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While riding a bicycle on a narrow road, the patient was hit from behind and thrown into a ditch, sustaining a pelvic fracture. What complications does the nurse know to monitor for that are common to pelvic fractures? A. Hemorrhage and shock B. Paralytic ileus and a lacerated urethra C. Paresthesia and ischemia D. Thrombophlebitis and infection

Answer: A Hemorrhage and shock are two of the most serious consequences that may occur in a pelvic fracture.

The nurse advises a 36-year-old patient who suffered a severe wrist sprain subsequent to a fall that she can begin progressive passive and active exercises in: A. 1 to 3 weeks. B. 1 month. C. 3 to 5 days. D. 24 to 48 hours.

Answer: A Depending on the severity of the injury, exercises can begin from 2 to 5 days (mild) or 1 to 3 weeks (severe). A sprain takes weeks to months to heal because tendons and ligaments are relatively avascular.

The nurse is monitoring a patient who sustained a fracture of the left hip. The nurse should be aware that which kind of shock can be a complication of this type of injury? A. Hypovolemic B. Septic C. Neurogenic D. Cardiogenic

Answer: A In a client with a pelvic fracture, the nurse should be aware of the potential for hypovolemic shock resulting from hemorrhage. Cardiogenic shock, in which the heart cannot pump enough blood to meet the body's needs, often arises from severe myocardial infarction. Neurogenic shock is often a consequence of spinal cord injury and resulting loss of sympathetic nervous system function. Septic shock results from body-wide infection.

Which factor inhibits fracture healing? A. Maximum bone fragment contact B. Local malignancy C. Exercise D. Vitamin D

Answer: B Factors that inhibit fracture healing include local malignancy, bone loss, and extensive local trauma. Factors that enhance fracture healing include proper nutrition, vitamin D, exercise, and maximum bone fragment contact.

When is it advisable for the nurse to apply heat to a sprain or a contusion? A. Do not apply at all B. After 2 days C. Immediately D. Only after a week

Answer: B It is advisable to apply heat on a sprain or a contusion 2 days after a sprain or a contusion has occurred. This is because after 2 days swelling is not likely to increase and as a result heat application reduces pain and relieves local edema by improving circulation. Delaying the application of heat prolongs the pain and increased the risk of local edema.

Radiographic evaluation of a client's fracture reveals that a bone fragment has been driven into another bone fragment. The nurse identifies this as which type of fracture? A. Impacted B. Greenstick C. Comminuted D. Compression

Answer: A An impacted fracture is one in which a bone fragment is driven into another bone fragment. A comminuted fracture is one in which the bone has splintered into several fragments. A compression fracture is one in which bone has been compressed. A greenstick fracture is one in which one side of the bone is broken, and the other side is bent.

An older adult client slipped on an area rug at home and fractured the left hip. The client is unable to have surgery immediately and is having severe pain. What interventions should the nurse provide for the patient to minimize energy loss in response to pain? A. Administer prescribed analgesics around-the-clock. B. Give pain medication to the client after providing care. C. Administer prescribed pain medication only when the client requests it. D. Avoid administering too much medication because the client is older.

Answer: A Pain associated with hip fracture is severe and must be carefully managed with around-the-clock dosing of pain medication to minimize energy loss in response to pain. The client may not request the medication even if they are in pain, and it should be offered at the prescribed time. Give pain medication prior to providing any type of care involved in moving the client.

Colles fracture occurs in which area? A. Humeral shaft B. Distal radius C. Elbow D. Clavicle

Answer: B A Colles fracture is a fracture of the distal radius (wrist). It is usually the result of a fall on an open, dorsiflexed hand.

Which nursing diagnosis takes highest priority for a client with a compound fracture? A. Impaired physical mobility related to trauma B. Infection related to effects of trauma C. Activity intolerance related to weight-bearing limitations D. Imbalanced nutrition: Less than body requirements related to immobility

Answer: B A compound fracture involves an opening in the skin at the fracture site. Because the skin is the body's first line of defense against infection, any skin opening places the client at risk for infection. Imbalanced nutrition: Less than body requirements is rarely associated with fractures. Although Impaired physical mobility and Activity intolerance may be associated with any fracture, these nursing diagnoses don't take precedence because they aren't as life-threatening as infection.

