Fractures and amputations- (in class)
NCLEX/20 Q’s and A’s
A middle-aged patient has a tight cast on the left lower leg. Which
assessment finding would prompt the nurse to assess further for
compartment syndrome?
A. Diminished pulses
B. Discoloration of some of the toes
C. Tingling sensation of the upper leg
D. Pain more intense than expected based on initial injury - -D. Pain more
intense than expected based on initial injury
The classic sign of acute compartment syndrome is pain, and the pain is
more intense than what would be expected from the injury itself.
-he nurse explains that which diagnostic test best demonstrates
musculoskeletal and soft tissue damage?
A. Standard x-rays
B. Electromyography (EMG)
C. Computed tomography (CT)
D. Magnetic resonance imaging (MRI) - -D. Magnetic resonance imaging
(MRI)
MRI is useful in determining the amount of soft tissue damage that may have
occurred with the fracture.
-54-year-old man presents to the ED with a deformed right ankle. He states
that he was jogging close to the edge of a hillside, and that he tripped and
fell down the hill. There are no openings in the skin. A pulse cannot be
obtained by touch to the right foot, which is pale and cool to palpation. The
patient rates his pain as an "8" on a 0-to-10 scale. What is the priority
nursing action at this time?
A. Administer pain medication.
B. Prepare for reduction.
C. Obtain a Doppler of the right foot pulse.
D. Notify the physician of the lack of a pulse in the right foot. - -C. Obtain a
Doppler of the right foot pulse.
The nurse should obtain a Doppler reading to see if any pulse can be
detected at all.
, -An ankle x-ray confirms that the patient has an ankle fracture. A fiberglass
cast is applied to immobilize the ankle and allow for healing. Which are
priority interventions after the cast is applied? (Select all that apply.)
A. Monitor for signs of infection.
B. Assess peripheral capillary refill.
C. Ask the patient about frequency of bowel movements.
D. Keep the cast uncovered for air-drying over several hours.
E. Insert a finger between the skin and the cast to be sure the cast is not too
tight. - -A. Monitor for signs of infection.
B. Assess peripheral capillary refill.
E. Insert a finger between the skin and the cast to be sure the cast is not too
tight.
A synthetic cast such as fiberglass will dry within 10 to 15 minutes and can
bear weight 30 minutes after application. Assessing capillary refill and ability
to insert a finger into the space between the skin and the cast allow the
nurse to assure that the client's circulation is not compromised by swelling of
the tissue or tightness of the cast. Monitoring for signs of infection are
always important.
-Your 70-year-old patient has a fracture of the femur; to control the patients
pain (8/10) which order would you exoect from the provider?
a. Morphine 1 to 2 mg. IV
b. Meperidine 50 mg IM
c. Acetaminophen 650 mg PO
d. Apply ice packs to the right ankle - -a. Morphine 1 to 2 mg. IV
Meperidine should not be used w/ older adults, and many hospitals no longer
use this drug for patients of any age. Acetaminophen will most likely not
relieve pain that is rated at 8 on a scale of 0-10. Ice may help with the
swelling and pain but will likely not relieve the patient's pain.
-The patient tells the nurse that he was jogging to train for a marathon,
which has been a lifelong goal. He asks, "Will I ever be able to run a
marathon now?" What is the correct nursing response?
A. "The doctor will be able to tell you that."
B. "Of course; after this heals, you will be fine."
C. "It is unlikely that your ankle will regain the necessary strength."
D. "It sounds like you are concerned that you may not be able to achieve
your goal." - -D. "It sounds like you are concerned that you may not be able
to achieve your goal."
NCLEX/20 Q’s and A’s
A middle-aged patient has a tight cast on the left lower leg. Which
assessment finding would prompt the nurse to assess further for
compartment syndrome?
A. Diminished pulses
B. Discoloration of some of the toes
C. Tingling sensation of the upper leg
D. Pain more intense than expected based on initial injury - -D. Pain more
intense than expected based on initial injury
The classic sign of acute compartment syndrome is pain, and the pain is
more intense than what would be expected from the injury itself.
-he nurse explains that which diagnostic test best demonstrates
musculoskeletal and soft tissue damage?
A. Standard x-rays
B. Electromyography (EMG)
C. Computed tomography (CT)
D. Magnetic resonance imaging (MRI) - -D. Magnetic resonance imaging
(MRI)
MRI is useful in determining the amount of soft tissue damage that may have
occurred with the fracture.
-54-year-old man presents to the ED with a deformed right ankle. He states
that he was jogging close to the edge of a hillside, and that he tripped and
fell down the hill. There are no openings in the skin. A pulse cannot be
obtained by touch to the right foot, which is pale and cool to palpation. The
patient rates his pain as an "8" on a 0-to-10 scale. What is the priority
nursing action at this time?
A. Administer pain medication.
B. Prepare for reduction.
C. Obtain a Doppler of the right foot pulse.
D. Notify the physician of the lack of a pulse in the right foot. - -C. Obtain a
Doppler of the right foot pulse.
The nurse should obtain a Doppler reading to see if any pulse can be
detected at all.
, -An ankle x-ray confirms that the patient has an ankle fracture. A fiberglass
cast is applied to immobilize the ankle and allow for healing. Which are
priority interventions after the cast is applied? (Select all that apply.)
A. Monitor for signs of infection.
B. Assess peripheral capillary refill.
C. Ask the patient about frequency of bowel movements.
D. Keep the cast uncovered for air-drying over several hours.
E. Insert a finger between the skin and the cast to be sure the cast is not too
tight. - -A. Monitor for signs of infection.
B. Assess peripheral capillary refill.
E. Insert a finger between the skin and the cast to be sure the cast is not too
tight.
A synthetic cast such as fiberglass will dry within 10 to 15 minutes and can
bear weight 30 minutes after application. Assessing capillary refill and ability
to insert a finger into the space between the skin and the cast allow the
nurse to assure that the client's circulation is not compromised by swelling of
the tissue or tightness of the cast. Monitoring for signs of infection are
always important.
-Your 70-year-old patient has a fracture of the femur; to control the patients
pain (8/10) which order would you exoect from the provider?
a. Morphine 1 to 2 mg. IV
b. Meperidine 50 mg IM
c. Acetaminophen 650 mg PO
d. Apply ice packs to the right ankle - -a. Morphine 1 to 2 mg. IV
Meperidine should not be used w/ older adults, and many hospitals no longer
use this drug for patients of any age. Acetaminophen will most likely not
relieve pain that is rated at 8 on a scale of 0-10. Ice may help with the
swelling and pain but will likely not relieve the patient's pain.
-The patient tells the nurse that he was jogging to train for a marathon,
which has been a lifelong goal. He asks, "Will I ever be able to run a
marathon now?" What is the correct nursing response?
A. "The doctor will be able to tell you that."
B. "Of course; after this heals, you will be fine."
C. "It is unlikely that your ankle will regain the necessary strength."
D. "It sounds like you are concerned that you may not be able to achieve
your goal." - -D. "It sounds like you are concerned that you may not be able
to achieve your goal."
