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NCLEX · Basic Care and Comfort

A nurse is caring for a client in a cast who reports severe, unrelenting pain, numbness, and the affected extremity is pale and cool. What complication should the nurse suspect?

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Correct answer

Compartment syndrome (a medical emergency)

  1. A Mild swelling
  2. B Normal cast discomfort
  3. C Improved circulation
  4. D Compartment syndrome (a medical emergency)

Why this is the answer

These findings (severe unrelenting pain out of proportion, numbness/tingling, pallor, coolness, and possibly pulselessness) suggest COMPARTMENT SYNDROME — a MEDICAL EMERGENCY where increased pressure within a muscle compartment compromises circulation and can cause permanent tissue/nerve damage or limb loss. NCLEX physiological/musculoskeletal. THE 6 P's: Pain (severe, unrelieved by analgesics, worse with passive stretch), Paresthesia (numbness/tingling), Pallor, Pulselessness, Paralysis, Poikilothermia (coolness).

Interventions: notify the provider IMMEDIATELY; do NOT elevate the extremity above heart level (can reduce arterial flow) — keep at heart level; loosen/remove constrictive dressings or the cast may need bivalving; prepare for possible fasciotomy. Recognizing compartment syndrome (the 6 P's) as an emergency is a heavily tested NCLEX concept.

Source: NCLEX Physiological — Compartment Syndrome

Practice more questions

This question is from our NCLEX Practice Tests practice test. Take the full practice test to test your knowledge across all Basic Care and Comfort and other topics.

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About this topic: Basic Care and Comfort

Basic care and comfort questions cover mobility, positioning, nutrition, elimination, hygiene, sleep and comfort measures, and the assistive devices and complementary therapies that support them. This is one of 6 RN: Physiological Integrity questions on basic care and comfort, each with a full explanation on a single study page.

New to this exam? Our NCLEX exam guide explains the format, scoring, and how to prepare.

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