Which is a hallmark sign of compartment syndrome? A. Edema B. Pain C. Weeping skin surfaces D. Motor weakness

Answer: B A hallmark sign of compartment syndrome is pain that occurs or intensifies with passive range of motion.

A client is admitted to the emergency room after being hit by a car while riding a bicycle. The client sustained a fracture of the left femur, and the bone is protruding through the skin. What type of fracture does the nurse recognize requires emergency intervention? A. Oblique B. Greenstick C. Compound D. Spiral

Answer: C A compound fracture is a fracture in which damage also involves the skin or mucous membranes with the risk of infection great. A greenstick fracture is where one side of the bone is broken and the other side is bent; it does not protrude through the skin. An oblique fracture occurs at an angle across the bone but does not protrude through the skin. A spiral fracture twists around the shaft of the bone but does not protrude through the skin.

A client asks the nurse why his residual limb cannot be elevated on a pillow. What is the best response by the nurse? A. "Elevating the extremity may increase your chances of compartment syndrome." B. "You need to turn yourself side to side. If your leg is on a pillow, you would not be able to do that." C. "Elevating the leg might lead to a flexion contracture." D. "I am sorry. We ran out of pillows. I can elevate it on a few blankets."

Answer: C Elevating the residual limb on a pillow may lead to a flexion contracture; this could jeopardize the client's ability to use a prosthesis. The client does need to turn to both sides but might still be able to do it with the extremity elevated. Elevating the extremity would not increase the risk for compartment syndrome. The limb should not be elevated on pillows or blankets.

Which factor inhibits fracture healing? A. Increased vitamin D and calcium in the diet B. Immobilization of the fracture C. History of diabetes D. Age of 35 years

Answer: C Factors that inhibit fracture healing include diabetes, smoking, local malignancy, bone loss, extensive local trauma, age greater than 40, and infection. Factors that enhance fracture healing include proper nutrition, vitamin D and calcium, exercise, maximum bone fragment contact, proper alignment, and immobilization of the fracture.

The nurse is assessing a client's knee. The area has a grating sensation. What would this be documented as? A. Shortening B. Dislocation C. Crepitus D. False motion

Answer: C When palpation of the extremity reveals a grating sensation, this is called crepitus. It is caused by the rubbing of the bone fragments against each other. In fractures of long bones, there is actual shortening of the extremity because the contraction of the muscles that are attached distal and proximal to the site of the fracture. Abnormal movement is false motion. With dislocation of a joint, the articular surfaces of the bones forming the joint are not longer in anatomic alignment.

An x-ray demonstrates a fracture in which a bone has splintered into several pieces. Which type of fracture is this? A. Depressed B. Impacted C. Compound D. Comminuted

Answer: D A comminuted fracture may require open reduction and internal fixation. A compound fracture is one in which damage also involves the skin or mucous membranes. A depressed fracture is one in which fragments are driven inward. An impacted fracture is one in which a bone fragment is driven into another bone fragment.

A client is brought to the emergency department after being struck with a baseball bat on the upper arm while diving for a pitched ball. Diagnostic tests reveal that the humerus is not broken but that the client has suffered another type of injury. What type of injury would the physician likely diagnose? A. strain B. sprain C. subluxation D. contusion

Answer: D A contusion is a soft tissue injury resulting from a blow or blunt trauma. Sprains are injuries to the ligaments surrounding a joint. A strain is an injury to a muscle when it is stretched or pulled beyond its capacity. A subluxation is a partial dislocation.

A client with metastatic bone cancer sustained a left hip fracture without injury. What type of fracture does the nurse understand occurs without trauma or fall? A. Transverse fracture B. Impacted fracture C. Compound fracture D. Pathologic fracture

Answer: D A pathologic fracture is a fracture that occurs through an area of diseased bone and can occur without trauma or a fall. An impacted fracture is a fracture in which a bone fragment is driven into another bone fragment. A transverse fracture is a fracture straight across the bone. A compound fracture is a fracture in which damage also involves the skin or mucous membranes.

