Deck 42: Fractures

Question 1

The nurse would teach the older patient with a newly casted Colles fracture to:

A) Apply cool compresses to the cast.
B) Let the hand and arm dangle to increase the drainage.
C) Keep the hand immobile to reduce swelling.
D) Move the shoulders to reduce contractures.

Answer 1

Move the shoulders to reduce contractures.

Question 2

In caring for a patient just admitted with a pelvic fracture,the assessment that would cause the most concern is:

A) Pain level rating of 8 on a scale of 1 to 10
B) No urinary output for 8 hours
C) Evidence of bruising along the patient's hips and buttocks
D) Complaints of the need for back care from resting in bed

Answer 2

No urinary output for 8 hours

Question 3

The older adult patient is at risk for constipation after sustaining a pelvic fracture.The nutritional suggestion that the nurse would make is:

A) Select food with high-sodium content.
B) Avoid foods high in dietary fiber.
C) While immobilized, drink at least 2 to 3 L of fluids daily.
D) Include milk products at every meal.

Answer 3

While immobilized, drink at least 2 to 3 L of fluids daily.

Question 4

Because the patient has a compound fracture,the nurse should:

A) Limit narcotics for 8 hours after surgery.
B) Monitor the patient's respirations every hour.
C) Assess for pulses distal to the injury.
D) Verify that the patient is not allergic to sulfa.

Question 5

The patient for which referral to home health care is most appropriate is the patient who:

A) Is married and has a laundry room on the first floor.
B) Is single and has a bedroom in a rooming house.
C) Lives in a college dormitory but is going home to stay with parents.
D) Is going to stay with a daughter and son-in-law at their one-story home.

Question 6

The patient has just had a plaster of Paris upper extremity cast placed because of a fractured radius.The statement indicating that the patient understands the discharge teaching related to cast care is:

A) "When I get home, I will remove some of the padding if it feels tight so my fingers don't swell."
B) "When I get home, I will wrap the cast in plastic so it will conserve the heat."
C) "When I get home, I will use a spoon handle to scratch inside if my arm itches."
D) "When I get home, I am going to rest in bed with my arm elevated above my heart."

Question 7

A 78-year-old retired teacher with a history of osteoporosis has fallen in her bathroom and sustained a subcapital femoral fracture.She is scheduled for an open-reduction internal fixation (ORIF)procedure in the morning.The type of traction in which the patient will most likely to be placed is:

A) Bryant
B) Buck
C) Pelvic
D) Crutchfield tongs

Question 8

Assistive devices such as canes,crutches,and walkers are used for people who need to limit weight-bearing activities on joints.The statement by the nurse that best illustrates an understanding of the appropriate use of these devices is:

A) "Canes provide minimal support and balance and are carried on the unaffected side."
B) "When using a cane, slide it as you go to decrease the arm strain."
C) "A three-point gait is used when walking with a walker."
D) "When using crutches, the unaffected leg goes down the steps first."

Question 9

The nurse assisting with the application of a short arm plaster cast application would take special care to:

A) Dampen the skin to make the stockinette adhere.
B) Tape the arm before applying the stockinette.
C) Smooth the stockinette to prevent a pressure ulcer.
D) Roll the stockinette tightly above and below the margins of the cast.

Question 10

The nurse would choose the nursing diagnoses with the highest priority after surgery for the open reduction and external fixation of an ankle,which is:

A) Risk for activity intolerance
B) Risk for infection
C) Risk for impaired physical mobility
D) Risk for constipation

Question 11

The patient with the crushed forearm cannot get pain relief with opioid medications.The injury is swollen,cool,and cyanotic,with weak distal pulses.The nurse assesses that this is a(n):

A) Compartment syndrome
B) Overwhelming infection
C) Fat embolus
D) Osteomyelitis

Question 12

A patient with bilateral avascular necrosis of the hips is to walk with crutches using a four-point gait for 6 weeks after her bone decompression surgeries.Which statement would indicate that the patient understands this technique?

A) "The axillary bars on the crutches should support my weight when I walk."
B) "I will move both crutches and then swing my legs to the crutches-2 and 2 equals 4!"
C) "I will move my right crutch and then my left leg and then the left crutch and my right leg."
D) "I will move both crutches and then swing my legs through the crutches together."

