N450 PrepU CH 42 Management of Patients with
Musculoskeletal Trauma
Which term refers to a break in the continuity of a bone? - ANS-Fracture
A fracture is a break in the continuity of the bone. A malunion occurs when a fractured bone
heals in a misaligned position. Dislocation is a separation of joint surfaces. A subluxation is a
partial separation or dislocation of joint surfaces.
The type of fracture described as having one side of the bone broken and the other side bent
would be: - ANS-greenstick
A greenstick fracture is the type of fracture described as having one side of the bone broken
and the other side bent. An oblique fracture occurs at an angle across the bone. A spiral
fracture is a fracture that twists around the shaft of the bone. A transverse fracture is a fracture
that is straight across the bone.
A client undergoes a total hip replacement. Which statement made by the client indicates to the
nurse that the client requires further teaching? - ANS-"I don't know if I'll be able to get off that
low toilet seat at home by myself."
The client requires additional teaching if he is concerned about using a low toilet seat. To
prevent hip dislocation after a total hip replacement, the client must avoid bending the hips
beyond 90 degrees. The nurse should instruct the client to use assistive devices, such as a
raised toilet seat, to prevent severe hip flexion. Using an abduction pillow or placing several
pillows between the legs reduces the risk of hip dislocation by preventing adduction and internal
rotation of the legs. Teaching the client to avoid crossing the legs also reduces the risk of hip
dislocation. A sock puller helps a client get dressed without flexing the hips beyond 90 degrees.
A nurse is caring for a construction worker who fell from the second story of a building site and
fractured the femoral neck. Which nursing diagnosis is a priority for the client? Select all that
apply. - ANS-Risk for injury
Impaired physical mobility
Risk for infection
The usual surgical management for a femoral neck fracture is an open reduction and internal
fixation with nails or screws, placing the client at risk for infection from a surgical incision. The
client's physical mobility is impaired, increasing the risk for injury. Disturbed body image and
urinary incontinence are not expected problems for the client with a femoral neck fracture.
, A client with a traumatic amputation of the right lower leg is refusing to look at the leg. Which
action by the nurse is most appropriate? - ANS-Provide feedback on the client's strengths and
available resources.
The nurse should encourage the client to look at, and assist with, care of the residual limb.
Providing feedback on the client's strengths and resources may allow the client to start to adapt
to the body image and lifestyle change. The nurse should also allow time for the client to
discuss their feelings related to the amputation. Requesting a referral to occupational therapy
and encouraging the client to perform ROM exercises are appropriate but do not address the
emotional aspect of losing an extremity.
A client who has fallen and injured a hip cannot place weight on the leg and is in significant
pain. After radiographs indicate intact but malpositioned bones, what would the physician
diagnose? - ANS-dislocation
In joint dislocation, radiographic films show intact yet malpositioned bones. Arthrography or
arthroscopy may reveal damage to other structures in the joint capsule. A strain is an injury to a
muscle when it is stretched or pulled beyond its capacity. Sprains are injuries to the ligaments
surrounding a joint. A fracture is a break in the continuity of a bone.
An adult is swinging a small child by the arms, and the child screams and grabs his left arm. It is
determined in the emergency department that the radial head is partially dislocated. What is this
partially dislocated radial head documented as? - ANS-Subluxation
A partial dislocation is referred to as a subluxation. A Volkmann's contracture is a claw like
deformity that results from compartment syndrome or obstructed arterial blood flow to the
forearm and hand. Compartment syndrome is a condition in which a structure such as a tendon
or nerve is constricted in a confined space and affects nerve innervation, leading to subsequent
palsy. A sprain is injury to the ligaments surrounding the joint.
A client with arterial insufficiency undergoes below-knee amputation of the right leg. Which
action should the nurse include in the postoperative care plan? - ANS-Elevating the stump for
the first 24 hours
Stump elevation for the first 24 hours after surgery helps reduce edema and pain by increasing
venous return and decreasing venous pooling at the distal portion of the extremity. Bed rest isn't
indicated and could predispose the client to complications of immobility. Heat application would
be inappropriate because it promotes vasodilation, which may cause hemorrhage and increase
pain. The initial pressure dressing usually remains in place for 48 to 72 hours after surgery.
A fracture is considered pathologic when it - ANS-occurs through an area of diseased bone.
