Nokea
Elevate the arm above the shoulder 3 to 4 times daily.
- A. Avoid moving the elbow, wrist, and fingers until bone remodeling is complete.
- B. Engage in active range of motion using the affected arm.
- C. Use the arm for light activities within the range of motion.
Correct Answer: D
Rationale: A patient with a clavicle fracture may use a sling to support the arm and relieve the pain. The patient may be permitted to use the arm for light activities within the range of comfort. The patient should not elevate the arm above the shoulder level until the ends of the bones have united, but the nurse should encourage the patient to exercise the elbow, wrist, and fingers.
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A patient is being treated for a fractured hip and the nurse is aware of the need to implement interventions to prevent muscle wasting and other complications of immobility. What intervention best addresses the patients need for exercise?
- A. Performing gentle leg lifts with both legs
- B. Performing massage to stimulate circulation
- C. Encouraging frequent use of the overbed trapeze
- D. Encouraging the patient to log roll side to side once per hour
Correct Answer: C
Rationale: The patient is encouraged to exercise as much as possible by means of the overbed trapeze. This device helps strengthen the arms and shoulders in preparation for protected ambulation. Independent logrolling may result in injury due to the location of the fracture. Leg lifts would be contraindicated for the same reason. Massage by the nurse is not a substitute for exercise.
A nurse is planning the care of an older adult patient who will soon be discharged home after treatment for a fractured hip. In an effort to prevent future fractures, the nurse should encourage which of the following? Select all that apply.
- A. Regular bone density testing
- B. A high-calcium diet
- C. Use of falls prevention precautions
- D. Use of corticosteroids as ordered
- E. Weight-bearing exercise
Correct Answer: A,B,C,E
Rationale: Health promotion measures after an older adults hip fracture include weight-bearing exercise, promotion of a healthy diet, falls prevention, and bone density testing. Corticosteroids have the potential to reduce bone density and increase the risk for fractures.
A patient who has had an amputation is being cared for by a multidisciplinary rehabilitation team. What is the primary goal of this multidisciplinary team?
- A. Maximize the efficiency of care
- B. Ensure that the patients health care is holistic
- C. Facilitate the patients adjustment to a new body image
- D. Promote the patients highest possible level of function
Correct Answer: D
Rationale: The multidisciplinary rehabilitation team helps the patient achieve the highest possible level of function and participation in life activities. The team is not primarily motivated by efficiency, the need for holistic care, or the need to foster the patients body image, despite the fact that each of these are valid goals.
A patient is brought to the emergency department by ambulance after stepping in a hole and falling. While assessing him the nurse notes that his right leg is shorter than his left leg; his right hip is noticeably deformed and he is in acute pain. Imaging does not reveal a fracture. Which of the following is the most plausible explanation for this patients signs and symptoms?
- A. Subluxated right hip
- B. Right hip contusion
- C. Hip strain
- D. Traumatic hip dislocation
Correct Answer: D
Rationale: Signs and symptoms of a traumatic dislocation include acute pain, change in positioning of the joint, shortening of the extremity, deformity, and decreased mobility. A subluxation would cause moderate deformity, or possibly no deformity. A contusion or strain would not cause obvious deformities.
A 25-year-old man is involved in a motorcycle accident and injures his arm. The physician diagnoses the man with an intra-articular fracture and splints the injury. The nurse implements the teaching plan developed for this patient. What sequela of intra-articular fractures should the nurse describe regarding this patient?
- A. Post-traumatic arthritis
- B. Fat embolism syndrome (FES)
- C. Osteomyelitis
- D. Compartment syndrome
Correct Answer: A
Rationale: Intra-articular fractures often lead to post-traumatic arthritis. Research does not indicate a correlation between intra-articular fractures and FES, osteomyelitis, or compartment syndrome.