Question 1

The nurse is preparing a presentation about adult bone health at the local health fair. Which of the following statements should the nurse include?

Accepted Answer

Strong bones depend on adequate calcium intake and weight-bearing exercise. Calcium is important for building and maintaining strong bones, but it must be combined with weight-bearing exercise to be effective. Avoiding obesity can contribute to bone health, but it is not a guarantee. Vitamin D is important for bone health, but it can be obtained from sunlight exposure or a few dietary sources, rather than requiring daily multivitamins.

Question 2

The nurse is teaching older adults about the risks for musculoskeletal trauma. What advice should the nurse include? Avoid:

Accepted Answer

B

Question 3

An elderly person was found at home on the floor. When trying to move, the person reported severe pain in the right hip. The admitting diagnosis is right hip fracture. Orders include Buck's traction, and the nurse is about to initiate the order. What should the nurse do? (Place the statements in the correct order.)

Accepted Answer

The correct order for initiating Buck's traction is as follows: 
C) Have an assistant stand at the foot of the bed, holding traction in a straight line. 
E) Place the Buck's boot around the lower leg. 
D) Secure the Buck's boot to the skin on the leg. 
A) Set up the traction at the foot of the bed. 
B) While the assistant holds straight traction, carefully attach the weight to hang at the foot of the bed.

Question 4

A person has been very slow to recover from a fracture. The doctor has ordered a treatment that will increase the migration of osteoblasts and osteoclasts to the fracture site. What is the treatment?

Accepted Answer

Electrical bone stimulation is a treatment that applies a low-level electrical current directly to the fracture site. This electrical stimulation is believed to enhance the migration of osteoblasts and osteoclasts, which are critical cells involved in bone formation and remodeling. By increasing the migration of these cells to the fracture site, the bone healing process can be accelerated, which may help the person recover more quickly from the fracture.

Question 5

What should the nurse do when moving a person with a fracture of the leg?

Accepted Answer

Supporting the extremity on either side of the fracture helps stabilize the injured area, reducing movement and potential for further injury. Direct support under the fracture or only proximal to it could exacerbate the injury, and disconnecting weights from a balanced traction setup could disrupt the prescribed treatment.

Question 6

What is the main nursing responsibility before and after applying traction to the leg?

Accepted Answer

Before and after applying traction to the leg, the main nursing responsibility is to check the distal pulse to ensure adequate circulation is being maintained. This is important because traction may compromise circulation, and prompt action can be taken if any changes are noted. Additionally, assessing for skin discoloration, pallor, and swelling are also important, but checking the distal pulse is the main priority.

Question 7

After trauma to the musculoskeletal or nervous system, reflex sympathetic dystrophy can occur. When does this complication occur? When:

Accepted Answer

Reflex sympathetic dystrophy occurs when the body's sympathetic nervous system responds abnormally to trauma, causing persistent pain, swelling, and changes in temperature. This can occur even after the expected healing time for a fracture or injury. Choices A and B describe other possible complications after injury, but not reflex sympathetic dystrophy. Choice C may indicate delayed healing, but does not specifically suggest the development of reflex sympathetic dystrophy.

Question 8

What is important when teaching a person how to use a walker?

Accepted Answer

Teaching the person how to lift the walker, advance it, then take two steps is important because this is the basic technique for using a walker and will help the person move safely and efficiently.

Answer: D 
 Teaching the person how to use the walker to assist in standing up is also important because this is a common challenge for people who need a walker and proper technique can help prevent falls or injury. Teaching them how to push down on the walker more forcefully on the affected side or carrying the walker while taking steps may not be as important or relevant to using a walker safely and effectively.

Question 9

What does the nurse need to do for a person with an external fixator device?

Accepted Answer

The nurse needs to cleanse the pin sites to reduce the chance of infection. Proper pin care and cleaning is important to prevent infection and promote healing.

Answer: B 
 The person should be encouraged to keep the limb with the external fixator still to prevent movement that could disrupt the device or cause pain.

Answer: D 
 Incorrect. The nurse should not adjust the weight on the pins without an order from the healthcare provider. This could cause harm to the person and is outside of the nurse's scope of practice.

Answer: A 
 Incorrect. The nurse should instruct the person to avoid bathing in a tub while the external fixator device is in place. This could increase the risk of infection or damage to the device.

Question 10

A person is scheduled to have skeletal traction. What will happen with skeletal traction?

