Chapter 69: Management of Patients With Musculoskeletal Trauma

Chapter 69: Management of Patients With Musculoskeletal Trauma

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

Multiple Choice

1. A patient is arriving to the orthopedic floor from the emergency room. While giving report to the floor nurse, the emergency room nurse states that the patient has a fracture of the nose that has resulted in a skin tear and involvement of the mucous membranes of the nasal passages. The orthopedic nurse is aware that this description likely indicates which type of fracture?
2. A) Compression
3. B) Compound
4. C) Impacted
5. D) Transverse

Ans:  B

Chapter:  69

Client Needs:  D-4

Cognitive Level:  Analysis

Difficulty:  Moderate

Integrated Process:  Nursing Process

Objective:  3

Page and Header:  2084, Fractures

Feedback:  A compound fracture involves damage to the skin or mucous membranes and is also called an open fracture. A compression fracture involves compression of bone and is seen in vertebral fractures. An impacted fracture occurs when a bone fragment is driven into another bone fragment. A transverse fracture occurs straight across the bone shaft.

2. A patient has sustained a long bone fracture. The nurse is preparing a care plan for this patient. Which intervention should the nurse include in the care plan to enhance fracture healing?
3. A) Limit weight-bearing and exercising
4. B) Monitor color, temperature, and pulses of the affected extremity
5. C) Avoid immobilization of the fracture fragments
6. D) Administration of high doses of corticosteroids

Ans:  B

Chapter:  69

Client Needs:  D-3

Cognitive Level:  Application

Difficulty:  Difficult

Integrated Process:  Nursing Process

Objective:  6

Page and Header:  2107, Fractures of Specific Sites

Feedback:  The nurse should include monitoring for sufficient blood supply by assessing the color, temperature, and pulses of the affected extremity as adequate blood supply enhances the healing of a fracture. Factors that inhibit fracture healing include inadequate or lack of immobilization of the fracture fragments and administration of corticosteroids. Weight-bearing exercises are encouraged for patients with long bone fractures.

3. The nurse is assessing a patient’s right knee. The assessment shows edema, tenderness, muscle spasms, and ecchymosis. The patient states that 2 days ago he ran 10 miles and now it hurts to stand up. Based upon these symptoms, the nurse bases her teaching upon the fact that she anticipates the patient has experienced what?
4. A) A first-degree strain
5. B) A second-degree strain
6. C) A first-degree sprain
7. D) A second-degree sprain

Ans:  B

Chapter:  69

Client Needs:  D-4

Cognitive Level:  Analysis

Difficulty:  Difficult

Integrated Process:  Nursing Process

Objective:  1

Page and Header:  2081, Contusions, Strains, and Sprains

Feedback:  A second-degree strain involves tearing of muscle fibers and is manifested by notable loss of load-bearing strength with accompanying edema, tenderness, muscle spasm, and ecchymosis. A first-degree strain reflects tearing of a few muscle fibers and is accompanied by minor edema, tenderness, and mild muscle spasm, without noticeable loss of function. A first-degree sprain is caused by tearing of a few ligamentous fibers and is manifested by mild edema, local tenderness, and pain that is elicited when the joint is moved, but there is no joint instability. A second-degree sprain involves tearing of nerve fibers and results in increased edema, tenderness, pain with motion, joint instability, and partial loss of normal joint function.

4. The nurse is preparing the patient for discharge from the emergency room to home after incurring a sprain to the left ankle. While providing discharge teaching, the nurse is correct when they instruct the patient to what?
5. A) Apply heat for the first 24 to 48 hours after injury
6. B) Maintain the ankle in a dependent position
7. C) Exercise hourly by performing rotation exercises of the ankle
8. D) Apply an elastic compression bandage to the ankle

Ans:  D

Chapter:  69

Client Needs:  D-3

Cognitive Level:  Application

Difficulty:  Easy

Integrated Process:  Teaching/Learning

Objective:  2

Page and Header:  2081, Contusions, Strains, and Sprains

Feedback:  Treatment of a sprain consists of resting and elevating the affected part, applying cold, and using a compression bandage. After the acute inflammatory stage (usually 24 to 48 hours after injury), heat may be applied intermittently.

5. The nurse is writing a care plan for a patient admitted to the Emergency Department (ED) with an open fracture. The nurse will assign priority to what nursing diagnosis for a patient with an open fracture of the radius?
6. A) Risk for infection
7. B) Risk for activity intolerance
8. C) Risk for imbalanced nutrition: less than body requirements
9. D) Risk for powerlessness

Ans:  A

Chapter:  69

Client Needs:  D-3

Cognitive Level:  Application

Difficulty:  Moderate

Integrated Process:  Nursing Process

Objective:  4

Page and Header:  2087, Fractures

Feedback:  While all nursing diagnoses may be pertinent to the care of a patient with an open fracture of the radius, the nursing diagnosis that will receive the highest priority is “Risk for infection” related to the risks of osteomyelitis and tetanus. The objectives of management are to prevent infection of the wound, soft tissue, and bone and to promote healing. Another priority diagnosis for a patient with an open fracture would be “Risk for peripheral neurovascular dysfunction”.