NURS 301 Exam #4 Musculoskeletal Questions

A client who has injured a hip in a fall cannot place weight on the leg and is in significant pain. After radiographs indicate intact yet malpositioned bones, what repair would the physician perform? 1) heat and immobilization 2) joint manipulation and immobilization 3) ice and immobilization 4) analgesia and immobilization

2

A client is hospitalized for open reduction of a fractured femur. During the postoperative assessment, the nurse notes that the client is restless and observes petechiae on the client's chest. Which nursing action is indicated first? 1) Contact the nursing supervisor. 2) Contact the health care provider. 3) Elevate the affected extremity. 4) Administer oxygen.

2

A client is being discharged from the Emergency Department after being diagnosed with a sprained ankle. Which client statement indicates the client understands the discharge teaching? 1) "I need to stay off my ankle for at least the next 3 to 4 weeks." 2) "I'll start with ice for the first couple of hours and then apply heat." 3) "I'll make sure to keep my ankle elevated as much as possible." 4) "I'll get the prescription filled for the narcotic pain reliever."

3

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? 1) Volkmann's contracture 2) Compartment syndrome 3) Subluxation 4) Sprain

3

Which of the following type of fracture is associated with osteoporosis? 1) Compression 2) Oblique 3) Stress 4) Simple

1

Which term refers to an injury to ligaments and other soft tissues surrounding a joint? 1) Sprain 2) Strain 3) Subluxation 4) Dislocation

1

Which type of fracture occurs when a bone fragment is driven into another bone fragment? 1) Impacted 2) Transverse 3) Oblique 4) Spiral

1

A client who has sustained a fracture reports an increase in pain and decreased function of the affected extremity. What will the nurse suspect? 1) Pulmonary embolism 2) Infection 3) Avascular necrosis 4) Hypovolemic shock

3

A client is treated in the emergency department for acute muscle strain in the left leg caused by trying a new exercise. During discharge preparation, the nurse should provide which instruction? 1) "Apply ice packs for the first 24 to 48 hours, then apply heat packs." 2) "Apply heat packs for the first 24 hours, then apply ice packs for the next 48 hours." 3) "Apply heat packs for the first 24 to 48 hours." 4) "Apply ice packs for the first 12 to 18 hours."

1

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? 1) Compartment syndrome 2) Dislocation 3) Muscle spasms 4) Subluxation

1

A fracture is considered pathologic when it... 1) occurs through an area of diseased bone. 2) results in a fragment of bone being pulled away by a ligament or tendon and its attachment. 3) presents as one side of the bone being broken and the other side being bent. 4) involves damage to the skin or mucous membranes.

1

A nurse is caring for a client who underwent a total hip replacement. What should the nurse and other caregivers do to prevent dislocation of the new prosthesis? 1) Use measures other than turning to prevent pressure ulcers. 2) Prevent internal rotation of the affected leg. 3) Keep the affected leg in a position of adduction. 4) Keep the hip flexed by placing pillows under the client's knee.

2

There are a variety of problems that can become complications after a fracture. Which is described as a condition that occurs from interruption of the blood supply to the fracture fragments after which the bone tissue dies, most commonly in the femoral head? 1) fat embolism 2) avascular necrosis 3) pulmonary embolism 4) shock

2

A client is experiencing pain, joint instability, and difficulty walking due to an injury to the knee ligaments. The injury was judged not to require surgery. Which intervention would not be included in this client's care? 1) ice and NSAIDs 2) limited weight bearing 3) traction 4) joint immobilization

3

The client with a fractured left humerus reports dyspnea and chest pain. Pulse oximetry is 88%. Temperature is 100.2 degrees Fahrenheit (38.5 degrees Centigrade); heart rate is 110 beats per minute; respiratory rate is 32 breaths per minute. The nurse suspects the client is experiencing: 1) Compartment syndrome 2) Delayed union 3) Fat embolism syndrome 4) Complex regional pain syndrome

3

Which term refers to a break in the continuity of a bone? 1) Subluxation 2) Dislocation 3) Malunion 4) Fracture

4

Which term refers to a fracture in which one side of a bone is broken and the other side is bent? 1) Spiral 2) Oblique 3) Avulsion 4) Greenstick

4

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.) 1) Splinting the injured limb 2) Wrapping the arm in an ace bandage 3) Covering the area with a clean dressing if the fracture is open 4) Immobilizing the affected site 5) Asking the patient if he or she is able to move the arm

1, 3, 4

Two days after application of a cast to treat a fractured femur, the client reports severe, deep, and constant pain in the leg. What will the nurse suspect? 1) Infection. 2) Phlebitis. 3) Compartment syndrome. 4) Chronic venous insufficiency

3

A client with a fracture develops compartment syndrome that requires surgical intervention. What treatment will the nurse would most likely prepare the client for? 1) Fasciotomy 2) Joint replacement 3) Amputation 4) Bone graft

1

An important nursing assessment, post fracture, is to evaluate neurovascular status. Therefore, the nurse should check for: 1) Capillary refill. 2) Crepitus. 3) Shortening and deformity. 4) Swelling and discoloration.

1

When providing discharge teaching to a client with a fractured toe, the nurse should include which instruction? 1) Use crutches for 1 week. 2) Apply heat to the fracture site. 3) Apply ice to the fracture site. 4) Perform ankle dorsiflexion three times per day.

3

A client with arterial insufficiency undergoes below-knee amputation of the right leg. Which action should the nurse include in the postoperative care plan? 1) Elevating the stump for the first 24 hours 2) Applying heat to the stump as the client desires 3) Maintaining the client on complete bed rest 4) Removing the pressure dressing after the first 8 hours

1

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? 1) Fat emboli 2) Cardiac tamponade 3) Pneumonia 4) Spontaneous pneumothorax

1

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? 1) Hypovolemic 2) Neurogenic 3) Cardiogenic 4) Septicemic

1

A client has had surgical repair of a hip injury after joint manipulation was unsuccessful. After surgery, the nurse implements measures to prevent complications. Which complications is the nurse seeking to prevent? Select all that apply. 1) wound infection 2) skin breakdown 3) diarrhea 4) pneumonia

1, 2, 4

The nurse caring for a client, who has been treated for a hip fracture, instructs the client not to cross their legs and to have someone assist with tying their shoes. Which additional instruction should the nurse provide to client? 1) Do not flex the hip more than 120 degrees. 2) Do not flex the hip more than 30 degrees. 3) Do not flex the hip more than 90 degrees. 4) Do not flex the hip more than 60 degrees.

3

Which is not one of the general nursing measures employed when caring for the client with a fracture? 1) providing comfort measures 2) administering analgesics 3) cranial nerve assessment 4) assisting with ADLs

3

Elderly clients who fall are most at risk for which injuries? 1) Humerus fractures 2) Wrist fractures 3) Cervical spine fractures 4) Pelvic fractures

4

Which is a hallmark sign of compartment syndrome? 1) Edema 2) Pain 3) Motor weakness 4) Weeping skin surfaces

2

Which nursing intervention is essential in caring for a client with compartment syndrome? 1) Wrapping the affected extremity with a compression dressing to help decrease the swelling 2) Removing all external sources of pressure, such as clothing and jewelry 3) Keeping the affected extremity below the level of the heart 4) Starting an I.V. line in the affected extremity in anticipation of venogram studies

2

A client who has fallen and injured a hip cannot place weight on the leg and is in significant pain. After radiographs indicate intact but malpositioned bones, what would the physician diagnose? 1) strain 2) fracture 3) sprain 4) dislocation

4