A patient sustains an open fracture with extensive soft tissue damage. The nurse determines that this fracture would be classified as what grade? A. I B. IV C. II D. III

Answer: D Open fractures are graded according to the following criteria (Schaller, 2012): Grade I is a clean wound less than 1 cm long. Grade II is a larger wound without extensive soft tissue damage or avulsions. Grade III is highly contaminated and has extensive soft tissue damage. It may be accompanied by traumatic amputation and is the most severe.

Pulselessness, a very late sign of compartment syndrome, may signify A. Nerve involvement B. Diminished arterial perfusion C. Venous congestion D. Lack of distal tissue perfusion

Answer: D Pulselessness is a very late sign that may signify lack of distal tissue perfusion. The other answers do not apply.

Which term refers to a break in the continuity of a bone? A. Fracture B. Dislocation C. Malunion D. Subluxation

Answer: A A fracture is a break in the continuity of the bone. A malunion occurs when a fractured bone heals in a misaligned position. Dislocation is a separation of joint surfaces. A subluxation is a partial separation or dislocation of joint surfaces.

A client is being discharged from the Emergency Department after being diagnosed with a sprained ankle. Which client statement indicates the client understands the discharge teaching? A. "I'll start with ice for the first couple of hours and then apply heat." B. "I'll get the prescription filled for the narcotic pain reliever." C. "I need to stay off my ankle for at least the next 3 to 4 weeks." D. "I'll make sure to keep my ankle elevated as much as possible."

Answer: D Treatment consists of applying ice or a chemical cold pack to the area to reduce swelling and relieve pain for the first 24 to 48 hours. Elevation of the part and compression with an elastic bandage also may be recommended. After 2 days, when swelling no longer is likely to increase, applying heat reduces pain and relieves local edema by improving circulation. Full use of the injured joint is discouraged temporarily, not necessarily three to four weeks. Nonsteroidal anti-inflammatory drugs (NSAIDs) are typically recommended; narcotic analgesics typically are not prescribed.

A patient sustained an open fracture of the femur 24 hours ago. While assessing the patient, the nurse observes the patient is having difficulty breathing, and oxygen saturation decreases to 88% from a previous 99%. What does the nurse understand is likely occurring with this patient? A. Fat emboli B. Cardiac tamponade C. Pneumonia D. Spontaneous pneumothorax

Answer: A After fracture of long bones or pelvic bones, or crush injuries, fat emboli frequently form. Fat embolism syndrome (FES) occurs when fat emboli cause morbid clinical manifestations. The classic triad of clinical manifestations of FES include hypoxemia, neurologic compromise, and a petechial rash (NAON, 2007), although not all signs and symptoms manifest at the same time (Tzioupis & Giannoudis, 2011). The typical first manifestations are pulmonary and include hypoxia and tachypnea.

A nurse is caring for a client who underwent a total hip replacement. What should the nurse and other caregivers do to prevent dislocation of the new prosthesis? A. Use measures other than turning to prevent pressure ulcers. B. Keep the hip flexed by placing pillows under the client's knee. C. Keep the affected leg in a position of adduction. D. Prevent internal rotation of the affected leg.

Answer: D The nurse and other caregivers should prevent internal rotation of the affected leg. However, external rotation and abduction of the hip will help prevent dislocation of a new hip joint. Postoperative total hip replacement clients may be turned onto the unaffected side. The hip may be flexed slightly, but it shouldn't exceed 90 degrees. Maintenance of flexion isn't necessary.

Which type of fracture involves a break through only part of the cross-section of the bone? A. Incomplete B. Oblique C. Comminuted D. Open

Answer: A An incomplete fracture involves a break through only part of the cross-section of the bone. A comminuted fracture is one that produces several bone fragments. An open fracture is one in which the skin or mucous membrane wound extends to the fractured bone. An oblique fracture runs across the bone at a diagonal angle of 45 to 60 degrees.

When providing discharge teaching to a client with a fractured toe, the nurse should include which instruction? A. Apply ice to the fracture site. B. Use crutches for 1 week. C. Perform ankle dorsiflexion three times per day. D. Apply heat to the fracture site.

