Exam #2 (CH 43 - Patients With Musculoskeletal Trauma)

c. III

4. 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. II c. III d. IV

b. Between 24 and 48 hours

1. A patient has stepped in a hole in the yard, causing an ankle injury. The ankle is edematous and painful to palpation. How long should the nurse inform the patient that the acute inflammatory stage will last? a. Less than 24 hours b. Between 24 and 48 hours c. About 72 hours d. At least 1 week

a. Covering the area with a clean dressing if the fracture is open b. Immobilizing the affected site c. Splinting the injured limb

5. A patient sustains an open fracture of the left arm after an accident at the roller skating rink. What does emergency management of this fracture involve? (Select all that apply.) a. Covering the area with a clean dressing if the fracture is open b. Immobilizing the affected site c. Splinting the injured limb d. Asking the patient if he or she is able to move the arm e. Wrapping the arm in an ace bandage

a. Infection

6. The nurse is caring for a patient who sustained an open fracture of the right femur in an automobile accident. What does the nurse understand is the most serious complication of an open fracture? a. Infection b. Muscle atrophy caused by loss of supporting bone structure c. Necrosis of adjacent soft tissue caused by blood loss d. Nerve damage

d. Volkmann's ischemic contracture

10. A patient falls while skiing and sustains a supracondylar fracture. What does the nurse know is the most serious complication of a supracondylar fracture of the humerus? a. Hemarthrosis b. Paresthesia c. Malunion d. Volkmann's ischemic contracture

b. Hemorrhage and shock

11. 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. Paresthesia and ischemia b. Hemorrhage and shock c. Paralytic ileus and a lacerated urethra d. Thrombophlebitis and infection

a. Checking the urine for hematuria b. Palpating peripheral pulses in both lower extremities c. Testing the stool for occult blood

12. The nurse is caring for a patient with a pelvic fracture. What nursing assessment for a pelvic fracture should be included? (Select all that apply.) a. Checking the urine for hematuria b. Palpating peripheral pulses in both lower extremities c. Testing the stool for occult blood d. Assessing level of consciousness e. Assessing pupillary response

a. Hypovolemic shock

13. A patient has suffered a femoral shaft fracture in an industrial accident. What is an immediate nursing concern for this patient? a. Hypovolemic shock b. Infection c. Knee and hip dislocation d. Pain resulting from muscle spasm

c. Coughing and deep breathing with pillow splinting

15. A patient was climbing a ladder, slipped on a rung, and fell on the right side of the chest. X-ray studies reveal three rib fractures, and the patient is complaining of pain with inspiration. What is the anticipated treatment for this patient? a. Chest strapping b. Mechanical ventilation c. Coughing and deep breathing with pillow splinting d. Thoracentesis

d. 6 to 12 months

2. The nurse is caring for a patient after arthroscopic surgery for a rotator cuff tear. The nurse informs the patient that full activity can usually resume after what period of time? a. 3 to 4 weeks b. 8 weeks c. 3 to 4 months d. 6 to 12 months

b. Hypovolemic

7. The nurse is monitoring a patient who sustained an open fracture of the left hip. What type of shock should the nurse be aware can occur with this type of injury? a. Cardiogenic b. Hypovolemic c. Neurogenic d. Septicemic

a. Encouraging the patient to care for the residual limb b. Allowing the expression of grief e. Introducing the patient to local amputee support groups.

14. A nurse is caring for a patient who has had an amputation. What interventions can the nurse provide to foster a positive self-image? (Select all that apply.) a. Encouraging the patient to care for the residual limb b. Allowing the expression of grief c. Encourage the patient to have family & friends view the residual limb to decrease self-consciousness. d. Encouraging family & friends to refrain from visiting temporarily because this may increase the patient's embarrassment. e. Introducing the patient to local amputee support groups.

b. Apply a tourniquet.

3. A patient had an above-the-knee amputation of the left leg related to complications from PVD. The nurse enters the patient's room and observes the dressing and bed covers saturated with blood. What is the first action by the nurse? a. Notify the physician. b. Apply a tourniquet. c. Use skin clips to close the wound. d. Reinforce the dressing.

d. Fat emboli

8. 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. Spontaneous pneumothorax b. Cardiac tamponade c. Pneumonia d. Fat emboli

a. As soon as tolerated, after a reasonable period of immobilization

9. 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 weeks, when callus ossification prevents easy movements of bony fragments c. In about 4 to 5 weeks, after new bone is well established d. In 2 to 3 months, after normal activities are resumed