Which assessment finding indicates to the nurse that the client who sustained a fractured femur in a motor vehicle accident is experiencing fat emboli syndrome?

Petechiae on the chest.

An edematous calf.

Elevated temperature.

Paresthesia distal to the fracture.

Answer and Explanation

The Correct Answer is A

Choice A Reason
Petechiae on the chest are a classic sign of fat emboli syndrome (FES). FES is a rare but serious complication that can occur after a long bone fracture, such as a femur fracture. The petechiae result from small fat droplets that travel to the skin's capillaries and cause pinpoint hemorrhages. This symptom is part of the classic triad for FES, which includes respiratory distress, neurological symptoms, and a petechial rash.

Choice B Reason
While an edematous calf may be a concern for deep vein thrombosis or other complications following a fracture, it is not a specific indicator of FES. Edema in the calf could be due to various reasons, including local trauma from the fracture itself or immobilization.

Choice C Reason
An elevated temperature can be associated with many post-injury complications, including infection or inflammatory response. However, it is not specific to FES. While patients with FES may present with fever, it is not one of the primary diagnostic criteria.

Choice D Reason
Paresthesia distal to the fracture could indicate nerve damage or compartment syndrome, which are important to assess in a patient with a femur fracture. However, paresthesia is not a specific sign of FES. The neurological symptoms associated with FES are more generalized and often include confusion or altered mental status.

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Correct Answer is A

Explanation

Choice A Reason
Acute compartment syndrome occurs when bleeding or swelling within an enclosed bundle of muscles – known as a muscle compartment – leads to increased pressure. This pressure can impede blood flow to the body tissue and destroy function. The fascia, which is a tough layer of fibrous tissue, does not stretch easily, so any swelling or bleeding can quickly lead to increased pressure.

Choice B Reason
While displaced bones can compress nerves and vessels, this is not the primary mechanism of acute compartment syndrome. Displaced bones are more likely to cause direct injury or impingement, but compartment syndrome specifically refers to the pressure build-up within a muscle compartment that affects circulation and tissue viability.

Choice C Reason
Interruption of blood supply to the bone is a serious concern and can lead to conditions such as avascular necrosis. However, in the context of acute compartment syndrome, the primary issue is the pressure within the muscle compartment rather than direct disruption of blood supply to the bone.

Choice D Reason
Compression of muscle tissue can restrict blood flow to the area, which is a part of the pathophysiology of compartment syndrome. However, the compression is a result of increased pressure within the compartment, not the primary cause. The increased pressure is due to bleeding and swelling, which is why choice A is the most accurate description.

A. "Forget him. There are other fish in the sea." B. "You must have been very upset to do what you did." C. "Don't worry, you'll get over him in time." D. "Why do you think your boyfriend broke up with you?"

Correct Answer is B

Explanation

Choice A Reason:
The statement "Forget him. There are other fish in the sea." minimizes the client's feelings and does not acknowledge the emotional pain they are experiencing. It is a cliché that can come across as dismissive rather than empathetic.

Choice B Reason:
"You must have been very upset to do what you did." This statement acknowledges the client's distress and does not judge their actions. It reflects an understanding of the depth of their emotional pain, which is a key component of empathy.

Choice C Reason:
"Don't worry, you'll get over him in time." While this statement may be intended to provide reassurance, it does not address the immediate emotional state of the client. It could be perceived as brushing aside their current feelings.

Choice D Reason:
"Why do you think your boyfriend broke up with you?" This question could be seen as probing for information rather than offering support. It might imply that the client is at fault for the breakup, which is not an empathetic approach.

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Which assessment finding indicates to the nurse that the client who sustained a fractured femur in a motor vehicle accident is experiencing fat emboli syndrome?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is B

Explanation

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