MLQ Ch 42

Which is one of the most common causes of death in clients diagnosed with fat emboli syndrome? A. Stroke B. Acute respiratory distress syndrome C. Myocardial infarction D. Pulmonary embolism

B

Which of the following disorders results in widespread hemorrhage andmicrothrombosis with ischemia? A. Complex regional pain syndrome (CRPS) B. Disseminated intravascular coagulation (DIC) C. Fat embolism syndrome (FES) D. Avascular necrosis (AVN)

B

Colles fracture occurs in which area? A. Humeral shaft B. Distal radius C. Clavicle D. Elbow

B

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? A. Fat emboli B. Pneumonia C. Spontaneous pneumothorax D. Cardiac tamponade

A

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. A. skin breakdown B. wound infection C. diarrhea D. pneumonia

A, B, D

In a client with a dislocation, the nurse should initially perform neurovascular assessments a minimum of every 15 minutes until stable. Which complication does the assessments help the nurse to monitor in the client? A. Compartment syndrome B. Disseminated intravascular coagulation C. Fat embolism syndrome D. Carpal tunnel syndrome

A

A 14-year-old client is treated in the emergency room for an acute knee sprain sustained during a soccer game. The nurse reviews discharge instructions with the client's parent. The nurse instructs the parent that the acute inflammatory stage will last how long? A. At least 7 days B. 24 to 48 hours C. 4 to 5 days D. 3 to 4 days

B

A client had an above-the-knee amputation of the left leg related to complications from peripheral vascular disease. The nurse enters the client's room and observes the dressing and bed covers saturated with blood. What is the first action by the nurse? A. Notify the health care provider. B. Apply a tourniquet. C. Reinforce the dressing. D. Use skin clips to close the wound.

B

A client asks the nurse why his residual limb cannot be elevated on a pillow. What is the bestresponse by the nurse? A. "You need to turn yourself side to side. If your leg is on a pillow, you would not be able to do that." B. "Elevating the extremity may increase your chances of compartment syndrome." C. "Elevating the leg might lead to a flexion contracture." D. "I am sorry. We ran out of pillows. I can elevate it on a few blankets."

C

A client sustains an injury to the ligaments surrounding a joint. What will the nurse identify this injury as? A. Fracture B. Strain C. Contusion D. Sprain

D

A client with a recent left above-the-knee amputation states, "I can feel pain in my left toes." Which is the best response by the nurse? A. "Your left toes have been amputated." B. "The pain is really from the nerves in the upper leg." C. "Pain medication usually does not help this type of pain." D. "Describe the pain and rate it on the pain scale."

D

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? A. "Apply ice packs for the first 24 to 48 hours, then apply heat packs." B. "Apply heat packs for the first 24 to 48 hours." C. "Apply heat packs for the first 24 hours, then apply ice packs for the next 48 hours." D. "Apply ice packs for the first 12 to 18 hours."

A

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

D

Which term refers to a break in the continuity of a bone? A. Dislocation B. Malunion C. Subluxation D. Fracture

D

Which type of fracture is one in which the skin or mucous membrane wound extends to the fractured bone? A. Complete B. Simple C. Incomplete D. Compound

D

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 occupational therapy. 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 range-of-motion (ROM) exercises to the right leg.

B

Which nursing intervention is appropriate for a client with a closed-reduction extremity fracture? A. Encourage participation in ADLs B. Use frequent dependent positioning to prevent edema C. Promote intake of omega-3 fatty acids D. Administer prescribed enema to prevent constipation

A

A professional tennis player comes to the orthopedic clinic and informs the nurse that he is having pain that radiates down the forearm and is unable to grasp the racket firmly. What does the nurse suspect is occurring with the client? A. Carpal tunnel syndrome B. Shoulder dislocation C. Epicondylitis D. Ganglion cyst

C

An x-ray demonstrates a fracture in which a bone has splintered into several pieces. Which type of fracture is this? A. Impacted B. Depressed C. Comminuted D. Compound

C

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

D

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? A. Less than 24 hours B. At least 1 week C. About 72 hours D. Between 24 and 48 hours

D

A client has delayed bone healing in a fractured right humerus. What should the nurse prepare the client for that promotes bone growth? A. Electrical stimulation B. Administration of antibiotics C. Joint fusion D. Administration of low-dose heparin

