Patho Exam 5 Ch 43

Which type of fracture involves healing of more than two pieces of bone?

Comminuted fracture.

A nurse is teaching the parent of a child with a diagnosis of Legg-Calvè-Perthes disease about the prescribed treatment. Which of the following statements by the parent indicates adequate understanding?

"A genetic pattern for this disease has not been established."

Which of the following information would the nurse include when teaching potential parents about prevention of congenital deformities? Select all that apply.

"Do not take any medication without first talking to your healthcare provider." and "Limit exposure to alcohol."

The nurse is providing discharge instructions to a client who experienced a ligamentous sprain. The nurse determines that teaching was effective when the client states:

"I should rest, apply ice, compression, and elevation to the extremity."

A 17 year-old male has been diagnosed with osteosarcoma of the upper tibia following several months of leg pain. Which of the following statements by the client demonstrates that he has an accurate understanding of his diagnosis?

"I'm really nervous about having to get surgery and chemo."

A month after surgical repair of a rotator cuff tear of the shoulder, a patient tells the nurse, "This is not getting any better. I still have a lot of pain and limited motion." Which of the following is the nurse's best response?

"The shoulder joint is complex and can take up to a year to heal completely."

A month after surgical repair of a rotator cuff tear of the shoulder, a patient tells the nurse, "This is not getting any better. I still have a lot of pan and limited motion." Which of the following is the nurse's best response?

"The shoulder joint is complex and can take up to a year to heal completely."

Which of the following should the nurse teach a patient about syndactyly?

"This is a simple webbing of the fingers or toes."

A teen diagnosed with stage 1 osteosarcoma of the knee tearfully asks the nurse if the leg must be amputated. Which of the following is the nurse's most appropriate response?

"What bothers you the most about the possibility of amputation?"

Following genetic testing and a thorough history from the child's mother and father, a 5 month-old boy has been diagnosed with osteogenesis imperfecta. What teaching point should the care team provide to the mother father?

"You'll need to be very careful to avoid causing fractures to his fragile bones."

Osteomyelitis is an infection of the bone. Chronic osteomyelitis is complicated by a piece of infected dead bone that has separated from the living bone. How long does the initial intravenous antibiotic therapy last for chronic osteomyelitis?

6 weeks.

Which person is most at risk for hip fractures?

66-year-old Caucasian female with history of alcoholism.

The nurse knows that which of the following patients listed below is at high risk for developing a hip fracture?

82 year old female with macular degeneration and uses a walker to go to the bathroom.

Which of the following patients' fracture will need the shortest healing time?

9-year-old client a simple wrist fracture.

Which of the following individuals is likely to have the highest risk of developing tuberculosis osteomyelitis?

A 79 year-old man who is immunocompromised following a bone marrow transplant.

Which of the following children requires further assessment of potential abnormalities?

A child who is walking who has external rotations of the feet.

A parent brings his child to the emergency department after the child sustains a fall from a tree. The child has severe right arm pain. A radiograph shows a complete break in the humerus with multiple pieces of bone at the fracture line and the skin is not broken. This type of fracture is classified as which of the following?

A closed, comminuted fracture.

Which of the following newborn infants demonstrates the highest risk of presenting with developmental dysplasia of the hip (DDH)?

A girl who was born with toeing-in and who was in a breech presentation.

The health care provider is evaluating a client with a suspected benign bone tumor. The provider confirms the diagnosis after evaluation of the client's x-ray results. Select the best description of the results.

A uniform and well-defined area with well-demarcated edges.

Which of the following is the definition of a congenital deformity?

Abnormalities present at birth.

The health care provider is caring for a client who has just been diagnosed with an osteosarcoma. Select the response that best describes the diagnosis.

Aggressive; malignant bone tumor.

Following prosthetic joint replacement of the knee, the patient continues to complain of pain and discomfort above what would be expected. There is poor incisional healing. The clinic nurse is concerned when she sees that the incision is still draining after three weeks post-op. The nurse suspects a prosthetic joint infection. The nurse should anticipate the physician will prescribe:

Antimicrobial treatment depending on the microbe.

A patient suffers a musculoskeletal injury while participating in a sporting event. Which of the following is the appropriate initial treatment?

Applying ice and sitting out the rest of the game.

The health care provider is evaluating a client who is at risk for the development of osteonecrosis. The client is at risk for:

Aseptic necrosis of a bone segment caused by interruption of the blood supply.

The nurse is screening a newborn for developmental dysplasia of the hip. Which of the following assessment findings supports this diagnosis?

Asymetrical gluteal and thigh folds.

What is the term use to describe a tumor that while growing slowly does not destroy the surrounding tissues?

Benign.

Which of the following interventions for a patient with metastatic bone disease can help prevent pathologic fractures? Select all that apply.

Bisphosphonates, and radiation therapy.

A child has been diagnosed with myopathic neuromuscular scoliosis. What other concurrent diagnosis may the child have?

Cerebral palsy.

Which of the following statements is true about congenital club foot?

Club foot may be associated with congenital syndromes.

The nurse is assessing a client who sustained a fractured radious. A cast was applied to the extremity approximately 1 hour ago, and the client is now complaining of increased pain and numbness to the finger tips. The client is most likely experiencing:

Compartment syndrome.

