N4 test Musculoskeletal Trauma

Ignatavicius & Workman: Medical-Surgical Nursing: Critical Thinking for Collaborative Care, 4th Edition
Chapter 52: Interventions for Clients with Musculoskeletal Trauma

1. Which of the following statements regarding bone fractures is true?

A. A simple fracture is one in which the bone is not divided into two portions.
B. A pathologic fracture is one that occurs in bones that are already weakened by disease.
C. A fracture is considered to be compound when more than one bone is broken as a result of a single injury.
D. Hematoma formation in a bone at the site of fracture within 48 to 72 hours after the fracture is an ominous clinical sign.

2. Which statement best describes the process involved in bone healing?

A. In a young, healthy bone, healing takes only two weeks.
B. The fracture is surrounded by new vascular tissue known as a callus.
C. Within 24 hours after the injury, a hematoma forms at the fracture site.
D. The healing process following a fracture begins one week following the injury.

3. The client sustained two fractured femurs three hours ago when a car pinned him against his own car bumper at a gas station. The nurse notes that his Foley catheter is draining dark brown urine and the client tells her his pain has increased. What is your best first action?

A. Notify the physician.
B. Increase the IV flow rate.
C. Administer prescribed analgesic agent.
D. Assess the client’s respiratory status.

4. Which of the following clinical manifestations alerts the nurse to the possibility of a bone fracture of the right femur?

A. The area over the right femur is discolored and the client experiences pain when the area is touched.
B. The client cannot move the toes on her right foot 20 minutes after the injury.
C. The right thigh is three inches shorter than the left thigh.
D. Turning the right leg inward causes pain.

5. Which nursing diagnosis would be considered the priority for a client with a fracture?

A. Risk of peripheral neurovascular dysfunction
B. Activity intolerance
C. Risk for infection
D. Acute pain

6. Within one hour after a plaster body cast has been applied, the client complains of feeling warm. What is your best action?

A. Notify the physician.
B. Take the client’s temperature.
C. Cover the cast with a cool, wet towel.
D. Explain that the plaster gives off heat in the initial drying stage.

7. The client in a balanced skeletal traction setup for a fractured femur tells the nurse that he wants to be repositioned with his head and chest up higher. What is the nurse’s best response?

A. “How high do you want the head of the bed raised?”
B. “Do you think you could wait until your doctor makes rounds?”
C. “If you are repositioned, the traction device will be altered and healing of your leg may be delayed.”
D. “I will add more weight to your traction after you are repositioned so that the correct amount of pull is maintained.”

8. A client in skeletal traction complains of muscle spasm 30 minutes following pain medication administration. What action could you take to best increase the client’s comfort?

A. Reposition the client
B. Remove the traction weights
C. Apply moist heat to the area
D. Administer an antianxiety agent

9. The elderly client with a hip fracture is scheduled to undergo an open reduction with internal fixation. The client’s daughter asks what advantage this has for her mother. What is your best response?

A. “The internal screws will result in a stronger bone than if it were allowed to heal without surgery.”
B. “Your mother will be able to be out of bed in a shorter period of time.”
C. “Your mother’s hip would probably be crooked without surgery.”
D. “There is less chance of infection with this method.”

10. You are caring for a client who received treatment for a complex fracture of the femur. Which physical assessment parameter should you monitor to assess the client’s tissue perfusion to the effected extremity?

A. Distal pulses
B. Level of pain
C. Blood pressure
D. Level of consciousness

11. For the client scheduled to undergo a below-the-knee amputation, teaching of which of the following exercises is the major priority?

A. Exercises to strengthen the upper body in preparation for crutch walking
B. Exercises of the abdominal muscles to prevent postoperative atelectasis
C. Range-of-motion exercises of the knee of the affected leg to prevent flexion contractures
D. Quadriceps setting exercises to promote venous return and prevent thrombus formation

12. The client has experienced a traumatic amputation of the arm. Which specific intervention can assist this client in adapting to a new body image?

A. Sitting with the client at eye level during the conversation
B. Arranging to have the hospital chaplain visit the client daily
C. Touching the client lightly on the shoulder at the end of the conversation
D. Arranging to have a person who has recovered well from an arm amputation visit the client

13. You are preparing a client who has undergone a below-the-knee amputation for discharge home. What teaching should be included in your teaching plan for this client?

A. “Rewrap the limb with an elastic bandage three times a day.”
B. “Apply the elastic bandage in a proximal-to-distal direction.”
C. “You should begin wrapping the limb before the sutures are removed.”
D. “You no longer need to monitor the skin of the residual limb after it is healed.”

14. Which collaborative measure is the priority in caring for the client with complex regional pain syndrome?

A. Pain relief
B. Skin care
C. Range-of-motion exercises
D. Nutritional management

15. Which of the following clinical manifestations alerts the nurse to the possibility of a torn rotator cuff? The client is unable to:

A. pronate the forearm.
B. supinate the forearm.
C. maintain the arm in a shoulder abducted position.
D. maintain the arm in a shoulder adducted position.