A

A client is brought to the emergency department after being struck with a baseball bat on the upper arm while diving for a pitched ball. Diagnostic tests reveal that the humerus is not broken but that the client has suffered another type of injury. What type of injury would the physician likely diagnose? A. contusion B. strain C. subluxation D. sprain

A

A client reports to the emergency department after experiencing pain in the left arm. The client reports having extended both arms in an attempt to prevent a fall. Which fracture type does the nurse anticipate? A. Greenstick fracture B. Colles fracture C. Compound fracture D. Spiral fracture

B

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? A. Do not flex the hip more than 30 degrees. B. Do not flex the hip more than 90 degrees. C. Do not flex the hip more than 120 degrees. D. Do not flex the hip more than 60 degrees.

B

A client undergoes open reduction with internal fixation to treat an intertrochanteric fracture of the right hip. The nurse should include which intervention in the postoperative care plan? A. Keeping a pillow between the client's legs at all times B. Performing passive range-of-motion (ROM) exercises on the client's legs once each shift C. Maintaining the client in semi-Fowler's position D. Turning the client from side to side every 2 hours

A

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

A

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? A. Impacted B. Compression C. Comminuted D. Greenstick

A

Which nursing diagnosis takes highest priority for a client with a compound fracture? A. Risk for infection related to effects of trauma B. Impaired physical mobility related to trauma C. Imbalanced nutrition: Less than body requirements related to immobility D. Activity intolerance related to weight-bearing limitations

A

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? A. analgesia and immobilization B. joint manipulation and immobilization C. ice and immobilization D. heat and immobilization

B

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? A. Bone fragments are separated at the fracture line. B. The fracture line extends through the entire bone substance. C. One side of the bone is broken and the other side is bent. D. The fracture results from an underlying bone disorder.

C

Which of the following would lead a nurse to suspect that a client has a rotator cuff tear? A. Pain worse in the morning B. Ability to stretch arm over the head C. Difficulty lying on affected side D. Minimal pain with movement

C

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? A. Administer prescribed analgesics around-the-clock. B. Avoid administering too much medication because the client is older. C. Give pain medication to the client after providing care. D. Administer prescribed pain medication only when the client requests it.

A

A nurse is assigned to support a patient while a cast is being applied to treat a greenstick fracture. The nurse documents that this fracture is classified as what type of fracture? A. Compression B. Incomplete C. Stress D. Closed

B

Which factor inhibits fracture healing? A. Exercise B. Local malignancy C. Vitamin D D. Maximum bone fragment contact

B

Which term refers to a fracture in which one side of a bone is broken and the other side is bent? A. Oblique B. Greenstick C. Spiral D. Avulsion

B

Elderly clients who fall are most at risk for which injuries? A. Wrist fractures B. Cervical spine fractures C. Pelvic fractures D. Humerus fractures

C

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? A. dislocation B. fracture C. sprain D. strain

A

A patient sustains a fracture of the arm. When does the nurse anticipate pendulum exercise should begin? A. In 2 to 3 months, after normal activities are resumed B. As soon as tolerated, after a reasonable period of immobilization C. In 2 to 3 weeks, when callus ossification prevents easy movements of bony fragments D. In about 4 to 5 weeks, after new bone is well established

B

The nurse is caring for a client who was involved in an automobile accident and sustained multiple trauma. The client has a Volkmann's contracture to the right hand. What objective data does the nurse document related to this finding? A. Dislocation of the fingers B. Claw-like deformity of the right hand without ability to extend fingers C. Extension of the fingers of the right hand D. Nodules on the knuckles of the third and fourth finger

B

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? A. "I'll start with ice for the first couple of hours and then apply heat." B. "I'll get the prescription filled for the narcotic pain reliever." C. "I'll make sure to keep my ankle elevated as much as possible." D. "I need to stay off my ankle for at least the next 3 to 4 weeks."

C

A client reports pain in the right knee, stating, "My knee got twisted when I was going down the stairs." The client was diagnosed with an injury to the ligaments and tendons of the right knee. Which terminology, documented by the nurse, best reflects the injury? A. Sprain B. Subluxation C. Strain D. Dislocation

A

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

B

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. a reaction to an internal fixation device. B. avascular necrosis of bone. C. heterotrophic ossification. D. complex regional pain syndrome.

D