A large tree fell across the thighs of a man who works as a logger, producing a crushing injury. The muddy ground cushioned the impact and x-rays revealed no broken bones. His thighs are bruised and swollen with pedal pulses present, but the left is stronger than the right. It is most important for the nurse to include in this client's plan of care assessment for signs of which pathophysiological condition?

Peripheral neuropathy.

Osteomyelitis.

Fat embolism.

Compartment syndrome.

Answer and Explanation

The Correct Answer is D

A) Peripheral neuropathy:

Peripheral neuropathy involves damage to the peripheral nerves and is not directly related to the described crushing injury. While nerve injury can occur as a result of trauma, the signs and symptoms described in the scenario, such as unequal strength between the left and right thighs, are more indicative of a potential vascular or musculoskeletal issue rather than peripheral neuropathy.

B) Osteomyelitis:

Osteomyelitis is a bone infection that can occur secondary to trauma or as a complication of open fractures. While it is possible for a crushing injury to lead to osteomyelitis if there is bone involvement or an open wound, the scenario mentions that x-rays revealed no broken bones. Additionally, the signs and symptoms described, such as bruising and swelling of the thighs, are not specific to osteomyelitis.

C) Fat embolism:

Fat embolism occurs when fat globules enter the bloodstream, often following traumatic injury to long bones or orthopedic procedures. While a crushing injury can theoretically lead to fat embolism, the absence of long bone fractures in the x-rays makes this less likely. Additionally, fat embolism typically presents with respiratory symptoms such as dyspnea and hypoxemia, which are not described in the scenario.

D) Compartment syndrome:

Correct. Compartment syndrome is a serious condition that can occur following a crushing injury, especially in the extremities. It is characterized by increased pressure within a muscle compartment, leading to compromised blood flow and potential tissue damage. Signs and symptoms of compartment syndrome include severe pain, swelling, bruising, decreased or absent pulses, and neurological deficits. The unequal strength between the left and right thighs could indicate neurological deficits due to compromised blood flow or nerve compression, making assessment for signs of compartment syndrome crucial in this client's plan of care. If compartment syndrome is suspected, prompt medical intervention, such as fasciotomy to relieve pressure, may be necessary to prevent complications.

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Correct Answer is A

Explanation

The atrioventricular (AV) node is an essential component of the cardiac conduction system responsible for transmitting electrical impulses from the atria to the ventricles. The inherent rate of the AV node refers to its intrinsic ability to generate electrical impulses in the absence of external influences.

Here's a breakdown of each option:

A) 40 to 60:

Correct. The inherent rate of the AV node is typically 40 to 60 beats per minute (bpm). This rate is slower than that of the sinoatrial (SA) node, which has an inherent rate of 60 to 100 bpm. The AV node acts as a backup pacemaker, ensuring that the ventricles receive electrical impulses even if the SA node fails to function properly.

B) 20 to 40:

This range is not consistent with the typical inherent rate of the AV node. A rate of 20 to 40 bpm would be unusually slow and could indicate significant conduction system abnormalities rather than the normal functioning of the AV node.

C) 60 to 80:

This range is more characteristic of the inherent rate of the SA node rather than the AV node. The SA node is the primary pacemaker of the heart, and its inherent rate is typically 60 to 100 bpm.

D) 80 to 100:

Similar to option C, this range is more consistent with the inherent rate of the SA node rather than the AV node. The SA node typically has a faster intrinsic rate compared to the AV node.

A. Abnormal growth results in loss of bladder muscle tone. B. Inflammation causes spasms of the gland. C. The enlarged gland compresses the urethra. D. Nerve compression decreases the sensation that the bladder is full

Correct Answer is C

Explanation

Benign prostatic hyperplasia (BPH) is a condition characterized by non-cancerous growth of the prostate gland, leading to its enlargement. This enlargement can contribute to urinary retention by obstructing the flow of urine through the urethra. Here's the breakdown of the explanation:

A) Abnormal growth results in loss of bladder muscle tone:

While BPH can lead to urinary symptoms such as urinary frequency, urgency, and nocturia, it does not directly cause loss of bladder muscle tone. Instead, the enlarged prostate gland obstructs the bladder outlet, making it difficult for urine to pass through the urethra.

B) Inflammation causes spasms of the gland:

Inflammation of the prostate gland, known as prostatitis, can cause symptoms such as pelvic pain, dysuria, and urinary frequency, but it is not typically associated with BPH. BPH is characterized by benign growth of the prostate tissue rather than inflammation and spasms.

C) The enlarged gland compresses the urethra:

Correct. The primary mechanism by which BPH causes urinary retention is by compressing the urethra, which obstructs the flow of urine from the bladder. As the prostate gland enlarges, it can constrict the urethra, leading to symptoms such as hesitancy, weak urinary stream, incomplete emptying, and urinary retention.

D) Nerve compression decreases the sensation that the bladder is full:

While compression of nerves in the pelvic region can contribute to urinary symptoms, such as decreased sensation of bladder fullness, it is not the primary mechanism by which BPH causes urinary retention. The compression of the urethra by the enlarged prostate gland is the main factor leading to urinary obstruction and retention.

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Naxlex Comprehensive Predictor Exams

What is the inherent rate of the AV (atrioventricular) node area?

Correct Answer is A

Explanation

Which explanation should the nurse give to a male client on why benign prostatic hyperplasia (BPH) often causes urinary retention

Correct Answer is C

Explanation

The nurse is assessing a client with a gunshot wound to the abdomen who is admitted to the intensive care unit (ICU) following a 3-hour surgical procedure. Which elevated laboratory value indicates pancreatic damage?

The nurse is caring for an immobilized client who is at risk for breakdown in skin integrity. Which pathophysiological process should the nurse note early in the development of a pressure injury?

A client is diagnosed with amyotrophic lateral sclerosis (ALS). Which pathophysiological process should the nurse use when providing the client with information about this disease prognosis?

A male client with type 1 diabetes mellitus (DM) develops a gangrenous toe and is admitted for possible amputation. Which pathophysiological consequence of DM has contributed to this client's complication?

Which statement is true regarding myocardial functioning in the normal heart, based upon the Frank Starling law?

The school nurse is teaching a group of clients about how tobacco smoke causes lung cancer. Which pathophysiological process supports the risk of cancer from smoking?

When planning care for a client who is diagnosed with a large abdominal aortic aneurysm (AAA), the nurse should carefully monitor for which signs and symptoms?

After the nurse obtains a blood sample from a client's right radial arterial client reports a sudden onset of pain at the arterial line insertion site. The nurse recognizes which physiological effect may be inducing the sudden pain?