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?

Hypovolemic shock

Fat embolism syndrome

Venous thromboembolism

Compartment syndrome

Answer and Explanation

The Correct Answer is B

A. Hypovolemic shock is characterized by a significant loss of blood volume. While it can occur due to severe trauma, the symptoms of shortness of breath and chest pain are more indicative of a potential respiratory issue, making Fat Embolism Syndrome (FES) a higher concern in this case.

B. Correct. Given the client's recent multiple long bone fractures and the symptoms of shortness of breath and chest pain, the nurse should be concerned about the possibility of fat embolism syndrome (FES). FES can occur as a result of long bone fractures, particularly those involving the femur, pelvis, or tibia. Fat emboli can enter the bloodstream and potentially obstruct blood vessels, leading to symptoms such as shortness of breath, chest pain, and altered mental status.

C. Venous thromboembolism (VTE) is a condition involving the formation of blood clots in the veins, which can lead to complications such as deep vein thrombosis (DVT) or pulmonary embolism (PE). While this is a consideration for clients with immobilization due to fractures, it is not the primary concern in this case based on the presenting symptoms.

D. Compartment syndrome is a condition characterized by increased pressure within a muscle compartment, leading to decreased blood flow and potential tissue damage. While it can occur after fractures, it typically presents with symptoms like severe pain, swelling, and tense muscles, rather than shortness of breath and chest pain.

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Correct Answer is C

Explanation

A. Twisting at the waist while lifting or moving an object can strain the back muscles and potentially lead to injury. The nurse should advise against this.

B. Relaxing the abdominal muscles while lifting an object can lead to inadequate support for the spine, potentially causing further strain or injury. The nurse should instruct the client to engage the abdominal muscles for stability.

C. Correct. Bending at the knees when picking up an object helps distribute the weight more evenly and reduces strain on the back muscles. This is a safe and recommended technique for lifting.

D. Holding an object away from the body while lifting it can increase the strain on the back muscles. The client should be advised to keep the object close to their body for better support and balance.

A. Ecchymosis of the distal foot B. Dependent edema distal to the cast C. Moderate level of pain D. Inability to flex the toes of the casted foot

Correct Answer is D

Explanation

A. Ecchymosis of the distal foot may be expected after the application of a cast and is not necessarily an immediate concern unless it is severe or rapidly worsening.

B. Dependent edema distal to the cast can occur as a normal response to immobilization. It is not an immediate concern unless it is severe or associated with other concerning symptoms.

C. A moderate level of pain can be expected after the application of a cast. It should be managed appropriately, but it is not an immediate concern unless it is severe or uncontrolled.

D. Inability to flex the toes of the casted foot suggests a potential issue with circulation or nerve function, which requires immediate notification of the provider.

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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?

Nursing Test Bank

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A nurse is teaching a client who has strained her back muscles while preparing to move to a new apartment. Which of the following instructions should the nurse include?

Correct Answer is C

Explanation

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Correct Answer is D

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