Fractures

4 Ans: 4 As charge nurse, you must assess the performance and attitude of the staff in relation to this client. After data are gathered from the nurses, additional information can be obtained from the records and the client as necessary. The educator may be of assistance if a knowledge deficit or need for performance improvement is the problem. Focus: Supervision, prioritization

1. You are initiating a nursing care plan for a patient with osteoporosis. All of these nursing interventions apply to the nursing diagnosis Risk for Falls. Which intervention should you delegate to the UAP? 1. Identifying environmental factors that increase risk for falls 2. Monitoring gait, balance, and fatigue level with ambulation 3. Collaborating with the physical therapist (PT) to provide the patient with a walker 4. Assisting the patient with ambulation to the bathroom and in the halls

Ans: 1 Ibuprofen can cause abdominal discomfort or pain and ulceration of the gastrointestinal tract. In such cases, it should be taken with meals or milk. Removal of throw rugs helps prevent falls. Range-of-motion exercises and rest are important strategies for coping with osteoporosis. Focus: Prioritization

13. When receiving discharge instructions, a patient with osteoporosis makes all of these statements. Which statement indicates to you that the patient needs additional teaching? 1. "I take my ibuprofen every morning as soon as I get up." 2. "My daughter removed all of the throw rugs in my home." 3. "My husband helps me every afternoon with range-of-motion exercises." 4. "I rest in my reclining chair every day for at least an hour."

Ans: 2 Fat embolism syndrome is a serious complication that often results from fractures of long bones. Its earliest manifestation is altered mental status caused by a low arterial oxygen level. The nurse would want to know about and treat the pain, but it is not life threatening. The nurse would also want to know about the blood pressure and the patient's voiding; however, this information is not urgent to report. Focus: Prioritization, delegation, supervision

14. A patient has a fractured femur. Which finding would you instruct the UAP to report immediately? 1. The patient reports pain. 2. The patient appears confused. 3. The patient's blood pressure is 136/88 mm Hg. 4. The patient voided using the bedpan.

3 Ans: 3 The patient with the tight cast is at risk for circulation impairment and peripheral nerve damage. Although all of the other patients' concerns are important and the nurse will want to see them as soon as possible, none of their complaints is urgent. Focus: Prioritization

15. After you receive the change-of-shift report, which patient should you assess first? 1. 42-year-old with CTS who reports pain 2. 64-year-old with osteoporosis awaiting discharge 3. 28-year-old with a fracture who reports that the cast is tight 4. 56-year-old with a left leg amputation who reports phantom pain

Ans: 3 When the weights are resting on the floor, they are not exerting pulling force to provide reduction and alignment or to prevent muscle spasm. The weights should always hang freely. Attending to the weights may reduce the patient's pain and spasm. With skeletal pins, a small amount of clear fluid drainage is expected. It is important to inspect the traction system after a patient changes position, because position changes may alter the traction. Focus: Delegation, supervision, prioritization

16. A patient with a fractured fibula is receiving skeletal traction and has skeletal pins in place. What would you instruct the UAP to report immediately? 1. The patient wants to change position in bed. 2. There is a small amount of clear fluid at the pin sites. 3. The traction weights are resting on the floor. 4. The patient reports pain and muscle spasm.

Ans: 1 Moving from a lying position first to a sitting position and then to a standing position allows the patient to establish balance before standing. Administering pain medication before the patient begins exercising decreases pain with exercise. Explanations about the purpose of the exercise program and proper use of crutches are appropriate interventions with this patient. Focus: Delegation, supervision

17. The nursing diagnosis for a patient with a fracture of the right ankle is Impaired Physical Mobility. As charge nurse, you observe a newly-graduated RN perform all of these interventions. For which action should you intervene? 1. Encouraging the patient to go from a lying to a standing position 2. Administering pain medication before the patient begins exercises 3. Explaining to the patient and family the purpose of the exercise program 4. Reminding the patient about the correct use of crutches

Ans: 1, 2, 3, 5 The purpose of the teaching is to help the patient prevent falls. The hip protector can prevent hip fractures if the patient falls. Throw rugs and obstacles in the home increase the risk of falls. Patients who are tired are also more likely to fall. Exercise helps to strengthen muscles and improve coordination. Focus: Prioritization

2. You are preparing to teach a patient with a new diagnosis of osteoporosis about strategies to prevent falls. Which teaching points will you be sure to include? (Select all that apply.) 1. Wear a hip protector when ambulating. 2. Remove throw rugs and other obstacles at home. 3. Exercise to help build your strength. 4. Expect a few bumps and bruises when you go home. 5. Rest when you are tired.

