Question 1

The nurse understands that all soft tissue injuries require the nurse to assist with or instruct about: (Select all that apply.)

Accepted Answer

All options listed are part of the care to a patient with a soft tissue injury except bed rest.Bed rest is not warranted with this type of injury.

Question 2

The nurse explains that the major advantage of the external fixation device is that the patient:

Accepted Answer

The external device for fracture reduction allows greater freedom of movement,decreasing the problems of immobility.Healing time and pain are the same as with any other fracture reduction method.

Question 3

The patient,who is a legal secretary,asks the nurse how she can avoid developing carpal tunnel syndrome.The nurse suggests:

Accepted Answer

Elevating the wrist with a firm support eliminates the need to keep the wrists flexed for long periods of time.This wrist support will help prevent carpal tunnel syndrome.

Question 4

A patient has come to the ambulatory care clinic with a sprain.The nurse correctly differentiates a grade 2 sprain from a grade 3 sprain with the assessment of:

Accepted Answer

The minor loss of function is the differentiating factor.Pain,swelling,and bleeding into the joint are true of both grade 2 and grade 3 sprains.A grade 3 sprain has loss of function of the joint.

Question 5

The nurse instructing a patient with rheumatic arthritis about the prescribed exercise program includes that the exercises should be:

Accepted Answer

Exercises are essential to preserve joint function and should be done every day 3 to 10 times per joint.Exercises should be omitted if there is inflammation present and should not be taken past the point of pain,or made up the next day.

Question 6

The nurse recognizes a need for further instruction about application of ice to a sprain when the patient says:

Accepted Answer

Ice should be applied for 20 minutes of each hour for the first 24 hours.

Question 7

An 80-year-old man falls and suffers a compound fracture of the femur.The most appropriate immediate action is to:

Accepted Answer

Any fracture,even a compound one,should be immobilized in position to avoid further injury to the soft tissue attached to the bones.Any other initial action may cause further injury.

Question 8

The industrial nurse examines an employee who states that his right shoulder hurts when he abducts it and points with one finger to the spot at the point of his shoulder that is painful.He mentions that he won a racquetball tournament yesterday.The nurse suspects the employee is suffering from:

Accepted Answer

Bursitis occurs after overuse,with pain in the joint on activity with no erythema and little,if any,swelling.Dislocations are very painful and the pain is spread all over the shoulder.The shoulder also looks misshapen in a dislocation.Rotator cuff tear would prevent the patient from abducting his shoulder.

Question 9

A patient has come to the emergency department.A dislocation is suspected.An x-ray has been ordered.Before confirmation by x-ray,the dislocation diagnosis is supported by which manifestations? (Select all that apply.)

Accepted Answer

A dislocation will be evidenced by severe pain aggravated by motion,muscle spasm,and an abnormal-appearing joint after the history of a forceful injury.A hematoma,if it forms,will not be evident for a few hours.

Question 10

When the clinic nurse starts to take the "air cast" off the grade 2 sprain,the patient asks why it is being removed as he still has pain.The nurse explains that the cast is removed because:

Accepted Answer

Lengthy immobilization can lead to permanent disability.Casts and splints are left on only until the joint is strengthened.

Question 11

While the nurse is giving morning care to a patient who sustained a fractured pelvis and bilateral fractures of the femur in a motorcycle accident yesterday,the patient complains of shortness of breath and is audibly wheezing.An assessment of the oxygen saturation reveals 76%.The initial intervention by the nurse should be to:

Accepted Answer

Raising the patient to high Fowler's position is the best initial intervention as it can be done immediately.There is no need to notify the code team,and 5 L/min of oxygen is too much.Informing the charge nurse and giving oxygen at 2 to 3 L/min can be done when the patient has been made more comfortable.

Question 12

The patient with mild discomfort from carpal tunnel syndrome delightedly reports amazing relief from taking a daily dose of vitamin:

Accepted Answer

Vitamin B? has been found helpful in relieving the pain of carpal tunnel syndrome.

Question 13

When caring for a patient who has an abductor wedge in place following a total hip replacement,the nurse should assess for:

Accepted Answer

Pressure from the abductor wedge can interrupt arterial blood supply and compress the peroneal nerve.

Question 14

The patient in a long arm cast (from below the shoulder to the wrist,with a 90-degree elbow flexion)complains of a burning sensation over the elbow.The nurse's initial intervention should be:

Accepted Answer

The initial intervention should be to assess for adequate support to the cast,then elevate the limb for 30 minutes.If the pain has not diminished,document the intervention and notify the charge nurse.

Question 15

The nurse is performing an assessment on the patient who is in bilateral Buck's traction.Which finding indicates the need to reposition the patient?

Accepted Answer

When the patient's feet are against the footboard,the traction is ineffective.The heels should be off the surface of the mattress to reduce the threat of pressure ulcer.The weights should be hanging free.

Question 16

An older adult has fallen and sprained his ankle in a local park.The correct initial management of the injury will include which action?

Accepted Answer

Elevation is the initial intervention as it can be done immediately.Applying ice and medicating for pain will follow quickly.

Question 17

A patient with osteoporosis calls the nurse in the doctor's office to report that she has forgotten to take her weekly bisphosphonate (alendronate [Fosamax])for 2 days past the weekly time.The nurse should advise the patient to:

Accepted Answer

If 2 or more days have passed since the regular dose time,this week's dose should be skipped and the weekly schedule should be picked up next week.

Question 18

The assessment made by the nurse caring for a patient just returned from surgery following a surgical decompression of the carpal tunnel that would require immediate remedy is:

Accepted Answer

A capillary refill of over 5 seconds is an indication of diminished perfusion.Pain and swelling are to be expected.

Question 19

A patient in Russell's traction with a Pearson attachment for a fracture of the tibia complains of intense pain at the fracture site.The nurse assesses a temperature of 102° F and increased swelling at the fracture site.These assessment findings suggest:

Accepted Answer

Osteomyelitis is a bacterial infection of the bone.The causative organism is most often Staphylococcus aureus,which enters the bloodstream from a distant focus of infection,such as a boil or furuncle,or from an open wound,as in an open (compound)fracture.It is usually found in the tibia or fibula,in vertebrae,or at the site of a prosthesis.Osteomyelitis has a sudden onset with severe pain and marked tenderness at the site,high fever with chills,swelling of adjacent soft parts,headache,and malaise.

Question 20

The nurse explains that carpal tunnel syndrome is caused when the carpal tunnel compresses the:

Accepted Answer

When the median nerve is compressed by the carpal tunnel to the point that numbness,pain,and tingling occur,the result is carpal tunnel syndrome.

Quiz 33: Care of Patients With Musculoskeletal and Connective Tissue Disorders