Difficulty: Medium
Average Score: 93%
Simulated
Passage / Scenario
A 6-year-old patient who has been placed in skeletal traction has pain, edema, and fever.A 6-year-old patient who has been placed in skeletal traction has pain, edema, and fever. The nurse should assess which of the following?
Correct answer
C
Rationale
The correct answer is C: Warmth at site of pain. Pain, edema, and fever in a patient in skeletal traction can indicate infection. Assessing warmth at the site of pain is crucial as it can be a sign of inflammation or infection. Increased warmth may indicate an inflammatory response or localized infection. Assessing neurologic status (choice A) is important in other situations, but in this case, addressing the infection should be the priority. Range of motion (choice B) is less relevant as the primary concern is identifying and managing the infection. Blood pressure (choice D) is not directly related to the current symptoms and should not be the priority in this case.