A patient has had surgical reduction of an open fracture of the right radius this morning. Which assessment findings should the nurse report immediately to the health care provider?
Right arm muscle spasms
Temperature of 99.9°F (37.7°C)
Loss of the right radial pulse
Pain with right arm movement
The Correct Answer is C
Choice A reason: Right arm muscle spasms may be uncomfortable but are not as critical as circulatory issues.
Choice B reason: A temperature of 99.9°F (37.7°C) is slightly elevated but not immediately alarming post-surgery.
Choice C reason: Loss of the right radial pulse could indicate a serious complication such as compartment syndrome, which requires urgent atention.
Choice D reason: Pain with arm movement is expected post-surgery but is not as urgent as loss of pulse.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: An RBC count of 4,500,000/mL is within the normal range and would not typically cause symptoms of anemia.
Choice B reason: Normal RBC indices do not indicate anemia and would not explain the symptoms.
Choice C reason: A hemoglobin level of 8.2 g/dL is below the normal range and would be consistent with symptoms of anemia such as fatigue and palpitations.
Choice D reason: A hematocrit of 38% is within the normal range for adult males and would not typically be associated with anemia symptoms.
Correct Answer is C
Explanation
Choice A reason: While disturbed body image is a concern, it is not the highest priority for a patient undergoing a bone marrow transplant.
Choice B reason: Anxiety is important to address but does not take precedence over physical health concerns in the immediate post-transplant period.
Choice C reason: Ineffective protection is the highest priority because patients undergoing bone marrow transplants have compromised immune systems and are at high risk for infection.
Choice D reason: Imbalanced nutrition is a concern but is secondary to the risk of infection in the immediate care of a patient post bone marrow transplant.
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