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

Question 1

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

A)bed rest.
B)pain control.
C)immobilization.
D)activity restrictions.
E)prevention of recurrence.

Answer 1

pain control.
immobilization.
activity restrictions.
prevention of recurrence.

Question 2

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

A)will heal more quickly.
B)can bear weight right away.
C)has greater freedom of movement.
D)experiences less pain.

Answer 2

has greater freedom of movement.

Question 3

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

A)exercising the wrist with repetitive flexion movements.
B)wrapping the wrists with elastic bandages.
C)acquiring a pad to support wrists while typing.
D)applying warm compresses to wrists every evening.

Answer 3

acquiring a pad to support wrists while typing.

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:

A)pain.
B)swelling.
C)bleeding into the joint.
D)minor loss of function.

Question 5

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

A)done every day 3 to 10 times for every joint.
B)done even if inflammation is present.
C)continued past the point of pain.
D)doubled the next day if one day is missed.

Question 6

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

A)"I know this ice will reduce the swelling."
B)"I will keep the ice on this knee for the rest of the day."
C)"I will use the ice as you have directed for 24 hours."
D)"I can elevate my leg and use ice to reduce swelling."

Question 7

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

A)help position him flat on his back.
B)place a tourniquet on the leg.
C)splint the leg as it is.
D)carefully straighten the leg.

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:

A)rotator cuff tear.
B)bursitis.
C)dislocation.
D)subluxation.

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.)

A)History of forceful injury
B)Purple-black hematoma over joint
C)Severe pain, aggravated by motion
D)Muscle spasm
E)Abnormal appearance of joint

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:

A)the cast will interfere with adequate circulation.
B)the cast will increase the edema.
C)long-term immobilization can cause permanent disability.
D)another heavier cast will be applied.

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:

A)alert the code team.
B)inform the charge nurse.
C)give oxygen at 4 to 5 L/min.
D)raise patient to high Fowler's position.

Question 12

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

A)A.
B)B6.
C)B12.
D)C.

Question 13

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

A)muscle spasms.
B)alteration in peripheral circulation.
C)compression fracture.
D)appropriateness of the size of the wedge.

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:

A)elevate the casted arm on pillows.
B)check to see if the cast is properly supported.
C)notify the charge nurse of developing pressure ulcer.
D)cut a "window" in the cast.

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?

A)Heels are not touching the surface of the mattress.
B)Elastic bandages need to be rewrapped.
C)Patient's feet are against the footboard.
D)Weights are 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?

A)Elevating the foot to reduce swelling
B)Applying ice to delay swelling
C)Administering aspirin to combat pain
D)Having the person ambulate to test for ability to bear weight

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:

A)take the dose now with 8 ounces of water.
B)take two doses 3 days apart.
C)skip this week and pick up the schedule next week.
D)take 2 tablets now with a snack.

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:

A)fingers swollen and warm.
B)complaint of pain.
C)capillary refill of 8 seconds.
D)fingers rosy.

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:

A)osteomyelitis.
B)fat embolism.
C)traction misalignment.
D)nonunion of the fracture.

Question 20

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

A)radial artery.
B)brachial artery.
C)median nerve.
D)ulnar nerve.

Question 21

Matching
Match the fracture type to the description that characterizes it.

Bone shattered in more than two pieces

A)Complete fracture
B)Comminuted fracture
C)Closed fracture
D)Compound fracture
E)Greenstick fracture

Question 22

The nurse lists the advantages of fiberglass casts,which include that this type of cast: (Select all that apply.)

A)is lighter.
B)allows weight bearing in 30 minutes.
C)is cheaper.
D)dries quickly.
E)is easily molded to body part.

Question 23

Place the steps of the process of fracture healing in proper order.

Step: 2

A)Medullary canal is reconstructed.
B)Mature bone cells form ossification.
C)Callus is formed.
D)Granulation tissue is formed.
E)Hematoma is formed between broken ends of bone.

Question 24

Match the type of fracture stabilization with the characteristics that best describe it.(The options can be used once, more than once, or not at all.)

Used with infected fractures that do not heal properly

A)Closed reduction
B)Open reduction
C)Internal fixation
D)External fixation

Question 25

Place the steps of the process of fracture healing in proper order.

Step: 1

A)Medullary canal is reconstructed.
B)Mature bone cells form ossification.
C)Callus is formed.
D)Granulation tissue is formed.
E)Hematoma is formed between broken ends of bone.

