Fractures
A patient arrives at the emergency department with a suspected fracture. The nurse observes bone fragments protruding through the skin. What is the priority nursing intervention? (Select all that apply)
A. Immobilize the affected extremity with a splint.
B. Apply a heating pad to reduce muscle spasm.
C. Cover the wound with a sterile dressing.
D. Monitor the patient's vital signs every hour.
A. Immobilize the affected extremity with a splint.
C. Cover the wound with a sterile dressing.
A patient with a cast is advised to perform isometric exercises. What is the primary purpose of these exercises?
A. To promote bone healing.
B. To prevent muscle atrophy.
C. To decrease pain.
D. To reduce swelling.
**Correct Answer: B. To prevent muscle atrophy.**
A patient with an open fracture develops a fever, tachycardia, and erythema around the wound. Which condition is most likely developing?
A. Compartment syndrome
B. Infection and osteomyelitis
C. Deep vein thrombosis
D. Fat embolism syndrome
**Correct Answer: B. Infection and osteomyelitis**
A patient is at risk for developing a venous thromboembolism (VTE) post-total hip arthroplasty. Which exercise should the nurse encourage to help prevent this complication?
A. Isometric and ankle exercises
B. High-impact aerobic exercises
C. Weightlifting exercises
D. Deep squatting exercises
**Correct Answer: A. Isometric and ankle exercises**
What potential complication should the nurse monitor for in a patient receiving frequent corticosteroid injections for shoulder bursitis?
A. Osteoporosis.
B. Hypotension.
C. Hyperglycemia.
D. Anemia.
**Correct Answer: A. Osteoporosis.**
Which type of fracture is characterized by the bone being splintered or crushed into numerous fragments?
A. Compression fracture
B. Comminuted fracture
C. Depressed fracture
D. Complete fracture
**Correct Answer: B. Comminuted fracture**
What teaching should a nurse reinforce to a patient who has a cast to prevent skin complications?
A. Insert objects into the cast to relieve itching.
B. Petal the cast edges or apply moleskin to prevent skin irritation.
C. Use a heating pad to keep the cast dry.
D. Avoid performing any exercises.
**Correct Answer: B. Petal the cast edges or apply moleskin to prevent skin irritation.**
Which of the following signs should alert a nurse to the possibility of compartment syndrome in a patient with a cast?
A. Pain with passive movement and joint dysfunction.
B. Increased pulse distal to the cast.
C. Absence of pain or discomfort.
D. Warm and dry skin distal to the cast.
**Correct Answer: A. Pain with passive movement and joint dysfunction.**
A patient post-total hip arthroplasty reports sudden groin pain and the inability to move the affected leg. What should the nurse suspect?
A. Hemorrhage
B. Dislocation of the prosthesis
C. Deep vein thrombosis (DVT)
D. Infection
**Correct Answer: B. Dislocation of the prosthesis**
Which of the following interventions is appropriate for managing pain in a patient with shoulder impingement syndrome?
A. High-dose opioids.
B. Arthroscopic surgery immediately.
C. Physical therapy and NSAIDs.
D. Avoiding all movement of the shoulder.
**Correct Answer: C. Physical therapy and NSAIDs.**
Which statement is true regarding the initial care for a patient with a fracture?
A. Check the neurovascular status of the extremity.
B. Apply a heating pad to reduce pain.
C. Administer pain medication immediately.
D. Encourage the patient to perform range-of-motion exercises.
**Correct Answer: A. Check the neurovascular status of the extremity.**
○Pulses
■Present, bounding, thready
○Capillary refill
■Less than 2 seconds
■Make sure you have light and a warm room
○Color
■Cyanosis/ Pallor (yikes)
○Temperature
○Motor movements (can they wiggle fingers / toes)
○Sensation
A patient with a cast complains of pain and a foul odor coming from the cast. What should the nurse suspect and prioritize?
A. Possible infection and notify the healthcare provider immediately.
B. Normal healing process and reassure the patient.
C. An allergic reaction to the cast material.
D. Improper application of the cast.
**Correct Answer: A. Possible infection and notify the healthcare provider immediately.**
Which intervention is appropriate for a nurse to perform when compartment syndrome is suspected?
A. Elevate the limb above the heart.
B. Loosen tight dressings or bivalve the restrictive cast as prescribed.
C. Apply cold compresses to the affected area.
D. Administer pain medication and reassess in an hour.
**Correct Answer: B. Loosen tight dressings or bivalve the restrictive cast as prescribed.**
A nurse is educating a patient post-total hip arthroplasty on activities to avoid. Which of the following should be included in the teaching?