Ans: 1 Pressure and pain may be due to increased compartment pressure and can indicate the serious complication of acute compartment syndrome. This situation is urgent. If it is not treated, cyanosis, tingling, numbness, paresis, and severe pain can occur. Focus: Prioritization

21. During assessment of a patient with fractures of the medial ulna and radius, you find all of these data. Which assessment finding should you report to the health care provider immediately? 1. The patient reports pressure and pain. 2. The cast is in place and is dry and intact. 3. The skin is pink and warm to the touch. 4. The patient can move all the fingers and the thumb.

Ans: 4 The PACU nurse is very familiar with the assessment skills necessary to monitor a patient who just underwent surgery. For the other patients, nurses familiar with musculoskeletal system-related nursing care are needed to provide teaching and assessment, and prepare a report to the long-term care facility. Focus: Assignment

5. As charge nurse, you are making assignments for the day shift. Which patient would you assign to the nurse who was floated from the postanesthesia care unit (PACU) for the day? 1. 35-year-old with osteomyelitis who needs teaching before hyperbaric oxygen therapy 2. 62-year-old with osteomalacia who is being discharged to a long-term care facility 3. 68-year-old with osteoporosis given a new orthotic device whose knowledge of its use must be assessed 4. 72-year-old with Paget disease who has just returned from surgery for total knee replacement

c The adult client with a fractured femur will be placed in bucks traction to realign the leg and to decrease spasms and pain.

A 25 year old arrives in the ER with a possible fracture of the right femur. The nurse should anticipate an order for: a. bryants traction b. ice to the entire extremity c. bucks traction d. an abduction pillow

b

A client is 1 day postoperative after a total hip replacement. The client should be placed in which of the following position? A Supine B Semi Fowler's C Orthopneic D Trendelenburg

d

A client is admitted following the repair of a fractured tibia with cast application. Which nursing assessment should be reported to the physician? a. pain beneath the cast b. warm toes c. pedal pulses weak and rapid d. paresthesia of the toes

b

A client is admitted to the ER with a gunshot wound to the R arm. After dressing the wound and administering antibiotics, the nurse should: a ask the clients allergies b. check the clients immunization record c. apply a splint to immobilize arm d. administer pain medication

d

A client is admitted with a right radial and ulnar fracture after a motorcycle crash. The nurse is concerned that the client may have neurovascular dysfunction. What would the nurse assess to determine if the client has neurovascular​ dysfunction? a The ABCs b Chronic illness c History of the traumatic event d The 5 P​'s

b Rationale In a comminuted​ fracture, the bone is broken in many pieces. The bone fragments may cause further injury or complications. An open or compound fracture involves bone breaking through the skin. A transverse fracture is horizontal to the bone shaft. In an impacted or buckle​ fracture, the ends of the broken bones are forced together.

A client is diagnosed with a comminuted fracture. How would the nurse describe this fracture to the​ client? a ​"The fracture travels horizontally across the bone​ shaft." ​b "The bone is broken into many​ pieces." c ​"The ends of the broken bones are forced​ together." d ​"The bone is breaking through the​ skin."

c

A client presents in the emergency department after falling from a roof. A fracture of the femoral neck is suspected. Which of these assessments best support this diagnosis. A The client reports pain in the affected leg B A large hematoma is visible in the affected extremity C The affected extremity is shortened, adducted, and extremely rotated D The affected extremity is edematou

a,c,d Rationale Clients who have open fractures are at risk for infection. The nurse would assess the wound for manifestations of​ infection, assess vital​ signs, use aseptic technique to change​ dressings, provide pin care as​ prescribed, and administer antibiotics as prescribed. Pin care varies by​ facility, but all pins require care to remove crusts and prevent infection. Pin care may include gently cleansing the pin site daily to weekly with a cleansing​ solution, such as sterile saline or chlorhexidine. Withholding pain medication would not be an appropriate intervention for a client with an open fracture. Manifestations of an infection can be assessed in a client receiving pain medication.

