EXAM 4
Fractures, Casts, and Orthopedic Complications
75 Multiple-Choice Questions • Correct Answers Highlighted • Brief Rationales
Instructions: Choose the single best answer for each question. The correct option is highlighted in yellow, followed by a brief
rationale.
Study resource: Original practice questions based on the working assumption that NR-252 covers Adult Health II /
medical-surgical nursing. This is not an official Chamberlain exam; verify topics against your current syllabus.
1. Complication prevention: A client in a cast reports numbness and increasing tightness in the fingers. Which complication
or risk should the nurse address first?
A. Assess circulation, sensation, movement, and notify the provider promptly
B. Insert objects deep under the cast
C. Ignore it until the next appointment
D. Cover the cast with a heating pad
Rationale: Neurovascular compromise can cause permanent damage.
2. During care: A client with suspected bacterial meningitis is admitted. Which nursing response is most appropriate?
A. Place the client in a shared room without assessment
B. Use only contact precautions in all cases
C. Use droplet precautions initially according to policy
D. Use no precautions
Rationale: Droplet precautions reduce transmission risk for common bacterial causes.
3. Client scenario: A caregiver asks how to communicate with a client who has dementia. Which instruction should the nurse
reinforce?
A. Correct every memory error confrontationally
B. Ask multiple questions rapidly
C. Use short sentences, one step at a time, and allow response time
D. Speak only to the caregiver
Rationale: Simple, respectful communication supports understanding and dignity.
4. During care: A caregiver asks how to communicate with a client who has dementia. Which nursing response is most
appropriate?
A. Use short sentences, one step at a time, and allow response time
B. Ask multiple questions rapidly
C. Correct every memory error confrontationally
D. Speak only to the caregiver
Rationale: Simple, respectful communication supports understanding and dignity.
, 5. A client has a newly applied plaster cast. Which action is the nurse's priority?
A. Cover it tightly with plastic while wet
B. Handle the wet cast with palms and allow it to dry
C. Use fingertips to make indentations
D. Rest it on a hard edge
Rationale: Fingertips can create pressure points; airflow helps drying.
6. Clinical review: A client with a long-bone fracture has severe pain unrelieved by opioids and pain with passive stretch.
Which finding or action best fits this situation?
A. Apply a tight wrap
B. Elevate far above heart and wait
C. Document as routine fracture pain
D. Suspect compartment syndrome and notify the surgeon urgently
Rationale: Pain out of proportion and pain with passive stretch are early warning signs.
7. Clinical review: A client with head injury develops unequal pupils and declining consciousness. Which finding or action
best fits this situation?
A. Encourage sleep without reassessment
B. Document as an expected finding
C. Give oral fluids
D. Notify the emergency team immediately
Rationale: These may indicate rising intracranial pressure or herniation.
8. At the bedside, a client with concussion asks about returning to sports. What should the nurse do next?
A. Return the same day if headache improves
B. Hide symptoms to avoid missing the game
C. Resume contact play while dizzy
D. Return gradually only after symptoms resolve and clinician clearance
Rationale: A graded return and medical clearance reduce risk from repeat injury.
9. Clinical review: A caregiver asks how to communicate with a client who has dementia. Which finding or action best fits this
situation?
A. Ask multiple questions rapidly
B. Use short sentences, one step at a time, and allow response time
C. Correct every memory error confrontationally
D. Speak only to the caregiver
Rationale: Simple, respectful communication supports understanding and dignity.
10. During care: A client with a basilar skull fracture has clear drainage from the nose. Which nursing response is most
appropriate?
A. Pack tightly with gauze
B. Do not pack the nose; notify the provider and assess drainage as directed
C. Insert a nasal airway blindly
D. Ask the client to blow the nose forcefully
Rationale: Clear drainage may be cerebrospinal fluid; avoid actions that increase injury.
Fractures, Casts, and Orthopedic Complications
75 Multiple-Choice Questions • Correct Answers Highlighted • Brief Rationales
Instructions: Choose the single best answer for each question. The correct option is highlighted in yellow, followed by a brief
rationale.
Study resource: Original practice questions based on the working assumption that NR-252 covers Adult Health II /
medical-surgical nursing. This is not an official Chamberlain exam; verify topics against your current syllabus.
1. Complication prevention: A client in a cast reports numbness and increasing tightness in the fingers. Which complication
or risk should the nurse address first?
A. Assess circulation, sensation, movement, and notify the provider promptly
B. Insert objects deep under the cast
C. Ignore it until the next appointment
D. Cover the cast with a heating pad
Rationale: Neurovascular compromise can cause permanent damage.
2. During care: A client with suspected bacterial meningitis is admitted. Which nursing response is most appropriate?
A. Place the client in a shared room without assessment
B. Use only contact precautions in all cases
C. Use droplet precautions initially according to policy
D. Use no precautions
Rationale: Droplet precautions reduce transmission risk for common bacterial causes.
3. Client scenario: A caregiver asks how to communicate with a client who has dementia. Which instruction should the nurse
reinforce?
A. Correct every memory error confrontationally
B. Ask multiple questions rapidly
C. Use short sentences, one step at a time, and allow response time
D. Speak only to the caregiver
Rationale: Simple, respectful communication supports understanding and dignity.
4. During care: A caregiver asks how to communicate with a client who has dementia. Which nursing response is most
appropriate?
A. Use short sentences, one step at a time, and allow response time
B. Ask multiple questions rapidly
C. Correct every memory error confrontationally
D. Speak only to the caregiver
Rationale: Simple, respectful communication supports understanding and dignity.
, 5. A client has a newly applied plaster cast. Which action is the nurse's priority?
A. Cover it tightly with plastic while wet
B. Handle the wet cast with palms and allow it to dry
C. Use fingertips to make indentations
D. Rest it on a hard edge
Rationale: Fingertips can create pressure points; airflow helps drying.
6. Clinical review: A client with a long-bone fracture has severe pain unrelieved by opioids and pain with passive stretch.
Which finding or action best fits this situation?
A. Apply a tight wrap
B. Elevate far above heart and wait
C. Document as routine fracture pain
D. Suspect compartment syndrome and notify the surgeon urgently
Rationale: Pain out of proportion and pain with passive stretch are early warning signs.
7. Clinical review: A client with head injury develops unequal pupils and declining consciousness. Which finding or action
best fits this situation?
A. Encourage sleep without reassessment
B. Document as an expected finding
C. Give oral fluids
D. Notify the emergency team immediately
Rationale: These may indicate rising intracranial pressure or herniation.
8. At the bedside, a client with concussion asks about returning to sports. What should the nurse do next?
A. Return the same day if headache improves
B. Hide symptoms to avoid missing the game
C. Resume contact play while dizzy
D. Return gradually only after symptoms resolve and clinician clearance
Rationale: A graded return and medical clearance reduce risk from repeat injury.
9. Clinical review: A caregiver asks how to communicate with a client who has dementia. Which finding or action best fits this
situation?
A. Ask multiple questions rapidly
B. Use short sentences, one step at a time, and allow response time
C. Correct every memory error confrontationally
D. Speak only to the caregiver
Rationale: Simple, respectful communication supports understanding and dignity.
10. During care: A client with a basilar skull fracture has clear drainage from the nose. Which nursing response is most
appropriate?
A. Pack tightly with gauze
B. Do not pack the nose; notify the provider and assess drainage as directed
C. Insert a nasal airway blindly
D. Ask the client to blow the nose forcefully
Rationale: Clear drainage may be cerebrospinal fluid; avoid actions that increase injury.
