Chapter 54: Coordinating Care for Patients with Musculoskeletal Trauma

During a home visit, the nurse suspects that a patient recovering from an amputation is not complying with prescribed postoperative care. The nurse makes this clinical determination based on what observation? 1. Suture line pink and slightly edematous 2. Evidence of a developing hip contracture 3. Stump wrapped with a compression bandage 4. Taking opioid medication every 8 to 10 hours

2. Evidence of a developing hip contracture

A victim of a motor vehicle crash has a partially severed lowered extremity. What are the priority actions the nurse needs to implement when the patient arrives in the emergency department? Select all that apply. 1. Administering antibiotics 2. Preparing for blood transfusions 3. Preparing for emergency surgery 4. Assessing for active hemorrhaging 5. Monitoring effectiveness of tourniquet

2. Preparing for blood transfusions 3. Preparing for emergency surgery 4. Assessing for active hemorrhaging 5. Monitoring effectiveness of tourniquet

A patient recovering from surgery to repair a fractured hip is placed in skin traction. The nurse correlates which data to the effectiveness of the traction? 1. Strong peripheral pulses 2. Reduction in muscle spasms 3. Improved mobility of the foot 4. Reduction of lower extremity edema

2. Reduction in muscle spasms

The nurse is reviewing statistics about the frequency of anterior cruciate ligament (ACL) tears. Which sports activities have the greatest risk of this type of injury? Select all that apply. 1. Weightlifting 2. Soccer 3. Baseball 4. Basketball 5. Gymnastics

2. Soccer 4. Basketball 5. Gymnastics

The nurse provides education to a patient who is diagnosed with tendinitis of the knee. Which patient statement indicates the need for further teaching? 1. "My condition is caused by overuse of my knee." 2. "My condition is an inflammation of the knee tendons." 3. "I will need to exercise my knee to decrease my symptoms." 4. "I will take my anti-inflammatory medication for the knee pain."

3. "I will need to exercise my knee to decrease my symptoms."

The nurse correlates that the patient with which type of musculoskeletal trauma has the highest risk of developing rhabdomyolysis? 1. Traumatic amputation 2. Compound fracture of the femur 3. Crush injury of the pelvis 4. Compression fracture of the lumbar spine

3. Crush injury of the pelvis

A patient has an injury where one side of the bone is bent and the other is fractured. How does the nurse document this fracture? 1. Spiral 2. Oblique 3. Greenstick 4. Comminuted

3. Greenstick

A patient is in skeletal traction secondary to a fracture of the left femur. When the patient's spouse asks about the purpose of traction, which response by the nurse is best? 1. "This type of traction prevents movement of any part of the left leg." 2. "This type of traction decreases the chance of bone infection." 3. "This type of traction is used to treat muscle spasms in the left leg." 4. "This type of traction aids in realigning the bone."

4. "This type of traction aids in realigning the bone."

The nurse provides care to a patient who experienced a femur fracture. Which clinical manifestation requires immediate notification of the healthcare provider? 1. Pain 2. Edema 3. Nausea 4. Restlessness

4. Restlessness

The nurse provides discharge instructions for a patient who experienced a traumatic amputation of the leg below the knee. Which patient statement indicates the need for further teaching? 1. "I will elevate my leg with a pillow." 2. "I will need to start wrapping my stump 1 to 3 days after surgery." 3. "I will eat foods high in protein and carbohydrates." 4. "I will apply ice to the area for no more than 15 to 20 minutes at a time."

1. "I will elevate my leg with a pillow."

The nurse provides education to patient who is diagnosed with an ankle sprain. Which patient statement indicates the need for further l teaching? 1. "I will need to rest my ankle for 24 hours." 2. "I will apply ice to my ankle for 30 minutes three to four times a day." 3. "I will keep the compression bandage in place to decrease further swelling." 4. "I will elevate my ankle to decrease the dependent swelling that may occur."

1. "I will need to rest my ankle for 24 hours."

The nurse correlates which etiology to a diagnosed low-energy fracture in a 65-year-old patient? 1. A fall 2. Golfing 3. Bicycle accident 4. Motor vehicle collision

1. A fall

While playing tennis a patient fell and sustained a nondisplaced fracture of the right elbow. The nurse prepares the patient for which treatment? 1. Closed reduction and cast 2. Splint 3. External fixator 4. Pressure dressing

1. Closed reduction and cast

A patient is diagnosed with a third-degree sprain. What should the nurse expect to assess in this patient? Select all that apply. 1. Edema 2. Severe pain 3. Ecchymosis 4. Joint instability 5. Altered ability to ambulate

