Chapter 62: Caring for Clients With Traumatic Musculoskeletal Injuries (NCLEX Review Questions/PrepU)
A fracture is considered pathologic when it
occurs through an area of diseased bone.
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
An x-ray demonstrates a fracture in which a bone has splintered into several pieces. Which type of fracture is this?
Comminuted
A client is diagnosed with a second-degree sprain of the left ankle. When planning for the client's discharge, the nurse provides instructions for care at home. From the following list, select all that apply:
Do not bear weight on the left ankle. Elevate left leg as much as possible. Keep the ankle wrapped with an Ace bandage. Place an ice pack on the left ankle.
A client has had surgical repair of a hip injury after joint manipulation was unsuccessful. In addition to the regular postoperative assessments prescribed by policy, what assessment is completed every 30 minutes for several hours?
Neurovascular
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?
One side of the bone is broken and the other side is bent.
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 ice packs for the first 24 to 48 hours, then apply heat packs."
How long does it take for the bone to regain its former structural strength after a break?
1 year
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?
6 to 12 months
A nurse is performing a shift assessment on an elderly client who is recovering after surgery for a hip fracture. The client reports chest pain, has an increased heart rate, and increased respiratory rate. The nurse further notes that the client is febrile and hypoxic, coughing, and producing large amounts of thick, white sputum. The nurse recognizes that this is a medical emergency and calls for assistance, recognizing that this client is likely demonstrating symptoms of what complication?
Fat embolism syndrome
Which term refers to an injury to ligaments and other soft tissues surrounding a joint?
Sprain
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?
Contusion
A school nurse is assessing a student who was kicked in the shin during a soccer game. The area of the injury has become swollen and discolored. The triage nurse should organize care for a:
Contusion
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?
Avascular necrosis
An emergency department client is diagnosed with a hip dislocation. The client's family is relieved that the client has not suffered a hip fracture, but the nurse explains that this is still considered to be a medical emergency. What is the rationale for the nurse's statement?
Avascular necrosis may develop at the site if it is not promptly resolved.
Which term refers to a break in the continuity of a bone?
Fracture
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
A client has come to the orthopedic clinic for a follow-up appointment 6 weeks after fracturing his ankle. Diagnostic imaging reveals that bone union is not taking place. What factor may have contributed to this complication?
Inadequate immobilization
What nursing intervention should the nurse prioritize to facilitate healing in a client who has suffered a hip fracture?
Place a pillow between the client's legs when turning
A graphic designer who spends hours working on the computer complains of slight pain in the right hand. The pain is more prominent at night and early in the morning. The client is diagnosed with a mild form of carpal tunnel syndrome. What is appropriate for the nurse to recommend for reducing the pain? Select all that apply.
Resting the hands when possible Shaking the affected hand
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
Two days after application of a cast to treat a fractured femur, the client reports severe, deep, and constant pain in the leg. What will the nurse suspect?
Compartment syndrome
A nurse is preparing to discharge a client from the emergency department after receiving treatment for an ankle sprain. While providing discharge education, the nurse should encourage what action?
Keep an elastic compression bandage on the ankle.
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.
Wound infection Skin breakdown Pneumonia
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?
Provide feedback on the client's strengths and available resources.
A client has sustained a fractured tibia and is in traction. Which signs need to be reported to the physician? Select all that apply.
Client complains of throbbing and unrelenting pain. Client states that the foot on the affected leg is numb. Client's toes on affected leg are bluish and cold to touch.
A nurse is planning the care of a client with osteomyelitis that resulted from a diabetic foot ulcer. The client requires a transmetatarsal amputation. When planning the client's postoperative care, which of the following nursing diagnoses should the nurse most likely include in the plan of care?
Disturbed Body Image
A client is hospitalized with a fractured right hip. What is the most typical sign of an intertrochanteric fracture of the hip seen during the nurse's admission assessment?
External rotation of the leg
A client experienced an open fracture to the left femur during a horse-riding accident. For which complication is this client at highest risk?
Infection
An elite high school football player has been diagnosed with a shoulder dislocation. The client has been treated and is eager to resume his role on his team, stating that he is not experiencing pain. What should the nurse emphasize during health education?
The importance of adhering to the prescribed treatment and rehabilitation regimen.
Which nursing intervention is essential in caring for a client with compartment syndrome?
Removing all external sources of pressure, such as clothing and jewelry
A client presents in the emergency room with a shoulder injury after falling from a stepladder. When the nurse assesses the client's injuries, which finding best indicates that the client has dislocated the shoulder?
The affected arm is shorter than the unaffected arm.
A client is brought to the emergency department by ambulance after stepping in a hole and falling. While assessing him the nurse notes that his right leg is shorter than his left leg; his right hip is noticeably deformed and he is in acute pain. Imaging does not reveal a fracture. What is the most plausible explanation for this client's signs and symptoms?
Traumatic hip dislocation
