Chapter 44: Fractures Test Questions
A patient with bilateral avascular necrosis of the hips is to walk with crutches using a four-point gait for 6 weeks after her bone decompression surgeries. Which statement would indicate that the patient understands this technique?
"I will move my right crutch and then my left leg and then the left crutch and my right leg."
A patient has just had a plaster of Paris upper extremity cast placed because of a fractured radius. Which statement indicates that the patient understands the discharge teaching related to cast care?
"When I get home, I am going to rest in bed with my arm elevated above my heart."
A patient with a crushed forearm cannot get pain relief with opioid medications. The injury is swollen, cool, and cyanotic, with weak distal pulses. What should the nurse suspect?
Compartment syndrome
A patient with a fractured pelvis says that she will not ambulate because of pain. What should a nurse inform the patient can be prevented with early ambulation?
DVT
A nurse is told that a patient has a compound comminuted fracture. What characteristic of the bone in this type of fracture causes the nurse to be concerned?
It is broken into two or more pieces, and bone fragments protrude through the skin.
What should a nurse teach an older patient with a newly casted Colles fracture?
Move the shoulders to reduce contractures.
Which assessment is of the greatest concern to a nurse when caring for a patient just admitted with a pelvic fracture?
No urinary output for 8 hours
An older patient who sustained a fractured hip and femur in a motor vehicle accident is to be in Russell traction for several weeks. What should be the focus of care for the nurse?
Preventing deep vein thrombosis (DVT)
Which finding should produce the most concern when performing pin care for a patient with an external fixator?
Purulent drainage
A patient who has osteomyelitis after multiple fractures inquires what the physician meant when he said that surgery would follow the antibiotic therapy. What is the nurse's most helpful reply to explain why this surgery will be performed?
To remove dead bone
An older adult patient is at risk for constipation after sustaining a pelvic fracture. Which nutritional suggestion by the nurse is most appropriate?
While immobilized, drink at least 2 to 3 L of fluids daily.
Which is true about a greenstick fracture?
Fracture is incomplete, and one side is bent.
Assistive devices such as canes, crutches, and walkers are used for people who need to limit weight-bearing activities on joints. Which statement by a nurse best illustrates an understanding of the appropriate use of these devices?
"Canes provide minimal support and balance and are carried on the unaffected side."
A patient in a full body cast (spica) complains of nausea and abdominal distention. What potential complication should a licensed vocational nurse (LVN) suspect?
Cast syndrome
Which patient is most appropriate for a nurse to refer to home health care?
A single woman with a bedroom in a rooming house
What action should a nurse implement when dealing with the weights that are applying traction to a patient?
Allow them to hang freely.
What action should a nurse implement when caring for a patient diagnosed with a compound fracture?
Assess for pulses distal to the injury.
A 78-year-old retired teacher with a history of osteoporosis has fallen in her bathroom and sustained a subcapital femoral fracture. She is scheduled for an open reduction and internal fixation (ORIF) procedure in the morning. Which type of traction will most likely be implemented?
Buck
A patient who sustained a simple fracture of the left fibula 7 days earlier asks in what stage of bone healing he might be. What stage of healing should the nurse relay to the patient?
Callus formation
Which assessment is considered abnormal when a nurse performs a neurovascular assessment on a patient in skeletal traction
Delayed capillary refill
What should a nurse who is documenting and reporting the signs and symptoms of an infection underneath a cast include in the medical record?
Elevated temperature
Two days after surgery for a crushed pelvis, a certified nursing assistant (CNA) reports that the patient is complaining of a shortness of breath and is demonstrating signs of confusion and restlessness. What should a nurse suspect, from these signs alone, that the patient has developed?
Fat embolus
Which nursing diagnosis has the highest priority after surgery for the open reduction and external fixation of an ankle?
Risk for infection
An older woman falls down at church and immediately complains of severe pain in her left hip. Which observation is recognized as the cardinal sign of a fractured hip?
Shortened left leg compared with the right
What special precaution should a nurse implement when assisting with the application of a short arm plaster cast?
Smooth the stockinette to prevent a pressure ulcer.