Question 57 - Coordinated Care Practice Test for the NCLEX-PN Exam

Intro to Case

The nurse is caring for a 20-year-old female client admitted to the orthopedic trauma floor yesterday after a motor vehicle accident. The client sustained a right tibia/fibula fracture and has two fractured ribs on the right side. She had open reduction and internal fixation (ORIF) surgery last night to repair her tibia/fibula fracture and is now in a cast from above the knee to the toes.

Nurse’s Notes

0930: Client called nurse to bedside to report 5/10 pain in her right leg and describes it as “aching.” She states the pain increases when she tries to move her leg or wiggle her toes. Client is requesting more pain medication. Last oxycodone given at 0800, so acetaminophen 650 mg given and repositioned client in bed.

1000: Nurse at bedside to help UAP with bed bath. Client states, “It feels like my toes are burning and my leg feels tingly and really tight, is that normal?” Nurse assessed client’s right leg and toes appear slightly purple and more swollen then assessment at 0800. Client states pain is now 8/10, and increases if she attempts to pick up her leg off the bed. Client states, “it hurts now more than it did before I had surgery.”

Vital Signs