Chapter 54: Care of Patients with Musculoskeletal Trauma

Chapter 54: Care of Patients with Musculoskeletal Trauma

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A client has a fracture and is being treated with skeletal traction. Which assessment causes the nurse to take immediate action?

a.	The client’s blood pressure is 130/86 mm Hg.
b.	The traction weights are resting on the floor.
c.	Slight oozing of clear fluid is noted at the pin site.
d.	Capillary refill of the extremity is less than 3 seconds.

 

 

ANS:  B

The immediate action of the nurse should be to reapply the weights to give traction to the fracture. The health care provider must be notified that the weights were lying on the floor, and the client should be realigned in bed. Slight oozing of clear fluid is normal as is the capillary refill time. The client’s blood pressure is slightly elevated; this could be related to pain and muscle spasms resulting from lack of pressure to reduce the fracture.

 

DIF:    Cognitive Level: Application/Applying or higher               REF:   N/A

TOP:   Client Needs Category: Safe and Effective Care Environment (Management of Care—Establishing Priorities)           MSC:              Integrated Process: Nursing Process (Assessment)

 

2. A client has been diagnosed with carpal tunnel syndrome. Which intervention does the nurse question in the treatment of this injury?

a.	Ibuprofen 600 mg three times a day with meals
b.	Weekly injections of a corticosteroid by the physician
c.	Morphine 30 mg to be taken orally every 4 hours
d.	Use of a hand brace or splint during the day

 

 

ANS:  C

The client with carpal tunnel syndrome can be treated nonsurgically by administration of oral NSAIDs and corticosteroid injections. Most clients find relief with taking these medications and the use of a hand brace or splint to immobilize the wrist. The use of opioids such as morphine should not be necessary. NSAIDs and corticosteroids decrease inflammation and pain.

 

DIF:    Cognitive Level: Application/Applying or higher               REF:   N/A

TOP:   Client Needs Category: Physiological Integrity (Physiological Adaptation—Illness Management)  MSC:           Integrated Process: Nursing Process (Implementation)

 

3. The nurse is caring for a client with a fractured femur. Which factor in the client’s history may impede healing of the fracture?

a.	A sedentary lifestyle
b.	A history of smoking
c.	Oral contraceptive use
d.	Paget’s disease

 

 

ANS:  D

Paget’s disease and bone cancer can cause pathologic fractures such as a fractured femur that do not achieve total healing. The other factors do not impede healing but may cause other health risks.

 

DIF:    Cognitive Level: Comprehension/Understanding               REF:   p. 1148

TOP:   Client Needs Category: Physiological Integrity (Physiological Adaptation—Alterations in Body Systems)  MSC:           Integrated Process: Nursing Process (Assessment)

 

4. A client who has sustained a crush injury to the right lower leg reports numbness and tingling of the affected extremity. The skin of the right leg appears pale. Which is the nurse’s first intervention?

a.	Assess pedal pulses.
b.	Apply oxygen by nasal cannula.
c.	Increase the IV flow rate.
d.	Document the finding.

 

 

ANS:  A

The symptoms represent early warning of acute compartment syndrome. In acute compartment syndrome, sensory deficits such as paresthesias precede changes in vascular or motor signs. If the nurse finds a decrease in pedal pulses, the health care provider should be notified as soon as possible.

 

DIF:    Cognitive Level: Application/Applying or higher               REF:   N/A

TOP:   Client Needs Category: Physiological Integrity (Reduction of Risk Potential—System-Specific Assessments)           MSC:              Integrated Process: Nursing Process (Assessment)