Nokea
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.
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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.
A client had a dislocated shoulder, and when healing, the client had insufficient deposits of collagen during the repair stage. What complication is the nurse aware can occur from this lack of collagen?
- A. Carpal tunnel syndrome
- B. Compartment syndrome
- C. Volkmann contracture
- D. Recurrent dislocations
Correct Answer: D
Rationale: A possible complication of dislocations 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. Carpal tunnel syndrome results from compression of the median nerve. Compartment syndrome is not a recurrent problem but will affect innervation. Volkmann contracture is a result of obstructed arterial blood flow to the forearm and hand and does not result from a dislocated shoulder.
A client with metastatic bone cancer sustained a left hip fracture without injury. What type of fracture does the nurse understand occurs without trauma or fall?
- A. Impacted fracture
- B. Transverse fracture
- C. Compound fracture
- D. Pathologic fracture
Correct Answer: D
Rationale: A pathologic fracture is a fracture that occurs through an area of diseased bone and can occur without trauma or a fall. An impacted fracture is a fracture in which a bone fragment is driven into another bone fragment. A transverse fracture is a fracture straight across the bone. A compound fracture is a fracture in which damage also involves the skin or mucous membranes.
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.
The nurse is caring for a client with a fracture. Which assessment would take priority?
- A. Neurovascular compromise
- B. Hormonal imbalances
- C. Cardiac problems
- D. Altered kidney function
Correct Answer: A
Rationale: When caring for a client with a fracture, the nurse assesses for the neurovascular compromise. A fracture or a treatment for fracture is not known to lead to hormonal imbalances, cardiac problems, or an altered kidney function.