A client sustained a left femur fracture 3 hours ago. Initial vital signs and assessment were within normal limits with the exception of left leg pain.

The nurse re-assesses the client and documents the following:

Temp: 37.2 C Pain: 7/10-chest 5/10 left leg.

Pulse: 110 bpm

Respirations: 40 breaths per min, labored 02 saturation: 88%

Neuro: A&O x 3. Anxious Skin: Petechiae to neck and anterior chest.

Based on this assessment, which action is appropriate at this time?

Notify the healthcare provider that the client's pain is not well-managed

Reassure the client that the pain and stress of the fracture will soon get better.

Order a chest CT Computerized Tomography) to rule out a pulmonary embolus (PE).

Notify the healthcare provider that the client may have a fat embolism

Answer and Explanation

The Correct Answer is D

Fat embolism syndrome can occur when fat globules enter the bloodstream after a long bone fracture, such as a femur fracture. The fat globules can travel to the lungs and cause respiratory distress and decreased oxygen saturation. The symptoms observed in the client, including tachypnea (labored breathing), decreased oxygen saturation (88%), and the presence of petechiae (small red or purple spots) on the neck and anterior chest, are consistent with fat embolism syndrome.

Fat embolism syndrome is a serious condition that requires immediate medical attention. Notifying the healthcare provider allows for prompt evaluation, confirmation of the diagnosis, and initiation of appropriate treatment. This may involve further diagnostic tests such as a chest CT scan, as mentioned in one of the options, to rule out other potential causes or complications.

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Free Nursing Study Resources

Correct Answer is A

Explanation

This statement demonstrates an understanding of proper cast care for itch relief. Using a cool air dryer on a low setting can help circulate air and provide relief from itching under the cast. It is important not to use a hot air dryer as it may cause discomfort, skin irritation, or burn. Trickling water or inserting objects into the cast can lead to moisture accumulation and potential complications.

A. Deficient intake of protein. B. Administration of hypotonic IV fluids. C. Excessive dietary intake of salt. D. Overdose of supplemental Potassium pills.

Correct Answer is B

Explanation

A likely cause of a low sodium level (hyponatremia) of 128 mEq/L is the administration of hypotonic IV fluids. Hypotonic IV fluids have a lower concentration of solutes compared to the body's fluids, which can lead to dilutional hyponatremia. When these fluids are administered, they can cause water to move into the cells, diluting the sodium concentration in the bloodstream.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A 5-year-old with an arm cast from a fractured wrist complains of itching under his cast. The nurse knows cast care teaching for the parent has been successful when the parent states:

Correct Answer is A

Explanation

A client's Sodium level is 128 meq/L. The nurse knows that a likely cause of this lab finding is:

Correct Answer is B

Explanation

The nurse is explaining the alteration in normal function to a patient recently diagnosed with gastroesophageal reflux disease (GERD). Which etiology contributing to GERD does the nurse include in the teaching session?

The nurse is caring for an infant with a hip spica cast who has just returned from surgery. Which nursing action will be priority for this patient?

The nurse assesses a patient who had a total abdominal hysterectomy 2 days ago. Which information about the patient is most important to communicate to the health care provider?

Heparin 7,000 units is ordered. Heparin 5,000 units per ml is available. How many milliliters (ml) should the nurse administer? (Do not round)

The nurse is administering nitroprusside by IV infusion for a client in hypertensive emergency. The nurse knows that the primary assessment will be:

A patient is being discharged 4 days after hip arthroplasty using the posterior approach. Which patient action requires intervention by the nurse?

A patient is receiving a 3% saline continuous IV infusion for hyponatremia. Which assessment data represents an adverse outcome (side effect) of this infusion?

Which assessment finding is the best Indicator to the nurse that a client's peristaltic activity (Gl motility) has resumed after surgery?