Review Ch 21, 42, 68
The nurse in an orthopedic clinic is caring for a new client. What sign or symptom would lead a nurse to suspect that a client has a rotator cuff tear? Ability to stretch arm over the head Difficulty lying on affected side Minimal pain with movement Pain worse in the morning
Difficulty lying on affected side
A client has delayed bone healing in a fractured right humerus. What should the nurse prepare the client for that promotes bone growth? Administration of antibiotics Administration of low-dose heparin Joint fusion Electrical stimulation
Electrical stimulation
Which term refers to a break in the continuity of a bone? Subluxation Malunion Fracture Dislocation
Fracture
A patient sustains an open fracture with extensive soft tissue damage. The nurse determines that this fracture would be classified as what grade? IV I III II
III
Which type of fracture occurs when a bone fragment is driven into another bone fragment? Spiral Impacted Oblique Transverse
Impacted
Which type of fracture involves a break through only part of the cross-section of the bone? Open Comminuted Incomplete Oblique
Incomplete
Which nursing intervention is essential in caring for a client with compartment syndrome? Removing all external sources of pressure, such as clothing and jewelry Keeping the affected extremity below the level of the heart term-3Wrapping the affected extremity with a compression dressing to help decrease the swelling Starting an I.V. line in the affected extremity in anticipation of venogram studies
Keeping the affected extremity below the level of the heart
Comminuted Fracture
This is what type of fracture
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? "Apply ice packs for the first 12 to 18 hours." "Apply heat packs for the first 24 to 48 hours." "Apply ice packs for the first 24 to 48 hours, then apply heat packs." "Apply heat packs for the first 24 hours, then apply ice packs for the next 48 hours."
"Apply ice packs for the first 24 to 48 hours, then apply heat packs."
A client has sustained a right tibial fracture and has just had a cast applied. Which instruction should the nurse provide in client cast care? "A foul smell from the cast is normal." "Keep your right leg elevated above heart level." "Use a knitting needle to scratch itches inside the cast." "Cover the cast with a blanket until the cast dries."
"Keep your right leg elevated above heart level."
A client is to undergo surgery to repair a ruptured Achilles tendon and application of a brace. The client demonstrates understanding of activity limitations when stating that a brace must be worn for which length of time? 6 to 8 weeks 10 to 12 weeks 2 to 4 weeks 14 to 16 weeks
6 to 8 weeks
A patient sustained a head trauma in a diving accident and has a cerebral hemorrhage located within the brain. What type of hematoma is this classified as? An extradural hematoma An epidural hematoma An intracerebral hematoma A subdural hematoma
A subdural hematoma
Which is one of the most common causes of death in clients diagnosed with fat emboli syndrome? Stroke Pulmonary embolism Myocardial infarction Acute respiratory distress syndrome
Acute respiratory distress syndrome
An older adult client slipped on an area rug at home and fractured the left hip. The client is unable to have surgery immediately and is having severe pain. What interventions should the nurse provide for the patient to minimize energy loss in response to pain? Administer prescribed pain medication only when the client requests it. Administer prescribed analgesics around-the-clock. Avoid administering too much medication because the client is older. Give pain medication to the client after providing care.
Administer prescribed analgesics around-the-clock.
When is it advisable for the nurse to apply heat to a sprain or a contusion? Immediately After 2 days Only after a week Do not apply at all
After 2 days
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? Between 24 and 48 hours About 72 hours Less than 24 hours At least 1 week
Between 24 and 48 hours
The nurse is caring for a patient in the emergency department with a diagnosed epidural hematoma. What procedure will the nurse prepare the patient for? Hypophysectomy Insertion of Crutchfield tongs Application of Halo traction Burr holes
Burr holes
Which assessment findings would the nurse expect to find in the postoperative client experiencing fat embolism syndrome? Column A Column B Column C Column D
Column B
An x-ray demonstrates a fracture in which a bone has splintered into several pieces. Which type of fracture is this? Comminuted Compound Depressed Impacted
Comminuted
A client comes to the emergency department and reports localized pain and swelling in the lower leg. Ecchymotic areas are noted. History reveals that the client got hit in the leg with a baseball bat. What will the nurse most likely suspect? Strain Fracture Sprain Contusion
Contusion
A client comes to the emergency department complaining of localized pain and swelling of the lower leg. Ecchymotic areas are noted. History reveals that the client got hit in the leg with a baseball bat. Which of the following would the nurse suspect as most likely? Strain Contusion Fracture Sprain
Contusion
A client is brought to the emergency department after injuring the right arm in a bicycle accident. The orthopedic surgeon tells the nurse that the client has a greenstick fracture of the arm. What does this mean? Bone fragments are separated at the fracture line. The fracture results from an underlying bone disorder. The fracture line extends through the entire bone substance. One side of the bone is broken and the other side is bent.
One side of the bone is broken and the other side is bent.
A client with metastatic bone cancer sustained a left hip fracture without injury. What type of fracture does the nurse understand occurs without trauma or fall? Pathologic fracture Impacted fracture Transverse fracture Compound fracture
Pathologic fracture
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? Keep the hip flexed by placing pillows under the client's knee. Prevent internal rotation of the affected leg. Keep the affected leg in a position of adduction. Use measures other than turning to prevent pressure ulcers.