A client sustained an open femoral fracture during a skiing accident. The nurse understands that this client is at risk for infection. What would the nurse need to do since the client is at risk for​ infection? ​(Select all that​ apply.) a Use aseptic technique with dressing changes b Avoid disturbing pins in external fixation device c Assess wound for​ size, color, or presence of drainage d Assess temperature every 4 hours e Withhold pain medication to assess for manifestations of infection

a,c,d,e Rationale The manifestations of a fracture include​ deformity, swelling,​ pain, tenderness,​ numbness, guarding,​ crepitus, hypovolemic​ shock, muscle​ spasms, or ecchymosis. A contusion is a swollen and discolored area on the skin. The musculoskeletal injury causes blood to leak into the soft​ tissue, resulting in a purple or blue discoloration or a bruise. When the blood​ reabsorbs, the area becomes brown and yellow until it disappears. The ecchymosis seen with a fracture will start as purple or blue in​ color, not brown or​ yellow, until reabsorption begins.

A female client fell approximately 10 feet off a ladder while hanging decorations on the outside of the house. As the client was​ landing, she attempted to catch herself with outstretched arms. EMS personnel are transporting the client to the emergency department and suspect a fracture of the right wrist. Which manifestations would the nurse anticipate observing in the​ client? ​(Select all that​ apply.) a Muscle spasms b Brown or yellow discoloration c Deformity d Crepitus e Pain

a,c,d Rationale A computed tomography scan​ (CT) provides a​ three-dimensional picture used to evaluate the extent of bone involvement and to what extent the surrounding soft tissues and neurovascular structures are affected. A magnetic resonance image​ (MRI) uses radio waves and magnetic fields.​ Gadolinium, an injected contrast​ media, is used to enhance the visualization of bony and soft tissues. The exam is used to evaluate the bone damage and to determine the amount of soft tissue and neurovascular involvement. A complete blood count and other blood tests can help assess if there is blood loss and tissue damage at the site of injury. An​ x-ray shows the location of the bone fracture and the extent of bone involvement. A bone scan detects the extent of the bone​ fracture, and detects whether or not the bone has adequate blood supply. These tests do not show soft tissue involvement.

A healthcare provider is concerned about soft tissue injury for a client with an ulnar fracture. Which tests would be used to diagnose this client​'s soft tissue​ injuries? ​(Select all that​ apply.) a MRI ​b X-ray c CT scan d Complete blood count e Bone scan

c

A nurse is caring for a pediatric client with a greenstick fracture. When educating the client�s parents regarding this fracture, the nurse will include which statement? a "This type of fracture is also called a stable fracture." b "With this type of fracture, broken ends of bones remain aligned." c "This type of fracture is also called an incomplete fracture." d "This type of fracture occurs more frequently with the elderly than with pediatric clients."

c

A pediatric client with a suspected arm fracture is brought to the emergency department. As the healthcare provider removes the splint applied by​ EMS, the​ client's mother​ exclaims, "Why are you taking that​ off? Doesn't my child need that​ splint?" What is the best response by the​ nurse? ​a "The Velcro straps make it easy for us to take the splint off. We are just adjusting it because EMS had to put it on​ quickly." b ​"We will put the splint right back on after we figure out what other treatments your child might​ need." c ​"A splint is used to stabilize fresh injuries. We have to remove it to see what other treatment your child might​ need." d ​"We are going to put a less supportive cast on your child. If any swelling​ occurs, this will keep the supportive device from getting too​ tight."

d Rationale Bony callus formation occurs after fibrocartilaginous formation and continues for 2dash-3 months after the injury. Fibrocartilaginous callus formation begins within 48 hours and lays the groundwork for bony callus formation. Macrophage wound invasion and hematoma formation occur immediately after the injury and ends within a few days. Bone remodeling is the last stage after bony callus formation.

