Medical Nursing Trivia Quiz

1. The nurse is writing a care plan for a patient admitted to the Emergency Department (ED) with an open fracture. The nurse will assign priority to what nursing diagnosis for a patient with an open fracture of the radius?

A) Risk for infection

B) Risk for activity intolerance

C) Risk for imbalanced nutrition: less than body requirements

D) Risk for powerlessness

The nurse should assign priority to the nursing diagnosis of "Risk for infection" for a patient with an open fracture of the radius. This is because an open fracture involves a break in the skin, which increases the risk of infection. The nurse needs to closely monitor the wound, provide appropriate wound care, and administer prophylactic antibiotics if necessary to prevent infection. Infection can lead to further complications and delay the healing process, so it is crucial to prioritize this nursing diagnosis.

Explanation

The nurse should assign priority to the nursing diagnosis of "Risk for infection" for a patient with an open fracture of the radius. This is because an open fracture involves a break in the skin, which increases the risk of infection. The nurse needs to closely monitor the wound, provide appropriate wound care, and administer prophylactic antibiotics if necessary to prevent infection. Infection can lead to further complications and delay the healing process, so it is crucial to prioritize this nursing diagnosis.

2. Which of the following is the most appropriate nursing intervention for the nursing diagnosis of Impaired physical mobility related to fractured hip?

A) Administer analgesics as required.

B) Place pillow between legs when turning.

C) Monitor vital signs.

D) Assess wound appearance.

The most appropriate nursing intervention for the nursing diagnosis of impaired physical mobility related to fractured hip is to place a pillow between the patient's legs when turning. This intervention helps to maintain proper alignment and prevent further injury to the fractured hip. By placing a pillow between the legs, it reduces friction and pressure on the hip joint, making it easier and more comfortable for the patient to turn. This intervention promotes safety and mobility while minimizing pain and discomfort.

Explanation

The most appropriate nursing intervention for the nursing diagnosis of impaired physical mobility related to fractured hip is to place a pillow between the patient's legs when turning. This intervention helps to maintain proper alignment and prevent further injury to the fractured hip. By placing a pillow between the legs, it reduces friction and pressure on the hip joint, making it easier and more comfortable for the patient to turn. This intervention promotes safety and mobility while minimizing pain and discomfort.

3. A patient has sustained a long bone fracture. The nurse is preparing a care plan for this patient. Which intervention should the nurse include in the care plan to enhance fracture healing?

A) Limit weight-bearing and exercising

B) Monitor color, temperature, and pulses of the affected extremity

C) Avoid immobilization of the fracture fragments

D) Administration of high doses of corticosteroids

Monitoring color, temperature, and pulses of the affected extremity is important in enhancing fracture healing because it helps in assessing the circulation and perfusion to the injured area. Changes in color, temperature, or pulses can indicate complications such as impaired blood flow or infection, which can delay healing. By closely monitoring these indicators, the nurse can identify any issues early on and intervene appropriately to promote optimal healing. Limiting weight-bearing and exercising, avoiding immobilization of fracture fragments, and administering high doses of corticosteroids are not interventions that directly enhance fracture healing.

Explanation

Monitoring color, temperature, and pulses of the affected extremity is important in enhancing fracture healing because it helps in assessing the circulation and perfusion to the injured area. Changes in color, temperature, or pulses can indicate complications such as impaired blood flow or infection, which can delay healing. By closely monitoring these indicators, the nurse can identify any issues early on and intervene appropriately to promote optimal healing. Limiting weight-bearing and exercising, avoiding immobilization of fracture fragments, and administering high doses of corticosteroids are not interventions that directly enhance fracture healing.

4. A patient is arriving on the orthopedic floor from the emergency room. While giving the report to the floor nurse, the emergency room nurse states that the patient has a fracture of the nose that has resulted in a skin tear and involvement of the mucous membranes of the nasal passages. The orthopedic nurse is aware that this description likely indicates which type of fracture?

A) Compression

B) Compound

C) Impacted

D) Transverse

The description of a fracture involving a skin tear and involvement of the mucous membranes of the nasal passages indicates a compound fracture. A compound fracture is a type of fracture where the broken bone penetrates through the skin, creating an open wound. In this case, the fracture of the nose has resulted in a skin tear and involvement of the nasal mucous membranes, suggesting that it is a compound fracture.

