Nokea
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.
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An older adult client slipped on an area rug at home and fractured the left hip. The client is unable to have surgery immediately and is having severe pain. What interventions should the nurse employ to minimize energy loss in response to pain?
- A. Administer prescribed analgesics around-the-clock.
- B. Administer prescribed pain medication only when the client requests it.
- C. Give pain medication to the client after providing care.
- D. Avoid administering too much medication because the client is older.
Correct Answer: A
Rationale: Pain associated with hip fracture is severe and must be carefully managed with around-the-clock dosing of pain medication to minimize energy loss in response to pain. The client may not request the medication even if they are in pain, and it should be offered at the prescribed time. Giving pain medication prior to providing any type of care involved in moving the client is appropriate to reduce discomfort.
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.
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.
A client comes to the emergency department complaining of localized pain and swelling of the lower leg. Ecchymotic areas are noted. History reveals that the client was hit in the leg with a baseball bat. What would the nurse suspect as most likely?
- A. Fracture
- B. Contusion
- C. Sprain
- D. Strain
Correct Answer: B
Rationale: The client's description of blunt trauma by a baseball bat and localized pain in conjunction with swelling and ecchymosis would most likely suggest a contusion. A fracture would be manifested by pain, loss of function, deformity, swelling, and spasm. A sprain would be manifested by pain and swelling; ecchymosis may appear later. A strain is characterized by inflammation, local tenderness, and muscle spasms.
The nurse is caring for a client who reports wrist pain. What does the nurse identify as a positive indicator of the Phalen sign?
- A. Percussion of the median nerve causes tingling and numbness.
- B. Wrist flexion for 30 seconds causes pain and numbness.
- C. Electrical stimulation shows a delay in motor responses.
- D. Shaking hands causes a reduction in the pain
Correct Answer: B
Rationale: Phalen sign involves having the client flex the wrist for 30 seconds to determine if pain or numbness occurs, which if it does, indicates a positive sign for carpal tunnel syndrome. Tinel sign involves percussion of the median nerve, which if positive, elicits tingling, numbness, and pain for clients with carpal tunnel syndrome. Electrical stimulation with delay would be evaluated by electromyography. Shaking hands that leads to a reduction in pain is a method for assessing carpal tunnel syndrome.