Nokea
A client arrives at the orthopedic clinic and reports suspecting a stress fracture of the right foot. The physician orders an x-ray with negative results. What does the nurse understand that these negative results can mean?
- A. The client does not have a stress fracture
- B. The client probably has a strain
- C. The stress fracture may not be seen on x-ray for a few weeks.
- D. The physician may have misread the x-ray.
Correct Answer: C
Rationale: A stress fracture may not be apparent radiographically for a few weeks. A bone scan usually can identify a nondisplaced or stress fracture earlier than an x-ray.
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A client comes to the emergency department and it is found that the client's radial head is partially dislocated. What is this partially dislocated radial head documented as?
- A. Volkmann's contracture
- B. Subluxation
- C. Compartment syndrome
- D. Sprain
Correct Answer: B
Rationale: A partial dislocation is referred to as a subluxation. A Volkmann 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 has a history of dislocations of the same joint. The nurse understands that this is most likely due to an insufficient deposit of collagen during the healing process leading to what complication?
- A. Loss of function
- B. Allergic reaction
- C. Lack of mobility
- D. Reduced tensile strength
Correct Answer: D
Rationale: A possible complication of dislocation during the healing process involves an insufficient deposit of collagen during the repair stage. The end result is that the ligaments may have reduced tensile strength and future instability, leading to recurrent dislocations of the same joint. An insufficient deposit of collagen does not lead to a loss of function necessarily, allergic reaction, or a complete lack of mobility.
A client arriving at the emergency department is diagnosed with a dislocation. Assessment would most likely result in which finding(s)?
- A. Complaint of a popping sound
- B. Protrusion in the joint
- C. Swelling
- D. Pain
Correct Answer: A,C,D
Rationale: With a dislocation, a client often reports hearing a popping sound when the dislocation occurs. In addition, the structural shape is altered, with a depression noted about the joint's circumference indicating that the bones above and below are no longer aligned. Swelling, coolness, numbness, tingling, and pale or dusky color of the distal tissue also are present. Pain is a common symptom associated with dislocations.
A client has sustained a left femur fracture in a skiing accident. When is the nurse aware that the complication of a fat emboli typically occurs and should be monitored for closely?
- A. The first hour after fracture of the long bone
- B. 8 to 12 hours
- C. 12 to 24 hours
- D. 48 to 72 hours
Correct Answer: D
Rationale: The client should be monitored for symptoms of a fat embolism, which typically occurs within 48 to 72 hours.
A client has delayed bone healing in a fractured right humerus. What should the nurse prepare the client for that promotes bone growth?
- A. Electrical stimulation
- B. Administration of low-dose heparin
- C. Joint fusion
- D. Administration of antibiotics
Correct Answer: A
Rationale: Delayed union may require surgical interventions to promote bone growth and correct the incorrect union. If necessary, prepare the client for use of electrical stimulation measures that promote bone growth, or for a bone graft. Administration of low-dose heparin would be used to prevent pulmonary embolism. Joint fusion may be used in the case of avascular necrosis. Administration of antibiotics would be used for the potential of infection or to treat an actual infection.