Question 1

A patient is prescribed RICE therapy. How should the nurse describe the components of this therapy?

Accepted Answer

RICE therapy stands for rest, ice, compression, and elevation. It is a common treatment for acute injuries to reduce swelling and pain. Rest refers to avoiding activities that can worsen the injury. Ice helps to reduce inflammation and pain. Compression helps to reduce swelling and improve circulation. Elevation helps to reduce swelling by allowing fluids to drain away from the injury.

Question 2

The nurse is explaining to a patient the procedure to alleviate pressure on a casted extremity. How should the nurse explain the procedure?

Accepted Answer

Bivalving is the procedure where the cast is split down both sides using a cast saw to alleviate pressure on the extremity. Option B, C, and D describe different procedures that are not related to bivalving.

Question 3

The nurse is changing a patient's stump dressing. The nurse understands that proper technique must be used for the above-the-knee amputation. Which technique should the nurse use for this dressing change?

Accepted Answer

The figure-eight bandage is the appropriate technique for dressing changes in patients with above-the-knee amputation. This technique ensures proper compression and coverage of the stump while allowing for movement and flexibility. Compression bandaging, splinting, and bivalving are not typically used for above-the-knee amputations.

Question 4

The nurse needs to reposition a patient with a fractured leg. Which action should the nurse take when moving this patient?

Accepted Answer

Supporting the extremity both above and below the fracture helps to prevent excessive movement and potential further injury to the fracture site. It is important to avoid putting pressure directly on the fracture by supporting the leg under the fracture or distal to the fracture. Disconnecting the weights from the balanced traction setup would only be necessary if the patient was in traction, which is not mentioned in the scenario.

Question 5

The nurse is concerned that patients on an orthopedic care area are at risk for compartment syndrome. In which circumstances should the nurse assess for manifestations of compartment syndrome?

Accepted Answer

Compartment syndrome can occur when a cast is applied too tightly to a limb or following a crush injury, both of which can increase pressure within a muscle compartment.

Question 6

A 70-year-old male patient has a fracture of the right hip from a motor vehicle accident. The orthopedic surgeon decides to perform surgery to correct the fracture to prevent complications and allow early rehabilitation. Which type of surgery and stabilization will be performed on this patient? Refer to the figure.

Accepted Answer

Open reduction and internal fixation is the preferred surgical treatment for a hip fracture in a patient of this age group. It involves realigning the bone fragments and then stabilizing them with internal fixation devices like screws, plates, or nails. External fixation is not commonly used for hip fractures due to the complex anatomy of the hip joint. Total hip arthroplasty and hip arthroscopy may be considered for some cases depending on the severity of the fracture and patient factors, but for a typical hip fracture in an elderly patient, open reduction and internal fixation is the preferred treatment.

Question 7

A patient who was in a fight sustained several direct blows to the face. The nurse assesses an elevated pulse (P 108), elevated respiratory rate (RR 24), and obvious deformity to the right side of the face. What should the nurse identify as the priority of care for this patient?

Accepted Answer

The priority of care in this situation is to maintain the patient's airway and monitor their respiratory rate due to the potential for facial trauma to cause airway obstruction or compromise. Although monitoring for signs of shock and administering pain medication are important, they are not as urgent as ensuring the patient's airway is maintained.

Question 8

The patient has a fracture of the right tibia and fibula. The orthopedic surgeon decides to surgically correct the fractures with the device in the figure. What type of device is being used?

Accepted Answer

The answer of The patient has a fracture of the...

Question 9

A patient recovering from an amputation refuses to look at the stump or participate in care. For what problem should the nurse plan interventions to help this patient?

Accepted Answer

The patient's refusal to look at the stump or participate in care suggests a problem with body image. Interventions should focus on supporting the patient's self-concept and promoting acceptance of the physical changes resulting from the amputation. Infection, nutrition, and chronic pain may be concerns as well, but they do not seem to be the primary issue in this scenario.

Question 10

The nurse is caring for a patient with an external fixator device. What care should the nurse provide to this patient?

Accepted Answer

The nurse should cleanse the pin sites per orders to reduce the chance of infection. It is important to keep the area around the pins clean to prevent infection from occurring.