Explanation

The description of a fracture involving a skin tear and involvement of the mucous membranes of the nasal passages indicates a compound fracture. A compound fracture is a type of fracture where the broken bone penetrates through the skin, creating an open wound. In this case, the fracture of the nose has resulted in a skin tear and involvement of the nasal mucous membranes, suggesting that it is a compound fracture.

5. Radiographs were ordered for a 10-year-old boy who had his right upper arm injured. The radiographs show that the humerus appears to be fractured on one side and slightly bent on the other. What type of fracture is this an example of?

A) Impacted

B) Compound

C) Compression

D) Greenstick

This is an example of a greenstick fracture. A greenstick fracture occurs when the bone bends and cracks, but does not completely break. It is commonly seen in children because their bones are still developing and more flexible. In this case, the radiographs show that the humerus is fractured on one side and slightly bent on the other, indicating a greenstick fracture.

Explanation

This is an example of a greenstick fracture. A greenstick fracture occurs when the bone bends and cracks, but does not completely break. It is commonly seen in children because their bones are still developing and more flexible. In this case, the radiographs show that the humerus is fractured on one side and slightly bent on the other, indicating a greenstick fracture.

6. The nurse is performing a shift assessment on an elderly patient who is recovering after surgery for a hip fracture. The nurse notes that the patient is complaining of chest pain, has an increased heart rate and respiratory rate. The nurse further notes that the patient is febrile and hypoxic, coughing and producing large amounts of thick white sputum. The nurse recognizes that this is a medical emergency and calls for assistance, as she recognizes that this patient is likely demonstrating symptoms related to what?

A) Avascular necrosis of bone

B) Compartment syndrome

C) Fat embolism syndrome

D) Complex regional pain syndrome

The patient's symptoms of chest pain, increased heart rate and respiratory rate, fever, hypoxia, coughing, and thick white sputum are indicative of fat embolism syndrome. Fat embolism syndrome occurs when fat globules enter the bloodstream and travel to the lungs, causing respiratory distress and other symptoms. This is a medical emergency that requires immediate attention and intervention. Avascular necrosis of bone, compartment syndrome, and complex regional pain syndrome do not present with the same combination of symptoms as seen in this patient.

Explanation

The patient's symptoms of chest pain, increased heart rate and respiratory rate, fever, hypoxia, coughing, and thick white sputum are indicative of fat embolism syndrome. Fat embolism syndrome occurs when fat globules enter the bloodstream and travel to the lungs, causing respiratory distress and other symptoms. This is a medical emergency that requires immediate attention and intervention. Avascular necrosis of bone, compartment syndrome, and complex regional pain syndrome do not present with the same combination of symptoms as seen in this patient.

7. A clinic nurse is caring for a patient who has a tibial fracture. The patient has just had a long-leg walking cast removed and a short leg cast applied. The nurse explains to the patient that the short leg cast will allow for what?

A) Ankle motion

B) Knee motion

C) Hip motion

D) Toe motion

The short leg cast will allow for knee motion. This means that the patient will be able to bend and straighten their knee while wearing the cast. This is important for maintaining joint mobility and preventing stiffness or contractures in the knee joint. The short leg cast will still provide support and immobilization for the tibial fracture, but it will allow for some movement at the knee joint.

Explanation

The short leg cast will allow for knee motion. This means that the patient will be able to bend and straighten their knee while wearing the cast. This is important for maintaining joint mobility and preventing stiffness or contractures in the knee joint. The short leg cast will still provide support and immobilization for the tibial fracture, but it will allow for some movement at the knee joint.

8. 33. Patients who have had amputations are cared for by a multidisciplinary rehabilitation team. What does the multidisciplinary team do for patients who are amputees?

A) Ensure top quality health care

B) Provide holistic health care

C) Assist in preventing complications

D) Help achieve the highest possible level of function

The multidisciplinary rehabilitation team helps patients who are amputees achieve the highest possible level of function. This means that the team works together to provide comprehensive care and support to help patients regain their physical abilities and independence. They may provide physical therapy, occupational therapy, prosthetic fitting, psychological support, and other services to help patients adapt to their amputation and learn how to perform daily activities and tasks with their new limitations. The goal is to help patients maximize their potential and improve their quality of life.

Explanation

The multidisciplinary rehabilitation team helps patients who are amputees achieve the highest possible level of function. This means that the team works together to provide comprehensive care and support to help patients regain their physical abilities and independence. They may provide physical therapy, occupational therapy, prosthetic fitting, psychological support, and other services to help patients adapt to their amputation and learn how to perform daily activities and tasks with their new limitations. The goal is to help patients maximize their potential and improve their quality of life.

