NURS 272 Exam 4 Questions and Correct Answers

NURS 272 Exam 4 Questions and Correct Answers A client with a fractured femur experiences sudden dyspnea. A set of arterial blood gas tests reveal the following: pH 7.35, PaCO2 88, PaO2 58, HCO3 - 23. A nurse interprets that the client probably has experienced a fat embolus because of the result of the -A. PaCo2. -B. PaO2. -C. HCO3. -D. pH ✅- PaO2 A key feature of fat embolism is a significant degree of hypoxemia with a PaO2 often less than 60 mm Hg. A client with a fat embolism is experiencing respiratory distress. The nurse plans to assist with which of the following therapies? -A. Administration of bronchodilators, intubation, and mechanical ventilation -B. Administration of plasma expanders, low -flow oxygen, and suctioning -C. Administration of corticosteroids, intubation, and mechanical ventilation with positive end-expiratory pressure -D. Administration of antihypertensives, high -flow oxygen, and continuous positive airway pressure mask ✅C - Respiratory failure is the most common cause of death after fat embolus. The client may be intubated and mechanically ventilated with positive end -expiratory pressure to treat the significant hypoxemia and pulmonary edema. Corticosteroids are given to tr eat inflammatory lung reactions and control cerebral edema. A nurse is caring for a client being treated for fat embolus after multiple fractures. Which of the following data would the nurse evaluate as the most favorable indication of resolution of the fat embolus? -A. Arterial oxygen level of 78 mm Hg -B. Minimal dyspnea -C. Clear chest radiograph -D. Oxygen saturation of 85% ✅C - A clear chest radiograph is a good indicator that the fat embolus is resolving. When fat embolism occurs, the chest radiograph has a "snowstorm" appearance. Eupnea, not minimal dyspnea, is a normal sign. Arterial oxygen levels should be 80 to 100 mm Hg. Oxygen saturation should be greater than 95%. A nurse is caring for a client who develops compartment syndrome from a severely fractured arm. The client asks the nurse how this can happen. The nurse's best response is based on the understanding that -A. an injured artery causes impaired arterial perfusion through the compartment. -B. the fascia expands with injury, causing pressure on underlying nerves and muscles. -C. a bone fragment has injured the nerve supply in the area. -D. bleeding and swelling cause increased pressure in an area that cannot expand. ✅D -Compartment syndrome is caused by bleeding and swelling within a compartment, which is lined by fascia and does not expand. The bleeding and swelling put pressure on the nerves, muscles, and blood vessels in the compartment, triggering the symptoms. A nurse has conducted teaching with a client in an arm cast about the signs and symptoms of compartment syndrome. The nurse determines that the client understands the information if the client stated that he or she should report which of the following early symptoms of compartment syndrome? -A. Pain that is relieved only by oxycodone and aspirin (Percodan) -B. Pain that increases when the arm is dependent -C. Cold, bluish -colored fingers -D. Numbness and tingling in the fingers ✅D -The earliest symptom of compartment syndrome is paresthesia (numbness and tingling in the fingers). Other symptoms include pain unrelieved by narcotics, pain that increases with limb elevation, and pallor and coolness to the distal limb. Cyanosis is a late sign. A client is suspected of having systemic lupus erythematous. The nurse monitors the client, knowing that which of the following is a characteristic sign of systemic lupus erythematous? -A. Rash on the face across the bridge of the nose and on the cheeks -B. Fatigue -C. Fever -D. Elevated red blood cell count ✅A -Skin lesions or rash on the face across the bridge of the nose and on the cheeks is a characteristic sign of systemic lupus erythematous (SLE). Fever and fatigue may occur potentially before and during exacerbation. Anemia is most likely to occur in SLE The nurse provides home care instructions to a client with systemic lupus erythematous and tells the client about the methods to manage fatigue. Which statement by the client indicates a need for further instructions? -A. "I should avoid long periods of rest." -B. "I should sit whenever possible." -C. "I should take a hot bath in the evening." -D. "I should do a moderate amount of low -impact exercises when I am not fatigued." ✅C -To help reduce fatigue in the client with systemic lupus erythematous, the nurse should instruct the client to sit whenever possible, to avoid hot baths, to schedule moderate low-impact exercises when not fatigued, and to maintain a balanced diet. The cli ent is instructed to avoid long periods of rest because it promotes joint stiffness.