Unlicensed assistive personnel (UAP) reports a client diagnosed with a fractured femur has "fatty globules" floating in the urinal. Which intervention should the nurse implement first?

Obtain an arterial blood gas and order a portable chest x-ray.

Instruct the UAP to keep the client on strict bed rest.

Assess the client for dyspnea and altered mental status.

Contact the healthcare provider for a ventilation and perfusion scan.

Answer and Explanation

The Correct Answer is C

A. Obtaining an arterial blood gas and ordering a chest x-ray may be necessary to evaluate the client further, but the nurse must first assess the client to determine the presence of clinical signs of fat embolism syndrome (FES), such as respiratory distress or neurological changes.

B. Keeping the client on strict bed rest may help reduce the risk of further complications, but it is not the first priority. Immediate assessment of the client’s condition is necessary to identify signs of fat embolism syndrome.

C. Assessing the client for dyspnea and altered mental status is the first priority because these symptoms are early indicators of fat embolism syndrome. Early recognition and intervention are critical in preventing further complications.

D. Contacting the healthcare provider for a ventilation and perfusion scan may be appropriate after assessing the client, but it is not the first action. Immediate assessment is essential to determine the urgency of the situation.

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Correct Answer is C

Explanation

A. Localized edema and discoloration are expected findings after a fracture and do not typically require immediate reporting unless they are accompanied by signs of compartment syndrome or other complications.

B. Pain relieved by hydromorphone indicates that the pain is being effectively managed. This does not require immediate reporting to the healthcare provider.

C. The absence of pedal pulses, even with the use of a Doppler, combined with increasing pain, is a critical finding that suggests compromised circulation, possibly due to compartment syndrome. This is a medical emergency requiring immediate intervention to prevent permanent tissue damage or loss of the limb.

D. Generalized weakness and pain at the site of injury are common findings after a fracture and do not indicate an urgent complication unless associated with other concerning symptoms.

A. Crepitus in the area above and surrounding the insertion site. B. Eyelets are not visible. C. Bubbling of the water in the water seal chamber with exhalation. D. Movement of the trachea toward the unaffected side.

Correct Answer is D

Explanation

A. Crepitus, or subcutaneous emphysema, near the insertion site can occur due to air leaking into the subcutaneous tissue. While it should be monitored, it does not always require immediate provider notification unless it is extensive or worsening.

B. The absence of visible eyelets indicates the chest tube is properly positioned within the pleural space. This is an expected finding and does not require provider notification.

C. Bubbling of the water in the water seal chamber with exhalation is normal in a client with a pneumothorax. It indicates air is being evacuated from the pleural space.

D. Movement of the trachea toward the unaffected side is a sign of tension pneumothorax, a life-threatening complication. This finding requires immediate notification of the provider and emergency intervention to relieve the pressure in the pleural space.

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Unlicensed assistive personnel (UAP) reports a client diagnosed with a fractured femur has "fatty globules" floating in the urinal. Which intervention should the nurse implement first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client diagnosed with a fractured left tibia and fibula. Which data should the nurse report to the healthcare provider immediately?

Correct Answer is C

Explanation

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Correct Answer is D

Explanation

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