Deck 38: Nursing Care of People With Musculoskeletal Trauma

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?

A)Calcium supplements are usually necessary for good adult bone health.
B)Avoiding obesity will guarantee healthy bones for adults.
C)In order to maintain bone health, daily multivitamins containing vitamin D are necessary.
D)Strong bones depend on adequate calcium intake and weight-bearing exercise.

Answer 1

Strong bones depend on adequate calcium intake and weight-bearing exercise.

Question 2

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

A)wearing comfortable slippers.
B)installing grab bars next to the toilet.
C)injury by not using assistive devices at home.
D)fire by not cooking in the kitchen when alone.

Answer 2

installing grab bars next to the toilet.

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.)
1) Set up the traction at the foot of the bed.
2) While the assistant holds straight traction, carefully attach the weight to hang at the foot of the bed.
3) Have an assistant stand at the foot of the bed, holding traction in a straight line.
4) Secure the Buck's boot to the skin on the leg.
5) Place the Buck's boot around the lower leg.

Answer 3

1, 3, 5, 4, 2

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?

A)Open visualisation and debridement.
B)Closed reduction and manipulation.
C)Sterile flushing of the fracture.
D)Electrical bone stimulation.

Question 5

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

A)Support the leg directly under the fracture.
B)Support the extremity either side of the fracture.
C)Disconnect the weights from the balanced traction set-up.
D)Make sure that the extremity is supported proximal to the fracture.

Question 6

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

A)Assess for skin discolouration.
B)Check the distal pulse.
C)Check for pallor.
D)Assess for swelling.

Question 7

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

A)the person complains of numbness beyond a cast and toes are pale with delayed capillary refill.
B)the person complains of leg swelling, pain, tenderness, and cramping.
C)the person's fracture has not healed by the usual time expected.
D)the person complains of persistent pain, swelling, and changes in temperature.

Question 8

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

A)How to lift the walker, advance it, then take two steps.
B)How to push down on the walker more forcefully on the affected side.
C)How to lift and carry the walker while taking steps.
D)How to use the walker to assist in standing up.

Question 9

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

A)Explain that bathing in a tub can be resumed after two or three days.
B)Encourage the person to keep the limb with the external fixator still.
C)Cleanse pin sites to reduce the chance of infection.
D)Readjust the weight on the pins whenever the person experiences pain.

Question 10

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

A)Manual traction is applied to the limb.
B)A surgical pin will be inserted into a bone and the traction will be applied to the pin.
C)A cast will be applied to the area and traction will be connected to the cast.
D)Weighted straight traction will be applied.

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?

A)Monitor the elevated pulse rate and look for signs of pallor.
B)Monitor the elevated respiratory rate and maintain the airway.
C)Frequently assess the blood pressure for signs of developing shock and insert an IV cannula.
D)Frequently assess for facial pain and administer pain medication PRN.

Question 12

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

A)is only needed when the person rolls onto their side.
B)is used for the first day after surgery.
C)will stay on except when bathing.
D)is taken off while the person sleeps.

Question 13

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

A)Chronic pain.
B)Risk for fluid volume deficit.
C)Risk of infection.
D)Disturbed body image.

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?

A)Reduced urinary output.
B)Chest pain.
C)Petechiae and tachycardia.
D)Fever.

Question 15

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

A)Determine why the person is refusing, then help the person assess his or her choices.
B)Explain that the person needs to cooperate, or the doctor will be called.
C)Tell the person that he or she is allowed to refuse this time only; going forward, they must go.
D)Write a nursing note on the chart, stating that the person refused physical therapy.

Question 16

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

A)Decreased peripheral pulse.
B)Decrease in pain.
C)Increased draining.
D)Tingling in an extremity.

Question 17

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

A)Rest, immobilisation, convalescence and elimination of pain.
B)Rest, ice, compression and elevation.
C)Rest, immobilisation, compression and elevation.
D)Rest, ice, CT scan and elimination of pain.

Question 18

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

A)are greenstick.
B)require direct visualisation and repair.
C)cannot be immobilised with a cast.
D)do not heal within the expected timeframe.

Question 19

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

A)Use a wooden stick to scratch itches under the cast.
B)A plaster cast dries in 3 hours.
C)If a plaster cast gets wet, it can be dried with a blow dryer on a cool setting.
D)It is permitted to get fiberglass casts wet.

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?

A)General discomfort in the right lower leg.
B)Complaint of increased pain in the right foot and toes.
C)Itching under the cast.
D)The right foot toes are pink, warm and sensation is intact.

Question 21

A common situation after amputation is phantom limb pain. How should the nurse help the person deal with this?

A)Request that the doctor order a referral to a psychologist to help the person deal with their limb loss.
B)Acknowledge that phantom limb sensation and pain are not uncommon and encourage the person to talk about it.
C)Reorient the person to the present and explain that the limb has been amputated.
D)Explain to the person that it is not possible to feel a limb that has been removed, and that it is important to get past their phantom pain.