The nurse cares for a client who sustained a femur fracture twelve hours ago.
Client reports shortness of breath and stated, 'something is not right.' The client was assessed to have a respiratory rate of 25/min and oxygen saturation of 90% while on room air.
Lung sounds had bilateral crackles throughout, and respirations were labored. Chest pain was reported that worsened with breathing. An emergent 12-lead electrocardiogram was obtained, and it was observed that the client had reddish-purple spots on their torso. A rapid response was called.
he client is demonstrating signs and symptoms of ?
pulmonary embolism
myocardial infarction
fat embolism syndrome
compartment syndrome
The Correct Answer is C
Choice A rationale: Pulmonary embolism would cause chest pain, dyspnea, and hemoptysis, but not petechiae or neurological changes.
Choice B rationale: While chest pain might be associated with myocardial infarction, the combination of symptoms aligns more with a pulmonary embolism.
Choice C rationale: Fat embolism syndrome occurs when fat globules from the bone marrow enter the bloodstream and travel to the lungs, brain, or other organs. This can
cause respiratory distress, neurological impairment, petechiae (reddish-purple spots on the skin), and cardiac dysfunction.
Choice D rationale: Compartment syndrome doesn't typically manifest with respiratory symptoms or reddish-purple spots.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale: Irregular respirations, bradycardia, and widened pulse pressure might indicate increased intracranial pressure.
Choice B rationale: This set of symptoms is often seen in cardiac tamponade and is referred to as the Beck’s triad and not Cushing's triad.
Choice C rationale: Cushing's triad is a set of clinical signs associated with increased intracranial pressure (ICP) and typically includes bradycardia (slow heart rate),
hypertension (elevated blood pressure), and irregular breathing patterns. Fixed pupils can also be present in some cases, but it's important to note that this triad is not always consistently present and may vary from person to person.
Choice D rationale: This set of symptoms describes symptoms of shock, not specifically Cushing's triad.
Correct Answer is D
Explanation
Choice A rationale: Gastrointestinal reflux disease is not typically a contraindication for sumatriptan.
Choice B rationale: Mild emphysema is not typically a contraindication for sumatriptan.
Choice C rationale: Hyperthyroidism is not typically a contraindication for sumatriptan.
Choice D rationale: Sumatriptan, a medication used for migraines, may elevate blood pressure, so it would be questionable for a client with hypertension.
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