Ortho Prep u 4

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

Greenstick

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? Septicemic Cardiogenic Neurogenic Hypovolemic

Hypovolemic

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? Compound fracture Pathologic fracture Impacted fracture Transverse fracture

Pathologic fracture

Elderly clients who fall are most at risk for which injuries? Cervical spine fractures Wrist fractures Humerus fractures Pelvic fractures

Pelvic fractures

Which may occur if a client experiences compartment syndrome in an upper extremity? Callus Volkmann's contracture Subluxation Whiplash injury

Volkmann's contracture

After surgery to treat a hip fracture, a client returns from the postanesthesia care unit to the medical-surgical unit. Postoperatively, how should the nurse position the client? With the leg on the affected side adducted With the affected hip flexed acutely With the leg on the affected side abducted With the affected hip rotated externally

With the leg on the affected side abducted

A nurse suspects that a client with a recent fracture has compartment syndrome. Assessment findings may include: a growth in and around the bone tissue. inability to perform passive movement and pain with active movement. body-wide decrease in bone mass. inability to perform active movement and pain with passive movement.

inability to perform active movement and pain with passive movement.

Which of the following disorders results in widespread hemorrhage and microthrombosis with ischemia? Disseminated intravascular coagulation (DIC) Fat embolism syndrome (FES) Complex regional pain syndrome (CRPS) Avascular necrosis (AVN)

Disseminated intravascular coagulation (DIC)

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 heat packs for the first 24 to 48 hours." "Apply ice packs for the first 24 to 48 hours, then apply heat packs." "Apply ice packs for the first 12 to 18 hours." "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 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? "Your left toes have been amputated." "The pain is really from the nerves in the upper leg." "Pain medication usually does not help this type of pain." "Describe the pain and rate it on the pain scale."

"Describe the pain and rate it on the pain scale."

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

"Elevating the leg might lead to a flexion contracture."

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

"I'll make sure to keep my ankle elevated as much as possible."

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

Avascular necrosis

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

Avascular necrosis

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

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? Disseminated intravascular coagulation Carpal tunnel syndrome Fat embolism syndrome Compartment syndrome

Compartment syndrome

A client presents to the emergency department with an open fracture. What is the first action the nurse should take? Cover the exposed bone with sterile dressing. Perform a neurovascular assessment of the affected extremity. Assist the physician with reduction of the fracture. Assess the client's vital signs and determine allergies.

Cover the exposed bone with sterile dressing.

The nurses 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? Do not flex the hip more than 30 degrees. Do not flex the hip more than 90 degrees. Do not flex the hip more than 120 degrees. Do not flex the hip more than 60 degrees.

Do not flex the hip more than 90 degrees.

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

Encourage participation in ADLs

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 Compartment syndrome Fat embolism Infection

Fat embolism

Which term refers to a break in the continuity of a bone? Dislocation Malunion Fracture Subluxation

Fracture

Which type of fracture involves a break through only part of the cross-section of the bone? Comminuted Oblique Incomplete Open

Incomplete

The nurse is caring for a patient who sustained an open fracture of the right femur in an automobile accident. What does the nurse understand is the most serious complication of an open fracture? Necrosis of adjacent soft tissue caused by blood loss Infection Muscle atrophy caused by loss of supporting bone structure Nerve damage

Infection

Which factor inhibits fracture healing? Exercise Vitamin D Local malignancy Maximum bone fragment contact

Local malignancy

Which nursing intervention is appropriate for minimizing muscle spasms in the client with a hip fracture? Maintain Buck's traction. Apply a soft compression dressing. Maintain the internal fixator. Assist the client with use of a trapeze.

Maintain Buck's traction.

Which term refers to the failure of fragments of a fractured bone to heal together? Dislocation Subluxation Nonunion Malunion

Nonunion

The emergency department nurse teaches clients with sports injuries to remember the acronym PRICE. This acronym stands for which combination of treatments? Pressure, rotation, ice, compression, examination Protection, rest, ice, circulation, examination Pressure, rotation, immersion, compression, elevation Protection, rest, ice, compression, elevation

Protection, rest, ice, compression, elevation

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

Risk for infection related to effects of trauma

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? Subluxation Volkmann's contracture Compartment syndrome Sprain

Subluxation

A client is diagnosed with a first-degree strain of the left ankle related to running 5 miles daily. How would the nurse differentiate the first-degree strain from other strains and sprains? The client has ecchymosis, edema, and has no function of the left foot and ankle. The client is unable to bear weight on the left ankle and has a large ecchymotic area. The client complains of pain when the joint is moved and has mild edema. The client has some edema of the left ankle with muscle spasms but is able to walk without assistive devices.