Prevent internal rotation of the affected leg.
Which nursing intervention is essential in caring for a client with compartment syndrome? Removing all external sources of pressure, such as clothing and jewelry Wrapping the affected extremity with a compression dressing to help decrease the swelling
Removing all external sources of pressure, such as clothing and jewelry
Which of the following musculoskeletal injuries is manifested by acromioclavicular joint pain? Heterotopic ossification Acute compartment syndrome Epicondylitis Rotator cuff tears
Rotator cuff tears
Which term refers to an injury to ligaments and other soft tissues surrounding a joint? Strain Sprain Dislocation Subluxation
Sprain
A client has had surgical repair of a hip injury after joint manipulation was unsuccessful. During postoperative recovery, what specific complication might develop in this client's case? compartment syndrome pyelonephritis subluxation All options are correct.
compartment syndrome
When the client who has experienced trauma to an extremity reports severe burning pain, vasomotor changes, and muscles spasms in the injured extremity, the nurse recognizes that the client is likely demonstrating signs of a reaction to an internal fixation device. heterotrophic ossification. complex regional pain syndrome. avascular necrosis of bone.
complex regional pain syndrome.
The type of fracture described as having one side of the bone broken and the other side bent would be: greenstick. transverse. spiral. oblique.
greenstick.
A fracture is considered pathologic when it presents as one side of the bone being broken and the other side being bent. results in a fragment of bone being pulled away by a ligament or tendon and its attachment. involves damage to the skin or mucous membranes. occurs through an area of diseased bone.
occurs through an area of diseased bone.
A fracture is considered pathologic when it presents as one side of the bone being broken and the other side being bent. results in a fragment of bone being pulled away by a ligament or tendon and its attachment. involves damage to the skin or mucous membranes. occurs through an area of diseased bone.
occurs through an area of diseased bone.
A client who has been severely beaten is admitted to the emergency department. The nurse suspects a basilar skull fracture after assessing: pupillary changes. motor loss in the legs that exceeds that in the arms. nuchal rigidity and Kernig's sign. raccoon's eyes and Battle sign.
raccoon's eyes and Battle sign.
Which of the following disorders results in widespread hemorrhage and microthrombosis with ischemia? Fat embolism syndrome (FES) Avascular necrosis (AVN) Complex regional pain syndrome (CRPS) Disseminated intravascular coagulation (DIC)
DIC
A client with arterial insufficiency undergoes below-knee amputation of the right leg. Which action should the nurse include in the postoperative care plan? Elevating the stump for the first 24 hours Removing the pressure dressing after the first 8 hours Maintaining the client on complete bed rest Applying heat to the stump as the client desires
Elevating the stump for the first 24 hours
The nurse working on a neurological unit is mentoring a nursing student who asks about a client who has sustained primary and secondary brain injuries. The nurse correctly tells the student which of the following, related to the secondary injury? It results from initial damage to the brain from the traumatic event. It refers to the difficulties suffered by the client and family related to the changes in the client. It results from inadequate delivery of nutrients and oxygen to the cells. It refers to the permanent deficits seen after the rehabilitation process.
It results from inadequate delivery of nutrients and oxygen to the cells.
Which may occur if a client experiences compartment syndrome in an upper extremity? Whiplash injury Volkmann's contracture Callus Subluxation
Volkmann's contracture
Which is not one of the general nursing measures employed when caring for the client with a fracture? cranial nerve assessment providing comfort measures administering analgesics assisting with ADLs
cranial nerve assessment
The nurse working on a neurological unit is mentoring a nursing student. The student asks about a client who has sustained a primary and secondary brain injury. The nurse correctly tells the student which of the following, related to the primary injury? It results from initial damage to the brain from the traumatic event. It refers to the difficulties suffered by the client and family related to the changes in the client. It refers to the permanent deficits seen after the rehabilitation process. It results from inadequate delivery of nutrients and oxygen to the cells.
It results from initial damage to the brain from the traumatic event.
A client has been in a motor vehicle collision. Radiographs indicate a fractured humerus; the client is awaiting the casting of the upper extremity and admission to the orthopedic unit. What is the primary treatment for musculoskeletal trauma? external rotation enhancing complications immobilization surgical repair
immobilization
The nurse assesses subtle personality changes, restlessness, irritability, and confusion in a client who has sustained a fracture. The nurse suspects which complication? Reflex sympathetic dystrophy syndrome Hypovolemic shock Compartment syndrome Fat embolism syndrome
Fat embolism syndrome
Radiographic evaluation of a client's fracture reveals that a bone fragment has been driven into another bone fragment. The nurse identifies this as which type of fracture? Comminuted Greenstick Compression Impacted
Impacted
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? Spontaneous pneumothorax Cardiac tamponade Pneumonia Fat emboli
Fat emboli
After a car accident, a client is admitted to an acute care facility with multiple traumatic injuries, including a fractured pelvis. For 24 to 48 hours after the accident, the nurse must monitor the client closely for which potential complication of a fractured pelvis? Volkmann's ischemic contracture Infection Compartment syndrome Fat embolism
Fat embolism
The nurse is discussing spinal cord injury (SCI) at a health fair at a local high school. The nurse relays that the most common cause of SCI is Motor vehicle crashes Sports-related injuries Acts of violence Falls
Motor vehicle crashes