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A nurse is caring for a client in an orthopedic unit.

Exhibits

Drag words from the choices below to fill in each blank in the following sentence.

The client is at risk for developing

and
Answer and Explanation

The Correct Answer is {"dropdown-group-1":"D","dropdown-group-2":"B"}

  • Deep vein syndrome: This is not a recognized condition. The intended term may have been deep vein thrombosis (DVT), which is a valid orthopedic complication, but the clinical findings in this scenario point more urgently toward compartment syndrome and infection.
  • Osteomyelitis: The client has an open fracture with drainage from the splint, a significantly elevated WBC count (28,000/mm³), and a high fever (38.9°C / 102°F). These findings suggest the development of a bone infection (osteomyelitis), especially in the context of recent surgery and internal fixation.
  • Fat embolism syndrome: While fat embolism is a risk with long bone fractures, this client is not displaying key hallmark signs such as respiratory distress, petechiae, or altered mental status. The findings are more consistent with infection and circulatory compromise.
  • Compartment syndrome: The client has classic signs including cool foot, numbness, inability to move toes, absent pulses, delayed capillary refill, and increased pain. These are hallmark signs of neurovascular compromise from compartment syndrome, a surgical emergency.


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Related Questions

Correct Answer is ["B","D"]

Explanation

A. Remove the thermometer from client's room for use on another client. Clients with C. difficile should have dedicated equipment (e.g., thermometers, stethoscopes) to prevent cross-contamination. Reusing equipment between patients increases the risk of infection transmission.
B. Wear a gown when providing care. Contact precautions are required for clients with C. difficile, including wearing a gown to protect against contamination from infectious material or surfaces.
C. Wear an N95 respirator when providing care. C. difficile is spread through the fecal-oral route, not airborne. A surgical mask is not required, and an N95 respirator is unnecessary unless another airborne condition is present.
D. Change gloves after contact with infectious material. Gloves must be changed after contact with contaminated materials to prevent spreading spores to other surfaces or clients. This is a standard part of contact precaution practices.
E. Wash hands with an alcohol-based cleaner. Alcohol-based hand sanitizers are ineffective against C. difficile spores. Handwashing with soap and water is required after caring for a client with this infection to properly remove the spores.

Correct Answer is B

Explanation

A. Rotate staff members caring for the client. Clients with paranoid personality disorder often struggle with mistrust and feel suspicious of others. Consistency in staffing is important to build rapport and reduce anxiety, so rotating staff can worsen paranoia.
B. Speak in a neutral tone when addressing the client. This is appropriate because a calm, neutral, and non-threatening tone helps reduce perceived threats or suspicion. It promotes a sense of safety and control, which is important for therapeutic communication with paranoid individuals.
C. Limit the client's opportunities to socialize with others. While clients with paranoid personality disorder may prefer limited interaction, completely restricting socialization can increase isolation and reinforce delusional thinking. Structured, safe interactions are often encouraged.
D. Mix the medication with the client's food items. Administering medication without the client’s knowledge is deceptive and unethical, especially in someone already prone to distrust. Open and honest communication about treatment is crucial for promoting cooperation and trust.

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