Accepted Answer

Skeletal traction involves the surgical insertion of a pin or wire directly into a bone, typically in the leg or arm. Traction is then applied to the pin/wire to align and immobilize the bones during the healing process. This provides more consistent and stable traction than other methods, such as manual or straight traction.

Question 11

The nurse is caring for a person who was admitted following a fight. The person had several direct blows to the face. The assessment reveals normal blood pressure (BP), elevated pulse (P-108), elevated respiratory rate (RR-24)and obvious deformity to the right side of the face. What is the most important priority for the person's care?

Accepted Answer

The most important priority for the person's care is to monitor the elevated respiratory rate and maintain the airway. The elevated respiratory rate indicates that the person may be experiencing difficulty breathing, which could lead to respiratory distress or failure. As such, ensuring that the airway is unobstructed and that the person is able to breathe easily should be the primary concern. The other options are important as well, but are not as critical as maintaining a clear airway.

Question 12

Following hip replacement surgery, the person returns with an abductor pillow splint in place. What does this mean? The splint:

Accepted Answer

The abductor pillow splint is used after hip replacement surgery to keep the hip joint in the correct position and prevent dislocation. It is typically worn continuously for the first few weeks after surgery, except when bathing.

Question 13

What is a priority nursing diagnosis to consider for every person who has undergone an above-the-knee amputation?

Accepted Answer

Disturbed body image is a priority nursing diagnosis for individuals who have undergone an above-the-knee amputation, as they may struggle with changes in their physical appearance and identity.

Question 14

There is a risk of fat embolus in a person who has had surgery to repair a fracture. What is (are)the early sign(s)and symptom(s)of a fat embolus?

Accepted Answer

Petechiae (small red or purple spots on the skin) and tachycardia (rapid heart rate) are early signs and symptoms of a fat embolus. Reduced urinary output and fever may also be present but are not specific to a fat embolus. Chest pain may occur, but it is not an early sign or symptom of a fat embolus.

Question 15

A person refuses physical therapy. What is the nurse's initial action?

Accepted Answer

The initial action of the nurse should be to determine why the person is refusing therapy. This will help the nurse understand the person's reasoning and concerns and then help the person assess his or her choices regarding the therapy. It is important to respect the person's right to refuse therapy, but also try to educate and support them in making informed decisions about their health. Simply telling the person to cooperate or threatening to call the doctor may not address underlying concerns or help them feel heard and understood. Writing a note on the chart is important for documentation, but it should not be the first action taken.

Question 16

What are the signs and symptoms of compartment syndrome? (Select all that apply.)

Accepted Answer

Compartment syndrome is a condition in which the pressure in a closed space within the body, such as a muscle compartment, becomes abnormally high, which leads to decreased blood flow to the tissues within that space. The signs and symptoms of compartment syndrome include decreased peripheral pulse, tingling in an extremity or area, pain that is out of proportion to the injury, swelling and tightness over the affected area, and eventually, loss of muscle function. Increased draining is not a sign of compartment syndrome. Therefore, the correct choices are A and D.

Question 17

What does the acronym RICE stand for in the RICE therapy plan?

Accepted Answer

RICE stands for Rest, Ice, Compression, and Elevation, which are four simple steps to help treat injuries such as sprains, strains, and bruises. Rest allows the injured area to heal, ice helps to reduce inflammation and pain, compression helps to limit swelling and provide support, and elevation helps to reduce swelling by allowing fluids to drain away from the injured area.

Question 18

When is surgery necessary for persons with fractures? When the fractures:

Accepted Answer

Surgery is necessary when the fractures require direct visualisation and repair.

Question 19

The nurse is caring for a person with a new cast. What is appropriate teaching for care of a cast?

Accepted Answer

If a plaster cast gets wet, it can be dried with a blow dryer on a cool setting to prevent damage.

Question 20

A person has a cast applied to the right lower leg. Following the cast application, the nurse is monitoring for complications. Which assessment data leads the nurse to be concerned about a serious complication?

Accepted Answer

Increased pain in the right foot and toes can indicate compartment syndrome, which is a serious complication that can occur after cast application. Itching under the cast is a common complaint and is not necessarily cause for concern. General discomfort in the right lower leg is also a common complaint after cast application and may not indicate a serious complication. Pink, warm toes with intact sensation is a normal finding and not a cause for concern.

Quiz 38: Nursing Care of People With Musculoskeletal Trauma