A young adult client is recovering from a fractured radius that occurred 7 weeks ago. The​ client's healing is progressing normally. The nurse anticipates that the client is experiencing which process of bone​ healing? a Macrophage invasion of wound b Bone remodeling c Hematoma formation d Bony callus formation

c

A​ client, concerned about a deformity that resulted from an oblique fracture of the​ femur, states,​ "I can't believe one leg is shorter than the other now. I look so​ strange!" The client has no complaints of pain. Physical assessment by the nurse reveals normal findings except for the shortened leg. The nurse understands that the client is at greatest risk for which potential​ problem? a Potential for neurovascular impairment b Diminished tissue perfusion c Increased risk for body image disruption d Alterations in skin integrity

a

In order for Buck's traction applied to the right leg to be effective, the client should be placed in which position? A Supine B Prone C Sim's D Lithotomy

a Based on the fact that the skin is​ broken, you know the fracture is open as opposed to closed. Without visualizing the bone​ itself, either by observation or by​ x-ray, you would not know if the fracture was complete or incomplete.

Jillian Adichie is a​ 16-year-old girl who fell from a balance beam at a practice meet and landed off the mat onto some protruding hardware. She fractured her left leg. In assessing​ Jillian's leg, you notice that the area above her ankle is warm and at an odd angle and the skin is broken. Based on this assessment​ alone, how would you initially classify this​ injury? a Open​ (compound) fracture b Incomplete c Closed​ (simple) fracture d Complete

d The best response accurately describes an external fixation device as a metal device attached outside of the leg until the bone heals. Although external fixation is indicated for fractures accompanied with soft tissue damage that prevent internal​ fixation, you are not directly answering his question if you respond in this manner. He asked what external fixation meant. Wires and screws attached directly to the bones describes​ internal, not​ external, fixation. Internal fixation has a shorter hospital stay than external fixation. Even if this were not the​ case, talking about hospital stays does not directly answer Mr.​ Erickson's question. Next Question

Len Erickson is a​ 55-year-old rancher who was involved in a motor vehicle accident that caused severe soft tissue damage to his left leg and an open tibial fracture. Mr. Erickson says the surgeon was just in and told him that he would need surgery to fix his leg using external fixation. He asks you what that means. What is your best​ response? ​a "Your leg has a lot of tissue damage so we have to use external fixation to fix​ it." ​b "Wires and screws will be attached directly to your bones to put them back​ together." c ​"External fixation has a shorter hospital stay than internal​ fixation, which is why​ we're using​ it." d ​"You will have metal rods attached to your leg on the outside until the bone​ heals."

d

Manuel Barreto is a​ 50-year-old man who presented to the emergency department with a broken right radius and ulna sustained when he fell on a patch of ice. You are assessing the 5​ P's and ask him to wiggle his fingers on his right arm. He asks why you are doing this. What would you include in your​ response? ​a "I am checking for​ pulse." b ​"I am checking for​ paleness." c ​"I am checking for​ numbness." d ​"I am checking for​ paralysis."

d

The client in skeletal traction for a right femur fracture is complaining of pain in the leg. The nurse determines that the right foot is pale and without a pedal pulse. The nurse takes what action? a Reassures the client that the finding is normal for older adults b Administers half of the pain medication ordered. c Releases the traction d Notifies the physician

d

The client with a fracture asks why the nurse palpates the casted area when doing the examination. What is the most appropriate response by the nurse? a "I am making sure the cast is not too tight." b "I am making sure that the cast has dried." c "I am evaluating the strength of the cast." d "I am checking for hot spots that might indicate infection."

d

The client with an above the knee amputation is to use crutches until the prosthesis is properly lifted. When teaching the client about using the crutches, the nurse instructs the client to support her weight primarily on which of the following body areas? a Axillae b Elbows c Upper arms d Hands

c

The client with right sided weakness needs to learn how to use a cane. The nurse plans to teach the client to position the cane by holding it with the: a Left hand and placing the cane in front of the left foot b Right hand and placing the cane in front of the right foot c Left hand and 6 inches lateral to the left foot d Right hand and 6 inches lateral to the left foot

d

The nurse is administering pain medication to a client with a radial fracture. The client asks what the difference is between the opioids being administered and the NSAIDs that the client is used to taking. What is the best response by the​ nurse? ​a "Unlike NSAIDs, you should request opioids before your pain becomes​ severe." b ​"Only opioids can be given with a​ patient-controlled pump." ​c "Only opioids can be given at a scheduled time around the​ clock." ​d "Unlike NSAIDs, opioids will only be given to you for a limited period of​ time."