9. 38. As an amputee a patient is being assessed prior to being discharged home. What is an expected patient outcome the nurse would assess for?

A) Patient exhibits healed, nontender, nonadherent scar

B) Patient can stand for at least 2 hours

C) Patient eats three nutritious meals daily

D) Patient exercises 30 minutes weekly

The expected patient outcome that the nurse would assess for in this scenario is that the patient exhibits a healed, nontender, nonadherent scar. This indicates that the patient's wound has healed properly without any signs of infection or complications. The nurse would assess the scar to ensure that it is healing well and does not cause any discomfort or adherence to clothing or bandages. This outcome is important for the patient's overall recovery and successful transition to home care.

Explanation

The expected patient outcome that the nurse would assess for in this scenario is that the patient exhibits a healed, nontender, nonadherent scar. This indicates that the patient's wound has healed properly without any signs of infection or complications. The nurse would assess the scar to ensure that it is healing well and does not cause any discomfort or adherence to clothing or bandages. This outcome is important for the patient's overall recovery and successful transition to home care.

10. The nurse is assessing a patient's right knee. The assessment shows edema, tenderness, muscle spasms, and ecchymosis. The patient states that 2 days ago he ran 10 miles and now it hurts to stand up. Based on these symptoms, the nurse bases her teaching upon the fact that she anticipates the patient has experienced what?

A) A first-degree strain

B) A second-degree strain

C) A first-degree sprain

D) A second-degree sprain

Based on the symptoms described, such as edema, tenderness, muscle spasms, and ecchymosis, it suggests that the patient has experienced a second-degree strain. This is because a strain involves the stretching or tearing of muscles or tendons, and the symptoms mentioned align with a moderate level of strain. A first-degree strain would typically present with milder symptoms, while a sprain involves the stretching or tearing of ligaments, which would not cause muscle spasms.

Explanation

Based on the symptoms described, such as edema, tenderness, muscle spasms, and ecchymosis, it suggests that the patient has experienced a second-degree strain. This is because a strain involves the stretching or tearing of muscles or tendons, and the symptoms mentioned align with a moderate level of strain. A first-degree strain would typically present with milder symptoms, while a sprain involves the stretching or tearing of ligaments, which would not cause muscle spasms.

11. The nurse is preparing the patient for discharge from the emergency room to home after incurring a sprain to the left ankle. While providing discharge teaching, the nurse is correct when they instruct the patient to what?

A) Apply heat for the first 24 to 48 hours after injury

B) Maintain the ankle in a dependent position

C) Exercise hourly by performing rotation exercises of the ankle

D) Apply an elastic compression bandage to the ankle

The nurse instructs the patient to apply an elastic compression bandage to the ankle because it helps reduce swelling and provides support to the injured area. This can help alleviate pain and promote healing. Applying heat for the first 24 to 48 hours after injury is not recommended as it can increase swelling. Maintaining the ankle in a dependent position may not be necessary and exercising hourly by performing rotation exercises of the ankle may be too strenuous for the patient at this stage.

Explanation

The nurse instructs the patient to apply an elastic compression bandage to the ankle because it helps reduce swelling and provides support to the injured area. This can help alleviate pain and promote healing. Applying heat for the first 24 to 48 hours after injury is not recommended as it can increase swelling. Maintaining the ankle in a dependent position may not be necessary and exercising hourly by performing rotation exercises of the ankle may be too strenuous for the patient at this stage.

12. 34. A rehabilitation nurse is working with a patient who is an amputee. The nurse knows that it is important for a patient who is an amputee to be an active participant is self-care. What do the nurse and patient need to maintain during the learning process?

A) Positive attitudes

B) Balanced nutrition

C) Optimal mobility

D) Family support

The nurse and patient need to maintain positive attitudes during the learning process. This is important because having a positive mindset can greatly influence the patient's ability to adapt to their new circumstances and engage in self-care activities. By maintaining a positive attitude, both the nurse and patient can approach the learning process with optimism, resilience, and motivation, which can ultimately lead to better outcomes in rehabilitation and overall well-being.

Explanation

The nurse and patient need to maintain positive attitudes during the learning process. This is important because having a positive mindset can greatly influence the patient's ability to adapt to their new circumstances and engage in self-care activities. By maintaining a positive attitude, both the nurse and patient can approach the learning process with optimism, resilience, and motivation, which can ultimately lead to better outcomes in rehabilitation and overall well-being.