Answer: D 
 The patient should be encouraged to keep the limb with the external fixator very still. Any movement can cause pain and increase the risk of complications. Adjusting the tension on the pins should only be done by the healthcare provider. Bathing in a tub may not be recommended depending on the provider's orders.

Question 11

Following the application of a cast to a patient's right lower leg, the nurse is monitoring for complications. Which assessment data leads the nurse to be concerned about a serious complication?

Accepted Answer

Numbness in the right foot and toes can indicate that there may be reduced blood flow or nerve damage, which are serious complications that require immediate medical attention. Pink and warm toes with intact sensation are expected findings. Itching under the cast is common and discomfort is also expected after applying a cast.

Question 12

A patient with an open fracture of the left femur that punctured the skin waited 2 hours before getting to the hospital. What would be the priority problem to address when caring for this patient?

Accepted Answer

The high potential for infection is the priority problem to address in a patient with an open fracture that has punctured the skin. Waiting for two hours before getting to the hospital increases the risk of infection as bacteria can enter the wound and cause further tissue damage. Thus, appropriate wound care, including cleaning and antibiotic therapy, should be started promptly to prevent infection. Insufficient nutrition, low body temperature, and fear and anxiety can be addressed after addressing the risk of infection.

Question 13

A patient recovering from a fractured hip is at risk for developing deep vein thrombosis (DVT). The nurse anticipates that which treatment would be indicated for the patient at this time?

Accepted Answer

The answer of A patient recovering from a fractured hip...

Question 14

A patient is scheduled to have skeletal traction. What should the nurse recognize about this type of traction?

Accepted Answer

Skeletal traction involves the insertion of surgical pins or wires into a bone, and then the weight and traction is applied to the pins/wires. This is a more direct and sturdy form of traction compared to skin traction.

Question 15

Following trauma to the musculoskeletal or nervous system, complex regional pain syndrome may develop. The nurse would recognize this complication when what is assessed?

Accepted Answer

Complex regional pain syndrome (CRPS) is characterized by persistent pain, swelling, and decreased motion after trauma to the musculoskeletal or nervous system. Option B refers to delayed bone healing, which is not specifically associated with CRPS. Option C and D may be associated with other conditions such as deep vein thrombosis or compartment syndrome.

Question 16

A patient is recovering from a below-the-knee amputation. For which complications should the nurse assess this patient?

Accepted Answer

B) Phantom pain is a common complication after amputation, where the patient feels pain in the removed limb. The nurse should assess the patient's level of pain and provide appropriate pain management.

C) Infection is a risk after any surgical procedure, including amputation. The nurse should monitor the patient's surgical site for signs of infection such as redness, swelling, and drainage.

D) Chronic stump pain is also a potential complication, where the patient experiences ongoing pain in the remaining portion of the amputated limb. The nurse should assess the patient's pain level and provide appropriate pain management.

E) Contractures can occur after amputation, where the remaining limb becomes fixed in a certain position. The nurse should monitor the patient's range of motion and provide exercises and positioning to prevent contractures.

Question 17

A patient is diagnosed with a rotator cuff tear. Which interventions should the nurse expect to be prescribed for this patient?

Accepted Answer

The answer of A patient is diagnosed with a rotator...

Question 18

The nurse has identified that a patient recovering from an above-the-knee amputation has a problem with pain control. Which nursing interventions would be beneficial for this patient?

Accepted Answer

The answer of The nurse has identified that a patient...

Question 19

The nurse is teaching older adults about lowering the risk for musculoskeletal trauma. Which strategy should the nurse include?

Accepted Answer

Avoiding falls at home by not using throw rugs is a recommended strategy to lower the risk for musculoskeletal trauma in older adults.

Question 20

A patient whose recovery from a fracture has been very slow is prescribed a treatment that will increase the migration of osteoblasts and osteoclasts to the fracture site. For which treatment should the nurse instruct this patient?

Accepted Answer

Electrical bone stimulation has been shown to increase the migration of osteoblasts and osteoclasts to the fracture site, thereby promoting bone healing. A and B are surgical procedures that may be used to promote healing in specific cases, but do not necessarily increase cell migration. D is not a recognized medical term or treatment option.

Quiz 39: Nursing Care of Patients With Musculoskeletal Trauma