Nokea
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.
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The nurse is demonstrating how to perform range-of-motion (ROM) exercises for a patient with tendinitis of the wrist. What intervention can the nurse encourage the client to use in order to decrease discomfort when performing the exercises?
- A. Perform the exercises when using hand weights.
- B. Perform the exercises and then take pain medication.
- C. Perform the exercises with the hand and wrist under warm water.
- D. Perform the exercises after icing the hand and wrist.
Correct Answer: C
Rationale: Some clients find that hand exercises are less painful if performed with the hand under warm water. Hand weights should not be used when performing exercises unless prescribed by the physician and will not decrease discomfort. Pain medication such as an NSAID should be taken prior to exercising. The use of ice is not recommended after 48 hours postinjury and may make the exercises more uncomfortable.
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.
A client had a dislocated shoulder, and when healing, the client had insufficient deposits of collagen during the repair stage. What complication is the nurse aware can occur from this lack of collagen?
- A. Carpal tunnel syndrome
- B. Compartment syndrome
- C. Volkmann contracture
- D. Recurrent dislocations
Correct Answer: D
Rationale: A possible complication of dislocations during the healing process involves an insufficient deposit of collagen during the repair stage. The end result is that the ligaments may have reduced tensile strength and future instability, leading to recurrent dislocations of the same joint. Carpal tunnel syndrome results from compression of the median nerve. Compartment syndrome is not a recurrent problem but will affect innervation. Volkmann contracture is a result of obstructed arterial blood flow to the forearm and hand and does not result from a dislocated shoulder.
A client is to undergo surgery to repair a ruptured Achilles tendon and application of a brace. The client demonstrates understanding of activity limitations when stating that a brace must be worn for which length of time?
- A. 2 to 4 weeks
- B. 6 to 8 weeks
- C. 10 to 12 weeks
- D. 14 to 16 weeks
Correct Answer: B
Rationale: Following surgical repair for a ruptured Achilles tendon, the client wears a brace or cast for 6 to 8 weeks. Two to four weeks is not long enough to support healing. The other answer choices are longer than necessary.
A client arrives at the orthopedic clinic and reports suspecting a stress fracture of the right foot. The physician orders an x-ray with negative results. What does the nurse understand that these negative results can mean?
- A. The client does not have a stress fracture
- B. The client probably has a strain
- C. The stress fracture may not be seen on x-ray for a few weeks.
- D. The physician may have misread the x-ray.
Correct Answer: C
Rationale: A stress fracture may not be apparent radiographically for a few weeks. A bone scan usually can identify a nondisplaced or stress fracture earlier than an x-ray.