Question 26

Matching
Match the fracture type to the description that characterizes it.

Bone that is in two distinct pieces

A)Complete fracture
B)Comminuted fracture
C)Closed fracture
D)Compound fracture
E)Greenstick fracture

Question 27

Matching
Match the fracture type to the description that characterizes it.

Fracture bone end protruding through skin

A)Complete fracture
B)Comminuted fracture
C)Closed fracture
D)Compound fracture
E)Greenstick fracture

Question 28

The nurse uses a visual aid to show the difference between a complete dislocation and a partial dislocation,which is also called a(n)__________.

Question 29

Match the type of fracture stabilization with the characteristics that best describe it.(The options can be used once, more than once, or not at all.)

Metal appliances are used to stabilize pieces of fracture

A)Closed reduction
B)Open reduction
C)Internal fixation
D)External fixation

Question 30

Matching
Match the fracture type to the description that characterizes it.

Bone is partially broken and partially bent

A)Complete fracture
B)Comminuted fracture
C)Closed fracture
D)Compound fracture
E)Greenstick fracture

Question 31

Match the type of fracture stabilization with the characteristics that best describe it.(The options can be used once, more than once, or not at all.)

Used with older adults when brittle bones do not heal quickly

A)Closed reduction
B)Open reduction
C)Internal fixation
D)External fixation

Question 32

Match the type of fracture stabilization with the characteristics that best describe it.(The options can be used once, more than once, or not at all.)

Reduction of fracture and fixation to device that maintains alignment

A)Closed reduction
B)Open reduction
C)Internal fixation
D)External fixation

Question 33

Match the type of fracture stabilization with the characteristics that best describe it.(The options can be used once, more than once, or not at all.)

Reduction of fracture through surgical incision

A)Closed reduction
B)Open reduction
C)Internal fixation
D)External fixation

Question 34

Match the type of fracture stabilization with the characteristics that best describe it.(The options can be used once, more than once, or not at all.)

Manual reduction and manipulation of bones into alignment

A)Closed reduction
B)Open reduction
C)Internal fixation
D)External fixation

Question 35

Place the steps of the process of fracture healing in proper order.

Step: 3

A)Medullary canal is reconstructed.
B)Mature bone cells form ossification.
C)Callus is formed.
D)Granulation tissue is formed.
E)Hematoma is formed between broken ends of bone.

Question 36

The nurse explains that the "C" in the acronym RICE for sprain treatment stands for _______.

Question 37

The nurse instructs a patient going home with a short arm synthetic cast to: (Select all that apply.)

A)cover the cast with a plastic bag when taking a shower.
B)blow warm air into the cast to relieve itching.
C)observe skin at the edge of the cast for irritation or injury.
D)check circulation and sensation in the fingers frequently.
E)move and flex the fingers to stimulate circulation.

Question 38

The probability of compartment syndrome in a patient with a side arm cast and traction is considered when the nurse assesses: (Select all that apply.)

A)warm, rosy fingers.
B)complaint of pain in hand and fingers.
C)edema of fingers.
D)weak radial pulse.
E)tingling and numbness.

Question 39

Matching
Match the fracture type to the description that characterizes it.

Fracture that has not broken through skin

A)Complete fracture
B)Comminuted fracture
C)Closed fracture
D)Compound fracture
E)Greenstick fracture

Question 40

The patient is returning to the unit with a wet long leg cast.To prevent damage to the wet cast,the nurse should: (Select all that apply.)

A)determine the cast material.
B)prop the casted limb on a footboard to elevate it until the cast is dry.
C)support the cast with the palms of the hands rather than holding it with the fingers.
D)assess heat generated from the drying cast.
E)explain that the cast has dried when it acquires a grayish color.

Question 41

Place the steps of the process of fracture healing in proper order.

Step: 4

A)Medullary canal is reconstructed.
B)Mature bone cells form ossification.
C)Callus is formed.
D)Granulation tissue is formed.
E)Hematoma is formed between broken ends of bone.

Question 42

Place the steps of the process of fracture healing in proper order.

Step: 5

A)Medullary canal is reconstructed.
B)Mature bone cells form ossification.
C)Callus is formed.
D)Granulation tissue is formed.
E)Hematoma is formed between broken ends of bone.