13. The nurse is caring for a patient who had a right extremity below the knee amputation (BKA). The nurse recognizes the importance of implementing measures that focus on preventing flexion contracture of the hip and maintaining proper positioning. Which of the following measures will achieve these goals?

A) Encouraging the patient to turn from side to side and to assume a prone position

B) Initiating ROM exercises of the hip and knee 3 months after the amputation

C) Minimizing movement of the flexor muscles of the hip

D) Encouraging the patient to sit in the chair for at least 8 hours of the day

Encouraging the patient to turn from side to side and assume a prone position helps prevent flexion contracture of the hip and maintain proper positioning. Turning from side to side helps prevent pressure ulcers and maintains joint mobility. Assuming a prone position helps stretch the hip flexor muscles and prevents contractures. Initiating ROM exercises 3 months after the amputation may be too late, and minimizing movement of the flexor muscles of the hip may lead to contractures. Encouraging the patient to sit in a chair for extended periods may also lead to contractures.

Explanation

Encouraging the patient to turn from side to side and assume a prone position helps prevent flexion contracture of the hip and maintain proper positioning. Turning from side to side helps prevent pressure ulcers and maintains joint mobility. Assuming a prone position helps stretch the hip flexor muscles and prevents contractures. Initiating ROM exercises 3 months after the amputation may be too late, and minimizing movement of the flexor muscles of the hip may lead to contractures. Encouraging the patient to sit in a chair for extended periods may also lead to contractures.

14. The orthopedic nurse is precepting a graduate nurse. They are caring for four fracture patients. The orthopedic nurse asks the graduate nurse which of their patients is at an increased risk for Volkmann's contracture. What should the graduate nurse respond?

A) Femur

B) Humerus

C) Radial head

D) Clavicle

The correct answer is B) Humerus. Volkmann's contracture is a condition characterized by a permanent flexion contracture of the hand, wrist, and fingers. It is caused by ischemic necrosis of the muscles in the forearm due to prolonged compression or injury to the brachial artery. Fractures of the humerus can lead to compression or damage to the brachial artery, increasing the risk of developing Volkmann's contracture.

Explanation

The correct answer is B) Humerus. Volkmann's contracture is a condition characterized by a permanent flexion contracture of the hand, wrist, and fingers. It is caused by ischemic necrosis of the muscles in the forearm due to prolonged compression or injury to the brachial artery. Fractures of the humerus can lead to compression or damage to the brachial artery, increasing the risk of developing Volkmann's contracture.

15. A 16-year-old girl is taken to the emergency department after being kicked in the lower leg during a volleyball match. The leg area has become swollen and discolored. The triage nurse recognizes that the patient has likely sustained what?

A) Sprain

B) Strain

C) Contusion

D) Dislocation

The correct answer is C) Contusion. A contusion refers to a bruise or injury to the soft tissues, such as muscles or blood vessels, caused by blunt force trauma. In this case, the patient's leg became swollen and discolored after being kicked, indicating a contusion. A sprain refers to an injury to a ligament, a strain refers to an injury to a muscle or tendon, and a dislocation refers to the displacement of a bone from its normal position. None of these options are indicated by the given symptoms.

Explanation

The correct answer is C) Contusion. A contusion refers to a bruise or injury to the soft tissues, such as muscles or blood vessels, caused by blunt force trauma. In this case, the patient's leg became swollen and discolored after being kicked, indicating a contusion. A sprain refers to an injury to a ligament, a strain refers to an injury to a muscle or tendon, and a dislocation refers to the displacement of a bone from its normal position. None of these options are indicated by the given symptoms.

16. 28. A 65-year-old female patient has fallen and injured her ankle. Radiographs show that the woman has a trimalleolar fracture. The physician informs the woman that she needs surgery to repair her ankle. What type of internal fixation device would be used to hold the malleolus of the tibia in place?

A) Plate

B) Wire

C) Screw

D) Rod

A screw would be used as an internal fixation device to hold the malleolus of the tibia in place. Screws are commonly used in orthopedic surgeries to stabilize fractures and provide stability to the bones during the healing process. In this case, a screw would be inserted into the malleolus of the tibia to hold it in place and promote proper healing of the trimalleolar fracture. Plates, wires, and rods are also used in orthopedic surgeries, but in this specific scenario, a screw would be the most appropriate choice.