d

The nurse is assessing the circulation of a patient in a long leg cast. Which of the following assessments indicate adequate circulation to the extremity? a. pt denies pain in the affected leg and foot b. pt is able to wiggle the toes on command c. sensation is reported when the soles of the feet are touched d. brisk capillary refill of less than 2 seconds

c

The nurse is caring for a child in a plaster of paris hip spica cast. To facilitate drying the nurse should: a. use a small dryer set on medium heat b. place a small heater by the childs bedside c. turn the child q2h d. allow one side to dry before changing positions

b

The nurse is caring for a client after a MVA. The client has a fractured tibia and the bone is protruding through the skin. Which action is the priority? a. provide manual traction above and below the leg b. cover the bone area with a sterile dressing c. apply an ACE bandage around the entire lower limb d. place the client in a prone position

b

The nurse is caring for a client with a cast and notices that the client does not respond to touch in that limb. How would the nurse describe this​ finding? a Prickliness b Paresthesia c Pallor d Paralysis

d

The nurse is caring for a client with a fractured femur. Which diet selection would be best for this client? a loaded baked potato, fried chicken and tea b dressed cheeseburger, french fries and diet coke c. tuna fish salad on sourdough bread, potato chips, and skim milk d. mandarin orange salad, broiled chicken and milk

b Rationale Red blood cell indices are used to assess for excessive blood loss and evaluate for anemia. As much as 500 mL of blood can leak into the surrounding tissues as a result of a fractured femur. White blood cell counts would be more useful in determining the presence of infection.​ X-rays and bone scans are more useful for determining bone damage.

The nurse is caring for a client with a​ nonbleeding, closed femur fracture. The healthcare provider wants to evaluate the client for leakage of blood into the surrounding tissue. The nurse anticipates that which test will be ordered for the​ client? a White blood cell count b Hematocrit c Bone scan d ​X-ray

b

The nurse is making initial rounds on a client with a C5 fracture stabalized by Crutchfield tongs. Which equipment should be kept at the bedside? a. forceps b. torque wrench c. wire cutters d. screwdriver

d

The nurse is observing the ambulation of a client recently fitted for crutches. Which observation REQUIRES INTERVENTION? a two finger widths are noted between the axilla and the top of the crutch b. the client bears weight on hands when ambulating c. the crutches and the clients feet move alternately d. the client bears weight on his axilla when standing

b

The nurse receives a client from the emergency department with a broken tibia who is in Buck traction. Which outcome goal will the nurse evaluate for? a The pins, wires, and tongs are in place. b The skin over bony prominences under the traction is intact. c Pain medications given in the field have been effective. d Medications given in the emergency department have been effective.

c long bone more frequent risk

The orthopedic nurse should be particularly alert for a fat embolus in which of the following clients having the greatest risk for this complication after a fracture? a. a 50 year old with a fractured fibula b. a 20 year old female with a wrist fracture c. a 21 year old male with a fractured femur d. an 8 year old with a fractured arm

c

What is a priority nursing diagnosis for a client with multiple fractures who has been placed in an external fixation device? a Activity Intolerance b Risk for Impaired Physical Mobility c Disturbed Body Image d Ineffective Coping

b,d The severity of a bone fracture depends on the force of the action against the bone and bone strength. Low bone density is often a precursor to a fracture. Diseases such as neoplasms​ (bone cancer) or osteoporosis may weaken the bones and result in fractures. It is compartment​ syndrome, not a bone​ fracture, that occurs when excess pressure in the space enclosed by the fascia constricts structures within the​ compartment, reducing circulation to muscles and nerves. Bone fractures may result from repetitive forces like​ running, twisting, or a direct blow to the bone.