Answer: A Applying ice to the injury site soon after an injury causes vasoconstriction, helping to relieve or prevent swelling and bleeding. Applying heat to the fracture site may increase swelling and bleeding. Ankle dorsiflexion has no therapeutic use after a toe fracture. It's unlikely the client would need crutches after a toe fracture.

A client who has sustained a fracture reports an increase in pain and decreased function of the affected extremity. What will the nurse suspect? A. Avascular necrosis B. Pulmonary embolism C. Hypovolemic shock D. Infection

Answer: A Avascular necrosis refers to the death of the bone from insufficient blood supply, typically manifested by complaints of increased pain and decreased function. Fever or redness, purulent drainage, and swelling of the site would suggest infection. Respiratory distress would suggest a pulmonary embolism. Changes in vital signs, level of consciousness, and signs and symptoms of fluid loss would suggest hypovolemic shock.

A client with a traumatic amputation of the right lower leg is refusing to look at the leg. Which action by the nurse is most appropriate? A. Provide wound care without discussing the amputation. B. Request a referral to occupational therapy. C. Provide feedback on the client's strengths and available resources. D. Encourage the client to perform range-of-motion (ROM) exercises to the right leg.

Answer: C The nurse should encourage the client to look at, and assist with, care of the residual limb. Providing feedback on the client's strengths and resources may allow the client to start to adapt to the body image and lifestyle change. The nurse should also allow time for the client to discuss their feelings related to the amputation. Requesting a referral to occupational therapy and encouraging the client to perform ROM exercises are appropriate but do not address the emotional aspect of losing an extremity.

A client reports pain in the right knee, stating, "My knee got twisted when I was going down the stairs." The client was diagnosed with an injury to the ligaments and tendons of the right knee. Which terminology, documented by the nurse, best reflects the injury? A. Dislocation B. Strain C. Subluxation D. Sprain

Answer: D A sprain is an injury to the ligaments and tendons surrounding a joint, usually caused by a wrenching or twisting motion. Dislocation refers to the separation of joint surfaces. Subluxation refers to partial separation or dislocation of joint surfaces. Strain refers to a muscle pull or tear.

A client who has injured a hip in a fall cannot place weight on the leg and is in significant pain. After radiographs indicate intact yet malpositioned bones, what repair would the physician perform? A. joint manipulation and immobilization B. heat and immobilization C. ice and immobilization D. analgesia and immobilization

Answer: A The physician manipulates the joint or reduces the displaced parts until they return to normal position, then immobilizes the joint with an elastic bandage, cast, or splint for several weeks.

Which of the following would lead a nurse to suspect that a client has a rotator cuff tear? A. Difficulty lying on affected side B. Minimal pain with movement C. Increased ability to stretch arm over the head D. Pain worse in the morning

Answer: A Clients with a rotator cuff tear experience pain with movement and limited mobility of the shoulder and arm. They especially have difficulty with activities that involve stretching their arm above their head. Many clients find that the pain is worse at night and that they are unable to sleep on the affected side.

A patient sustains a fracture of the arm. When does the nurse anticipate pendulum exercise should begin? A. As soon as tolerated, after a reasonable period of immobilization B. In 2 to 3 months, after normal activities are resumed C. In about 4 to 5 weeks, after new bone is well established D. In 2 to 3 weeks, when callus ossification prevents easy movements of bony fragments

Answer: A Many impacted fractures of the surgical neck of the humerus are not displaced and do not require reduction. The arm is supported and immobilized by a sling and swathe that secure the supported arm to the trunk (Fig. 43-10). Limitation of motion and stiffness of the shoulder occur with disuse. Therefore, pendulum exercises begin as soon as tolerated by the patient. In pendulum or circumduction exercises, the physical therapist instructs the patient to lean forward and allow the affected arm to hang in abduction and rotate. These fractures require approximately 4 to 10 weeks to heal, and the patient should avoid vigorous arm activity for an additional 4 weeks. Residual stiffness, aching, and some limitation of ROM may persist for 6 months or longer (NAON, 2007).

