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Twelve hours after experiencing a traumatic closed fracture of the lower left tibia, a client reports pain, tingling, and diminished toe movement in the left foot. Which nursing problem has the highest priority based on this information?

Impaired comfort.

Impaired skin integrity.

Risk for infection related to traumatic fracture.

Risk for peripheral neurovascular dysfunction.

Answer and Explanation

The Correct Answer is D

A. While impaired comfort is a concern, the priority is to address potential neurovascular compromise.

B. Impaired skin integrity is a concern but not the most immediate issue given the symptoms described.

C. Risk for infection is important but secondary to the acute concern of neurovascular function.

D. Risk for peripheral neurovascular dysfunction is the highest priority as it indicates potential compartment syndrome or other serious complications requiring urgent intervention.

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Correct Answer is ["A","B","C","G"]

Explanation

A. Rise slowly when getting up: Finasteride and tamsulosin can cause orthostatic hypotension, making it important for the client to change positions slowly to prevent dizziness and falls.

B. Take medication in the morning: Tamsulosin is typically taken once daily, 30 minutes after the same meal each day, often recommended in the morning to align with the daily routine and reduce the likelihood of missing doses.

C. Erectile dysfunction is common with the prescribed medication: Finasteride may cause sexual side effects such as erectile dysfunction, decreased libido, and ejaculation disorders. It is important to inform the client of these potential side effects.

D. Medication may cause the heart to race: This is not a common side effect of finasteride or tamsulosin. Tamsulosin can cause hypotension, but it does not typically cause tachycardia.

E. Ibuprofen should be taken 2 hours before taking medication: There is no specific interaction that requires timing ibuprofen around these medications.

F. Symptoms should be resolved within 1 week: Improvement in symptoms of benign prostatic hyperplasia (BPH) with medications like finasteride and tamsulosin typically takes several weeks to months, not just one week.

G. Ensure cane is used when ambulating: Given the client's use of a cane and the potential for orthostatic hypotension, it is crucial to reinforce the use of the cane to prevent falls and ensure safe ambulation.

A. Initiate bilateral intermittent sequential pneumatic compression devices. B. Raise the head of the bed to 30 degrees keeping head and neck in neutral alignment. C. Maintain elevated positioning of the dependent joints on affected side. D. Obtain a focused history to determine recent bleeding and use of anticoagulants.

Correct Answer is B

Explanation

A. Initiating sequential pneumatic compression devices is not immediately relevant to managing acute stroke symptoms.

B. Raising the head of the bed to 30 degrees and keeping the head and neck in neutral alignment helps reduce intracranial pressure and facilitates venous drainage, which is crucial in managing potential stroke patients.

C. Elevating the dependent joints on the affected side is not immediately necessary and does not address the acute neurological symptoms.

D. While obtaining a focused history is important, it should follow after initial stabilization measures such as positioning and securing immediate diagnostic tests.

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Twelve hours after experiencing a traumatic closed fracture of the lower left tibia, a client reports pain, tingling, and diminished toe movement in the left foot. Which nursing problem has the highest priority based on this information?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Exhibits The nurse reviews the healthcare provider's orders. Select the 4 things the nurse should educate the client about taking his medication.

Correct Answer is ["A","B","C","G"]

Explanation

Correct Answer is B

Explanation

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