Chapter 43 Med Surg
A 14-year-old patient is treated in the emergency room for an acute knee sprain sustained during a soccer game. The nurse reviews discharge instructions with the patient's mother. The instructions cover pain management and swelling reduction for the acute inflammatory stage which lasts: 1 3 to 4 days. 2 24 to 48 hours. 3 4 to 5 days. 4 At least 7 days.
24 to 48 hours.
After an arm fracture, the nurse practitioner advises the patient that pendulum exercises are begun: 1In 2 to 3 months, after normal activities are resumed. 2As soon as tolerated, after a reasonable period of immobilization. 3In about 4 to 5 weeks, after new bone is well established. 4In 2 to 3 weeks, when callus ossification prevents easy movements of bony fragments.
As soon as tolerated, after a reasonable period of immobilization
The nurse recognizes that proper positioning of an amputated lower extremity for the prevention of contractures is: 1Flexion 2Extension 3Abduction 4External rotation
Extension
A client with a fracture develops compartment syndrome that requires surgical intervention. The nurse would most likely prepare the client for which of the following? 1Joint replacement 2Amputation 3Bone graft 4Fasciotomy
Fasciotomy
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? 1Spontaneous pneumothorax 2Pneumonia 3Cardiac tamponade 4Fat emboli
Fat emboli
The nurse assesses subtle personality changes, restlessness, irritability, and confusion in a patient who has sustained a fracture. The nurse suspects which complication? 1Compartment syndrome 2Reflex sympathetic dystrophy syndrome 3Hypovolemic shock 4Fat embolism syndrome
Fat embolism syndrome
Which of the following musculoskeletal injuries is manifested by acromioclavicular joint pain? 1Heterotopic ossification 2Acute compartment syndrome 3Epicondylitis 4Rotator cuff tears
Rotator cuff tears
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? 1Third-degree strain 2Third-degree sprain 3Second-degree sprain 4 First-degree strain
Second-degree sprain
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? 1Less than 24 hours 2Between 24 and 48 hours 3About 72 hours 4At least 1 week
Between 24 and 48 hours
Which type of fracture is one in which the skin or mucous membranes extends to the fractured bone? 1Incomplete 2 Simple 3 Complete 4Compound
Compound
Which of the following is one of the most common causes of death in patients diagnosed with fat emboli syndrome? 1ARDS 2MI 3Stroke 4PE
ARDS
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? 1Increased participation in self-care 2Decreased need for pain medication 3Absence of fever 4Decreased activity tolerance
Absence of fever
The nurse is required to design a teaching plan for a client with a ruptured Achilles tendon. Which of the following would the nurse emphasize? 1Activity restrictions 2Effective pin care 3Use of nonprescription medications 4Dietary restrictions
Activity restrictions
When is it advisable for the nurse to apply heat to a sprain or a contusion? 1Do not apply at all 2After 2 days 3Only after a week 4Immediately
After 2 days
When reviewing the history of a female client with a ganglion cyst, which factor would the nurse identify as most likely contributing to the client's current condition? 1Recurrent dislocations 2Employment as a cashier 3Age below 50 years 4Participation as a softball pitcher
Age below 50 years
A patient is transported to the ED for a femur fracture following a motor vehicle crash. What action by the nurse is the highest priority? 1Assess the diameter of the thigh every 15 minutes. 2Administer pain medication per orders. 3Assess pedal pulses. 4Assess vital signs and level of consciousness.
Assess vital signs and level of consciousness
There are a variety of problems that can become complications after a fracture. Which of the following 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? 1Avascular necrosis 2Shock 3Pulmonary embolism 4Fat embolism
Avascular necrosis
An important nursing assessment, post fracture, is to evaluate neurovascular status. Therefore, the nurse should check for: 1Crepitus. 2Capillary refill. 3Shortening and deformity. 4Swelling and discoloration.
