Chapter 46. Nursing Care of Patients With Musculoskeletal and Connective Tissue Disorders

Understanding Medical Surgical Nursing 5th Edition by Linda S. Williams Paula D. Hopper

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Chapter 46. Nursing Care of Patients With Musculoskeletal and Connective Tissue Disorders

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

Multiple Choice

Identify the choice that best completes the statement or answers the question.

 

____     1.   The nurse is contributing to the plan of care for a patient who has a right fractured femur. What intervention should the nurse include in the plan of care to prevent fat emboli?

a. Decrease dietary consumption of fats.
b. Maintain immobilization of the right leg.
c. Encourage coughing and deep breathing hourly.
d. Perform passive range of motion on the right leg.

 

 

____     2.   A patient has an open reduction of a radial fracture and is casted. Several hours after the operation, the patient reports a throbbing pain in the arm. What nursing action is essential for the nurse to take?

a. Reposition arm.
b. Perform neurovascular checks.
c. Administer analgesics as ordered.
d. Notify the physician immediately.

 

 

____     3.   The nurse is monitoring a patient with a casted left tibial fracture and a contusion of the thigh. The patient reports increasing pain in the left foot that has not been relieved by morphine injections. What should the nurse do?

a. Reposition the casted leg.
b. Repeat the morphine injection now.
c. Give a higher ordered dose of morphine.
d. Ensure physician is immediately notified.

 

 

____     4.   The nurse finds a 2-day postoperative patient who had a right total hip replacement lying supine with crossed legs. What data should the nurse collect on this patient?

a. The right leg for shortening
b. The right knee for crepitation
c. The left leg for internal rotation
d. The left leg for loss of function

 

 

____     5.   The nurse is caring for a patient who had a closed reduction of the ulna with a cast applied. Later the patient reports left arm pain. What should the nurse do first?

a. Pad the edges of the cast.
b. Notify the physician immediately.
c. Administer an analgesic as ordered.
d. Perform neurovascular check on fingers.

 

MULTIPLE CHOICE

 

  1. ANS:  B

Prevention of fat emboli includes keeping the fracture immobilized and hydrating the patient to help dilute and excrete any fat that may escape from the fractured bone. A. Decreasing the consumption of fat will not help prevent fat emboli. C. D. Deep breathing and coughing and performing passive range of motion will not prevent the development of fat emboli.

 

PTS:   1                    DIF:    Moderate

KEY:  Client Need: Physiological Integrity—Reduction of Risk Potential | Cognitive Level: Application

 

  1. ANS:  B

The nurse should begin with data collection to determine what the next action to take. For this patient the nurse should perform neurovascular checks. A. The arm might need to be positioned however this should not be done until a neurovascular check is completed. C. Administering pain medication might be indicted however should not be done until a pain assessment is completed. D. The nurse needs to determine the patient’s neurovascular status before notifying the physician.

 

PTS:   1                    DIF:    Moderate

KEY:  Client Need: Physiological Integrity—Reduction of Risk Potential | Cognitive Level: Analysis

 

  1. ANS:  D

The early symptom of acute compartment syndrome is the patient’s report of severe, increasing pain that is not relieved with narcotics, so the physician should be notified. A. B. C. These actions might be done if prescribed by the physician.

 

PTS:   1                    DIF:    Moderate

KEY:  Client Need: Physiological Integrity—Reduction of Risk Potential | Cognitive Level: Application

 

  1. ANS:  A

Crossing the legs puts the hip at risk for dislocation. Symptoms are pain in the affected hip, shortening of the leg, and possibly rotation of the surgical leg. B. The patient did not have surgery on the right knee. C. D. The patient did not have surgery to the left limb.

 

PTS:   1                    DIF:    Moderate

KEY:  Client Need: Physiological Integrity—Reduction of Risk Potential | Cognitive Level: Analysis

 

  1. ANS:  D

The nurse should begin with data collection to determine what the next action is to take. The nurse should perform a neurovascular check. A. The edges of the cast may need to be padded if this is the cause of the patient’s pain. B. The physician should not be notified until neurovascular checks are performed. C. The nurse needs to assess the patient’s pain level before providing an analgesic.

 

PTS:   1                    DIF:    Moderate

KEY:  Client Need: Physiological Integrity—Reduction of Risk Potential | Cognitive Level: Application

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