Nokea
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.
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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.
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.
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.
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.
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.