Explanation

A screw would be used as an internal fixation device to hold the malleolus of the tibia in place. Screws are commonly used in orthopedic surgeries to stabilize fractures and provide stability to the bones during the healing process. In this case, a screw would be inserted into the malleolus of the tibia to hold it in place and promote proper healing of the trimalleolar fracture. Plates, wires, and rods are also used in orthopedic surgeries, but in this specific scenario, a screw would be the most appropriate choice.

17. 22. The nursing instructor is discussing dislocations and subluxations with the beginning nursing students. Why would the instructor tell the students that dislocation and subluxations are medical emergencies and need to be reduced immediately?

A) The longer the joint is misplaced, the harder it is to get it back in place

B) Because the pain is so bad

C) The longer the joint is misplaced, the more difficult it is to apply splints to immobilize the extremity

D) Avascular necrosis may develop

Avascular necrosis is a condition where the bone tissue dies due to a lack of blood supply. If a joint is left dislocated or subluxated for a prolonged period of time, it can lead to avascular necrosis. This is because the dislocation or subluxation can disrupt the blood vessels supplying the bone, causing the bone tissue to die. Therefore, it is important to reduce the joint immediately to restore blood flow and prevent the development of avascular necrosis.

Explanation

Avascular necrosis is a condition where the bone tissue dies due to a lack of blood supply. If a joint is left dislocated or subluxated for a prolonged period of time, it can lead to avascular necrosis. This is because the dislocation or subluxation can disrupt the blood vessels supplying the bone, causing the bone tissue to die. Therefore, it is important to reduce the joint immediately to restore blood flow and prevent the development of avascular necrosis.

18. 24. A hockey player is brought to the emergency department after a game because of an injury. He is complaining of not being able to move his left arm, and his left arm appears longer than his right arm. The triage nurse suspects the hockey player has what?

A) Dislocated left shoulder

B) Fractured left clavicle

C) Dislocated left elbow

D) Fractured left humerus

The triage nurse suspects that the hockey player has a dislocated left shoulder because the player is complaining of not being able to move his left arm and his left arm appears longer than his right arm. These symptoms are consistent with a dislocated shoulder, as the humerus bone is displaced from the shoulder socket, causing pain and limited movement.

Explanation

The triage nurse suspects that the hockey player has a dislocated left shoulder because the player is complaining of not being able to move his left arm and his left arm appears longer than his right arm. These symptoms are consistent with a dislocated shoulder, as the humerus bone is displaced from the shoulder socket, causing pain and limited movement.

19. 40. The patient was placed in a long arm cast after fracturing her humerus. Twelve hours after the application of the cast, the patient tells the nurse that her arm hurts. Analgesics do not relieve the pain. What would be the most appropriate nursing action?

A) Preparing the patient for cast removal or bivalving of the cast

B) Obtaining an order for a different pain medication

C) Encouraging the patient to wiggle and move the fingers

D) Petaling the edges of his cast

The patient's complaint of persistent pain in the arm, even after taking analgesics, suggests that there may be a problem with the cast. The most appropriate nursing action would be to prepare the patient for cast removal or bivalving of the cast. This would allow for assessment of the arm and identification of any issues that may be causing the pain.

Explanation

The patient's complaint of persistent pain in the arm, even after taking analgesics, suggests that there may be a problem with the cast. The most appropriate nursing action would be to prepare the patient for cast removal or bivalving of the cast. This would allow for assessment of the arm and identification of any issues that may be causing the pain.

20. A 28-year-old man with a fractured humerus calls the nurse into his room. Upon assessment, the nurse finds the patient to be tachycardic, pale, and confused. The nurse suspects the patient may be experiencing which of the following complications?

A) Disseminated intravascular coagulopathy

B) Compartment syndrome

C) Fat emboli

D) Deep vein thrombosis

The patient's symptoms of tachycardia, pallor, and confusion are indicative of a fat embolism. Fat embolism occurs when fat globules are released into the bloodstream, often as a result of a long bone fracture. These fat globules can travel to various organs, causing symptoms such as confusion, respiratory distress, and petechial rash. This is a serious complication that requires immediate medical attention.

Explanation

The patient's symptoms of tachycardia, pallor, and confusion are indicative of a fat embolism. Fat embolism occurs when fat globules are released into the bloodstream, often as a result of a long bone fracture. These fat globules can travel to various organs, causing symptoms such as confusion, respiratory distress, and petechial rash. This is a serious complication that requires immediate medical attention.

