Nokea
A client comes to the clinic 2 days after sustaining a sprain to the left ankle. What intervention can the nurse encourage the client to perform that will help improve circulation?
- A. Active range-of-motion exercises
- B. Take nonsteroidal anti-inflammatory drugs
- C. Applying cold compresses
- D. Applying heat
Correct Answer: D
Rationale: After 2 days, when swelling is no longer likely to increase, applying heat reduces pain and relieves local edema by improving circulation. Full use of the injured joint is discouraged temporarily. Nonsteroidal anti-inflammatory drugs will ease discomfort but not improve circulation. Applying cold compresses is only used in the first 24 to 48 hours after an injury to reduce swelling and relieve pain.
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The nurse is designing a teaching plan for a client with a ruptured Achilles tendon. What education will the nurse provide?
- A. Dietary restrictions
- B. Activity restrictions
- C. Use of nonprescription medications
- D. Effective pin care
Correct Answer: B
Rationale: The nurse should emphasize information about the activity restrictions, the use of ambulatory aids, and pain management to a client with a ruptured Achilles tendon. The client need not be advised about his or her diet or the use of nonprescription medications. Teaching about pin care is also not necessary for such a client because pins are not used to treat a ruptured Achilles tendon.
The nurse in an orthopedic clinic is caring for a new client. What sign or symptom would lead a nurse to suspect that a client has a rotator cuff tear?
- A. Ability to stretch arm over the head
- B. Difficulty lying on affected side
- C. Pain worse in the morning
- D. Minimal pain with movement
Correct Answer: B
Rationale: Clients with a rotator cuff tear experience pain with movement and limited mobility of the shoulder and arm. They especially have difficulty with activities that involve stretching their arm above their head. Many clients find that the pain is worse at night and that they are unable to sleep on the affected side.
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.
A client sustained a sprained ankle while skiing, and the health care provider prescribed PRICE. Upon discharge, the client asks the nurse what this acronym stands for. How does the nurse respond?
- A. Protection, Rest, Ice, Compression, Elevation
- B. Prevention, Rest, Inflammation, Compression, Elevation
- C. Propping up the joint, Rate the pain, Increase activity, Compression, Elevation
- D. Perfusion, Range of motion, Ice, Circulation, Elevation, Steroids
Correct Answer: A
Rationale: Treatment consists of protecting the joint from further injury and applying ice or a chemical cold pack to the area to reduce swelling and relieve pain for the first 24 to 48 hours. Elevation of the part and compression with an elastic bandage also may be recommended. The acronym PRICE refers to protection, rest, ice, compression, and elevation - a method for remembering the treatment for strains, contusions, and sprains.
Radiographic evaluation of a client's fracture reveals that a bone fragment has been driven into another bone fragment. The nurse identifies this as which type of fracture?
- A. Comminuted
- B. Compression
- C. Impacted
- D. Greenstick
Correct Answer: C
Rationale: An impacted fracture is one in which a bone fragment is driven into another bone fragment. A comminuted fracture is one in which the bone has splintered into several fragments. A compression fracture is one in which bone has been compressed. A greenstick fracture is one in which one side of the bone is broken, and the other side is bent.