Capillary refill
A patient who has extremity right wrist fracture complains of severe burning pain, frequent changes in the skin from hot and dry to cold and feeling clammy shiny skin that is growing more hair in the injured extremity. The nurse should anticipate providing care for what complication? 1Heterotrophic ossification 2Avascular necrosis of bone 3Reaction to an internal fixation device 4Complex regional pain syndrome (CRPS)
Complex regional pain syndrome (CRPS)
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? 1Fracture 2Strain 3Contusion 4Sprain
Contusion
Which of the following is an inaccurate clinical manifestation of a fracture? 1Lengthening 2Pain 3Deformity 4Crepitus
Lengthening
General nursing measures employed when caring for the client with fracture include all of the following, except? 1Assisting with ADLs 2Providing comfort measures 3Administering analgesics 4Cranial nerve assessment
Cranial nerve assessment
In a patient with a dislocation, the nurse should initially perform neurovascular assessments a minimum of every 15 minutes until stable. Which of the following complications do the assessments help the nurse to monitor in the patient? 1Carpal tunnel syndrome 2Fat embolism syndrome 3Compartment syndrome 4Disseminated intravascular coagulation
Disseminated intravascular coagulation
Which of the following disorders results in widespread hemorrhage and microthrombosis with ischemia? 1Complex regional pain syndrome (CRPS) 2Disseminated intravascular coagulation (DIC) 3Avascular necrosis (AVN) 4Fat embolism syndrome (FES)
Disseminated intravascular coagulation (DIC)
A client presents to the emergency department gently holding the left arm, which is slightly swollen and painful to the touch. Based on these findings, the nurse: 1Has the client perform active range of motion 2Elevates the arm and applies an ice pack 3Positions the arm below the level of the heart 4Elevates the arm and applies a heating pad
Elevates the arm and applies an ice pack.
The femur fracture that commonly leads to avascular necrosis or nonunion because of an abundant supply of blood vessels in the area is a fracture of the: 1Trochanteric region. 2Femoral neck. 3Condylar area. 4Shaft of the femur.
Femoral Neck
Which of the following terms refers to a break in the continuity of a bone? 1Fracture 2Malunion 3Subluxation 4Dislocation
Fracture
Which of the following is a factor that inhibits fracture healing? 1Immobilization of the fracture 2Patient age of 35 3Increased vitamin D and calcium in the diet 4History of diabetes
History of diabetes
A classic indicator of edema and alveolar hemorrhage associated with FES is: 1Hyperventilation. 2Crackles and wheezes. 3Tachycardia. 4Tachypnea.
Hyperventilation
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? 1Hypovolemic 2Cardiogenic 3Neurogenic 4Septicemic
Hypovolemic
Which type of fracture involves a break through only part of the cross-section of the bone? 1Incomplete 2Open 3Comminuted 4Oblique
Incomplete
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? 1Ice and immobilization 2Joint manipulation and immobilization 3Heat and immobilization 4Analgesia and immobilization
Joint manipulation and immobilization
Which nursing intervention is appropriate for minimizing muscle spasms in the client with a hip fracture? 1Maintain Buck's traction. 2Apply a soft compression dressing. 3Assist the client with use of a trapeze. 4Maintain the internal fixator.
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: 1Anemia 2Muscular agility 3 Female gender 4 Osteoporosis
Muscular agility
When caring for a client with a fracture, assessment of which of the following would be the priority? 1Neurovascular compromise 2Cardiac problems 3Hormonal imbalances 4Altered kidney function
Neurovascular compromise
Which of the following describes failure of the ends of a fractured bone to unite in normal alignment? 1Malunion 2Nonunion 3Delayed union 4Subluxation
Nonunion
Which of the following terms refers to failure of fragments of a fractured bone to heal together? 1Subluxation 2Nonunion 3Dislocation 4Malunion
Nonunion
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? 1Request a referral to occupational therapy. 2Provide wound care without discussing the amputation. 3Encourage the patient to perform range-of-motion (ROM) exercises to the right leg. 4Provide feedback on the patient's strengths and available resources.
Provide feedback on the patient's strengths and available resources.
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? 1Subluxation 2Volkmann's contracture 3Sprain 4Compartment syndrome
Subluxation
Which of the following is a term used to describe a soft tissue injury produced by a blunt force? 1Strain 2Sprain 3Hematoma 4Contusion
contusion
A nurse is developing a teaching plan for a client who must undergo an above-the-knee amputation of the left leg. After a leg amputation, exercise of the remaining limb: 1Begins at a rehabilitation center. 2Should begin the day after surgery. 3Should begin immediately postoperatively. 4Isn't necessary.
Should begin the day after surgery
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"? 1Stretched or pulled beyond its capacity 2Subluxation of a joint 3Injuries to ligaments surrounding a joint 4Injury resulting from a blow or blunt trauma
Stretched or pulled beyond its capacity
An x-ray demonstrates a fracture in which a bone has splintered into several pieces. Which type of fracture is this? 1Compound 2Depressed 3Impacted 4Comminuted
Comminuted
A patient with a recent left above-the-knee amputation states, "I can feel pain in my left toes." Which of the following is the best response by the nurse? 1"Describe the pain and rate it on the pain scale." 2"Pain medication usually does not help this type of pain." 3"Your left toes have been amputated." 4"The pain is really from the nerves in the upper leg."
Describe the pain and rate it on the pain scale.
