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A client is a passenger in a vehicle that was hit in the rear by another vehicle. The client is complaining of pain in the neck from the head rapidly moving toward and then back against the headrest. What type of injury does the nurse suspect the client sustained in the accident?
- A. Strain
- B. Avulsion fracture
- C. Whiplash injury
- D. Contusion
Correct Answer: C
Rationale: A sprain of the cervical spine is commonly called a whiplash injury and results from sudden, unusual movement or stretching around a joint, which is common with falls or other accidental injuries. A strain results from excessive stress, overuse, or overstretching. An avulsion fracture is when the ligament is torn or ruptured completely, with possible detachment of a fragment to bone. In a contusion, the injury is confined to the soft tissues and does not affect the musculoskeletal structure.
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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 was involved in an automobile accident and sustained multiple traumas. The client has a Volkmann contracture to the right hand. What objective data does the nurse document related to this finding?
- A. Extension of the fingers of the right hand
- B. Nodules on the knuckles of the third and fourth finger
- C. Clawlike deformity of the right hand without ability to extend fingers
- D. Dislocation of the fingers
Correct Answer: C
Rationale: A Volkmann contracture is a clawlike deformity of the hand resulting from obstructed arterial blood flow to the forearm and hand. The client is unable to extend the fingers and reports unrelenting pain, particularly if attempting to stretch the hand. Nodules on the knuckles and dislocation are not indicative of Volkmann contracture.
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 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.
A client sustains an injury to the left ankle after a fall. There was immediate swelling and pain from the injury, and the client was taken to the local emergency department. What initial test does the nurse anticipate the physician will order to rule out a fracture?
- A. Arthrography
- B. Arthroscopy
- C. X-ray
- D. Computerized tomography (CT scan)
Correct Answer: C
Rationale: X-rays may show a larger-than-usual joint space and rule out or confirm an accompanying fracture. Arthrography demonstrates asymmetry in the joint as a result of the damaged ligaments, or arthroscopy may disclose trauma in the joint capsule. A CT scan is costly and not used as a first-line diagnostic tool in the initial stage of an ankle injury.