Question 1

When the patient who has been in a full body cast (spica)complains of nausea and abdominal distention,the licensed vocational nurse (LVN)alerts the charge nurse about the possibility of:

Accepted Answer

Cast syndrome is an uncommon complication for a person in a spica cast,in which compression of a portion of the duodenum occurs between the mesenteric artery and the spinal column.

Question 2

Two days after surgery for a crushed pelvis,the certified nursing assistant (CNA)reports that the patient is complaining of a shortness of breath and is demonstrating signs of confusion and restlessness.The nurse suspects,from these signs alone,that the patient has suffered:

Accepted Answer

These are the classic symptoms of a fat embolus that has escaped from the crushed marrow.

Question 3

In caring for a patient just admitted with a pelvic fracture,the assessment that would cause the most concern is:

Accepted Answer

The absence of urinary output could indicate a perforated bladder.

Question 4

When an older woman falls down at church and immediately complains of severe pain in her left hip,the choir director recognizes the cardinal sign of a fractured hip when he sees:

Accepted Answer

The classic sign of a fractured hip is a shortened limb on the affected side,with an externally rotated limb.

Question 5

The patient who sustained a simple fracture of the left fibula 7 days earlier asks in what stage of bone healing he might be.The nurse replies that at 7 days,the patient would be in the stage of:

Accepted Answer

Callus formation occurs at the end of the first week after injury.

Question 6

The nurse assisting with the application of a short arm plaster cast application would take special care to:

Accepted Answer

The stockinette is smoothed on the limb before applying the casting material to help reduce the threat of a pressure ulcer.

Question 7

When the nurse is told that a patient has a compound comminuted fracture,the nurse is concerned because this type of fracture is one in which the bone is:

Accepted Answer

A compound comminuted fracture is a severe fracture with the bone broken in two or more pieces,with the pieces broken into small fragments,and a portion of the bone protruding through the skin.

Question 8

A patient with bilateral avascular necrosis of the hips is to walk with crutches using a four-point gait for 6 weeks after her bone decompression surgeries.Which statement would indicate that the patient understands this technique?

Accepted Answer

This option describes the correct sequence for a four-point gait,which allows bearing of weight and one foot to be placed in front of the other.

Question 9

The patient for which referral to home health care is most appropriate is the patient who:

Accepted Answer

The patient will need help with laundry and other activities of daily living (ADLs).

Question 10

The older patient who sustained a fractured hip and femur in a motor vehicle accident is to be in Russell traction for several weeks; consequently,the nurse will focus care on:

Accepted Answer

DVT is a threat for the person who is going to experience lengthy periods of inactivity.Although nutrition,pain relief,and boredom will be nursing concerns as well,the prevention of DVT is the priority.

Question 11

Assistive devices such as canes,crutches,and walkers are used for people who need to limit weight-bearing activities on joints.The statement by the nurse that best illustrates an understanding of the appropriate use of these devices is:

Accepted Answer

"Canes provide minimal support and balance and are carried on the unaffected side," is the only true statement.

Question 12

The patient has just had a plaster of Paris upper extremity cast placed because of a fractured radius.The statement indicating that the patient understands the discharge teaching related to cast care is:

Accepted Answer

Resting with the limb elevated above the heart helps prevent swelling.

Question 13

The patient with the crushed forearm cannot get pain relief with opioid medications.The injury is swollen,cool,and cyanotic,with weak distal pulses.The nurse assesses that this is a(n):

Accepted Answer

A compartment syndrome may occur after a massive injury or an inappropriately tight cast.The tissues become swollen to the point that they cut off their own circulation.

Question 14

The nurse would teach the older patient with a newly casted Colles fracture to:

Accepted Answer

Movement of the shoulders will help decrease the threat of contracture from immobility.

Question 15

A 78-year-old retired teacher with a history of osteoporosis has fallen in her bathroom and sustained a subcapital femoral fracture.She is scheduled for an open-reduction internal fixation (ORIF)procedure in the morning.The type of traction in which the patient will most likely to be placed is:

Accepted Answer

Buck traction is used to stabilize the fracture.The other options are not applicable.

Question 16

The older adult patient is at risk for constipation after sustaining a pelvic fracture.The nutritional suggestion that the nurse would make is:

Accepted Answer

During periods of immobilization,a daily fluid intake of 2 to 3 L is recommended to promote bowel and bladder function.Food with sodium causes fluid retention.Dietary fiber helps diminish constipation.

Question 17

Because the patient has a compound fracture,the nurse should:

Accepted Answer

Assessing for pulses distal to the injury is performed to monitor for ineffective tissue perfusion.

Question 18

The patient who has osteomyelitis after multiple fractures inquires what the physician meant when he said that surgery would follow the antibiotic therapy.The nurse's most helpful reply is to explain that surgery will be performed to:

Accepted Answer

After the antibiotic has controlled the infection in the bone,surgery will be performed to remove the dead bone.

Question 19

The nurse who is documenting and reporting the signs and symptoms of an infection underneath a cast would include:

Accepted Answer

Elevated temperature on the affected extremity may be a symptom of an infection under the cast.

Question 20

The nurse would choose the nursing diagnoses with the highest priority after surgery for the open reduction and external fixation of an ankle,which is:

Accepted Answer

All are possible diagnoses,but Risk for Infection would have the highest priority because bone infections are serious complications.

Quiz 42: Fractures

When the patient who has been in a full body cast (spica) complains of nausea and abdominal distention,the licensed vocational nurse (LVN) alerts the charge nurse about the possibility of:

Two days after surgery for a crushed pelvis,the certified nursing assistant (CNA) reports that the patient is complaining of a shortness of breath and is demonstrating signs of confusion and restlessness.The nurse suspects,from these signs alone,that the patient has suffered: