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A client is brought to the emergency department by a softball team member who states the client and another player ran into each other, and the client is having severe pain in the right shoulder. What symptoms of a fractured clavicle does the nurse recognize?
- A. Client complains of tingling and numbness in the right shoulder.
- B. Right shoulder is elevated above the left.
- C. Client complains of pain in the unaffected shoulder.
- D. Right shoulder slopes downward and droops inward.
Correct Answer: D
Rationale: The client with a fractured clavicle has restricted motion, and the affected shoulder appears to slope downward and droop inward. The client will have pain, not typically tingling and numbness in the right shoulder. Pain is not felt in the unaffected shoulder.
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During the assessment of a client scheduled for orthopedic surgery, the nurse discovers that the client was previously treated for the disorder. In such a case, what additional data need to be collected?
- A. Occurrence of complications or problems during treatment
- B. Measures taken to minimize postoperative wound infection
- C. Perception of the client about the previous treatment
- D. Details of the medical team that handled the previous treatment
Correct Answer: A
Rationale: If the same disorder has been treated earlier, the nurse needs to determine and document any complications or problems that occurred during treatment. The nurse can determine whether the client understands the treatment or not based on the measures taken by the client to minimize postoperative wound infection. However, this factor can be assessed later because the nurse needs to explain the new treatment to the client. Although the client's perceptions of the previous treatment may be helpful, this data would not be as important. In addition, the nurse does not need to get details about the medical team that handled the previous treatment, unless specifically asked to do so.
The nurse is caring for a patient with a fractured right femur who is not a candidate to repair the femur immediately. What intervention should the nurse anticipate the physician will order to relieve muscle spasm and pain until surgery is performed?
- A. Skeletal traction
- B. Skin traction
- C. Open reduction
- D. External fixator
Correct Answer: B
Rationale: If surgery for a fracture cannot be performed right away, Buck's traction or other skin traction may be applied to relieve muscle spasm and pain until surgery is performed. The other distractors all require surgical intervention.
A client had a surgical amputation of an arm and is having a myoelectric arm applied. What does the nurse understand is the benefit(s) of this type of device? Select all that apply.
- A. Eliminates the need to wear a harness
- B. Terminal device looks natural
- C. Better function than cosmetic hand
- D. Stronger than other devices
- E. Lasts longer than other devices
Correct Answer: A,B,C
Rationale: The myoelectric arm has three advantages: eliminates the need to wear a harness, the terminal device looks natural, and it has somewhat better function than the cosmetic hand. Despite its advantages, the myoelectric arm is not rugged enough to do the work of the mechanical terminal device, and it does not last longer than other devices.
The nurse is caring for a client in skeletal traction. When performing pin care, which action by the nurse is most important?
- A. Clean the site, working toward the pin.
- B. Use an applicator only once.
- C. Gently remove crusts around pin sites.
- D. Apply an antimicrobial ointment.
Correct Answer: B
Rationale: When performing pin care, the nurse should use at least one applicator per pin and not use an applicator more than once, cleaning the site from the pin outward. Crusts around pin sites should be gently removed, but that is less important than not re-using applicators. Ointment is avoided unless it is specifically ordered.
A client is having traction applied to a fractured left lower extremity prior to surgery. What outcome(s) does the nurse expect from the application of the traction for the client? Select all that apply.
- A. Surgery will not be required.
- B. Muscle spasms will be relieved.
- C. The bones of the left leg will be aligned.
- D. Immobilization of the left leg will be maintained.
- E. Less pain medication will be required.
Correct Answer: B,C,D
Rationale: Traction is used to relieve muscle spasm, align bones, and maintain immobilization when used properly. It will not replace surgery to correct the fracture. The client will still require pain medication prior to surgical correction.