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? 1Use measures other than turning to prevent pressure ulcers. 2Keep the hip flexed by placing pillows under the client's knee. 3Keep the affected leg in a position of adduction. 4Prevent internal rotation of the affected leg.
Prevent internal rotation of the affected leg.
A client with arterial insufficiency undergoes below-knee amputation of the right leg. Which action should the nurse include in the postoperative care plan? 1Elevating the stump for the first 24 hours 2Removing the pressure dressing after the first 8 hours 3Maintaining the client on complete bed rest 4Applying heat to the stump as the client desires
Elevating the stump for the first 24 hours
Which of the following terms refers to a fracture in which one side of a bone is broken and the other side is bent? 1Greenstick 2Spiral 3Oblique 4Avulsion
Greenstick
A patient who was in a motor vehicle crash is diagnosed with a stable T7 spinal fracture with no neurologic deficits. Which of the following nursing interventions should the nurse implement? 1Withhold opioid pain medication to prevent ileus. 2Maintain NPO status (nothing by mouth) for surgical repair. 3Maintain bed rest with head of bed at 20 degrees. 4Sit patient upright in a padded chair for meals.
Maintain bed rest with heads of bed at 20 degrees.
Which of the following terms refers to an injury to ligaments and other soft tissues of a joint? 1Strain 2Subluxation 3Sprain 4Dislocation
Sprain
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? 1"Apply heat packs for the first 24 to 48 hours." 2"Apply ice packs for the first 24 to 48 hours, then apply heat packs." 3"Apply ice packs for the first 12 to 18 hours." 4"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 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? 1 10 to 12 weeks 2 2 to 4 weeks 3 6 to 8 weeks 4 14 to 16 weeks
6 to 8 weeks
When providing discharge teaching to a client with a fractured toe, the nurse should include which instruction? 1Apply ice to the fracture site. 2Use crutches for 1 week. 3Apply heat to the fracture site. 4Perform ankle dorsiflexion three times per day.
Apply ice to the fracture site.
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? 1Greenstick 2Oblique 3Compound 4Spiral
Compound
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? 1Reduce the fracture to prevent additional tissue damage. 2Immobilize the joint to prevent movement of bone fragments. 3Apply a pressure bandage to decrease tissue damage. 4Cover the wound with a sterile dressing to prevent infection.
Cover the wound with a sterile dressing to prevent infection.
A 39-year-old client 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 indicated intact but malpositioned bones, what would you expect the physician to diagnose? 1Fracture 2Sprain 3Dislocation 4Strain
Dislocation
patient asks the nurse why his residual limb cannot be elevated on a pillow. What is the best response by the nurse? 1"Elevating the leg might lead to a flexion contracture." 2"You need to turn yourself side to side. If your leg is on a pillow, you would not be able to do that." 3"I am sorry. We ran out of pillows. I can elevate it on a few blankets." 4"Elevating the extremity may increase your chances of compartment syndrome."
Elevating the leg might lead to a flexion contracture.
A 16-year-old female is brought to the clinic by her mother who is concerned about her daughter's complaints of pain in her arm. The client is a member of her high school crew team and practices for 2 ½ hours every day after school. Which of the following would the nurse suspect? 1Epicondylitis 2Tendonitis 3Ganglion 4Carpal tunnel syndrome
Epicondylitis
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? 1Infection 2Depression 3Malunion 4Complex regional pain syndrome
Infection
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? 1Nerve damage 2Necrosis of adjacent soft tissue caused by blood loss 3Infection 4Muscle atrophy caused by loss of supporting bone structure
Infection
A client has sustained a right tibial fracture and has just had a cast applied. Which instruction should the nurse provide in his cast care? 1 "A foul smell from the cast is normal." 2"Cover the cast with a blanket until the cast dries." 3"Use a knitting needle to scratch itches inside the cast." 4"Keep your right leg elevated above heart level."
Keep your right leg elevated about heart level.
A fracture is termed pathologic when the fracture 1Results in a pulling away of a fragment of bone by a ligament or tendon and its attachment. 2Involves damage to the skin or mucous membranes. 3Occurs through an area of diseased bone. 4Presents as one side of the bone being broken and the other side being bent.
Occurs through an area of diseased bone
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? 1One side of the bone is broken and the other side is bent. 2The fracture results from an underlying bone disorder. 3The fracture line extends through the entire bone substance. 4Bone fragments are separated at the fracture line.