21. 23. According to the U.S. Department of Labor, occupation-related musculoskeletal disorders are illnesses or injuries of what? (Mark all that apply.)

A) Nerves

B) Cartilage

C) Tendons

D) Arteries

E) Veins

Occupation-related musculoskeletal disorders are illnesses or injuries that affect the nerves, cartilage, and tendons. These disorders can be caused by repetitive motions, awkward postures, or excessive force exerted on these body parts during work activities. Arteries and veins are not directly involved in musculoskeletal disorders, so they are not included in the correct answer.

Explanation

Occupation-related musculoskeletal disorders are illnesses or injuries that affect the nerves, cartilage, and tendons. These disorders can be caused by repetitive motions, awkward postures, or excessive force exerted on these body parts during work activities. Arteries and veins are not directly involved in musculoskeletal disorders, so they are not included in the correct answer.

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22. 31. A 77-year-old female has fallen in her home and is brought to the emergency department by ambulance with a suspected fractured hip. X-rays confirm a fracture of the neck of the left femur. What complication is common in fractures of the neck of the femur?

A) Osteoporosis

B) Avascular necrosis

C) Nonadherance of bones

D) Septicemia

Fractures of the neck of the femur commonly lead to avascular necrosis. This is because the blood supply to the femoral head is often disrupted during the fracture, causing the bone tissue to die due to lack of blood flow. Avascular necrosis can result in pain, limited mobility, and the need for surgical intervention such as a hip replacement.

Explanation

Fractures of the neck of the femur commonly lead to avascular necrosis. This is because the blood supply to the femoral head is often disrupted during the fracture, causing the bone tissue to die due to lack of blood flow. Avascular necrosis can result in pain, limited mobility, and the need for surgical intervention such as a hip replacement.

23. 37. A patient is a BKA amputee who is to be discharged in 48 hours. You are going over discharge teaching with this patient. You review what factors with this patient?

A) Exercise

B) Nutrition

C) Support groups

D) Mobility aids

When going over discharge teaching with a BKA amputee patient who is being discharged in 48 hours, it is important to review factors related to their mobility aids. This includes discussing the proper use and maintenance of any assistive devices they may be using, such as crutches, prosthetic limbs, or wheelchairs. By reviewing these factors, the patient can ensure they are able to safely and effectively use their mobility aids, which will greatly contribute to their overall mobility and independence after discharge.

Explanation

When going over discharge teaching with a BKA amputee patient who is being discharged in 48 hours, it is important to review factors related to their mobility aids. This includes discussing the proper use and maintenance of any assistive devices they may be using, such as crutches, prosthetic limbs, or wheelchairs. By reviewing these factors, the patient can ensure they are able to safely and effectively use their mobility aids, which will greatly contribute to their overall mobility and independence after discharge.

24. A patient with a fractured left femur is being cared for by an orthopedic nurse. The nurse would know that what signs indicate potential fat emboli?

A) Increased partial pressure of arterial oxygen (PaO2), reduced sensation in left leg or foot

B) Left leg pain, dyspnea

C) Bradycardia, skin bruises

D) Cyanosis, decreased PaO2

Cyanosis, which refers to a bluish discoloration of the skin and mucous membranes, is a sign of potential fat emboli. Decreased partial pressure of arterial oxygen (PaO2) is also a sign of fat emboli. Fat emboli occur when fat globules enter the bloodstream and can cause blockages in blood vessels, leading to decreased oxygen levels and cyanosis. Therefore, option D is the correct answer as it includes both of these signs.

Explanation

Cyanosis, which refers to a bluish discoloration of the skin and mucous membranes, is a sign of potential fat emboli. Decreased partial pressure of arterial oxygen (PaO2) is also a sign of fat emboli. Fat emboli occur when fat globules enter the bloodstream and can cause blockages in blood vessels, leading to decreased oxygen levels and cyanosis. Therefore, option D is the correct answer as it includes both of these signs.

25. 21. A 55-year-old male is brought to the emergency department by ambulance after stepping in a hole and falling. While assessing him the nurse notes that his right leg is shorter than his left leg; his right hip is deformed and he is in acute pain. What would the nurse suspect has happened to this patient?

