Discuss AACN CCRN-Adult Exam Topic 2 Question 22

A patient is admitted with a femoral shaft fracture and an oblique fracture of three ribs on the right side. The patient suddenly reports shortness of breath. Assessment reveals new-onset headache, central and peripheral cyanosis, and petechiae of the neck and anterior chest wall. Available data are:

The nurse should suspect the development of

Aa pulmonary embolus.

Bsepsis.

Cacute pulmonary edema.

Da fat embolus

Suggested Answer: D

The patient's clinical presentation and recent history of femoral shaft and rib fractures are highly suggestive of a fat embolism syndrome (FES). FES typically occurs after long bone fractures and is characterized by sudden onset of respiratory distress, neurological symptoms, and petechial rash, which aligns with the new-onset headache, central and peripheral cyanosis, and petechiae of the neck and anterior chest wall observed in this patient. The fat emboli originate from the bone marrow and enter the bloodstream, traveling to the lungs and other organs, leading to respiratory and systemic symptoms. Reference: =

CCRN (Adult) Certification Review Course Online: Pulmonary Embolism and Fat Embolism.

American Association of Critical-Care Nurses (AACN). (2024). CCRN Exam Handbook. Retrieved from AACN CCRN Exam Handbook

Adult CCRN/CCRN-E/CCRN-K Certification Review Course Online. AACN

Get Premium CCRN-Adult Questions as Interactive Web-Based Practice Test or PDF Real Exam Format Detailed Explanations Instant Access Get Your Practice Test

24 comments · newest first

Sabra 2 days ago

Exactly! The headache and cyanosis support that theory.

Latrice 7 days ago

I’m leaning towards fat embolus too. It matches the timeline.

Gerald 12 days ago

Right, especially with the recent fractures.

Sabra 17 days ago

True, but the rib fractures suggest fat embolism more.

Latrice 22 days ago

But what about pulmonary embolus? It’s also a possibility.

Gerald 28 days ago

I agree, the symptoms fit. Shortness of breath and petechiae are key.

Sabra 1 month ago

This is tricky. I feel like it could be a fat embolus.

Kenneth 1 month ago

Yes, monitoring is crucial now.

Dalene 1 month ago

Definitely. We need to act fast.

Kayleigh 2 months ago

I see your point. Fat embolus makes sense.

Kenneth 2 months ago

Right, and the timing fits too.

Dalene 2 months ago

True, but the petechiae suggest fat embolism.

Kayleigh 2 months ago

But what about pulmonary embolus? Symptoms match.

Kenneth 2 months ago

I agree, especially with the rib fractures.

Dalene 2 months ago

This is tricky. I feel like it's a fat embolus.

Gracie 3 months ago

I was thinking sepsis at first, but the cyanosis is telling.

Derick 3 months ago

Definitely a pulmonary embolus, those signs are classic.

Noe 3 months ago

Wait, could it really be a fat embolus? Seems a bit quick.

Catherin 3 months ago

Totally agree, the symptoms fit!

Alease 3 months ago

Sounds like a fat embolus to me.

Gail 4 months ago

I’m torn between fat embolus and pulmonary embolus. Both can cause respiratory distress, but I feel like the rib fractures might point more towards fat embolism.

Carmelina 5 months ago

This case feels familiar. I practiced a question about fat embolism before, and I think the headache and petechiae were key indicators.

Delpha 5 months ago

I'm not entirely sure, but I think pulmonary embolism could also cause shortness of breath and cyanosis. It’s just that the rib fractures make me lean towards fat embolism.

Garry 5 months ago

I remember studying fat embolism syndrome, especially after long bone fractures. The symptoms seem to match, especially the petechiae.

AACN CCRN-Adult Exam - Topic 2 Question 22 Discussion