Olympic gymnast Ms. Slovenski sufferd a great fall and suffered a great fall and fractured her femur. Approximately after 20 hours in the hospital she became dyspneic, tachypneic, and with scattered crackles in her lung fields. She is coughing up large amounts of thick, white sputum. The nurse correctly interprets this as:

Correct Answer: C

Rationale: The symptoms described in the scenario - dyspnea, tachypnea, crackles in lung fields, and coughing up thick, white sputum - are indicative of fat embolism syndrome (FES), which occurs as a complication of long bone fractures like the femur fracture in this case. FES is characterized by the release of fat droplets into the bloodstream, which can then travel to the lungs and cause respiratory distress. The onset of symptoms typically occurs within 24-72 hours after the initial injury, making it a likely cause for Ms. Slovenski's condition. This is a medical emergency that requires prompt recognition and intervention to prevent further complications. The other options (A, B, and D) do not align with the clinical picture presented in the scenario and are less likely causes of her current symptoms.

Correct Answer: A

Rationale: An ileostomy is a surgical procedure that involves creating a stoma from the ileum (part of the small intestine) to the abdominal wall, allowing waste to bypass the colon and exit the body through the stoma into a pouch worn on the outside of the body. Therefore, it is important for Nurse Beverly to inform Ian that his stool output will be collected in a pouch following the surgery. Option A is the correct choice as it directly relates to the postoperative care and management specific to an ileostomy procedure.

Correct Answer: A

Rationale: Mrs. Go, who is suspected of experiencing respiratory distress from a left-sided pneumothorax, should be positioned in a semi-fowler's position. This position involves elevating the head of the bed to approximately 30 to 45 degrees. Placing the patient in a semi-fowler's position helps improve lung expansion, facilitates breathing, and promotes optimal oxygenation. It can also help prevent the collapse of the affected lung and assist in reducing the symptoms associated with pneumothorax. Trendelenburg position (B) and prone position (C) are not recommended for pneumothorax as they can worsen the condition by putting additional pressure on the affected lung. Placing the patient on the right side (D) would not specifically address the respiratory distress caused by a left-sided pneumothorax. Therefore, the most appropriate position for Mrs. Go in this situation is the semi-fowler's position.

Correct Answer: A

Rationale: A client with the syndrome of inappropriate antidiuretic hormone (SIADH) retains water excessively due to overproduction of antidiuretic hormone (ADH). This leads to dilutional hyponatremia, resulting in decreased serum sodium levels. Hyponatremia is a hallmark laboratory finding in patients with SIADH. Other laboratory values you might see in SIADH include decreased serum osmolality, concentrated urine with a high sodium concentration, and normal renal function tests such as BUN and creatinine. Therefore, the most anticipated laboratory test result in a client with SIADH is a decreased serum sodium level.

Correct Answer: C

Rationale: Oral antidiabetic agents are medications designed specifically for the management of type 2 diabetes mellitus. They work by improving insulin sensitivity, increasing insulin production, or reducing glucose production in the liver. Type 1 diabetes mellitus is characterized by an absolute deficiency of insulin production, requiring lifelong insulin therapy. Therefore, oral antidiabetic agents are not effective for individuals with type 1 diabetes like the client in this scenario.