Question 13

When the patient who has been in a full body cast (spica)complains of nausea and abdominal distention,the licensed vocational nurse (LVN)alerts the charge nurse about the possibility of:

A) Constipation
B) Compartment syndrome
C) Cast syndrome
D) Shock

Question 14

Two days after surgery for a crushed pelvis,the certified nursing assistant (CNA)reports that the patient is complaining of a shortness of breath and is demonstrating signs of confusion and restlessness.The nurse suspects,from these signs alone,that the patient has suffered:

A) Impending shock
B) Fat embolus
C) Anxiety
D) Neurovascular compromise

Question 15

The older patient who sustained a fractured hip and femur in a motor vehicle accident is to be in Russell traction for several weeks; consequently,the nurse will focus care on:

A) Offering frequent distractions.
B) Encouraging nutrition.
C) Offering pain relief.
D) Preventing deep-vein thrombosis (DVT).

Question 16

The nurse who is documenting and reporting the signs and symptoms of an infection underneath a cast would include:

A) Elevated temperature
B) Tingling and decreased sensation
C) Full pulses and absence of pain
D) Swelling and diminished motor function

Question 17

When an older woman falls down at church and immediately complains of severe pain in her left hip,the choir director recognizes the cardinal sign of a fractured hip when he sees:

A) Shortened left leg when compared with the right
B) Downward curled toes
C) Internal rotation of the left leg
D) Hematoma on the left hip

Question 18

The patient who sustained a simple fracture of the left fibula 7 days earlier asks in what stage of bone healing he might be.The nurse replies that at 7 days,the patient would be in the stage of:

A) Hematoma formation
B) Ossification
C) Callus formation
D) Fibrocartilage formation

Question 19

The patient who has osteomyelitis after multiple fractures inquires what the physician meant when he said that surgery would follow the antibiotic therapy.The nurse's most helpful reply is to explain that surgery will be performed to:

A) Remove dead bone.
B) Close the open draining wound.
C) Close the area with casting material.
D) Amputate.

Question 20

When the nurse is told that a patient has a compound comminuted fracture,the nurse is concerned because this type of fracture is one in which the bone is:

A) Bent but not completely broken, and the bent piece protrudes through the skin.
B) Compressed, and bone pieces protrude through the skin.
C) Twisted, and the fragments are separated.
D) Broken into two or more pieces, and bone fragments protrude through the skin.

Question 21

When the patient with a fractured pelvis says that she will not ambulate because of pain,the nurse cautions that early ambulation will prevent:

A) Back injury
B) DVT
C) Callus formation
D) Disuse syndrome

Question 22

The nurse uses a diagram to show the process of a fractured bone healing.(Arrange the options in the appropriate sequence.)

A) Ossification
B) Hematoma
C) Fibrocartilage
D) Consolidated
E) Callus

Question 23

In dealing with the weights that are applying traction,the nurse should:

A) Remove them to pull the patient up in bed.
B) Hold them while the patient is changing positions in bed.
C) Hold them for a few minutes if the patient complains of pain.
D) Allow them to hang freely.

Question 24

A fracture that occurs because of osteoporosis is classified as a _____________ fracture.

Question 25

The properly fitted crutch will be: (Select all that apply.)

A) Adjusted so that axilla piece is 3 to 4 fingerbreadths below the axilla.
B) Fitted closely to the axilla for secure support.
C) Measured and adjusted when the patient is in the tripod position.
D) Adjusted for the handgrips to allow for a 45-degree flexion of the elbow.
E) Padded so patient can bear weight on the axilla piece when ambulating.

Question 26

The nurse clarifies that in a greenstick fracture,the:

A) Line of the fracture goes across the bone in right angles to the longitudinal axis.
B) Periosteum is not torn away from the bone.
C) Fracture is incomplete, and one side is bent.
D) Fracture occurred in one of the long bones of the body.

Question 27

The finding that would produce the most concern when performing pin care for the patient with an external fixator is:

A) Crusts around the pin
B) Serous drainage on the dressing
C) Purulent drainage
D) Absence of pain

Question 28

The nurse performing a neurovascular assessment of the patient in skeletal traction assesses the abnormal sign of:

A) Delayed capillary refill
B) Bilateral equal pulses
C) Absence of pain and swelling
D) Limbis the same color as the unaffected side

Question 29

Delayed union of a fracture can be attributed to: (Select all that apply.)

A) Inadequate immobilization
B) Hormone replacement therapy
C) Long-term use of corticosteroids
D) Infection
E) Poor nutrition

Question 30

Arrange the process of stair climbing with crutches in the correct sequence:

A) Body weight is supported with crutches.
B) Crutches are moved to the next step.
C) Affected leg moves to the next step.
D) Unaffected leg is moved to the next step.
E) Body weight is transferred to the unaffected leg.