The client has some edema of the left ankle with muscle spasms but is able to walk without assistive devices.

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? sprain subluxation strain contusion

contusion

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? dislocation fracture sprain strain

dislocation

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? immobilization surgical repair external rotation enhancing complications

immobilization

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. diarrhea skin breakdown pneumonia wound infection

skin breakdown wound infection pneumonia

A client who suffers an injury in a local high school hockey game presents with left shoulder pain. The client cannot move the left arm, and the left shoulder is lower than the right shoulder. The nurse recognizes the client most likely has a: Clavicle fracture Dislocated elbow Cervical injury Dislocated shoulder

Dislocated shoulder

Which of the following disorders results in widespread hemorrhage and microthrombosis with ischemia? Disseminated intravascular coagulation (DIC) Complex regional pain syndrome (CRPS) Fat embolism syndrome (FES) Avascular necrosis (AVN)

Disseminated intravascular coagulation (DIC)

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 Compression Greenstick Impacted

Impacted

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? Compression Greenstick Comminuted Impacted

Impacted

Elderly clients who fall are most at risk for which injuries? Pelvic fractures Humerus fractures Wrist fractures Cervical spine fractures

Pelvic fractures

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 to perform? analgesia and immobilization heat and immobilization ice and immobilization joint manipulation and immobilization

joint manipulation and immobilization

The post-amputation client is seen by the home health nurse. One client outcome included preventing exposure to infection. Which finding would indicate to the nurse that this outcome was met? Decreased need for pain medication Absence of fever Decreased activity tolerance Increased participation in self-care

Absence of fever

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

Capillary refill.

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

Difficulty lying on affected side

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

Difficulty lying on affected side

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

As soon as tolerated, after a reasonable period of immobilization

A client undergoes a total hip replacement. Which statement made by the client indicates to the nurse that the client requires further teaching? "The occupational therapist is showing me how to use a sock puller to help me get dressed." "I don't know if I'll be able to get off that low toilet seat at home by myself." "I'll need to keep several pillows between my legs at night." "I need to remember not to cross my legs. It's such a habit."

"I don't know if I'll be able to get off that low toilet seat at home by myself."

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

Apply ice to the fracture site.

A client comes to the emergency department complaining of localized pain and swelling of his 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? Fracture Sprain Contusion Strain

Contusion

The patient presents to the emergency room with an open fracture of the femur. Which action would the nurse implement to prevent the most serious complication of an open fracture? Cover the wound with a sterile dressing to prevent infection. Apply a pressure bandage to decrease tissue damage. Reduce the fracture to prevent additional tissue damage. Immobilize the joint to prevent movement of bone fragments.

Cover the wound with a sterile dressing to prevent infection.

Which term refers to a blunt force injury to soft tissue? Strain Fracture Dislocation Contusion

Contusion

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

Elevating the stump for the first 24 hours

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? fat embolism avascular necrosis shock pulmonary embolism

avascular necrosis

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? Turning the client from side to side every 2 hours Performing passive range-of-motion (ROM) exercises on the client's legs once each shift Maintaining the client in semi-Fowler's position Keeping a pillow between the client's legs at all times

Keeping a pillow between the client's legs at all times

A client who was in a motor vehicle crash is diagnosed with a stable T7 spinal fracture with no neurologic deficits. Which nursing intervention should the nurse implement? Maintain bed rest with the head of the bed at 20 degrees. Maintain NPO (nothing by mouth) status for surgical repair. Withhold opioid pain medication to prevent ileus. Sit the client upright in a padded chair for meals.

Maintain bed rest with the head of the bed at 20 degrees.

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? Encourage the client to perform range-of-motion (ROM) exercises to the right leg. Provide feedback on the client's strengths and available resources. Request a referral to occupational therapy. Provide wound care without discussing the amputation.

Provide feedback on the client's strengths and available resources.