Which nursing intervention is essential in caring for a client with compartment syndrome? A. Removing all external sources of pressure, such as clothing and jewelry B. Starting an I.V. line in the affected extremity in anticipation of venogram studies C. Keeping the affected extremity below the level of the heart D. Wrapping the affected extremity with a compression dressing to help decrease the swelling

Answer: A Nursing measures should include removing all clothing, jewelry, and external forms of pressure (such as dressings or casts) to prevent constriction and additional tissue compromise. The extremity should be maintained at heart level (further elevation may increase circulatory compromise, whereas a dependent position may increase edema). A compression wrap, which increases tissue pressure, could further damage the affected extremity. There is no indication that diagnostic studies would require I.V. access in the affected extremity.

A fracture is considered pathologic when it A. occurs through an area of diseased bone. B. involves damage to the skin or mucous membranes. C. presents as one side of the bone being broken and the other side being bent. D. results in a fragment of bone being pulled away by a ligament or tendon and its attachment.

Answer: A Pathologic fractures can occur without the trauma of a fall. An avulsion fracture results in a fragment of bone being pulled away by a ligament or tendon and its attachment. A greenstick fracture presents as one side of the bone being broken and the other side being bent. A compound fracture involves damage to the skin or mucous membranes.

The client with a fractured left humerus reports dyspnea and chest pain. Pulse oximetry is 88%. Temperature is 100.2 degrees Fahrenheit (38.5 degrees Centigrade); heart rate is 110 beats per minute; respiratory rate is 32 breaths per minute. The nurse suspects the client is experiencing: A. Fat embolism syndrome B. Compartment syndrome C. Complex regional pain syndrome D. Delayed union

Answer: A The clinical manifestations described in the scenario are characteristic of fat embolism syndrome.

A client has had surgical repair of a hip injury after joint manipulation was unsuccessful. After surgery, the nurse implements measures to prevent complications. Which complications is the nurse seeking to prevent? Select all that apply. A. skin breakdown B. pneumonia C. wound infection D. diarrhea

Answer: A, B, C After surgery, the nurse implements measures to prevent skin breakdown, wound infection, pneumonia, constipation, urinary retention, muscle atrophy, and contractures.

A 75-year-old client had surgery for a left hip fracture yesterday. When completing the plan of care, the nurse should include assessment for which complications? Select all that apply. A. Delirium B. Sepsis C. Necrosis of the humerus D. Pneumonia E. Skin breakdown

Answer: A, B, D, E Complications in clients with hip fractures are often related to the client's age. During the first 24 to 48 hours following surgery for hip fracture, atelectasis or pneumonia can develop as a result of the anesthesia. Thromboemboli are possible, as is sepsis. Elderly clients are also at risk for delirium in hospital settings because of the stress of the trauma, unfamiliar surroundings, sleep deprivation, and medications. An elderly client with decreased mobility is at risk for skin breakdown. Necrosis is a potential complication of the surgery, but the complication would be with the femur, not the humerus.

A nurse is caring for a client who has had an amputation. What interventions can the nurse provide to foster a positive self-image? (Select all that apply.) A. Introducing the client to local amputee support groups B. Encouraging the client to have family and friends view the residual limb to decrease self-consciousness C. Encouraging the client to care for the residual limb D. Allowing the client to express grief E. Encouraging family and friends to refrain from visiting temporarily because this may increase the client's embarrassment

Answer: A, C, D The nurse helps the client set realistic rehabilitation goals and encourages the client to be an active participant in self-care. The nurse creates an accepting and supportive atmosphere in which the patient and family are encouraged to express and share their feelings and work through the grieving process; support from family and friends promotes the patient's acceptance of the loss. Mental health and support group referrals may be appropriate. Although the nurse supports the client in coming to terms with the appearance and function of the residual limb, and in sharing feelings about the amputation with family and friends, viewing of the residual limb by family and friends is not a priority and may not be helpful for the client's well-being.

The type of fracture described as having one side of the bone broken and the other side bent would be: A. spiral. B. greenstick. C. transverse. D. oblique.

Answer: B A greenstick fracture is the type of fracture described as having one side of the bone broken and the other side bent. An oblique fracture occurs at an angle across the bone. A spiral fracture is a fracture that twists around the shaft of the bone. A transverse fracture is a fracture that is straight across the bone.

