AACN Updated CCRN-Adult Exam Questions and Answers by xanthe

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. References: =

• 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

Given the patient's symptoms of hypotension, tachycardia, and intermittent confusion, the safest course of action is to keep the patient in bed to prevent falls and further injury. The patient is at high risk for falls due to their hemodynamic instability and altered mental status. Using a bed pan minimizes the risk of injury compared to allowing the patient to walk, which could lead to falls and worsen their condition. References: = CCRN Exam Handbook, AACN Adult CCRN Certification Review Course