The nurse is assessing a client who sustained a fractured radius. A cast was applied to the extremity approximately 1 hour ago, and the client is now complaining of increased pain and numbness to the finger tips. The client is most likely experiencing:

Compartment syndrome.

The nurse is caring for a client who states that he is suddenly having severe pain at a leg fracture site. The nurse notes increased swelling in the limb and difficulty palpating a pulse. The nurse suspects that the client may have which of the following?

Compartment syndrome.

A basketball player collided hard with another player and suffered a soft tissue injury to the forearm from the impact though it did not break the skin. The nurse should recognize the presence of which type of injury?

Contusion.

What term describes an injury to the soft tissue of the body?

Contusion.

A 22 year-old woman has sustained a lateral blow to her right knee during a game, and subsequent imaging has confirmed a severe meniscus injury. Which of the following consequences should the woman expect over the course of recovery? Select all that apply.

Decreased lubrication in the knee joint, decreased stability of the knee, and reduced shock absorption capacity.

The nurse is caring for a client several fractures that have been immobilized. Which of the following assessment data would be most indicative of a potential complication?

Deep, throbbing, unrelenting pain.

Which of the following activities is most likely to create a spiral fracture?

Falling on a ski hill with bindings that do not release.

A nursing student who is studying about disorders of the skeletal system is heard making the following statement, "Many skeletal disorders of early infancy are caused by intrauterine positions and need to be surgically fixed." Is this statement true or false?

False.

A nurse admitting a patient to the emergency department with a suspected fracture notes a deep abrasion with bruising. The patient reports receiving a hard tackle during a football game. Which of the following grades of tissue damage accompanies this fracture?

Grade 2.

A client tells the nurse she is very concerned because the health care provider informed her that her fractured arm is healing with malunion. The nurse recognizes this as:

Healing with deformity, angulation, or rotation that is visible on x-ray films.

The client develops osteomyelitis that has originated from infectious organisms that reach the bone through the bloodstream. This is known as which type of osteomyelitis?

Hematogenous.

Athletic injuries fall into two types, acute or overuse injuries. Where do overuse injuries commonly occur?

Knee.

The physical therapy student is explaining complication of fracture healing. Which of the following is a contributing factor to failure of a bone to heal before the process of bone repair stops?

Mobility at fracture site.

The primary care provider has positioned an infant in the supine position with both knees flexed and applied gentle downward pressure to both knees. The knee and thigh have been abducted while an upward and medial pressure was applied to the proximal thigh. What examination technique has been performed on this infant?

Ortolani manoeuvre.

A patient sustains a musculoskeletal injury of the wrist. Which of the following manifestations would the nurse expect to accompany the strain?

Pain and stiffness.

A patient had a closed reduction of a wrist fracture and had a plaster cast applied. Which of the following nursing actions is the highest priority immediately after the procedure?

Performing a neurovascular assessment (NVA).

A patient with a compound fracture of the femur is in balanced skeletal traction. Which of the following assessment data must be reported immediately?

Redness and heat at fracture site.

The health care provider is explaining the course of treatment to the parents of a 2-day-old infant born with clubfeet. The most appropriate information to provide would be:

Serial manipulations and casting of the affected extremity.

The health care provider is explaining the course treatment to the parents of a 2-day-old infant born with clubfeet. The most appropriate information to provide would be:

Serial manipulations and casting of the affected extremity.

Tuberculosis can spread from the lungs into the musculoskeletal system. What is the most common site in the skeletal system for tuberculosis to be found?

Spine.

An 80-year-old client is admitted to the hospital with a displaced intracapsular hip fracture. The physician explains to the client's family that this type of fracture is best treated by which of the following?

Surgical hip replacement and early mobilization.

What assessment findings will the nurse find in a client who has patellar subluxation? Select all that apply.

Swelling, crepitus, stiffness, and "popping" sound.

When trying to explain to a patient diagnosed with a benign bone tumor, the nurse should emphasize the fact that benign tumors primarily:

Tend to grow very slowly without destroying the supporting tissue.

Which client admitted to the emergency department should the nurse prioritize to see first?

The client with a puncture would of the chest.

A 41 year-old woman has been diagnosed as having a loose body of cartilage in her left knee. What data would be most likely to lead clinicians to this conclusion?

The woman experiences intermittent, painful locking of her joint.

Osgood-Schlatter disease is a disease that strikes children between the ages of 11 and 15. This disease involves microfractures, where the patellar tendon inserts into the tibial tubercle. What is Osgood-Schlatter disease characterized by?

Thickening of patellar tendon.

The nurse assesses the neurovascular status of a patient who had surgery to repair a fractured hip. Which of the following assessment data for the affected leg indicates that the patient has developed a neurological complication?

Tingling sensations.

A newly admitted client's health record states that the client's health history includes tubercular osteomyelitis. Where is the most likely anatomical site of this infection?

Vertebrae.

A client with a fractured clavicle is told that the bone will heal well if immobilized for the next 6 to 8 weeks, but there will be a large "bump" where the break occurred. This bump will be caused by:

formation of a bony callus.