What statements concerning bone fractures are​ correct? ​(Select all that​ apply.) a Diseases such as neoplasms do not cause bone fractures. b The severity of a bone fracture depends on the force of the action against the bone and bone strength. c Bone fractures do not result from low bone density. d Bone fractures may result from repetitive forces or twisting. e A bone fracture can be the direct result of excess pressure in the fibrous membrane or fascia.

d

Which action by the nurse indicates an understanding of the care of a client with a fiberglass leg cast? a. The nurse handles the cast with the fingertips b. the nurse allows 24 hours for the cast to dry c. the nurse drys the cast with a blow dryer d. the nurse tells the client to wait 30 minutes before bearing weight

a,c,d,e You may palpate crepitus at the site of the injury if bone pieces grate​ together, and there will likely be ecchymosis​ (bruising) and swelling at the injury​ site, as well as muscle spasms in the injured limb.​ Hypovolemia, not fluid​ excess, may occur due to blood loss caused by the fracture.

Which are clinical manifestations of a​ fracture? ​(Select all that​ apply.) a Muscle spasms b Fluid excess c Swelling d Crepitus e Ecchymosis

b

Which classic symptom would the nurse look for to detect development of this osteomyelitis after an open fracture? a Low bone density b Elevated temperature c cute respiratory distress d Shortening of the affected extrem

b,d,e

Which clinical manifestations would the nurse expect a client with a diagnosis of acute osteomyelitis to exhibit? select all that apply a. normal sedimentation rate b pain and fever c low blood count d tenderness in affected area e edema and pus from wound

b

Which complaint by the client raises the possibility of compartment syndrome following cast application to the leg? a diffuse aching in the leg b. tight burning pain in the calf c. localized pain along the shin d. throbbing sensation in the toes

c A fat embolism occurs when fat globules released by injured tissue lodge in the pulmonary​ vasculature, resulting in dyspnea. Compartment syndrome is manifested by pain resulting from pressure when fascia constricts. Deep vein thrombosis is a clot that commonly forms in the leg and causes​ redness, warmth, leg​ pain, cramping, and swelling. Infection causes​ warmth, redness,​ pain, swelling,​ stiffness, fever,​ chills, and purulent drainage.

Which complication of a fracture causes​ dyspnea? a Infection b Deep vein thrombosis c Fat embolism d Compartment syndrome

a

Which equipment would assist the client with a total hip replacement with ADLS? a. raised commode b, velcro fastners c. hand grip utensils d. large button clothing

a,b,c,e

Which neurovascular assessment findings are found in client with a​ fracture? ​(Select all that​ apply.) a Paralysis b Pulselessness c Pain d Perspiration e Paresthesia

a

Which nursing intervention is appropriate for a client with skeletal traction? A Pin care B Prone positioning C Intermittent weights D 5lb weight limit

c

Which of the following is within the scope of the nursing assistant? a. obtaining vital signs following a craniotomy b. obtaining hourly I&O's of a pt with preeclampsia c. feeding a client with depression d. ambulating the client following a hip replacement

a

Which of the following would lead the nurse to suspect that a client with a fracture of the right femur may be developing a fat embolus? a Acute respiratory distress syndrome b Migraine like headaches c Numbness in the right leg d Muscle spasms in the right thighb

b

Which of these nursing actions will best promote independence for the client in skeletal traction? A Instruct the client to call for an analgesic before pain becomes severe. B Provide an overhead trapeze for client use C Encourage leg exercise within the limits of traction D Provide skin care to prevent skin breakdown.

b

Which one of the following statements is correct when measuring the client for crutches? a. a distance of 5 finger breadths should exist between the top of the crutch and axilla b. The nurse should measure 3 inches or 3 finger breadths between the top of the crutch and the axilla c. the clients elbows should be flexed at a 10 degree angle d. the crutches should extend 8-10 inches from the side of the foot

d

A client with a C4 spinal cord injury has been placed in traction with cervical tongs. Nursing care should include: a. releasing the traction for 5 minutes each shift b. loosening the pins if the client complains of a head ache c. elevating the HOB 90 degrees d. performing sterile pin care as ordered

c

An elderly client has sustained intertrochanteric fracture of the hip and has just returned from surgery where a nail plate was inserted for internal fixation. The client has been instructed that she should not flex her hip. The best explanation of why this movement would be harmful is: A It will be very painful for the client B The soft tissue around the site will be damaged C Displacement can occur with flexion D It will pull the hip out of alignment

d symptoms include shortening, adduction, and external rotation of the affected limb

