A nurse is caring for an older adult client who had a femoral head fracture 24 hours ago and is in skin traction. The client reports shortness of breath and dyspnea. The nurse should suspect that the client has developed which of the following complications?
Pneumothorax
Pneumonia
Airway obstruction
Fat embolism
The Correct Answer is D
Choice A reason:
Pneumothorax, a collapsed lung, can indeed cause shortness of breath and dyspnea. However, it is typically associated with a sudden onset of these symptoms following a chest injury or spontaneously in the case of a ruptured air blister. In the context of a femoral head fracture, pneumothorax is less likely unless there was additional trauma to the chest area.
Choice B reason:
Pneumonia is an infection of the lungs that leads to inflammation of the air sacs, causing them to fill with fluid or pus. Symptoms include cough with phlegm, fever, chills, and difficulty breathing. While pneumonia could cause dyspnea, it usually develops due to an infectious process rather than directly from a femoral head fracture.
Choice C reason:
Airway obstruction involves a blockage that prevents air from passing freely to the lungs. It can be caused by foreign objects, swelling due to allergic reactions, or other medical conditions. The symptoms of airway obstruction include difficulty breathing, wheezing, and potential changes in skin color. However, airway obstruction is not commonly a direct complication of a femoral head fracture.
Choice D reason:
Fat embolism syndrome is a serious condition that occurs when fat globules enter the bloodstream and lodge within the pulmonary vasculature, leading to respiratory distress. It is a known complication following long bone fractures, such as the femur, and presents with symptoms like shortness of breath, hypoxemia, and neurological manifestations. Given the recent femoral head fracture and the symptoms reported, fat embolism syndrome is the most likely diagnosis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Drink 3L of fluid every day
Drinking adequate fluids, especially water, is one of the most effective ways to prevent kidney stones. Fluids dilute the substances in urine that lead to stones. For someone with a history of kidney stones, drinking about 3 liters of water each day can help prevent stone formation¹².
Choice B reason: Take 3,000 mg of vitamin C daily
High doses of vitamin C can increase the risk of kidney stones as the body converts vitamin C into oxalate, which can then form stones. Therefore, taking 3,000 mg of vitamin C daily is not recommended for individuals prone to calcium oxalate stones².
Choice C reason: Restrict calcium intake to one serving per day
Contrary to what might seem intuitive, restricting calcium intake is not generally advised for preventing calcium oxalate stones. Adequate dietary calcium can help reduce the amount of oxalate being absorbed by the body, thus lowering the risk of stone formation. It's important to consume calcium-rich foods in moderation and not to restrict them severely.
Choice D reason: Eat 12 oz of animal protein daily
A high intake of animal protein can increase the risk of kidney stones in susceptible individuals. Animal protein can increase calcium and oxalate levels in urine and reduce levels of citrate, a substance that prevents stones. Therefore, it's recommended to limit animal protein intake rather than consume large amounts.
Correct Answer is D
Explanation
Choice A reason:
Using closed-ended questions when obtaining a health history can be limiting and may not provide the full context of the patient's sexual health risks. Open-ended questions are generally recommended to encourage a more comprehensive discussion about sexual behaviors and risks.
Choice B reason:
A client's reproductive health history is crucial for counseling purposes. It provides insight into potential risks for STIs and helps tailor the counseling to the client's specific needs and circumstances.
Choice C reason:
Referring a client to genetic counseling for having had an STI is not typically necessary. Genetic counseling is more relevant for hereditary conditions and is not a standard part of STI management.
Choice D reason:
Asking about a client's exposure to past or present STIs is essential in STI counseling. It helps assess the client's risk level and informs the necessary prevention and treatment strategies.
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