NURS 272 EXAM 4 QUESTIONS & 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 - Answer -- 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 - Answer -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 treat
inflammatory lung reactions and control cerebral edema.
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 - Answer -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 - Answer -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." -
Answer -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 client is
instructed to avoid long periods of rest because it promotes joint stiffness.
The nurse is providing dietary instructions to the client with systematic lupus
erythematous. Which of the following dietary items would the nurse instruct the client to
avoid?
-A. Cantaloupe
-B. Broccoli
-C. Turkey
-D. Steak - Answer -D
-The client with systemic lupus erythematous is at risk for cardiovascular disorders such
as coronary artery disease and hypertension. The client is advised of lifestyle changes
to reduce these risks, which include smoking cessation and prevention of obesity and
hyperlipidemia. The client is advised to reduce salt, fat, and cholesterol intake.
A client who experiences a spinal cord injury at the level of T5 rings the call bell for
assistance. Upon entering the room, the nurse finds the client to have a flushed head
and neck, complaining of severe headache, and being diaphoretic. The pulse is 47 and
the BP is 220/114 mm Hg. The nurse concludes that immediate treatment is needed for
-A. malignant hypertension.
-B. pulmonary embolism.
-C. autonomic dysreflexia.
-D. spinal shock. - Answer -C
-Above the level of T6, clients with spinal cord injury are at risk for autonomic
dysreflexia. It is a life-threatening syndrome triggered by a noxious stimulus below the
level of the injury. This complication is characterized by severe, throbbing headache,
flushing of the face and neck, bradycardia, and sudden severe hypertension (option C).
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 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 - Answer -- 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 - Answer -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 treat
inflammatory lung reactions and control cerebral edema.
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 - Answer -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 - Answer -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." -
Answer -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 client is
instructed to avoid long periods of rest because it promotes joint stiffness.
The nurse is providing dietary instructions to the client with systematic lupus
erythematous. Which of the following dietary items would the nurse instruct the client to
avoid?
-A. Cantaloupe
-B. Broccoli
-C. Turkey
-D. Steak - Answer -D
-The client with systemic lupus erythematous is at risk for cardiovascular disorders such
as coronary artery disease and hypertension. The client is advised of lifestyle changes
to reduce these risks, which include smoking cessation and prevention of obesity and
hyperlipidemia. The client is advised to reduce salt, fat, and cholesterol intake.
A client who experiences a spinal cord injury at the level of T5 rings the call bell for
assistance. Upon entering the room, the nurse finds the client to have a flushed head
and neck, complaining of severe headache, and being diaphoretic. The pulse is 47 and
the BP is 220/114 mm Hg. The nurse concludes that immediate treatment is needed for
-A. malignant hypertension.
-B. pulmonary embolism.
-C. autonomic dysreflexia.
-D. spinal shock. - Answer -C
-Above the level of T6, clients with spinal cord injury are at risk for autonomic
dysreflexia. It is a life-threatening syndrome triggered by a noxious stimulus below the
level of the injury. This complication is characterized by severe, throbbing headache,
flushing of the face and neck, bradycardia, and sudden severe hypertension (option C).
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?
