Chapter 62 MS

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An adult is swinging a small child by the arms, and the child screams and grabs his left arm. It is determined in the emergency department that the radial head is partially dislocated. What is this partially dislocated radial head documented as? A) V olkmann's contracture B) Subluxation C) Compartment syndrome D) Sprain

B) Subluxation

A client is a passenger in a vehicle that was hit in the rear by another vehicle. The client is complaining of pain in the neck from the head rapidly moving forward and then back against the headrest. What type of injury does the nurse suspect the client sustained in the accident? A) Strain B) Avulsion fracture C) Whiplash injury D) Contusion

C) Whiplash injury

A client sustains an injury to the left ankle when he fell down three steps. There was immediate swelling and pain from the injury, and the client was taken to the local emergency department. What initial test does the nurse anticipate the physician will order to rule out a fracture? A) Arthrography B) Arthroscopy C) X-ray D) Computerized tomography (CT scan)

C) X-ray

When caring for a client with a fracture, assessment of which of the following would be the priority? A. Neurovascular compromise B. Hormonal imbalances C. Cardiac problems D. Altered kidney function

A. Neurovascular compromise

A client had a dislocated shoulder, and when healing, the client had insufficient deposits of collagen during the repair stage. What complication is the nurse aware can occur from this lack of collagen? A) Carpal tunnel syndrome B) Compartment syndrome C) V olkmann's contracture D) Recurrent dislocations

D) Recurrent dislocations

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) Impacted fracture B) Transverse fracture C) Compound fracture D) Pathologic fracture

D) Pathologic fracture

The nurse is preparing to assess Phalen's sign. Which of the following would the nurse identify as indicative of a positive indicator for this sign? A) Percussion of the median nerve causes tingling and numbness. B) Wrist flexion for 30 seconds causes pain and numbness. C) Electrical stimulation shows a delay in motor responses. D) Shaking hands causes a reduction in the pain.

B) Wrist flexion for 30 seconds causes pain and numbness

A patient has sustained a left femur fracture in a skiing accident. When is the nurse aware that the complication of a fat emboli typically occurs and should be monitored for closely? A) The first hour after fracture of the long bone B) 8 to 12 hours C) 12 to 24 hours D) 48 to 72 hours

D) 48 to 72 hours

A client comes to the clinic 2 days after sustaining a sprain to the left ankle. What intervention can the nurse encourage the client to perform that will help improve circulation? A) Active range-of-motion exercises B) Take nonsteroidal anti-inflammatory drugs C) Applying cold compresses D) Applying heat

D) Applying heat

A client suffered a subtrochanteric hip fracture after falling out of the bed. What complication should the nurse monitor closely for related to this type of fracture? A) Pulmonary edema B) Abdominal pain C) Urinary retention D) Hypovolemic shock

D) Hypovolemic shock

A client has a history of dislocations of the same joint. The nurse understands that this is most likely due to an insufficient deposit of collagen during the healing process leading to which of the following? A. Loss of function B. Allergic reaction C. Lack of mobility D. Reduced tensile strength

D. Reduced tensile strength

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) Avoid administering too much medication because the client is older. C) Administer prescribed pain medication only when the client requests it. D) Give pain medication to the client after providing care.

A) Administer prescribed analgesics around-the-clock.

A client sustains a fractured right humerus in an automobile accident. The arm is edematous, the client states that he cannot feel or move his fingers, and the nurse does not feel a pulse. What condition should the nurse be concerned about that requires emergency measures? A) Compartment syndrome B) Dislocation C) Muscle spasms D) Subluxation

A) Compartment syndrome

A client arriving at the emergency department is diagnosed with a dislocation. Assessment would most likely reveal which of the following? SATA. A) Complaint of a popping sound B) Protrusion in the area of the dislocation C) Swelling D) Pain E) Area warm to touch

A) Complaint of a popping sound C) Swelling D) Pain

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) Compound B) Greenstick C) Oblique D) Spiral

A) Compound

A client has delayed bone healing in a fractured right humerus. What should the nurse prepare the client for that promotes bone growth? A) Electrical stimulation B) Administration of low-dose heparin C) Joint fusion D) Administration of antibiotics

A) Electrical stimulation

A patient has had surgery to repair a fractured hip. What intervention is important for the nurse to perform when turning the client from side to side? A) Place abductor pillows between the legs. B) Place pillows between the legs. C) Have the client pull on the side rails when turning. D) Place a pillow under the hips.

A) Place abductor pillows between the legs.

A client sustained a sprained ankle while skiing, and the physician ordered RICES. What will the nurse inform the client to do related to the physician's order upon discharge? A) Rest, ice, compression, elevation, stabilization B) Rest, inflammation, compression, elevation, stabilization C) Rate the pain, increase activity, compression, elevation, stop skiing D) Range of motion, ice, circulation, elevation, steroids

A) Rest, ice, compression, elevation, stabilization

A client is diagnosed with a first-degree strain of the left ankle related to running 5 miles daily. How would the nurse differentiate the first-degree strain from other strains and sprains? A) The client has some edema of the left ankle with muscle spasms but is able to walk without assistive devices. B) The client is unable to bear weight on the left ankle and has a large ecchymotic area. C) The client has ecchymosis, edema, and has no function of the left foot and ankle. D) The client complains of pain when the joint is moved and has mild edema.