1. Edema 2. Severe pain 3. Ecchymosis 4. Joint instability

The nurse requests an occupational therapy consultation for a patient with bilateral carpal tunnel syndrome to assist the patient with which behavior? 1. Evaluate work environment 2. Instruct on hand exercises 3. Instruct on the use of splints 4. Review the action of NSAIDs

1. Evaluate work environment

A patient recovering from surgery to repair a fractured femur is experiencing extreme pain and pulselessness. The nurse recognizes which treatment is indicated for this patient? 1. Fasciotomy 2. Skeletal traction 3. Intravenous fluids 4. Patient-controlled pain management

1. Fasciotomy

Which prescribed medication for the patient recovering from a traumatic amputation does the nurse correlate to the treatment of phantom limb pain? 1. Gabapentin 2. Ibuprofen 3. Opioids 4. Muscle relaxants

1. Gabapentin

A patient is diagnosed with a small meniscus tear of the right knee. For which interventions does the nurse prepare the patient? Select all that apply. 1. Ice 2. Limited rest 3. Physical therapy for a month 4. Total immobility for several weeks 5. Use of nonsteroidal anti-inflammatory drugs (NSAIDs)

1. Ice 2. Limited rest 5. Use of nonsteroidal anti-inflammatory drugs (NSAIDs)

The nurse suspects that a patient sustained a meniscus tear while playing basketball. The nurse makes this determination based on which clinical manifestations? 1. Knee pops when bent 2. Weak peripheral pulses 3. Reduced muscle tone of the thigh 4. Calf cramping with the knees bent

1. Knee pops when bent

The nurse monitors for which clinical manifestations of neurovascular compromise in the patient with an injured ankle? Select all that apply. 1. Pain 2. Pressure 3. Paralysis 4. Purulence 5. Pulselessness

1. Pain 2. Pressure 3. Paralysis 5. Pulselessness

The nurse monitors for which clinical manifestations in the patient with suspected compartment syndrome? Select all that apply. 1. The patient reports pain. 2. The patient's limb is red. 3. The patient reports numbness. 4. The patient's pulses are bounding. 5. The patient reports a feeling of pressure.

1. The patient reports pain. 3. The patient reports numbness. 5. The patient reports a feeling of pressure.

The nurse is reviewing postoperative instructions with a patient recovering from carpal tunnel syndrome (CTS) surgery. Which statement by the patient indicates the need for further teaching? 1. "I should take the pain medication as prescribed." 2. "I should expect my hand to feel numb for a few weeks." 3. "I should perform hand exercises as directed by the therapist." 4. "I should stop any activity that causes hand numbness or pain."

2. "I should expect my hand to feel numb for a few weeks."

Which statement by the patient scheduled for an open reduction and internal fixation (ORIF) of a compound fracture of the femur indicates the need for further teaching? 1. "The surgeon will put rods and nails into my leg to align the fracture." 2. "I will have to be in traction after this surgery." 3. "The pins do not have to be removed; they will stay in my body." 4. "I will need to monitor for infection as I heal."

2. "I will have to be in traction after this surgery."

A patient with Paget's disease is demonstrating manifestations of a fracture. The results of which diagnostic test is most effective in confirming the fracture? 1. X-ray 2. Bone scan 3. Arthroscopy 4. Bone density test

2. Bone scan

A patient with bilateral carpal tunnel syndrome (CTS) does not want to have surgery. The nurse teaches the patient that this increases the risk of which complication? 1. Infection 2. Chronic pain 3. Decreased circulation 4. Hematoma formation

2. Chronic pain

In providing care to the patient with an aseptic nonunion of a fracture, the nurse correlates which prescribed medication as a potential cause of this complication? 1. Antibiotics 2. Muscle relaxants 3. NSAIDs 4. Opioids

3. NSAIDs

Which statement by the patient diagnosed with a second-degree sprain indicates the need for further teaching? 1. "I should apply ice." 2. "I should elevate my leg." 3. "I should expect the leg to feel numb." 4. "I should take pain medication as directed."

3. "I should expect the leg to feel numb."

The nurse is preparing a teaching tool for a community health program. What does the nurse include as a risk factor for the development of carpal tunnel syndrome (CTS)? 1. Male gender 2. Age younger than 20 3. Plays musical instruments 4. Works as a marketing manager

3. Plays musical instruments

The nurse monitors for which clinical manifestations in the patient with suspected carpal tunnel syndrome (CTS)? 1. Reduced radial pulses 2. Fingers cool to touch 3. Capillary refill 3 seconds 4. Hand tingling during the night

4. Hand tingling during the night

A patient sustained a meniscus injury several months ago and did not seek medical attention. The nurse monitors the patient for the development of which complication? 1. Tendonitis 2. Fractured patella 3. Dependent edema 4. Permanent joint damage

4. Permanent joint damage