One side of the bone is broken and the other side is bent
Which nursing intervention is essential in caring for a client with compartment syndrome? 1Starting an I.V. line in the affected extremity in anticipation of venogram studies 2 Wrapping the affected extremity with a compression dressing to help decrease the swelling 3 Keeping the affected extremity below the level of the heart 4Removing all external sources of pressure, such as clothing and jewelry
Removing all external sources of pressure, such as clothing and jewelry
Which nursing diagnosis takes highest priority for a client with a compound fracture? 1Imbalanced nutrition: Less than body requirements related to immobility 2Risk for infection related to effects of trauma 3Activity intolerance related to weight-bearing limitations 4Impaired physical mobility related to trauma
Risk for infection related to effects of trauma
Which patient(s) is most likely to have compartment syndrome after sustaining a fracture? Select all that apply. 1The patient using ice for pain control in the extremity 2The patient who sustained a clavicle fracture 3The patient with hemorrhage in the site of injury 4The patient with a plaster cast applied immediately after injury 5The patient with elevated pressure level within the muscles
The patient with elevated pressure level within the muscles The patient with hemorrhage in the site of injury The patient with a plaster cast applied immediately after injury
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? 1Apply a pressure bandage to decrease tissue damage. 2Immobilize the joint to prevent movement of bone fragments. 3Cover the wound with a sterile dressing to prevent infection. 4Reduce the fracture to prevent additional tissue damage.
cover the wound with a sterile dressing to prevent infection.
A nurse is caring for a client who has sustained ligament and a meniscal injury to the knee. Which action would be most appropriate to allow the client to progress without causing further injury? 1Apply a cold pack to the affected area every night. 2Assist with a gradual introduction of activity. 3Apply heat to the affected area every night. 4Administer nonsteroidal anti-inflammatory drugs (NSAIDs) regularly.
Assist with a gradual introduction of activity.
Susan Albert has fractured her femur and is being seen in the emergency department. As you are assessing the area, you notice there is a grating sound that you suspect is bone ends moving over one another. What would this be called? 1Crepitus 2Deformity 3False motion 4Spasm
Crepitus
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? 1Complex regional pain syndrome 2Infection 3Malunion 4Depression
Infection
Which nursing diagnosis is a priority for a client with a traumatically amputated lower extremity? 1Risk for injury related to amputation 2Anticipatory grieving related to the loss of a limb 3Impaired skin integrity related to effects of the injury 4Disturbed body image related to changes in the structure of a body part
Risk for injury related to amputation
A 34-year-old client was playing a pick-up game of basketball when he became injured. He was brought to the urgent care facility where you practice nursing with an extremely painful elbow, which was very edematous. What type of injury would you suspect that the client experienced? 1Strain 2Contusion 3Sprain 4All options are correct.
Sprain
Colles' fracture occurs in which of the following areas? 1Elbow 2Clavicle 3Humeral shaft 4Distal radius
Distal Radius
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? 1Do not flex the hip more than 120 degrees. 2Do not flex the hip more than 90 degrees. 3Do not flex the hip more than 30 degrees. 4Do not flex the hip more than 60 degrees.
Do not flex the hip more than 90 degrees.
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? 1"I need to stay off my ankle for at least the next 3 to 4 weeks." 2"I'll get the prescription filled for the narcotic pain reliever." 3 "I'll make sure to keep my ankle elevated as much as possible." 4 "I'll start with ice for the first couple of hours and then apply heat."
I'll make sure to keep my ankle elevated as much as possible.
Which intervention should the nurse implement, when caring for the client who complains of phantom limb pain two months after amputation? 1Reassure the client that phantom pain is common. 2Reposition the stump, elevating it on two pillows. 3Assess the stump for signs and symptoms of bleeding. 4Assess the stump for signs and symptoms of infection.
Reassure the client that phantom pain is common.
A nurse is caring for a construction worker who fell from the second story of a building site and fractured the femoral neck. Which nursing diagnosis is a priority for the client? Select all that apply. 1Risk for infection 2Urinary incontinence 3Disturbed body image 4Risk for injury 5Impaired physical mobility
risk for infection risk for injury impaired physical mobility
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: 1Dislocated shoulder 2Dislocated elbow 3Cervical injury 4Clavicle fracture
Dislocated shoulder
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? 1Avoid administering too much medication becausethe client is older. 2Give pain medication to the client after providing care. 3Administer prescribed pain medication only when the client requests it. 4Administer prescribed analgesics around-the-clock.
Administer prescribed analgesics around-the-clock.
Which type of fracture produces several bone fragments? 1Incomplete 2Open 3Oblique 4Comminuted
Comminuted
Two days after application of a cast to treat a fractured femur, the patient tells the orthopedic heath care provider that he is experiencing severe, deep, and constant pain in his leg. The nurse suspects a diagnosis of: 1Chronic venous insufficiency. 2Phlebitis. 3Infection. 4Compartment syndrome.
