Chapter 47: Concepts of Care for Patients
with Musculoskeletal Trauma
Ignatavicius: Medical-Surgical Nursing, 10th Edition
MULTIPLE CHOICE
1. A nurse cares for a client with a recently fractured tibia. Which assessment would alert
the nurse to take immediate action?
a. Pain of 4 on a scale of 0-10
b. Numbness in the extremity
c. Swollen extremity at the injury site
d. Feeling cold while lying in bed
ANS: B
The client with numbness and/or tingling of the extremity may be displaying the first
signs of acute compartment syndrome. This is an acute problem that requires
immediate intervention because of possible decreased circulation. Moderate pain and
swelling is an expected assessment after a fracture. These findings can be treated with
comfort measures. Being cold can be treated with additional blankets or by increasing
the temperature of the room.
DIF: Applying TOP: Integrated Process: Nursing Process: Assessment
KEY: Fracture, Complications MSC: Client Needs Category:
Safe and Effective Care Environment: Management of Care
2. After teaching a client with a fractured humerus, the nurse assesses the client’s
understanding. Which dietary choice demonstrates that the client correctly understands
the nutrition needed to assist in healing the fracture?
, a. Baked fish with orange juice and a vitamin D supplement
b. Bacon, lettuce, and tomato sandwich with a vitamin B supplement
c. Vegetable lasagna with a green salad and a vitamin A supplement
d. Roast beef with low-fat milk and a vitamin C supplement
ANS: D
The client with a healing fracture needs supplements of vitamins B and C and a high-
protein, high-calorie diet. Milk for calcium supplementation and vitamin C
supplementation is appropriate. Meat would increase protein in the diet that is
necessary for bone healing. Fish, a sandwich, and vegetable lasagna would provide
less protein.
DIF: Analyzing TOP: Integrated Process: Teaching/Learning
KEY: Fracture, Health promotion MSC: Client Needs Category:
Health Promotion and Maintenance
3. A client who had a traumatic above-the-knee amputation states that he fears he will
never have an intimate relationship again. What is the nurse’s best response?
a. “You’ll be able to get a leg prosthesis soon.”
b. “You think you won’t be able to have sex again?”
c. “I will ask the social worker to talk with you.”
d. “Are you married now or have a girl friend?”
ANS: B
The nurse’s response needs to allow further exploration of the client’s feelings.
Referring the client to another health professional might be appropriate at a later time
but discounts the client’s current feelings. Asking about marriage or a girlfriend
assumes that the client is heterosexual.
DIF: Analyzing TOP: Integrated Process: Communication and
Documentation KEY: Amputation, Psychosocial assessment
MSC: Client Needs Category: Psychosocial Integrity
, 4. A nurse is caring for an older client who is recovering from a leg amputation surgery.
The client states, “I don’t want to live with only one leg. I should have died during the
surgery.” What is the nurse’s best response?
a. “Your vital signs are good, and you are doing just fine right now.”
b. “Your children are waiting outside. Do you want them to grow up without a
father?”
c. “This is a big change for you. What support system do you have to help you
cope?”
d. “You will be able to do some of the same things as before you became
disabled.”
ANS: C
The client feels like less of a person following the amputation. The nurse would help
the client to identify coping mechanisms that have worked in the past and current
support systems to assist with coping. The nurse would not ignore the client’s feelings
by focusing on vital signs. The nurse would not try to make the client feel guilty by
alluding to family members. The nurse would not refer to the patient as being
“disabled” as this labels the client and may fuel poor body image.
