Which question is crucial for a nurse to ask a client with an open leg fracture?

Asking about the last tetanus vaccine is crucial for a client with an open leg fracture because open fractures expose the wound to the external environment, increasing the risk of infection, particularly from tetanus, which is caused by the bacterium Clostridium tetani that can enter the body through open wounds. Tetanus is a serious and potentially fatal condition, and the wound’s exposure heightens the need for adequate immunization.

For a patient with an open fracture, ensuring that they are up-to-date with their tetanus vaccinations is vital for preventing tetanus infection and managing the patient's overall health during treatment. If the patient is due for a tetanus booster – typically every ten years – or if they have not had one within the last five years and the injury is particularly severe, administering a tetanus booster would be a critical step in the plan of care.

Questions regarding previous medical tests, such as a tuberculin test or chest x-ray, or inquiring about the last physical examination, while relevant in some contexts, do not address the immediate concern of infection risk from the open fracture. Therefore, focusing on the tetanus vaccine aligns with safe and effective management of the patient’s fracture and overall health.