Chapter 67: Musculoskeletal Trauma and Orthopedic Surgery |Harding: Lewis’s Medical-Surgical Nursing, 12th Edition
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Course
Lewis medical surgical nursing 12th
Institution
Lewis Medical Surgical Nursing 12th
MULTIPLE CHOICE
1. Which information would the nurse teach older adults at a community recreation center about ways to prevent fractures?
a. Tack down scatter rugs on the floor in the home.
b. Expect most falls to happen outside the home in the yard.
c. Buy supportive nonskid shoes that are c...
Harding: Lewis’s Medical -Surgical Nursing , 12th Edition MULTIPLE CHOICE 1. Which information would the nurse teach older adults at a community recreation center about ways to prevent fractures? a. Tack down scatter rugs on the floor in the home. b. Expect most falls to happen outside the home in the y ard. c. Buy supportive nonskid shoes that are comfortable to wear. d. Get instruction in range -of-motion exercises from a physical therapist. ANS: C Comfortable nonskid shoes with good support will help decrease the risk for falls. Scatter rugs should be elimina ted, not just tacked down. Activities of daily living provide exercise for active adults; range -of-
motion does not need to be taught by a physical therapist. Falls inside the home are responsible for many injuries. DIF: Cognitive Level : Apply (Application) TOP: Nursing Process : Implementation MSC: NCLEX: Health Promotion and Maintenance 2. A factory line worker has developed repetitive strain injury in the left elbow. Which topic would the nurse plan to include in patient teaching? a. Surgical options b. Elbow injecti ons c. Wearing a left wrist splint d. Modifying arm movements ANS: D Treatment for repetitive strain injury 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 us ed for hand or wrist pain. DIF: Cognitive Level : Apply (Application) TOP: Nursing Process : Planning MSC: NCLEX: Physiological Integrity 3. Which recommendation would the occupational health nurse provide to a patient whose job involves many hours of typing? a. Obta in a keyboard pad to support the wrist. b. Do stretching exercises before starting work. c. Wrap the wrists with compression bandages each morning. d. Avoid using nonsteroidal anti-inflammatory drugs (NSAIDS). ANS: A Repetitive strain injuries caused by prolonged w ork at a keyboard can be prevented by using a pad to keep the wrists in a straight position. Stretching exercises during the day may be helpful, but these would not be needed before starting work. Use of a compression bandage is not needed, although a spli nt may be used for carpal tunnel syndrome. NSAIDs are appropriate to decrease swelling. DIF: Cognitive Level : Apply (Application) TOP: Nursing Process : Implementation MSC: NCLEX: Health Promotion and Maintenance 4. Which discharge instruction would the emergenc y department nurse include for a patient with a sprained ankle? a. Keep the ankle loosely wrapped with gauze. b. Apply a heating pad to reduce muscle spasms. c. Use pillows to elevate the ankle above the heart. d. Gently move the ankle through the range of motion. ANS : C Elevation of the leg will reduce 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 ankle should be rested and kept immobile to prevent further swelling or in jury. DIF: Cognitive Level : Apply (Application) TOP: Nursing Process : Implementation MSC: NCLEX: Physiological Integrity 5. A tennis player has an arthroscopic repair of a rotator cuff injury performed in same -day surgery. Which information will the nurse includ e in postoperative teaching? a. “You will not be able to serve a tennis ball again.” b. “You will begin exercises with a physical therapist tomorrow.” c. “Keep the shoulder immobilizer on for the first 6 months to minimize pain.” d. “The surgeon will use the drop arm test to determine the success of surgery.” ANS: B Physical therapy exercises to prevent “frozen shoulder” begin on the first postoperative day after a rotator cuff repair. A shoulder immobilizer is used immediately after the surgery, but leaving the arm im mobilized for months would lead to loss of range of motion. The drop arm test is used to test for rotator cuff injury but not after surgery. The patient may be able to return to tennis after rehabilitation. DIF: Cognitive Level : Apply (Application) TOP: Nursing Process : Planning MSC: NCLEX: Physiologica l Integrity 6. The nurse would instruct a patient with a nondisplaced fractured left radius that the cast will need to remain in place for what amount of time? a. Two weeks b. At least six weeks c. Until swelling of the wri st has resolved d. Until x -rays show complete bony union ANS: B Bone healing starts immediately after the injury, but because ossification does not begin until 3 weeks after injury, the cast will need to be worn for more than 3 weeks. Complete union may take up to 1 year. Resolution of swelling does not indicate bone healing. DIF: Cognitive Level : Apply (Application) TOP: Nursing Process : Implementation MSC: NCLEX: Physiological Integrity 7. The nurse is caring for a patient who has a pelvic fracture and an external fixation device. Which method would the nurse use to assess pressure areas
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