A) Subluxated right hip

B) Fractured right hip

C) Right pelvic fracture

D) Traumatic dislocation of right hip

The nurse would suspect that the patient has experienced a traumatic dislocation of the right hip. This is indicated by the patient's shorter right leg, deformed right hip, and acute pain, which are all consistent with a hip dislocation. Subluxation refers to a partial dislocation, but the description suggests a complete dislocation. A fractured hip or pelvic fracture would not cause the leg to appear shorter, and the deformity suggests a dislocation rather than a fracture.

Explanation

The nurse would suspect that the patient has experienced a traumatic dislocation of the right hip. This is indicated by the patient's shorter right leg, deformed right hip, and acute pain, which are all consistent with a hip dislocation. Subluxation refers to a partial dislocation, but the description suggests a complete dislocation. A fractured hip or pelvic fracture would not cause the leg to appear shorter, and the deformity suggests a dislocation rather than a fracture.

26. 30. The patient is 6 weeks post-ORIF of his ankle when he comes to the orthopedic clinic for a follow-up appointment. The physician informs the patient that the bones in his ankle have not grown back together. What type of complication is this considered?

A) Late complication

B) Early complication

C) Minor complication

D) Major complication

This is considered a late complication because it occurs 6 weeks post-ORIF, indicating that the bones should have already grown back together by this time. If the bones have not yet fused, it suggests a delayed healing process or a problem with the surgery.

Explanation

This is considered a late complication because it occurs 6 weeks post-ORIF, indicating that the bones should have already grown back together by this time. If the bones have not yet fused, it suggests a delayed healing process or a problem with the surgery.

27. While caring for a patient with a hip fracture, the nurse will instruct the patient to do what to prevent the most common complication associated with a hip fracture?

A) Take the prescribed stool softener daily.

B) Use the prescribed oxygen with ambulation.

C) Increase fluid intake.

D) Avoid movement of the feet and ankles.

Increasing fluid intake is important to prevent the most common complication associated with a hip fracture, which is deep vein thrombosis (DVT). DVT occurs when a blood clot forms in a deep vein, usually in the legs. Increasing fluid intake helps to prevent blood from becoming too thick and reduces the risk of clot formation. It also promotes blood circulation, which is important for healing and preventing complications. Taking stool softeners, using oxygen with ambulation, or avoiding movement of the feet and ankles are not directly related to preventing DVT in patients with a hip fracture.

Explanation

Increasing fluid intake is important to prevent the most common complication associated with a hip fracture, which is deep vein thrombosis (DVT). DVT occurs when a blood clot forms in a deep vein, usually in the legs. Increasing fluid intake helps to prevent blood from becoming too thick and reduces the risk of clot formation. It also promotes blood circulation, which is important for healing and preventing complications. Taking stool softeners, using oxygen with ambulation, or avoiding movement of the feet and ankles are not directly related to preventing DVT in patients with a hip fracture.

28. 35. You are caring for a patient who has had an amputation. What nursing action would you be least likely to perform with this type of patient?

A) Teaching the patient self-care activities

B) Placing the residual limb on a pillow

C) Promoting mobility

D) Teaching the patient how to wrap the stump

The nursing action of placing the residual limb on a pillow would be least likely to be performed with a patient who has had an amputation. Placing the residual limb on a pillow may increase the risk of pressure ulcers or contractures. Instead, it is important to promote mobility and teach the patient self-care activities, such as wrapping the stump, to ensure proper healing and adaptation to the amputation.

Explanation

The nursing action of placing the residual limb on a pillow would be least likely to be performed with a patient who has had an amputation. Placing the residual limb on a pillow may increase the risk of pressure ulcers or contractures. Instead, it is important to promote mobility and teach the patient self-care activities, such as wrapping the stump, to ensure proper healing and adaptation to the amputation.

29. You are caring for a patient wearing a sling to support her arm after a clavicle fracture. What would the nurse instruct the patient to do?

A) Elevate the arm above the shoulder 3 or 4 times daily.

B) Avoid moving the elbow, wrist, and fingers for about 2 months.

C) Engage in active range of motion using the affected bone.

D) Use the arm for light activities within the range of motion.

The nurse would instruct the patient to elevate the arm above the shoulder 3 or 4 times daily. This helps to reduce swelling and promote healing in the affected area. Elevating the arm can also help to alleviate pain and discomfort.

Explanation

The nurse would instruct the patient to elevate the arm above the shoulder 3 or 4 times daily. This helps to reduce swelling and promote healing in the affected area. Elevating the arm can also help to alleviate pain and discomfort.

30. A patient with a simple fracture is involved in discharge teaching with their nurse. What would the nurse instruct the patient to do?