A client has been diagnosed with a muscle strain. What does the physician mean with the term "strain"? A. injuries to ligaments surrounding a joint B. stretched or pulled beyond its capacity C. subluxation of a joint D. injury resulting from a blow or blunt trauma

Answer: B A strain is an injury to a muscle when it is stretched or pulled beyond its capacity.

An important nursing assessment, post fracture, is to evaluate neurovascular status. Therefore, the nurse should check for: A. Crepitus. B. Capillary refill. C. Swelling and discoloration. D. Shortening and deformity.

Answer: B Assessment for neurovascular impairment includes checking for weak pulses or delayed capillary refill (normal is <2 seconds).

Elderly clients who fall are most at risk for which injuries? A. Wrist fractures B. Pelvic fractures C. Humerus fractures D. Cervical spine fractures

Answer: B Elderly clients who fall are most at risk for pelvic and lower extremity fractures. These injuries are devastating because they can seriously alter an elderly client's lifestyle and reduce functional independence. Wrist fractures usually occur with falls on an outstretched hand or from a direct blow. Such fractures are commonly found in young men. Humerus fractures and cervical spine fractures aren't age-specific.

A client undergoes a total hip replacement. Which statement made by the client indicates to the nurse that the client requires further teaching? A. "I need to remember not to cross my legs. It's such a habit." B. "I don't know if I'll be able to get off that low toilet seat at home by myself." C. "I'll need to keep several pillows between my legs at night." D. "The occupational therapist is showing me how to use a sock puller to help me get dressed."

Answer: B The client requires additional teaching if he is concerned about using a low toilet seat. To prevent hip dislocation after a total hip replacement, the client must avoid bending the hips beyond 90 degrees. The nurse should instruct the client to use assistive devices, such as a raised toilet seat, to prevent severe hip flexion. Using an abduction pillow or placing several pillows between the legs reduces the risk of hip dislocation by preventing adduction and internal rotation of the legs. Teaching the client to avoid crossing the legs also reduces the risk of hip dislocation. A sock puller helps a client get dressed without flexing the hips beyond 90 degrees.

Which type of fracture is one in which the skin or mucous membrane wound extends to the fractured bone? A. Simple B. Complete C. Compound D. Incomplete

Answer: C A compound fracture is one in which the skin or mucous membrane wound extends to the fractured bone. A complete fracture involves a break across the entire cross section of the bone and is frequently displaced. An incomplete fracture involves a break through only part of the cross section of the bone. A simple fracture is one that does not cause a break in the skin.

Which of the following is a term used to describe a soft tissue injury produced by a blunt force? A. Sprain B. Hematoma C. Contusion D. Strain

Answer: C A contusion is a soft tissue injury produced by blunt force, such as a blow, kick, or fall, that results in bleeding into soft tissues (ecchymosis, or bruising). A hematoma develops when the bleeding is sufficient to form an appreciable solid swelling. A strain, or a "pulled muscle," is an injury to a musculotendinous unit caused by overuse, overstretching, or excessive stress. A sprain is an injury to the ligaments and supporting muscle fibers that surround a joint often caused by a trauma, wrenching or twisting motion.

A client undergoes open reduction with internal fixation to treat an intertrochanteric fracture of the right hip. The nurse should include which intervention in the postoperative care plan? A. Maintaining the client in semi-Fowler's position B. Performing passive range-of-motion (ROM) exercises on the client's legs once each shift C. Keeping a pillow between the client's legs at all times D. Turning the client from side to side every 2 hours

Answer: C After open reduction with internal fixation, the client must keep the affected leg abducted at all times; placing a pillow between the legs reminds the client not to cross the legs and to keep the leg abducted. Passive or active ROM exercises shouldn't be performed on the affected leg during the postoperative period, because this could damage the operative site and cause hip dislocation. Most clients should be turned to the unaffected side, not from side to side. After open reduction with internal fixation, the client must avoid acute flexion of the affected hip to prevent possible hip dislocation; therefore, semi-Fowler's position should be avoided.

