Question 1

The nurse is caring for a patient with a long leg cast. What should the nurse include when assessing this patient for indications of compromised circulation?

Accepted Answer

Swelling of the toes is an indication of compromised circulation because the cast may be too tight, causing pressure on the blood vessels. A tight cast is also a potential indication of compromised circulation for the same reason. The other options (B, C, and D) are not necessarily indicative of compromised circulation in a patient with a long leg cast. Drainage on the cast could indicate infection or another issue, increased temperature could be a sign of infection or inflammation, and foul odor could indicate infection or poor hygiene, but these symptoms do not necessarily point to compromised circulation.

Question 2

The nurse is planning care for a patient recovering from an above-the-knee amputation. Which position should the nurse include in this patient's plan of care?

Accepted Answer

Prone positioning for 1 hour several times a day is recommended for patients recovering from an above-the-knee amputation to prevent hip flexion contractures by stretching the hip extensor muscles.

Question 3

A patient diagnosed with bursitis asks the nurse, "Why do you keep asking what my pain level is? Don't you believe me?" How should the nurse respond?

Accepted Answer

The nurse should explain that knowing the patient's pain level is important for selecting the appropriate medication to relieve the pain. By providing this explanation, the patient may better understand the need for the nurse's repeated questioning.

Question 4

A patient is placed in Buck's traction after a hip fracture. What should be included in this patient's plan of care?

Accepted Answer

In Buck's traction, the weights should hang freely and not be held or supported, even when repositioning the patient. This ensures continuous traction and proper alignment.

Question 5

An older patient with a history of diabetes is experiencing poor healing of a fractured ankle. The nurse recognizes that which factors contribute to the delay in bone healing?

Accepted Answer

Advanced age and diabetes can impair circulation and cellular function, delaying healing. A foreign body can cause inflammation and infection, further hindering the healing process.

Question 6

A patient is recovering from endoscopic carpal tunnel surgery. The nurse knows that the surgery has been effective based on which patient statement?

Accepted Answer

The absence of tingling or numbness in the thumb or index finger indicates that the surgery was effective in relieving pressure on the median nerve, which is the goal of carpal tunnel surgery. Options A, B, and C all suggest that the patient is still experiencing symptoms of carpal tunnel syndrome, which would indicate that the surgery was not completely effective.

Question 7

A patient is diagnosed with a sprained right ankle. The nurse should instruct the patient about which treatment for the sprain?

Accepted Answer

Rest, ice, compression, and elevation (RICE) is the recommended treatment for a sprained ankle. A long leg cast and pain medication are not necessary for a sprain, and heat is not recommended in the first few days as it can increase swelling.

Question 8

A patient is diagnosed with an open compound fracture and is scheduled for immediate surgery. On which problems should the nurse focus during the patient's immediate postoperative period?

Accepted Answer

The patient with an open compound fracture is at high risk for infection due to exposure of bone to the external environment. Therefore, infection prevention measures should be a priority during the immediate postoperative period. While mobility, anxiety, and fall risk are important considerations for postoperative care, preventing infection is the highest priority in this case.

Question 9

A patient is diagnosed with a humeral fracture. What should the nurse identify as a priority treatment goal for the patient?

Accepted Answer

Immobilizing the fractured bone in normal anatomic position is a priority goal for patient with humeral fracture as it will help reduce pain, promote healing, and prevent further damage to the soft tissue and nerves around the fracture. While surgical correction may be necessary in some cases, it is not always an immediate priority. Applying ice and compression, as well as wrapping and elevating the arm, can also help manage pain and swelling but are not the primary treatment goal.

Question 10

A patient is diagnosed with an oblique fracture of the left femur. In which order should the nurse explain the steps of healing? Standard Text: Click and drag the options below to move them up or down.

Accepted Answer

The stages of bone healing typically begin with hematoma formation as blood vessels in the bone and surrounding tissue rupture, causing a blood clot to form. This is followed by fibrocartilaginous callus formation as cells begin to produce a soft callus made up of collagen and cartilage. Bony callus formation then occurs as osteoblasts create new bone tissue, creating a hard callus around the fracture. Finally, remodeling occurs as the new bone tissue is reshaped and refined to match the pre-injury bone structure.

