Chapter 63: Nursing Management: Musculoskeletal Trauma and Orthopedic Surgery

Chapter 63: Nursing Management: Musculoskeletal Trauma and Orthopedic
Surgery

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE
1. When counseling an older patient about ways to prevent fractures, which information will
the nurse include?
a. Tack down scatter rugs in the home.
b. Most falls happen outside the home.
c. Buy shoes that provide good support and are comfortable to wear.
d. Range-of-motion exercises should be taught by a physical therapist.
ANS: C
Comfortable shoes with good support will help decrease the risk for falls. Scatter rugs
should be eliminated, not just tacked down. Activities of daily living provide range of
motion exercise; these do not need to be taught by a physical therapist. Falls inside the
home are responsible for many injuries.
DIF: Cognitive Level: Application REF: 1586
TOP: Nursing Process: Implementation MSC: NCLEX: Safe and Effective Care
Environment
2. A checkout clerk in a grocery store has repetitive strain syndrome in the left elbow. The
nurse will plan to teach the patient about
a. surgical options.
b. elbow injections.
c. utilization of a left wrist splint.
d. modifications in arm movement.
ANS: D
Treatment for repetitive strain syndrome includes changing the ergonomics of the
activity. Elbow injections and surgery are not initial options for this type of injury. A
wrist splint might be used for hand or wrist pain.
DIF: Cognitive Level: Application REF: 1588-1589 TOP: Nursing Process:
Planning
MSC: NCLEX: Physiological Integrity
3. When working with a patient whose job involves many hours of word processing, the
nurse will teach the patient about the need to
a. do stretching and warm-up exercises before starting work.
b. wrap the wrists with a compression bandage every morning.
c. use acetaminophen (Tylenol) instead of nonsteroidal anti-inflammatory drugs
(NSAIDs) for wrist pain.
Test Bank 63-2
d. obtain a keyboard pad to support the wrist while word processing.
ANS: D
Repetitive strain injuries caused by prolonged times working at a keyboard can be
prevented by the use of a pad that will keep the wrists in a straight position. Stretching
exercises during the day may be helpful, but these would not be needed before starting.
Use of a compression bandage is not needed, although a splint may be used for carpal
tunnel syndrome. NSAIDs are appropriate to use to decrease swelling.
DIF: Cognitive Level: Application REF: 1589-1590
TOP: Nursing Process: Implementation MSC: NCLEX: Health Promotion and Maintenance
4. Which information will the nurse include when discharging a patient with a sprained
wrist from the emergency department?
a. Keep the wrist loosely wrapped with gauze.
b. Apply a heating pad to reduce muscle spasms.
c. Use pillows to elevate the arm above the heart.
d. Gently move the wrist through the range of motion.
ANS: C
Elevation of the arm will reduce the amount of swelling and pain. Compression bandages
are used to decrease swelling. For the first 24 to 48 hours, cold packs are used to reduce
swelling. The wrist should be rested and kept immobile to prevent further swelling or
injury.
DIF: Cognitive Level: Application REF: 1587-1588
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
5. A 20-year-old baseball pitcher has an arthroscopic repair of a rotator cuff injury
performed in same-day surgery. When the nurse plans postoperative teaching for the
patient, which information will be included?
a. “You have an appointment with a physical therapist for tomorrow.”
b. “You can still play baseball but you will not be able to return to pitching.”
c. “The doctor will use the drop-arm test to determine the success of surgery.”
d. “Leave the shoulder immobilizer on for the first few days to minimize pain.”
ANS: A
Physical therapy after a rotator cuff repair begins on the first postoperative day to prevent
“frozen shoulder.” A shoulder immobilizer is used immediately after the surgery, but
leaving the arm immobilized for several days would lead to loss of range of motion
(ROM). The drop-arm test is used to test for rotator cuff injury, but not after surgery. The
patient may be able to return to pitching after rehabilitation.
DIF: Cognitive Level: Application REF: 1590-1591 TOP: Nursing Process:
Planning
MSC: NCLEX: Physiological Integrity