Compartment syndrome
A patient who has extremity right wrist fracture complains of severe burning pain, frequent changes in the skin from hot and dry to cold and feeling clammy shiny skin that is growing more hair in the injured extremity. The nurse should anticipate providing care for what complication? 1Reaction to an internal fixation device 2Avascular necrosis of bone 3Complex regional pain syndrome (CRPS) 4Heterotrophic ossification
Complex regional pain syndrome (CRPS)
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: 1Compartment syndrome 2Fat embolism syndrome 3Complex regional pain syndrome 4Delayed union
Fat embolism syndrome
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? 1Performing passive range-of-motion (ROM) exercises on the client's legs once each shift 2Turning the client from side to side every 2 hours 3Maintaining the client in semi-Fowler's position 4Keeping a pillow between the client's legs at all times
Keeping a pillow between the client's legs at all times
Which intervention should the nurse implement, when caring for the client who complains of phantom limb pain two months after amputation? 1Assess the stump for signs and symptoms of bleeding. 2Reassure the client that phantom pain is common. 3Assess the stump for signs and symptoms of infection. 4Reposition the stump, elevating it on two pillows.
Reassure the client that phantom pain is common.
The nurse is caring for a patient after arthroscopic surgery for a rotator cuff tear. The nurse informs the patient that full activity can usually resume after what period of time? 1 6 to 12 months 2 8 weeks 3 3 to 4 months 4 3 to 4 weeks
6 to 12 months
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? 1Extension of the fingers of the right hand 2Nodules on the knuckles of the third and fourth finger 3Clawlike deformity of the right hand without ability to extend fingers 4Dislocation of the fingers
Clawlike deformity of the right hand without ability to extend fingers.
A client presents to the emergency department with an open fracture. What is the first action the nurse should take? 1Assess the client's vital signs and determine allergies. 2Perform a neurovascular assessment of the affected extremity. 3Cover the exposed bone with sterile dressing. 4Assist the physician with reduction of the fracture.
Cover the exposed bone with sterile dressing.
hich of the following would lead a nurse to suspect that a client has a rotator cuff tear? 1Ability to stretch arm over the head 2Minimal pain with movement 3Pain worse in the morning 4Difficulty lying on affected side
Difficulty lying on affected side.
Which nursing intervention is appropriate for a patient with a closed reduction extremity fracture? 1Encouraging participation in ADLs 2Using frequent dependent positioning to prevent edema 3Administering prescribed enema to prevent constipation 4Promoting intake of omega-3 fatty acids
Encouraging participation in ADLs
Pelvic fractures have a high mortality rate. The nurse knows to be conscientious in assessing for the two most serious complications. What are those complications? 1Paresthesia and ischemia 2Paralytic ileus and a lacerated urethra 3Hemorrhage and shock 4Thrombophlebitis and infection
Hemorrhage and shock
A 78-year-old client is in the emergency department following involvement in a motor vehicle collision. Radiographs indicate a fractured humerus; the client is awaiting the casting of her upper extremity and admission to the orthopedic unit. What is the primary treatment for musculoskeletal trauma? 1Enhancing complications 2Surgical repair 3External rotation 4Immobilization
Immobilization
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? 1Compression 2Comminuted 3 Impacted 4Greenstick
Impacted
Which of the following is a hallmark sign of compartment syndrome? 1Pain 2Motor weakness 3Weeping skin surfaces 4Edema
Pain.
Elderly clients who fall are most at risk for which injuries? 1Wrist fractures 2Cervical spine fractures 3Humerus fractures 4Pelvic fractures
Pelvic fractures
Joe Blake, age 16 years, was playing soccer when he received an injury to the ligaments of his knee. He was brought to the emergency department because of pain, joint instability, and difficulty walking. His injury was judged not to require surgery. Which of the following interventions would not be included in his care? 1Ice and NSAIDs 2Traction 3Joint immobilization 4Limited weight bearing
Traction
A client sustains an injury to the ligaments surrounding a joint. The nurse identifies this as which of the following? 1Contusion 2Strain 3Sprain 4Fracture
Sprain
A 75-year-old patient had surgery for a left hip fracture yesterday. When completing the plan of care, the nurse should include assessment for which of the following complications? Select all that apply. 1Skin breakdown 2Sepsis 3Pneumonia 4 Delirium 5Necrosis of the humerus
Skin breakdown Sepsis Pneumonia Delirium
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. 1Pneumonia 2Skin breakdown 3Diarrhea 4Wound infection
Pneumonia Skin breakdown Wound infection