Question 11

An older patient lives at home alone. Which assessment data would indicate modifiable risk factors for a hip fracture?

Accepted Answer

- Lower extremity weakness and balance problems increase the risk of falls, which can lead to hip fractures. These conditions can often be improved through physical therapy and exercise.- Certain medications, such as Xanax (a benzodiazepine) and Seroquel (an antipsychotic), can increase the risk of falls due to their side effects, such as dizziness or sedation. Adjusting these medications can reduce the risk of falls and thus hip fractures.

Question 12

Nonunion of a fractured tibia is seen in a patient after 8 weeks in a long leg cast. Which intervention may be necessary to encourage bone healing?

Accepted Answer

Nonunion of a fractured tibia after 8 weeks of immobilization suggests that the fracture is not healing. Surgical intervention with open reduction and internal fixation may be necessary to encourage bone healing. This involves realignment of the fractured bone and fixing it using screws, plates or rods which provides stability allowing for healing to occur. Removing the old cast and reapplying another or placing the patient in Buck's traction may not be effective for nonunion management. Bone debridement is used in the management of infected nonunion, not for nonunion without infection.

Question 13

A patient with facial and chest injuries from a motor vehicle accident has rhonchi in the upper airways. For which problem should the nurse plan care?

Accepted Answer

Rhonchi in the upper airways indicate partial obstruction and difficulty passing air through the airways. This can lead to an inability to clear the airway and may result in respiratory compromise. Therefore, the nurse should plan care to ensure that the airway is kept clear and that the patient is monitored closely for any signs of respiratory distress.

Question 14

The nurse is concerned that a patient is at risk for developing carpal tunnel syndrome. Which occupation would increase this patient's risk?

Accepted Answer

The answer of The nurse is concerned that a patient...

Question 15

After sustaining a fracture, a patient was treated by applying ice and a cast. After several weeks, the cast is removed and the patient is able to ambulate without difficulty. Which positive local factors influenced this patient's bone healing?

Accepted Answer

The answer of After sustaining a fracture, a patient was...

Question 16

The nurse suspects that a patient is experiencing fat embolism syndrome (FES). Which assessment data support the nurse's clinical decision?

Accepted Answer

Fat embolism syndrome is characterized by respiratory distress (low pulse oximetry, shortness of breath, increased respiratory rate) and petechiae, especially on the chest and upper arms. Warm and dry skin is not indicative of FES.

Question 17

A patient with a long leg cast is exhibiting signs of compartment syndrome. What should the nurse prepare to aid in the treatment of the patient?

Accepted Answer

Bivalving the cast involves cutting it to relieve pressure, and straps are used to secure the cast after it has been split to allow for swelling and reduce the risk of compartment syndrome.

Question 18

A patient is diagnosed with epicondylitis. The nurse recognizes that which treatment might be indicated for this condition?

Accepted Answer

The answer of A patient is diagnosed with epicondylitis. The...

Question 19

A patient diagnosed with a fractured left femur complains of chest pain, shortness of breath, and a rash on the chest. What complication should the nurse suspect?

Accepted Answer

The symptoms of chest pain, shortness of breath, and rash on the chest are indicative of fat embolism syndrome, which occurs when fat globules enter the bloodstream and can cause respiratory and cardiovascular symptoms. Fractured bones, particularly the femur, are a common cause of this syndrome. Deep vein thrombosis, compartment syndrome, and DIC may also occur as complications of a fractured femur but would not typically present with the same symptoms as seen in fat embolism syndrome.

Question 20

The nurse instructs an adolescent patient on the care of a sprain at home. Which patient statement indicates the need for further instruction?

Accepted Answer

The patient should not use heat therapy on a new sprain, as this can increase swelling and inflammation. Cold therapy is recommended for the first 24-48 hours after a sprain. Choices B, C, and D are all appropriate instructions for caring for a sprain at home.

Quiz 39: Nursing Care of Patients With Musculoskeletal Trauma