A nurse is assisting with the care of an adolescent.
Complete the following sentence by using the lists of options.
The adolescent is at risk for developing
The Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"C"}
Rationale for Correct Options:
Compartment syndrome is a serious complication that can occur after a fracture, particularly of a long bone like the femur. It results from increased pressure within a muscle compartment, leading to decreased blood flow and potential tissue damage.
Edema of the toes suggests swelling, which may indicate increasing pressure within the affected limb. The adolescent is already reporting significant pain (7/10) and has required repeated doses of IV morphine, which may not be sufficient to relieve compartment syndrome pain (a key warning sign). If left untreated, compartment syndrome can cause nerve and muscle damage, ischemia, and even permanent disability.
Rationale for Incorrect Options:
Deep Vein Thrombosis (DVT): DVT is a risk with immobilization, but it usually presents with unilateral swelling, warmth, and pain in the affected limb, not just toe edema.
Fat Embolism Syndrome: This occurs due to fat globules entering circulation after a long bone fracture. Symptoms include respiratory distress, mental status changes, and petechiae, which are not present here.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Recommend the client spend time alone in his room. Social isolation can worsen depressive symptoms by increasing feelings of loneliness and hopelessness. Clients with major depressive disorder benefit from structured activities and social engagement, which help improve mood and prevent withdrawal.
B. Offer the client low-protein snacks throughout the day. Clients with depression may experience changes in appetite and energy levels, but protein is essential for neurotransmitter function and overall health. Instead of low-protein snacks, balanced meals with adequate nutrients should be encouraged to support physical and mental well-being.
C. Encourage the client to use positive self-talk. Negative thought patterns contribute to depressive symptoms, and cognitive-behavioral strategies such as positive self-talk help clients challenge and replace negative beliefs. Encouraging the client to engage in self-affirming statements can improve self-esteem and foster a more positive outlook.
D. Suggest the client exercise before going to bed. While exercise is beneficial for mood regulation and depression management, engaging in physical activity right before bedtime can lead to increased alertness, potentially disrupting sleep. Exercise is best scheduled earlier in the day to maximize its mood-enhancing and sleep-promoting effects.
Correct Answer is C
Explanation
A. The client's next dressing change is scheduled in 4 hr. While the next dressing change is relevant to nursing care, it may not be critical for all members of the interprofessional team. The focus of the meeting should be on issues that impact the overall care plan and interdisciplinary collaboration.
B. The client's vital signs are checked every 8 hr. Checking vital signs every 8 hours is more specific to nursing care and may not be necessary for other team members to know unless there are concerns related to the client's condition that could affect their care.
C. The client has developed difficulty ambulating. Difficulty ambulating is important for the interprofessional team as it impacts the client's mobility, safety, and overall care plan. Difficulty ambulating may require the involvement of physical therapy, occupational therapy, and adjustments to the care approach, making it a critical point for discussion.
D. The client has state-sponsored health insurance. Having state-sponsored health insurance is relevant to the financial and administrative aspects of care, but it may not directly influence the clinical care decisions made by the interprofessional team and may not need to be addressed during the meeting.
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