Chapter 44: Fractures

Introduction To Medical Surgical Nursing, 6th Edition by Linton

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Chapter 44: Fractures

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

  1. Two days after surgery for a crushed pelvis, a certified nursing assistant (CNA) reports that the patient is complaining of a shortness of breath and is demonstrating signs of confusion and restlessness. What should a nurse suspect, from these signs alone, that the patient has developed?
a. Impending shock
b. Fat embolus
c. Anxiety
d. Neurovascular compromise

 

 

ANS:  B

These are the classic symptoms of a fat embolus that has escaped from the crushed marrow.

 

DIF:    Cognitive Level: Analysis                REF:   p. 974             OBJ:   3 | 6

TOP:   Complications: Fat Embolism

KEY:  Nursing Process Step: Assessment| Nursing Process Step: Evaluation

MSC:  NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

 

  1. What should a nurse teach an older patient with a newly casted Colles fracture?
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.

 

 

ANS:  D

Movement of the shoulders will help decrease the threat of contracture from immobility.

 

DIF:    Cognitive Level: Comprehension     REF:   p. 987             OBJ:   7

TOP:   Colles Fracture                                KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

 

  1. A patient who has osteomyelitis after multiple fractures inquires what the physician meant when he said that surgery would follow the antibiotic therapy. What is the nurse’s most helpful reply to explain why this surgery will be performed?
a. To remove dead bone
b. To close the open draining wound
c. To close the area with casting material
d. To amputate

 

 

ANS:  A

After the antibiotic has controlled the infection in the bone, surgery will be performed to remove the dead bone.

 

DIF:    Cognitive Level: Comprehension     REF:   p. 973             OBJ:   4

TOP:   Osteomyelitis                                  KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

 

  1. A patient with a crushed forearm cannot get pain relief with opioid medications. The injury is swollen, cool, and cyanotic, with weak distal pulses. What should the nurse suspect?
a. Compartment syndrome
b. Overwhelming infection
c. Fat embolus
d. Osteomyelitis

 

 

ANS:  A

Compartment syndrome may occur after a massive injury or an inappropriately tight cast. The tissues become swollen to the point that they cut off their own circulation.

 

DIF:    Cognitive Level: Analysis                REF:   p. 974             OBJ:   3

TOP:   Compartment Syndrome                  KEY:  Nursing Process Step: Assessment

MSC:  NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

 

  1. A patient who sustained a simple fracture of the left fibula 7 days earlier asks in what stage of bone healing he might be. What stage of healing should the nurse relay to the patient?
a. Hematoma formation
b. Ossification
c. Callus formation
d. Fibrocartilage formation

 

 

ANS:  C

Callus formation occurs at the end of the first week after injury.

 

DIF:    Cognitive Level: Comprehension     REF:   p. 972             OBJ:   2

TOP:   Healing Process of Fractures            KEY:  Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity: Physiological Adaptation

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