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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.
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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 with a fracture develops compartment syndrome that requires surgical intervention. What treatment will the nurse most likely prepare the client for?
- A. Bone graft
- B. Joint replacement
- C. Fasciotomy
- D. Amputation
Correct Answer: C
Rationale: Surgical treatment of compartment syndrome is achieved with a fasciotomy, a surgical incision of the fascia and separation of the muscle to relieve pressure and restore tissue perfusion. Bone graft, joint replacement or amputation may be done for a client who experiences avascular necrosis.
A client is diagnosed with a first-degree strain of the left ankle related to running 5 miles daily. How would the nurse differentiate the first-degree strain from other strains and sprains?
- A. The client has some edema of the left ankle with muscle spasms but is able to walk without assistive devices.
- B. The client is unable to bear weight on the left ankle and has a large ecchymotic area.
- C. The client has ecchymosis, edema, and has no function of the left foot and ankle.
- D. The client complains of pain when the joint is moved and has mild edema.
Correct Answer: A
Rationale: A first-degree strain involves mild stretching of the muscle or tendon, causing some edema and muscle spasm, but no real loss of function. The second-degree strain is partial tearing of muscle or tendon, leading to inability to bear weight and causing edema, muscle tenderness, muscle spasm, and ecchymosis. The third-degree tear is severe muscle and/or tendon tearing, causing severe pain, muscle/spasm ecchymosis, edema, and loss of function. A first-degree sprain involves stretching of the ligament fibers characterized by mild edema, tenderness, and pain if the joint is moved.
A client arrives in the emergency department complaining of severe pain in the left hip after falling out of the bed. What indication(s) upon assessment does the nurse recognize as a dislocated left hip?
- A. The left leg appears shorter
- B. The skin is warm to the touch
- C. Limited range of motion of the left hip
- D. Swelling around the hip
- E. The skin of the lower left leg is pale
- F. The client is able to bend the knee but not move toes
Correct Answer: A,C,D
Rationale: The leg may be shorter than its unaffected counterpart as a result of the displacement of one of the articulating bones. Range of motion is limited. Evidence of soft tissue injury includes swelling, coolness, numbness, tingling, and pale or dusky color. The client will not be able to bend the knee easily, and toe movement is typically preserved unless there is nerve damage.
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.