DIF: Applying TOP: Integrated Process: Caring KEY: Amputation
| Psychosocial assessment MSC: Client Needs Category: Psychosocial
Integrity
5. After teaching a client who is recovering from a vertebroplasty, the nurse assesses the
patient’s understanding. Which statement by the client indicates a need for additional
teaching?
a. “I can drive myself home after the procedure.”
b. “I will monitor the puncture site for signs of infection.”
c. “I can start walking tomorrow and increase my activity slowly.”
d. “I will remove the dressing the day after discharge.”
with Musculoskeletal Trauma
Ignatavicius: Medical-Surgical Nursing, 10th Edition
MULTIPLE CHOICE
1. A nurse cares for a client with a recently fractured tibia. Which assessment would alert
the nurse to take immediate action?
a. Pain of 4 on a scale of 0-10
b. Numbness in the extremity
c. Swollen extremity at the injury site
d. Feeling cold while lying in bed
ANS: B
The client with numbness and/or tingling of the extremity may be displaying the first
signs of acute compartment syndrome. This is an acute problem that requires
immediate intervention because of possible decreased circulation. Moderate pain and
swelling is an expected assessment after a fracture. These findings can be treated with
comfort measures. Being cold can be treated with additional blankets or by increasing
the temperature of the room.
DIF: Applying TOP: Integrated Process: Nursing Process: Assessment
KEY: Fracture, Complications MSC: Client Needs Category:
Safe and Effective Care Environment: Management of Care
2. After teaching a client with a fractured humerus, the nurse assesses the client’s
understanding. Which dietary choice demonstrates that the client correctly understands
the nutrition needed to assist in healing the fracture?
, a. Baked fish with orange juice and a vitamin D supplement
b. Bacon, lettuce, and tomato sandwich with a vitamin B supplement
c. Vegetable lasagna with a green salad and a vitamin A supplement
d. Roast beef with low-fat milk and a vitamin C supplement
ANS: D
The client with a healing fracture needs supplements of vitamins B and C and a high-
protein, high-calorie diet. Milk for calcium supplementation and vitamin C
supplementation is appropriate. Meat would increase protein in the diet that is
necessary for bone healing. Fish, a sandwich, and vegetable lasagna would provide
less protein.
DIF: Analyzing TOP: Integrated Process: Teaching/Learning
KEY: Fracture, Health promotion MSC: Client Needs Category:
Health Promotion and Maintenance
3. A client who had a traumatic above-the-knee amputation states that he fears he will
never have an intimate relationship again. What is the nurse’s best response?
a. “You’ll be able to get a leg prosthesis soon.”
b. “You think you won’t be able to have sex again?”
c. “I will ask the social worker to talk with you.”
d. “Are you married now or have a girl friend?”
ANS: B
The nurse’s response needs to allow further exploration of the client’s feelings.
Referring the client to another health professional might be appropriate at a later time
but discounts the client’s current feelings. Asking about marriage or a girlfriend
assumes that the client is heterosexual.
DIF: Analyzing TOP: Integrated Process: Communication and
Documentation KEY: Amputation, Psychosocial assessment
MSC: Client Needs Category: Psychosocial Integrity
, 4. A nurse is caring for an older client who is recovering from a leg amputation surgery.
The client states, “I don’t want to live with only one leg. I should have died during the
surgery.” What is the nurse’s best response?
a. “Your vital signs are good, and you are doing just fine right now.”
b. “Your children are waiting outside. Do you want them to grow up without a
father?”
c. “This is a big change for you. What support system do you have to help you
cope?”
d. “You will be able to do some of the same things as before you became
disabled.”
ANS: C
The client feels like less of a person following the amputation. The nurse would help
the client to identify coping mechanisms that have worked in the past and current
support systems to assist with coping. The nurse would not ignore the client’s feelings
by focusing on vital signs. The nurse would not try to make the client feel guilty by
alluding to family members. The nurse would not refer to the patient as being
“disabled” as this labels the client and may fuel poor body image.
DIF: Applying TOP: Integrated Process: Caring KEY: Amputation
| Psychosocial assessment MSC: Client Needs Category: Psychosocial
Integrity
5. After teaching a client who is recovering from a vertebroplasty, the nurse assesses the
patient’s understanding. Which statement by the client indicates a need for additional
teaching?
a. “I can drive myself home after the procedure.”
b. “I will monitor the puncture site for signs of infection.”
c. “I can start walking tomorrow and increase my activity slowly.”
d. “I will remove the dressing the day after discharge.”
