A client is brought to the emergency department by ambulance after stepping in a hole and falling. During the assessment, the nurse notes that the right leg is shorter than the left leg the right hip is noticeably deformed and acute pain is noted. Imaging does not reveal a fracture. What is the most likely explanation for this client's signs and symptoms?

Right hip dislocation

Right hip contusion

Right hip strain

Right hip osteoarthritis

Answer and Explanation

The Correct Answer is A

A. Right hip dislocation: In a hip dislocation, the head of the femur is forced out of the acetabulum, which is the socket in the pelvis. This can cause a noticeably shorter leg, hip deformity, and acute pain. Imaging might not show a fracture in the case of a dislocation.

B. Right hip contusion: A hip contusion is a bruise on the hip, usually caused by a direct blow or trauma. While it can cause pain and swelling, it typically does not result in a noticeably shorter leg or hip deformity.

C. Right hip strain: Hip strain refers to damage to the muscles or tendons around the hip joint due to overuse or sudden twisting movements. While it can cause pain, it does not typically lead to a noticeable leg shortening or hip deformity.

D. Right hip osteoarthritis: Osteoarthritis is a degenerative joint disease that can affect the hip joint. It leads to joint pain and stiffness but does not usually cause a noticeable leg shortening or acute deformity unless there are severe complications, which are not mentioned in the scenario.

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Correct Answer is C

Explanation

A. Hypovolemic shock: Hypovolemic shock occurs when there is a significant loss of blood or fluids in the body, leading to insufficient blood volume to maintain normal circulation. Symptoms include rapid heart rate, low blood pressure, confusion, and cold, clammy skin. While hypovolemic shock is a concern in trauma patients, the symptoms described by the client (shortness of breath and chest pain) are not typical of hypovolemic shock.

B. Fat embolism syndrome: Fat embolism syndrome occurs when fat particles are released into the bloodstream, often after a long bone fracture or trauma. These fat particles can block small blood vessels, leading to symptoms such as respiratory distress, confusion, and petechial rash (small red or purple spots under the skin). While fat embolism syndrome is a concern in patients with long bone fractures, the symptoms described by the client are more suggestive of a pulmonary embolism.

C. Venous thromboembolism (VTE): VTE refers to the formation of blood clots in the veins. Deep vein thrombosis (DVT) occurs when a blood clot forms in a deep vein, usually in the legs, while pulmonary embolism (PE) occurs when a clot breaks loose and travels to the lungs. Symptoms of PE can include sudden chest pain, shortness of breath, rapid heart rate, and cough, which may produce bloody or blood-streaked sputum. Given the client's symptoms of shortness of breath and chest pain, VTE, specifically pulmonary embolism, is a significant concern.

D. Compartment syndrome: Compartment syndrome occurs when there is increased pressure within a muscle compartment, leading to reduced blood flow and potential nerve damage. Symptoms can include severe pain, swelling, and numbness or tingling. While compartment syndrome is a complication of fractures, the symptoms described by the client (shortness of breath and chest pain) are not characteristic of compartment syndrome.

Correct Answer is ["500"]

Explanation

To calculate the infusion rate in ml/hr for a 500 ml bolus to be administered over 1 hour, you can simply set the pump to deliver the entire volume in the specified time:

500 ml / 1 hour = 500 ml/hr

So, the pump should be set at 500 ml/hr to administer the 500 ml bolus over 1 hour.

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has multiple long bone fractures caused by a motor-vehicle crash that happened 24 hr ago. The client tells the nurse he is short of breath and experiencing chest pain. The nurse should assess the client further for which of the following potential complications?

Correct Answer is C

Explanation

A nurse is to administer a 500ml bolus of normal saline to a patient over 1 hour?

Correct Answer is ["500"]

Explanation

A nurse is providing teaching to a client about measures to prevent urinary tract infections (UTIs). Which of the following client statements indicates a need for further teaching?

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A nurse is caring for a client who has a pulmonary embolism and has a new prescription for enoxaparin 1.5-2.5mg/kg subcutaneous. The client weighs 245 lbs. How many mg should the nurse administer for the low range of the dosage range? (Round the answer to the nearest whole number.)

Which of the following is the most common substance found on analysis of a renal stone?

A nurse is to infuse two 1L bags of normal saline to a patient at 80ml/hr. How many hours will it take to infuse the total amount of normal saline? (Round to the whole number. Assume no interruptions in the infusion.)

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A nurse is teaching a client about preventing osteoporosis. Which of the following statements by the client indicates a need for further teaching?