Exam 3 Test Bank: Mgmt. of Pts. with musculoskeletal trauma
Which type of fracture is one in which the skin or mucous membrane extends to the fractured bone? A) complete B) simple C) compound D) incomplete
C
Which term refers to an injury to ligaments and other soft tissues surrounding a joint? A) strain B) subluxation C) dislocation D) sprain
D
A client with a right BKA is being transferred from the PACU to a med-surg unit. What is the highest priority nursing intervention by the receiving nurse? A) ensure that a large tourniquet is in the room B) document the receiving report from the transferring nurse C) review the physicians order for type and frequency of pain meds D) delegate the gathering of enough pillows for proper positioning and comfort
A
Which term refers to a fracture in which one side of a bone is broken and the other side is bent? A) greenstick B) avulsion C) oblique D) spiral
A
Which type of fracture occurs when a bone fragment is driven into another bone fragment? A) impacted B) transverse C) spiral D) oblique
A
With fractures of the femoral neck, the leg is? A) shortened, adducted, and externally rotated B) abducted and externally rotated C) shortened, abduction, and internally rotated D) adducted and internally rotated
A
Which factors inhibit fracture healing? SATA A) local malignancy B) bone loss C) extensive local trauma D) vitamin D E) exercise F) minimum bone fragment contact
A, B, C
Which nursing intervention measure is used for a client with a closed reduction extremity fracture? A) assist w/ intake of immune-enhancing tube feeding formulas B) encourage participation in ADLs C) promote intake of omega-3 fatty acids D) examine the abdomen for enlarged liver or spleen
B
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) request a referral to OT B) provide feedback on the client's strengths and available resources C) provide wound care without discussing the amputation D) encourage the client to perform ROM exercises to the right leg
B
An XR demonstrates a fracture in which the fragments of bone are driven inward. This type of fracture is referred to as? A) comminuted B) depressed C) compound D) impacted
B
Pulselessness, a very late sign of compartment syndrome, may signify? A) venous congestion B) lack of distal tissue perfusion C) nerve involvement D) diminished arterial perfusion
B
The ED nurse teaches clients with sports injuries to remember the acronym PRICE. This acronym stands for which combination of treatment? A) pressure, rotation, immersion, compression, elevation B) protection, rest, ice, compression, elevation C) protection, rest, ice, circulation, examination D) pressure, rotation, ice, compression, examination
B
Which is a hallmark sign of compartment syndrome? A) edema B) pain C) weeping skin surfaces D) motor weakness
B
Which term refers to a break in the continuity of a bone? A) dislocation B) fracture C) subluxation D) malunion
B
A client experienced an open fracture to the left femur during a horse-riding accident. For which complication is this client at highest risk for? A) complex regional pain syndrome B) malunion C) infection D) depression
C
A client is transported to the ED for a femur fracture following an MVC. What action by the nurse is the highest priority? A) assess the diameter of the thigh every 15 minutes B) administer pain medication per orders C) assess vital signs and level of consciousness D) assess pedal pulses
C
A client who was in an MVC is diagnosed with a stable T7 spinal fracture w/ no neurologic deficits. Which nursing intervention should the nurse implement? A) withhold opioid pain medication to prevent ileus B) sit the client upright in a padded chair for meals C) maintain bedrest with the HOB at 20 degrees D) maintain NPO status for surgical repair
C
A client with a recent LAK amputation states "I can feel pain in my left toes." What is the best response by the nurse? A) pain meditation usually doesn't help this type of pain B) your left toes have been amputated C) describe the pain and rate it on a pain scale D) the pain is really from the nerves in the upper legs
C
Colles fracture occurs in which area? A) humeral shaft B) clavicle C) distal radius D) elbow
C
In a client with a dislocation, the nurse should initially perform neurovascular assessment a minimum of q15min until stable. Which complication does the assessment help the nurse to monitor? A) ganglion cysts B) GI bleeding C) compartment syndrome D) carpal tunnel syndrome
C
The nurse assesses subtle personality changes, restlessness, irritability, and confusion in a client who has sustained a fracture. The nurse expects which complication? A) reflex sympathetic dystrophy syndrome B) hypovolemic shock C) fat embolism syndrome D) compartment syndrome
C
When is it advisable for the nurse to apply heat to a sprain or a contusion? A) only after a week B) do not apply at all C) after 2 days D) immediately
C
Which factor may contribute to compartment syndrome? A) venous thromboembolism B) macular lesion C) hemorrhage D) disuse syndrome
C
Which factor inhibits fracture healing? A) age of 35 years B) immobilization of the fracture C) increased vitamin D and calcium in the diet D) history of diabetes
D
An XR demonstrates a fracture in which a bone has splintered into several pieces. Which type of fracture is this? A) compound B) impacted C) depressed D) comminuted
D
Which is one of the most common causes of death in clients diagnosed w/ fat emboli syndrome? A) MI B) stroke C) pulmonary embolism D) acute respiratory distress syndrome
D
Which term refers to a blunt force injury to soft tissue? A) strain B) fracture C) dislocation D) contusion
D
When the client who has experienced trauma to an extremity reports severe burning pain, vasomotor changes, and muscle spasms in the injured extremity, the nurse recognizes that the client is likely demonstrating signs of? A) a reaction to an internal fixation device B) avascular necrosis of the bone C) heterotrophic ossification D) complex regional pain syndrome
D
A client asks the nurse why his residual limb cannot be elevated on a pillow. What is the best response by the nurse? A) you need to turn yourself side to side B) I am sorry. We ran out of pillows. I can elevate it on a few blankets C) elevating the extremity may increase your chances of compartment syndrome D) elevating the leg might lead to a flexion contracture
D
A fracture is considered pathologic when it? A) involves damage to the skin or mucous membrane B) results in a fragment of bone being pulled away by a ligament or tendon and its attachment C) presents as one side of the bone being broken and the other side being bent D) occurs through an area of diseased bone
D
Which are clinical manifestations of a fracture? SATA A) crepitus B) pain C) deformity D) shortening E) loss of function F) lengthening
A, B, C, D, E
A 75 y/o client had surgery for a left hip fracture yesterday. When completing the plan of care, the nurse should include assessment for which complications? SATA A) pneumonia B) delirium C) skin breakdown D) necrosis of the humerus E) sepsis
A, B, C, E
Which client is most likely to have compartment syndrome after sustaining a fracture? SATA A) the client w/ elevated pressure within the muscles B) the client using ice to control pain in the extremity C) the client with hemorrhage at the site of injury D) the client who sustained a clavicle fracture E) the client with a plaster cast applied immediately after injury
A, C, E
Which term refers to the failure of fragments of a fractured bone to heal together? A) dislocation B) malunion C) nonunion D) subluxation
C