A) The client has some edema of the left ankle with muscle spasms but is able to walk without assistive devices.

A client arrives in the emergency room complaining of severe pain in her left hip after falling out of the bed. What indication upon assessment does the nurse recognize as a dislocated left hip? SATA A) The left leg is shorter than the right. B) Limited range of motion of the left hip. C) The skin over the left hip is warm. D) The skin of the lower left leg is pale. E) The client is able to bend the knee but not move toes.

A) The left leg is shorter than the right. B) Limited range of motion of the left hip. D) The skin of the lower left leg is pale.

A client was playing softball and was hit in the right ankle by the ball sustaining a contusion. What is the first action taken to help alleviate pain and swelling? A) Apply heat to the ankle. B) Apply a cold pack to the ankle. C) Administer ibuprofen (Advil). D) Ask the client to walk to stretch the ligaments.

B) Apply a cold pack to the ankle.

A client comes to the emergency department complaining of localized pain and swelling of his lower leg. Ecchymotic areas are noted. History reveals that the client got hit in the leg with a baseball bat. Which of the following would the nurse suspect as most likely? A) Fracture B) Contusion C) Sprain D) Strain

B) Contusion

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

B) Difficulty lying on affected side

The nurse is assisting with an examination of a client suspected of having carpal tunnel syndrome. The physician has the patient flex the wrist for 30 seconds and percusses the median nerve. The client complains of pain and numbness when this is done. What does the nurse know this positive sign is documented as? A) Tinel's sign B) Phalen's sign C) Crepitus D) Spasm

B) Phalen's sign

A client has been prescribed nonsteroidal anti-inflammatory medications for treatment of carpal tunnel syndrome. What should the nurse be sure to include when educating the client about taking this medication? A) Take the medication on an empty stomach to assist in faster absorption. B) Take the medication with food. C) The medication may cause drowsiness, so do not operate machinery or drive a vehicle. D) The dosage may be exceeded if pain is not relieved by the prescribed dose.

B) Take the medication with food.

The nurse is required to design a teaching plan for a client with a ruptured Achilles tendon. Which of the following would the nurse emphasize? A. Dietary restrictions B. Activity restrictions C. Use of nonprescription medications D. Effective pin care

B. Activity restrictions

The nurse is caring for a client who was involved in an automobile accident and sustained multiple trauma. The client has a Volkmann's contracture to the right hand. What objective data does the nurse document related to this finding? A) Extension of the fingers of the right hand B) Nodules on the knuckles of the third and fourth finger C) Clawlike deformity of the right hand without ability to extend fingers D) Dislocation of the fingers

C) Clawlike deformity of the right hand without ability to extend fingers

A professional tennis player comes to the orthopedic clinic and informs the nurse that he is having pain that radiates down the forearm and is unable to grasp the racket firmly. What does the nurse suspect is occurring with the client? A) Carpal tunnel syndrome B) Ganglion cyst C) Epicondylitis D) Shoulder dislocation

C) Epicondylitis

A client with a fracture develops compartment syndrome that requires surgical intervention. The nurse would most likely prepare the client for which of the following? A) Bone graft B) Joint replacement C) Fasciotomy D) Amputation

C) Fasciotomy

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) Comminuted B) Compression C) Impacted D) Greenstick

C) Impacted

A client is diagnosed with carpal tunnel syndrome. Which of the following assessment findings would the nurse expect? A) Pain radiating down the dorsal surface of the forearm B) Tenderness in the affected wrist C) Inability to flex index and middle fingers D) A decrease in grasp strength

C) Inability to flex index and middle fingers

The nurse is demonstrating how to perform range-of-motion (ROM) exercises for a patient with tendinitis of the wrist. What intervention can the nurse encourage the client to use in order to decrease discomfort when performing the exercises? A) Perform the exercises when using hand weights. B) Perform the exercises and then take pain medication. C) Perform the exercises with the hand and wrist under warm water. D) Perform the exercises after icing the hand and wrist.

C) Perform the exercises with the hand and wrist under warm water.

A client arrives at the orthopedic clinic and informs the nurse that he thinks he has another stress fracture of the right foot. The physician orders an x-ray with negative results. What does the nurse understand that these negative results can mean? A) The client does not have a stress fracture. B) The client probably has a strain. C) The stress fracture may not be seen on x-ray for a few weeks. D) The physician may have misread the x-ray.

C) The stress fracture may not be seen on x-ray for a few weeks.

A client suffered a fractured femur during a football game. The client asks how long until the bone is back to its former structural strength. What should the client be informed? A) 3 months B) 6 months C) 9 months D) 12 months

D) 12 months


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