps improve respiratory function and comfort in clients with COPD.

Increased coughing or choking after administration: Monitoring for increased coughing or choking after taking the medication can help identify early signs of aspiration and allow for prompt intervention to prevent respiratory complications.

Level of consciousness: Monitoring the level of consciousness is important as changes in consciousness can affect the client’s ability to swallow properly and increase the risk of aspiration. It helps ensure the client remains alert and responsive.

A. Report any increase the white blood cell count. B. Wear a face mask while performing wound care. C. Instruct the family to adhere to contact precautions. D. Change the surgical dressing readily when soiled.

Correct Answer is D

Explanation

A. While reporting an increase in white blood cell count is important, it is more a sign of infection rather than a direct preventive measure.

B. Wearing a face mask can help prevent respiratory spread but is less critical for MRSA, which is typically spread by direct contact.

C. Instructing the family to adhere to contact precautions is important but not the primary action.

D. Changing the surgical dressing when soiled is crucial to prevent contamination and potential infection of the wound, directly reducing the risk of MRSA recurrence.

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Twelve hours after experiencing a traumatic closed fracture of the lower left tibia, a client reports pain, tingling, and diminished toe movement in the left foot. Which nursing problem has the highest priority based on this information?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Patient Data Exhibits Complete the diagram by dragging from the choices area to specify which condition the client is most likely experiencing, two actions the nurse should take to address that condition, and two parameters the nurse should monitor to assess the client's progress.

Correct Answer is []

Explanation

Correct Answer is D

Explanation

After receiving a change of shift report for clients on a medical surgical unit, which task should the nurse assign to an unlicensed assistive personnel (UAP)?

Which client should the charge nurse on the oncology unit assign to an RN, rather than a practical nurse (PN)?

Patient Data Exhibits The nurse reviews the prescriptions and assessment data. Click to indicate which interventions could help reduce symptoms if added to the plan of care. Each row must have one response option selected.

An unresponsive victim of a diving accident is brought to the emergency department where it is determined that immediate surgery is required to save the client's life. The client is accompanied by a close friend, but no family members are available. Which action should the nurse take first?

An client who weighs 160 pounds receives a prescription for gentamicin 5 mg/kg/day intravenously in divided doses every 8 hours. How many mg should the nurse administer with each dose? (Enter numerical value only. If rounding is required, round to the nearest whole number.)

While changing a client's postoperative dressing, the nurse observes purulent drainage at the site. Before reporting this finding to the healthcare provider, the nurse should note which of the client's laboratory values?

Patient Data Exhibits Complete the diagram by dragging from the choices area to specify which condition the client is most likely experiencing, two actions the nurse should take to address that condition, and two parameters the nurse should monitor to assess the client's progress.