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A client has had surgery to repair a fractured hip. What intervention is important for the nurse to perform when turning the client from side to side?
- A. Place abductor pillows between the legs
- B. Place 2 pillows between the legs
- C. Place 6 to 8 pillows between the legs
- D. Have client put weight on the operated side
Correct Answer: A
Rationale: The nurse places abductor pillows between the client's legs when turning the client from side to side to avoid dislocating the hip. Regular pillows do not provide the support required to avoid a dislocation. The client should not bear weight on the operated side immediately after surgery.
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A client sustains a fractured right humerus in an automobile accident. The arm is edematous, the client reports not being able to feel or move the fingers, and the nurse does not feel a pulse. What condition should the nurse be concerned about that requires emergency measures?
- A. Compartment syndrome
- B. Dislocation
- C. Muscle spasms
- D. Subluxation
Correct Answer: A
Rationale: Separation of adjacent bones from their articulating joint interferes with normal use and produces a distorted appearance. The injury may disrupt local blood supply to structures such as the joint cartilage, causing degeneration, chronic pain, and restricted movement. Compartment syndrome is a condition in which a structure such as a tendon or nerve is constricted in a confined space. The fractured humerus may also be dislocated but is not the result of the impaired circulatory status. Muscle spasms may occur around the fracture site but are not the cause of circulatory impairment. Subluxation is a partial dislocation.
The nurse is demonstrating how to perform range-of-motion (ROM) exercises for a patient with tendinitis of the wrist. What intervention can the nurse encourage the client to use in order to decrease discomfort when performing the exercises?
- A. Perform the exercises when using hand weights.
- B. Perform the exercises and then take pain medication.
- C. Perform the exercises with the hand and wrist under warm water.
- D. Perform the exercises after icing the hand and wrist.
Correct Answer: C
Rationale: Some clients find that hand exercises are less painful if performed with the hand under warm water. Hand weights should not be used when performing exercises unless prescribed by the physician and will not decrease discomfort. Pain medication such as an NSAID should be taken prior to exercising. The use of ice is not recommended after 48 hours postinjury and may make the exercises more uncomfortable.
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.
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.
A client is admitted to the emergency department after being hit by a car while riding a bicycle. The client sustained a fracture of the left femur, and the bone is protruding through the skin. What type of fracture does the nurse recognize requires emergency intervention?
- A. Compound
- B. Greenstick
- C. Oblique
- D. Spiral
Correct Answer: A
Rationale: A compound fracture is a fracture in which damage also involves the skin or mucous membranes with the risk of infection great. A greenstick fracture is where one side of the bone is broken and the other side is bent; it does not protrude through the skin. An oblique fracture occurs at an angle across the bone but does not protrude through the skin. A spiral fracture twists around the shaft of the bone but does not protrude through the skin.