Nokea
A nurse is preparing to discharge a patient from the emergency department after receiving treatment for an ankle sprain. While providing discharge education, the nurse should encourage which of the following?
- A. Apply heat for the first 24 to 48 hours after the injury.
- B. Maintain the ankle in a dependent position.
- C. Exercise hourly by performing rotation exercises of the ankle.
- D. Keep an elastic compression bandage on the ankle.
Correct Answer: D
Rationale: Treatment of a sprain consists of resting and elevating the affected part, applying cold, and using a compression bandage. After the acute inflammatory stage (usually 24 to 48 hours after injury), heat may be applied intermittently. Rotation exercises would likely be painful.
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An older adult patient has fallen in her home and is brought to the emergency department by ambulance with a suspected fractured hip. X-rays confirm a fracture of the left femoral neck. When planning assessments during the patients presurgical care, the nurse should be aware of the patients heightened risk of what complication?
- A. Osteomyelitis
- B. Avascular necrosis
- C. Phantom pain
- D. Septicemia
Correct Answer: B
Rationale: Fractures of the neck of the femur may damage the vascular system that supplies blood to the head and the neck of the femur, and the bone may become ischemic. For this reason, AVN is common in patients with femoral neck fractures. Infections are not immediate complications and phantom pain applies to patients with amputations, not hip fractures.
The nurse is providing care for a patient who has had a below-the-knee amputation. The nurse enters the patients room and finds him resting in bed with his residual limb supported on pillow. What is the nurses most appropriate action?
- A. Inform the surgeon of this finding.
- B. Explain the risks of flexion contracture to the patient.
- C. Transfer the patient to a sitting position.
- D. Encourage the patient to perform active ROM exercises with the residual limb.
Correct Answer: B
Rationale: The residual limb should not be placed on a pillow, because a flexion contracture of the hip may result. There is no acute need to contact the patients surgeon. Encouraging exercise or transferring the patient does not address the risk of flexion contracture.
Which of the following is the most appropriate nursing intervention to facilitate healing in a patient who has suffered a hip fracture?
- A. Administer analgesics as required.
- B. Place a pillow between the patients legs when turning.
- C. Maintain prone positioning at all times.
- D. Encourage internal and external rotation of the affected leg.
Correct Answer: B
Rationale: Placing a pillow between the patients legs when turning prevents adduction and supports the patients legs. Administering analgesics addresses pain but does not directly protect bone remodeling and promote healing. Rotation of the affected leg can cause dislocation and must be avoided. Prone positioning does not need to be maintained at all times.
Six weeks after an above-the-knee amputation (AKA), a patient returns to the outpatient office for a routine postoperative checkup. During the nurses assessment, the patient reports symptoms of phantom pain. What should the nurse tell the patient to do to reduce the discomfort of the phantom pain?
- A. Apply intermittent hot compresses to the area of the amputation.
- B. Avoid activity until the pain subsides.
- C. Take opioid analgesics as ordered.
- D. Elevate the level of the amputation site.
Correct Answer: C
Rationale: Opioid analgesics may be effective in relieving phantom pain. Heat, immobility, and elevation are not noted to relieve this form of pain.
Radiographs of a boys upper arm show that the humerus appears to be fractured on one side and slightly bent on the other. This diagnostic result suggests what type of fracture?
- A. Impacted
- B. Compound
- C. Compression
- D. Greenstick
Correct Answer: D
Rationale: Greenstick fractures are an incomplete fracture that results in the bone being broken on one side, while the other side is bent. This is not characteristic of an impacted, compound, or compression fracture.