MEDSURGE CH.45 EAQ's

Which explanation would the nurse use to describe a closed reduction procedure after a fracture?

Nonsurgical realignment of the bones that returns them to their previous anatomic position

Which procedure is the initial treatment for a compound fracture?

Open reduction

Which complication should the nurse suspect when assessing redness and purulent drainage at the site of hip replacement surgery?

Osteomyelitis

A patient with a cast to the lower left leg has an opening cut into the cast to allow for inspection of the leg. The nurse is concerned when the patient makes which statement?

"I do not need the cut out portion."

Which statement made by the older adult with osteoporosis is indicative of effective teaching about preventing fractures?

"I should do weight-bearing exercises because this will strengthen my bones."

Which statement made by the patient indicates a need for further teaching about plaster of Paris cast care?

"My cast will be drying for 10 to 15 minutes."

Which statement made by the patient indicates a need for further teaching about fracture healing?

"Prednisone does not affect my osteoporosis and does not interfere with my healing."

Which statement made by the patient indicates a need for further teaching about crutch walking?

"To sit down, I walk up to the chair, turn using my crutches until my affected leg touches the seat of the chair, and then lower myself into the chair."

Which findings alert the nurse to compartment syndrome? Select all that apply.

- Paralysis of the arm - Weak or unequal pulses - Pain unrelieved by opioids

Which findings indicate that a body cast is applied too tightly? Select all that apply.

- Abdominal distention - Nausea and vomiting

What instructions should the nurse give to a patient using a cane because of a right tibial fracture? Select all that apply.

- Hold the cane in the left hand. - Keep the top of the cane even with the level of the trochanter.

Which common signs and symptoms are indications of a fracture? Select all that apply.

- Pain - Bruising - Crepitus - Swelling - Tenderness

Which nursing intervention would the nurse include in the plan of care for a child treated with internal fixation of a left tibial fracture? Select all that apply.

- Administer pain medication as prescribed. - Position and maintain proper body alignment. - Report diminished neurovascular status of the affected extremity.

Which factors increase the risk for hip fractures? Select all that apply.

- Falls - Advanced age - Anticonvulsant drugs - Corticosteroids

Which nursing interventions are appropriate for the patient recovering from a total hip surgery? Select all that apply.

- Perform exercises for physical therapy. - Limit weight bearing on the affected side initially. - Walk the patient with use of a walker as prescribed. - Employ comfort measures such as repositioning and back massage.

Which observation by the nurse determines if the skeletal traction system is in proper working condition? Select all that apply.

- Weights hang freely. - The correct weight is hanging from the system. - The patient is in proper body position and alignment.

When discussing complications of fractures, which complications are long-term? Select all that apply.

Arthritis Joint stiffness Contractures

When teaching a patient with crutches how to move from standing to sitting down, the nurse would explain the steps in which order?

1) Patient walks up to the chair and turns using crutches. 2) Patient backs up until the unaffected leg touches the seat of the chair. 3) The hand on the unaffected side grips both crutches by the hand grips. 4) Crutches are placed to the unaffected side; patient bends at the waist. 5) Patient places the hand on the affected side on the chair. 6) Patient moves the affected leg forward and lowers onto the seat slowly.

A patient with a femur fracture begins to complain of difficulty breathing and does not realize that he is in the hospital. Vital signs are heart rate of 120, respirations of 30, temperature of 101°F, and blood pressure of 145/80. The nurse also notes that the patient has a measles-like rash over the upper body. Which nursing interventions would the nurse implement? Select all that apply.

Bed rest Fluid restriction Gentle handling Ventilatory support

Which type of cast does the nurse expect the primary health care provider to place on a fractured femur?

Bilateral long leg hip spica cast

Which population is at highest risk for osteoporosis?

Caucasian women

A patient has a complete displaced fracture of the right humerus in the middle part of the bone. Which treatment would the nurse expect the health care provider to use to correct the fracture?

Closed reduction

Which nutritional instruction is effective to prevent osteoporosis in the older adult?

Add calcium to the diet, and take calcium supplements.

Which patient is at the highest risk for fat embolism?

An 80-year-old man with a hip fracture

The nurse gathers equipment to prepare for which procedure to treat a Colles fracture?

Applying a cast to the patient's forearm

Which activities should the nurse recommend for an older female patient diagnosed with osteoporosis? Select all that apply.

Dancing Swimming Stair climbing

Which fracture is a complete fracture?

Displaced

What complications would the nurse assess for during the first 48 hours post tibia-fibula fracture? Select all that apply.

Fat embolism Compartment syndrome Deep vein thrombosis (DVT)

Which cast material would most likely be recommended for a fractured right ulna?

Fiberglass

Which type of fracture does the nurse suspect in a child who injured his radius during a reported fall?

Greenstick

Which complication is the most common complication with a Colles fracture?

Impaired circulation

Which type of gait is appropriate for use with a walker?

Modified swing-to gait

Which cause of fractures is most common in young adults?

Motor vehicle accidents

The nurse would encourage the patient with a femur fracture to increase intake of which essential nutritional elements? Select all that apply.

Protein Calcium Vitamin D & C

Which stage of fractured bone healing is characterized by the formation of a callus that is larger than the diameter of the bone and serves as a temporary splint?

Stage 3

Which observation by the nurse indicates that the patient needs further instruction for safe ambulation with a cane?

The older adult patient slides the cane along.

The nurse expects Buck traction to include which aspect of care?

Weights no heavier than 5 to 10 lb

Which position is appropriate for a patient after a total hip arthroplasty?

With right hip flexed 70 degrees, abduction