A. Do not bring your knee up higher than your hip.
B. Use a heating pad on the surgical site.
C. Sleep on the affected side.
D. Perform high-impact exercises.
**Correct Answer: A. Do not bring your knee up higher than your hip.**
Which of the following treatments is recommended for a patient with tendonitis of the shoulder?
A. Immediate surgical intervention.
B. Prolonged bed rest.
C. Intermittent application of ice for 20 minutes.
D. High-intensity physical activity.
**Correct Answer: C. Intermittent application of ice for 20 minutes.**
What is the primary purpose of reduction in the management of fractures?
A. To prevent infection
B. To manage pain
C. To restore the bone to proper alignment
D. To promote callus formation
**Correct Answer: C. To restore the bone to proper alignment**
Which intervention is essential for preventing complications in a patient with a cast?
A. Applying lotion to the skin under the cast.
B. Monitoring for signs of circulatory impairment such as pain, swelling, or numbness.
C. Wrapping the cast in plastic wrap to protect it from moisture.
D. Instructing the patient to remove the cast if it becomes uncomfortable.
**Correct Answer: B. Monitoring for signs of circulatory impairment such as pain, swelling, or numbness.**
Which laboratory findings would a nurse expect to see in a patient with osteomyelitis?
A. Decreased white blood cell count and decreased erythrocyte sedimentation rate (ESR).
B. Leukocytosis and elevated erythrocyte sedimentation rate (ESR).
C. Elevated hemoglobin and hematocrit levels.
D. Decreased platelet count and increased hematocrit levels.
**Correct Answer: B. Leukocytosis and elevated erythrocyte sedimentation rate (ESR).**
A nurse is caring for a patient who underwent total hip arthroplasty. Which action is essential to prevent dislocation of the prosthesis?
A. Keep the hip in abduction and neutral rotation.
B. Cross the legs at the knees to maintain alignment.
C. Flex the hip more than 90 degrees when sitting.
D. Encourage the patient to lean forward while sitting down.
**Correct Answer: A. Keep the hip in abduction and neutral rotation.**
A patient with shoulder tendonitis asks the nurse why it is important to limit the frequency of corticosteroid injections. What is the best response by the nurse?
A. "Frequent injections can weaken your immune system."
B. "Corticosteroids can weaken tendons and ligaments, increasing the risk of rupture."
C. "Injections are painful and should be minimized."
D. "Too many injections can lead to hypertension."
**Correct Answer: B. "Corticosteroids can weaken tendons and ligaments, increasing the risk of rupture."**
A patient has an oblique fracture. How is the fracture line oriented in this type of fracture?
A. The fracture line is horizontal.
B. The fracture line is vertical.
C. The fracture line runs at an angle across the axis of the bone.
D. The fracture line is in a spiral pattern.
**Correct Answer: C. The fracture line runs at an angle across the axis of the bone.**
A nurse needs to reinforce instructions to a patient with a cast. Which statement should be included to prevent complications?
A. "Keep the cast dry by covering it with plastic when showering."
B. "Apply heat to the cast if it becomes too uncomfortable."
C. "Do not insert any objects inside the cast to scratch the skin."
D. "Ignore any foul odor coming from the cast as it is normal.
**Correct Answer: C. "Do not insert any objects inside the cast to scratch the skin."**
A nurse is assessing a patient for compartment syndrome. Which finding would be most indicative of this condition?
A. Increased range of motion in the affected limb.
B. Unrelieved or increased pain in the limb.
C. Warm and flushed skin distal to the cast.
D. Decreased heart rate and blood pressure.
**Correct Answer: B. Unrelieved or increased pain in the limb.**
Which intervention should a nurse implement to prevent complications from impaired mobility in a patient post-total hip arthroplasty?
A. Encourage the patient to remain in bed at all times.
B. Maintain proper limb position in abduction, away from the midline.
C. Avoid the use of assistive devices.
D. Allow the patient to perform weight-bearing activities independently.
**Correct Answer: B. Maintain proper limb position in abduction, away from the midline.**
A patient presents with shoulder pain, and the nurse suspects bursitis. Which of the following is a characteristic of bursitis?
A. Inflammation of a tendon.
B. Fluid-filled sacs that prevent friction between joint structures.
C. Degeneration of cartilage within a joint.
D. Formation of loose bodies within the joint.
**Correct Answer: B. Fluid-filled sacs that prevent friction between joint structures.**