Nokea
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.
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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.
A client comes to the clinic 2 days after sustaining a sprain to the left ankle. What intervention can the nurse encourage the client to perform that will help improve circulation?
- A. Active range-of-motion exercises
- B. Take nonsteroidal anti-inflammatory drugs
- C. Applying cold compresses
- D. Applying heat
Correct Answer: D
Rationale: After 2 days, when swelling is no longer likely to increase, applying heat reduces pain and relieves local edema by improving circulation. Full use of the injured joint is discouraged temporarily. Nonsteroidal anti-inflammatory drugs will ease discomfort but not improve circulation. Applying cold compresses is only used in the first 24 to 48 hours after an injury to reduce swelling and relieve pain.
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.
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.
A client suffered a subtrochanteric hip fracture after falling out of the bed. What complication should the nurse monitor closely for related to this type of fracture?
- A. Pulmonary edema
- B. Abdominal pain
- C. Urinary retention
- D. Hypovolemia
Correct Answer: D
Rationale: Subtrochanteric hip fractures can lead to significant blood loss into the surrounding tissues, increasing the risk of hypovolemia. The nurse should monitor for signs of hypovolemia, such as tachycardia, hypotension, and decreased urine output.