Which nursing intervention is appropriate for a client with a closed-reduction extremity fracture? A. Promote intake of omega-3 fatty acids B. Administer prescribed enema to prevent constipation C. Encourage participation in ADLs D. Use frequent dependent positioning to prevent edema

Answer: C General nursing measures for a client with a fracture reduction include administering analgesics, providing comfort measures, encouraging participation with ADLs, promoting physical mobility, preventing infection, maintaining skin integrity, and preparing the client for self-care. Omega-3 fatty acids have no implications on the diet of a client with a fracture reduction. Dependent positioning may increase edema because the extremity is below the level of the heart. While some pain medications may contribute to constipation, this intervention would be reserved for a client experiencing constipation and not as a preventative measure.

A client who has suffered a compound fracture is preparing for discharge to home. During the teaching session, the client asks why he needs antibiotics for a broken bone. Which response by the nurse is most appropriate? A. "You may discuss your prescriptions with your physician at your follow-up appointment." B. "The antibiotics will help the bone to heal." C. "Antibiotic therapy has been prescribed as a precaution because your bone was exposed to the environment at the time of your injury." D. "If your temperature is normal for 48 hours, you may discontinue the medication."

Answer: C The nurse should tell the client that antibiotics are prescribed as a preventive measure for a client with a compound fracture because such fractures expose the bone to the environment and possible infection. Telling the client to discuss his medications with the physician at his follow-up appointment doesn't address the client's questions or immediate needs. The client needs this medication regardless of his body temperature. Antibiotics don't help a bone fracture to heal.

The nurse caring for a client, who has been treated for a hip fracture, instructs the client not to cross their legs and to have someone assist with tying their shoes. Which additional instruction should the nurse provide to client? A. Do not flex the hip more than 60 degrees. B. Do not flex the hip more than 120 degrees. C. Do not flex the hip more than 30 degrees. D. Do not flex the hip more than 90 degrees.

Answer: D Proper alignment and supported abduction are encouraged for hip repairs. Flexion of the hip more than 90 degrees can cause damage to the a repaired hip fracture.

A 14-year-old client is treated in the emergency room for an acute knee sprain sustained during a soccer game. The nurse reviews discharge instructions with the client's parent. The nurse instructs the parent that the acute inflammatory stage will last how long? A. 4 to 5 days B. At least 7 days C. 3 to 4 days D. 24 to 48 hours

Answer: D Rest and ice applications during the first 24 to 48 hours produce vasoconstriction while decreasing bleeding and edema. After this time, the acute inflammatory stage decreases.

A client who was injured while playing basketball reports an extremely painful elbow, which is very edematous. What type of injury has the client experienced? A. strain B. contusion C. All options are correct. D. sprain

Answer: D Sprains are injuries to the ligaments surrounding a joint. A strain is an injury to a muscle when it is stretched or pulled beyond its capacity. A contusion is a soft tissue injury resulting from a blow or blunt trauma. Sprains are injuries to the ligaments surrounding a joint.

A client with arterial insufficiency undergoes below-knee amputation of the right leg. Which action should the nurse include in the postoperative care plan? A. Removing the pressure dressing after the first 8 hours B. Maintaining the client on complete bed rest C. Applying heat to the stump as the client desires D. Elevating the stump for the first 24 hours

Answer: D Stump elevation for the first 24 hours after surgery helps reduce edema and pain by increasing venous return and decreasing venous pooling at the distal portion of the extremity. Bed rest isn't indicated and could predispose the client to complications of immobility. Heat application would be inappropriate because it promotes vasodilation, which may cause hemorrhage and increase pain. The initial pressure dressing usually remains in place for 48 to 72 hours after surgery.

A client who plays tennis is experiencing elbow discomfort. Following assessment, the client receives a diagnosis of tendinitis, epicondylitis, or tennis elbow. What symptoms and signs did the client have? Select all that apply. A. weak grasp B. pain more prominent at night C. pain or burning in one or both hands D. pain radiating down the dorsal surface of the forearm

Answer: D, A Tennis elbow is characterized by pain radiating down the dorsal surface of the forearm and weak grasp. Carpal tunnel syndrome is characterized by pain or burning in one or both hands and pain more prominent at night.