Brunner-Suddarth Med-Surg 13th Ed. Ch. 43

A client is to undergo surgery to repair a ruptured Achilles tendon and application of a brace. The client demonstrates understanding of his activity limitations when he states that he will need to wear the brace for which length of time?

6 to 8 weeks

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 analgesics around-the-clock.

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

The type of fracture described as having one side of the bone broken and the other side bent would be

greenstick.

A fracture is termed pathologic when the fracture

occurs through an area of diseased bone.

A client is hospitalized for open reduction of a fractured femur. During the postoperative assessment, the nurse notes that the client is restless and she observes petechiae on the client's chest. Which nursing action is indicated first?

Administer oxygen.

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.

Which of the following would lead a nurse to suspect that a client has a rotator cuff tear?

Difficulty lying on affected side

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

Which assessment findings would the nurse expect to find in the postoperative client experiencing fat embolism syndrome?

Column 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?

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?

Fat embolism

The client with a fractured left humerus reports dyspnea and chest pain. Pulse oximetry is 88%. Temperature is 100.2 degrees Fahrenheit (38.5 degrees Centigrade); heart rate is 110 beats per minute; respiratory rate is 32 breaths per minute. The nurse suspects the client is experiencing:

Fat embolism syndrome

A 19-year-old patient presents to the emergency room with an injury to her left ankle that occurred during a high school basketball game. She complains of limited motion and pain on walking, which increased over the last 2 hours. The nurse knows that her diagnosis is most likely which of the following?

Second-degree sprain

A nurse suspects that a client with a recent fracture has compartment syndrome. Assessment findings may include:

inability to perform active movement and pain with passive movement.

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?

Absence of fever

When is it advisable for the nurse to apply heat to a sprain or a contusion?

After 2 days

When providing discharge teaching to a client with a fractured toe, the nurse should include which instruction?

Apply ice to the fracture site.

A client who has sustained a fracture reports an increase in pain and decreased function of the affected extremity. The nurse would suspect which of the following?

Avascular necrosis

An important nursing assessment, post fracture, is to evaluate neurovascular status. Therefore, the nurse should check for:

Capillary refill.

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?

Clawlike deformity of the right hand without ability to extend fingers

Which assessment findings would cause the nurse to suspect compartment syndrome after casting of the leg?

Complaints of numbness and tingling in toes of affected leg

A client is admitted to the emergency room after being hit by a car while riding a bicycle. The client sustained a fracture of the left femur, and the bone is protruding through the skin. What type of fracture does the nurse recognize requires emergency intervention?

Compound

A 13-year-old client is brought to the emergency department. The client's mother reports that the client was struck with a baseball bat on his upper arm while diving for a pitched ball. After diagnostic tests are completed, the physician reassures the mother that her son's humerus is not broken but he has suffered another type of injury. What type of injury would you expect the physician to diagnose?

Contusion

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?

Contusion

The nurse 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 90 degrees.

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 90 degrees.

Which of the following are general nursing measures for a patient with a fracture reduction?

Encourage participation in ADLs

Which nursing intervention is appropriate for a patient with a closed reduction extremity fracture?

Encouraging participation in ADLs

Which of the following terms refers to a break in the continuity of a bone?

Fracture

When evaluating for hypovolemic shock, the nurse should be aware of which of the following clinical manifestations?

Hypotension

A patient has suffered a femoral shaft fracture in an industrial accident. What is an immediate nursing concern for this patient?

Hypovolemic shock

A patient suffered an open fracture to the left femur during a horse-riding accident. For which of the following complications is this patient at highest risk?

Infection

Which of the following is a factor that inhibits fracture healing?

Local malignancy

A 39-year-old softball player has been brought to the ED by his teammates. The client was fielding a fly ball, fell, and injured his hip. He cannot place weight on the leg and is in significant pain. After radiographs indicate intact yet malpositioned bones, what repair would you expect the physician to perform?

Joint manipulation and immobilization

A client undergoes hip-pinning surgery to treat an intertrochanteric fracture of the right hip. The nurse should include which intervention in the postoperative care plan?

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

Which of the following is an inaccurate clinical manifestation of a fracture?

Lengthening

Which nursing intervention is appropriate for minimizing muscle spasms in the client with a hip fracture?

Maintain Buck's traction.

The nurse is caring for an older woman with a hip fracture. The nurse recognizes that an incorrect risk factor for hip fracture is:

Muscular agility

A client is brought to the emergency department after injuring his 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?

One side of the bone is broken and the other side is bent.

A patient with a traumatic amputation of the right lower leg is refusing to look at the leg. Which of the following actions by the nurse is most appropriate?

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

Which nursing diagnosis is a priority for a client with a traumatically amputated lower extremity?

Risk for injury related to amputation

When joint manipulation is unsuccessful for a client, he is taken to surgery for surgical repair of his hip injury. He is brought to the ICU where you practice nursing for postoperative recovery. After surgery, the nurse implements measures to prevent complications. Select all of the following which are complications that the nurse seeks to prevent.

Skin breakdown Wound infection Pneumonia

A client sustains an injury to the ligaments surrounding a joint. The nurse identifies this as which of the following?

Sprain

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

Which of the following may occur if a client experiences compartment syndrome in an upper extremity?

Volkmann's contracture

A nurse advises a patient with a casted femur fracture to check for signs of a fat embolism. She tells the patient that the onset of symptoms for FES occur:

Within 12 to 48 hours.

A client sustains a fractured right humerus in an automobile accident. The arm is edematous, the client states that he cannot feel or move his fingers, and the nurse does not feel a pulse. What condition should the nurse be concerned about that requires emergency measures?

Compartment 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?

Impacted

An x-ray demonstrates a fracture in which a bone has splintered into several pieces, which type of fracture is this?

Comminuted

Which intervention should the nurse implement, when caring for the client who complains of phantom limb pain two months after amputation?

Reassure the client that phantom pain is common.

A 45-year-old softball player arrives at the emergency department following his injury while sliding into a base during a game. After his examination and radiographs, the physician diagnoses muscle strain and prescribes appropriate treatment. What does the physician mean with the term "strain"?

Stretched or pulled beyond its capacity