An elderly woman is admitted with a fractured right femoral neck. Which clinical manifestations would the nurse expect to find? a. free movement of the right leg b abduction of the right leg c internal rotation of the right hip d shortening of the right leg

rest,ice,compression,elevation

R______,I________,C____________,E___________

a

The teenager with the fiberglass cast asks the nurse if it will be ok to autograph his cast. Which response would be best? a. it will be alright for your friends to autograph the cast b. because the cast is made of plaster, autographing can weaken the cast c. if they dont use chalk to autograph it is ok d. autographing or writing on the cast in any form will harm the cast

d

To prevent foot drop in a client with Buck's traction, the nurse should: A Place pillows under the client's heels. B Tuck the sheets into the foot of the bed C Teach the client isometric exercises D Ensure proper body positioning.

a

Which radiologic study is the best method to diagnose a​ fracture? ​a X-ray b CT scan c MRI d Bone scan

b

Which roommate would be most suitable for the six year old male with a fractured femur in traction? a sixteen year old male with leukemia b twelve year old male with fractured humerus c. ten year old male with sarcoma d. six year old with osteomyelitis

a

Which statement is true regarding balanced skeletal traction? Balanced skeletal traction: a. uses a Steinman pin b. requires both legs be secured c. utilizes Kirschner wires d. is used primarily to heal fractured hips

c

Which statement is true regarding the care of the patient in skeletal traction? a. the nurse may remove the weights for bathing b. blocks should be placed beneath the HOB c. The weights must hang freely to be effective d. The nurse should massage the reddened areas to prevent skin breakdown

b

Which therapy for fractures applies a straightening or pulling force to return or maintain the fractured bones in normal anatomic​ position? a Electrical bone stimulation b Traction c Cast d Splint

d

While caring for a client with a newly applied plaster of Paris cast, the nurse makes note of all the following conditions. Which assessment finding requires immediate notification of the physician? A Moderate pain, as reported by the client B Report, by client, the heat is being felt under the cast C Presence of slight edema of the toes of the casted foot D Onset of paralysis in the toes of the casted foot

Compartment

_______________ syndrome is increased pressure within the confined space of the compartment and results in entrapment of nerves, blood vessels, and muscles. Assessment skills are very important in identifying compartment syndrome after a fracture. Risk factors that may lead to the development are: Hemorrhage within the compartment Edema within the compartment Fracture Crush injury External compression from a cast that is too tight

a

a client with a fractured hip is being taught correct use of the walker. The nurse is aware the correct use of the walker is achieved if a. palms of the hands rest lightly on the walker b. elbows are extended 0 degrees c. client steps all the way forward to the front of the walker d. client lifts and carries the walker when ambulating

b

a client with a fractured leg is exhibiting shortness of breath, pain upon deep breathing and hemoptysis. What do these clinical manifestations indicate to the nurse? a CHF b. pulmonary embolus c adult respiratory distress syndrome d. tension pneumothorax

d

skeletal traction is applied to the right femur of a client injured in a fall. The primary purpose of skeletal traction is to : a realign the tibia and fibula b provide traction to the muscles c. provide traction on the ligaments d. realign femoral bone fragments

d

The nurse is giving the client with a left cast crutch walking instructions using the three point gait. The client is allowed touchdown of the affected leg. The nurse tells the client to advance the: a Left leg and right crutch then right leg and left crutch b Crutches and then both legs simultaneously c Crutches and the right leg then advance the left leg d Crutches and the left leg then advance the right leg

a

A client with a right arm cast tells the nurse he has not been able to extend his fingers on his right hand since this morning. Which action is the priority for the nurse? a Evaluate neurovascular status. b Ask the client to massage the fingers. c Encourage the client to take the prescribed analgesics as ordered. d Elevate the right arm on a pillow to reduce edema.

a,b,c Rationale Bone​ neoplasms, osteoporosis, and Paget disease are associated with pathological fractures. Osteoarthritis and leukemia are not associated with pathological fractures.

The nurse is reviewing the records of newly admitted clients in a nursing home. The nurse understands that which clients are at greater risk for​ fractures? ​(Select all that​ apply.) a The client with Paget disease b The client with osteoporosis c The client with bone neoplasms d The client with leukemia e The client with osteoarthritis