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    PN Comprehensive Predictor 2023 Proctored Exam

    A nurse is assisting with the care of a client on an orthopedic unit. Drag words from the choices below to fill in each blank in the following sentence. The client is at risk for developing dropdownanddropdown

    Explanation & Rationale

    Rationale for correct choices: • Compartment syndrome: The client demonstrates classic neurovascular compromise: severe escalating pain, numbness, inability to move toes, cool extremity, absent distal pulses, delayed capillary refill, and increasing edema. These findings reflect increased intracompartmental pressure compromising circulation and nerve function. This is a limb-threatening postoperative emergency following fractures and splinting. • Osteomyelitis: The client has an open fracture with internal fixation, drainage at the surgical site, fever, and a marked rise in WBC count. Open fractures significantly increase the risk of bone infection due to direct contamination. Persistent fever and leukocytosis support developing osteomyelitis rather than normal postoperative inflammation. Rationale for incorrect choices: • Fat embolism syndrome: Fat embolism typically presents with acute respiratory distress, hypoxemia, altered mental status, and petechial rash. This client maintains adequate oxygen saturation and denies shortness of breath, making this condition less likely at this time. • Deep vein thrombosis: DVT commonly presents with unilateral calf pain, warmth, erythema, and swelling, but does not cause absent pulses, motor loss, or sensory deficits. The acute neurovascular changes seen here point to arterial compromise rather than venous obstruction.

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