A patient with a long leg cast reports pain in the toes. The nurse discovers that the toes are pale and cool to the touch with intact pulses and minimal neuropathy. The findings indicate that the patient may be experiencing which complications?

A fat embolism

Osteomyelitis

Compartment syndrome

A pressure ulcer

Answer and Explanation

The Correct Answer is C

A. A fat embolism typically presents with respiratory distress, altered mental status, and petechial rash, not the symptoms of pale and cool toes with intact pulses. It is unlikely to cause localized pain in the toes alone.
B. Osteomyelitis is an infection of the bone and would not cause the pale, cool appearance of the toes in this scenario. Symptoms of osteomyelitis include fever, localized pain, and swelling, but it does not present with the same vascular and neurovascular changes as compartment syndrome.
C. Compartment syndrome occurs when there is increased pressure within a muscle compartment, leading to reduced blood flow. The symptoms of pale, cool toes with pain and intact pulses are indicative of impaired circulation due to increased pressure, which is a hallmark of compartment syndrome. This is a medical emergency that requires prompt intervention.
D. A pressure ulcer typically presents with localized skin damage due to prolonged pressure, but it would not cause pale, cool toes or pain in the way compartment syndrome would.

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Correct Answer is D

Explanation

A. While notifying the dietary department of the client's allergy to shellfish is important, the priority is to ensure that the healthcare provider is aware of the allergy, especially since shellfish allergies are often associated with iodine-based contrast agents used in cardiac catheterization.
B. Asking about other foods causing a reaction is helpful for understanding the scope of the client's allergies, but it is not the priority in this situation. The primary concern is the shellfish allergy, which may relate to contrast dye.
C. While it is important to attach an allergy wristband, the most critical action is to notify the provider so that alternative contrast agents can be considered if necessary.
D. Notifying the provider of the client's shellfish allergy is the priority action. Shellfish allergies can indicate a potential reaction to iodine-based contrast media, which could lead to severe reactions such as anaphylaxis. The provider needs to be aware to take appropriate precautions.

A. Bone demineralization B. Fat embolism syndrome C. Muscle atrophy D. Renal calculi

Correct Answer is B

Explanation

A. Bone demineralization occurs over a longer period of immobilization and is not a primary concern within the first 24 to 48 hours following a fracture.
B. Fat embolism syndrome (FES) is a serious complication that can occur within 24 to 48 hours after a long bone fracture, especially a femur fracture. Fat droplets from the bone marrow can enter the bloodstream, leading to embolism in the lungs, brain, or heart, causing symptoms such as respiratory distress, confusion, and petechial rash.
C. Muscle atrophy is a concern with prolonged immobility, but it develops over a longer period of time, not within the first 24 to 48 hours after a fracture.
D. Renal calculi (kidney stones) are more commonly associated with long-term immobility or dehydration, not an immediate complication following a fracture.

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A patient with a long leg cast reports pain in the toes. The nurse discovers that the toes are pale and cool to the touch with intact pulses and minimal neuropathy. The findings indicate that the patient may be experiencing which complications?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse asks a client who is about to have a cardiac catheterization about any allergies. The client states, "I always get a rash when I eat shellfish." Which of the following is the priority nursing action?

Correct Answer is D

Explanation

The nurse plans of care for a patient who has a fractured femur. During the 24 to 48 hours after the fracture, the nurse monitors the patient for the development of which complication?

Correct Answer is B

Explanation

A patient with a long leg cast reports pain in the toes. The nurse discovers that the toes are pale and cool to the touch with intact pulses and minimal neuropathy. The findings indicate that the patient may be experiencing which complications?

A nurse is admitting a client who has acute heart failure following myocardial infarction (MI). The nurse recognizes that which of the following prescriptions by the provider requires clarification?

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A nurse is caring for a client who has Cushing's syndrome. Which of the following interventions should the nurse expect to perform? (Select all that apply.)

A nurse is caring for a client who has acute osteomyelitis. Which of the following interventions is the nurse's priority?