Chapter 45: Fractures Linton: Medical-Surgical Nursing, 7th Edition

1. Two days after surgery for a crushed pelvis, a certified nursing assistant (CNA) reports that the patient is complaining of a shortness of breath and is demonstrating signs of confusion and restlessness. What should a nurse suspect, from these signs alone, that the patient has developed? a. Impending shock b. Fat embolus c. Anxiety d. Neurovascular compromise ANS: B These are the classic symptoms of a fat embolus that has escaped from the crushed marrow. DIF: Cognitive Level: Analysis REF: p. 881 OBJ: 3 | 6 TOP: Complications: Fat Embolism KEY: Nursing Process Step: Assessment| Nursing Process Step: Evaluation MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease 2. What should a nurse teach an older patient with a newly casted Colles fracture? a. Apply cool compresses to the cast. b. Let the hand and arm dangle to increase the drainage. c. Keep the hand immobile to reduce swelling. d. Move the shoulders to reduce contractures. ANS: D Movement of the shoulders will help decrease the threat of contracture from immobility. DIF: Cognitive Level: Comprehension REF: p. 891 OBJ: 7 TOP: Colles Fracture KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease 3. A patient who has osteomyelitis after multiple fractures inquires what the physician meant when he said that surgery would follow the antibiotic therapy. What is the nurse’s most helpful reply to explain why this surgery will be performed? a. To remove dead bone b. To close the open draining wound c. To close the area with casting material d. To amputate ANS: A After the antibiotic has controlled the infection in the bone, surgery will be performed to remove the dead bone. DIF: Cognitive Level: Comprehension REF: p. 882 OBJ: 4 TOP: Osteomyelitis KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Ma