Musculoskeletal Trauma
Which term refers to a break in the continuity of a bone? - ANS-Fracture
A fracture is a break in the continuity of the bone. A malunion occurs when a fractured bone
heals in a misaligned position. Dislocation is a separation of joint surfaces. A subluxation is a
partial separation or dislocation of joint surfaces.
The type of fracture described as having one side of the bone broken and the other side bent
would be: - ANS-greenstick
A greenstick fracture is the type of fracture described as having one side of the bone broken
and the other side bent. An oblique fracture occurs at an angle across the bone. A spiral
fracture is a fracture that twists around the shaft of the bone. A transverse fracture is a fracture
that is straight across the bone.
A client undergoes a total hip replacement. Which statement made by the client indicates to the
nurse that the client requires further teaching? - ANS-"I don't know if I'll be able to get off that
low toilet seat at home by myself."
The client requires additional teaching if he is concerned about using a low toilet seat. To
prevent hip dislocation after a total hip replacement, the client must avoid bending the hips
beyond 90 degrees. The nurse should instruct the client to use assistive devices, such as a
raised toilet seat, to prevent severe hip flexion. Using an abduction pillow or placing several
pillows between the legs reduces the risk of hip dislocation by preventing adduction and internal
rotation of the legs. Teaching the client to avoid crossing the legs also reduces the risk of hip
dislocation. A sock puller helps a client get dressed without flexing the hips beyond 90 degrees.
A nurse is caring for a construction worker who fell from the second story of a building site and
fractured the femoral neck. Which nursing diagnosis is a priority for the client? Select all that
apply. - ANS-Risk for injury
Impaired physical mobility
Risk for infection
The usual surgical management for a femoral neck fracture is an open reduction and internal
fixation with nails or screws, placing the client at risk for infection from a surgical incision. The
client's physical mobility is impaired, increasing the risk for injury. Disturbed body image and
urinary incontinence are not expected problems for the client with a femoral neck fracture.
, A client with a traumatic amputation of the right lower leg is refusing to look at the leg. Which
action by the nurse is most appropriate? - ANS-Provide feedback on the client's strengths and
available resources.
The nurse should encourage the client to look at, and assist with, care of the residual limb.
Providing feedback on the client's strengths and resources may allow the client to start to adapt
to the body image and lifestyle change. The nurse should also allow time for the client to
discuss their feelings related to the amputation. Requesting a referral to occupational therapy
and encouraging the client to perform ROM exercises are appropriate but do not address the
emotional aspect of losing an extremity.
A client who has fallen and injured a hip cannot place weight on the leg and is in significant
pain. After radiographs indicate intact but malpositioned bones, what would the physician
diagnose? - ANS-dislocation
In joint dislocation, radiographic films show intact yet malpositioned bones. Arthrography or
arthroscopy may reveal damage to other structures in the joint capsule. A strain is an injury to a
muscle when it is stretched or pulled beyond its capacity. Sprains are injuries to the ligaments
surrounding a joint. A fracture is a break in the continuity of a bone.
An adult is swinging a small child by the arms, and the child screams and grabs his left arm. It is
determined in the emergency department that the radial head is partially dislocated. What is this
partially dislocated radial head documented as? - ANS-Subluxation
A partial dislocation is referred to as a subluxation. A Volkmann's contracture is a claw like
deformity that results from compartment syndrome or obstructed arterial blood flow to the
forearm and hand. Compartment syndrome is a condition in which a structure such as a tendon
or nerve is constricted in a confined space and affects nerve innervation, leading to subsequent
palsy. A sprain is injury to the ligaments surrounding the joint.
A client with arterial insufficiency undergoes below-knee amputation of the right leg. Which
action should the nurse include in the postoperative care plan? - ANS-Elevating the stump for
the first 24 hours
Stump elevation for the first 24 hours after surgery helps reduce edema and pain by increasing
venous return and decreasing venous pooling at the distal portion of the extremity. Bed rest isn't
indicated and could predispose the client to complications of immobility. Heat application would
be inappropriate because it promotes vasodilation, which may cause hemorrhage and increase
pain. The initial pressure dressing usually remains in place for 48 to 72 hours after surgery.
A fracture is considered pathologic when it - ANS-occurs through an area of diseased bone.