A) Elevate the affected extremity to shoulder level.

B) Engage in exercises that strengthen the unaffected muscles.

C) Take corticosteroids as prescribed.

D) Expect to regain full strength and mobility in 2 to 4 weeks.

The nurse would instruct the patient to engage in exercises that strengthen the unaffected muscles because this can help to maintain overall muscle strength and prevent muscle atrophy while the fracture is healing. It is important to keep the unaffected muscles active and strong to prevent any further complications or weakness. Elevating the affected extremity to shoulder level may be recommended for swelling and pain management, but it is not the primary instruction for discharge teaching. Taking corticosteroids as prescribed may be specific to certain cases and should be addressed by the healthcare provider. Expecting to regain full strength and mobility in 2 to 4 weeks is not realistic for a simple fracture, as the healing process can take longer.

Explanation

The nurse would instruct the patient to engage in exercises that strengthen the unaffected muscles because this can help to maintain overall muscle strength and prevent muscle atrophy while the fracture is healing. It is important to keep the unaffected muscles active and strong to prevent any further complications or weakness. Elevating the affected extremity to shoulder level may be recommended for swelling and pain management, but it is not the primary instruction for discharge teaching. Taking corticosteroids as prescribed may be specific to certain cases and should be addressed by the healthcare provider. Expecting to regain full strength and mobility in 2 to 4 weeks is not realistic for a simple fracture, as the healing process can take longer.

31. Six weeks after an above the knee (AKA) amputation, a patient returns to the outpatient office for a routine postoperative check-up. During the nurse's assessment, the patient reports symptoms of phantom pain. What would the nurse correctly tell the patient to do to reduce the discomfort of the phantom pain?

A) Apply hot compresses to the area of the amputation.

B) Avoid rehabilitation exercises until the pain subsides.

C) Comfortably increase their level of activity.

D) Assess for a pulse in the extremity of the amputation every 4 to 6 hours.

The nurse would correctly tell the patient to comfortably increase their level of activity to reduce the discomfort of phantom pain. Increasing activity helps to distract the brain from focusing on the pain and can also improve blood circulation to the residual limb, which may alleviate the symptoms of phantom pain. Applying hot compresses, avoiding rehabilitation exercises, or assessing for a pulse in the extremity would not directly address or alleviate the phantom pain.

Explanation

The nurse would correctly tell the patient to comfortably increase their level of activity to reduce the discomfort of phantom pain. Increasing activity helps to distract the brain from focusing on the pain and can also improve blood circulation to the residual limb, which may alleviate the symptoms of phantom pain. Applying hot compresses, avoiding rehabilitation exercises, or assessing for a pulse in the extremity would not directly address or alleviate the phantom pain.

32. 27. A 25-year-old male is involved in a motorcycle accident and injures his arm. The physician diagnoses the man with an intra-articular fracture and splints the injury. When the man comes back for his 6-week checkup the nurse implements the teaching plan she has developed for this patient. What sequelae of intra-articular fractures would the nurse be sure to inform the patient about?

A) Post-traumatic arthritis

B) Post-traumatic nerve damage

C) Post-traumatic stress syndrome

D) Post-traumatic compartment syndrome

The nurse would inform the patient about post-traumatic arthritis as a sequelae of intra-articular fractures. Intra-articular fractures involve the joint surface, and if not properly treated, can lead to the development of arthritis in the affected joint. This can cause pain, stiffness, and limited range of motion in the joint, affecting the patient's overall function and quality of life. Therefore, it is important for the patient to be aware of this potential complication and take appropriate measures to prevent or manage it.

Explanation

The nurse would inform the patient about post-traumatic arthritis as a sequelae of intra-articular fractures. Intra-articular fractures involve the joint surface, and if not properly treated, can lead to the development of arthritis in the affected joint. This can cause pain, stiffness, and limited range of motion in the joint, affecting the patient's overall function and quality of life. Therefore, it is important for the patient to be aware of this potential complication and take appropriate measures to prevent or manage it.

33. The patient scheduled for a Syme amputation in the morning is concerned about the ability to stand on the amputated extremity. The patient asks the nurse about his ability to stand after surgery. What is the nurse's best response to this question?

A) “You will be able to withstand full weight-bearing on this durable extremity after the amputation.”

B) “You will have minimal weight-bearing on this extremity and will require the use of an assistive device.”

C) “You will not be able to use this extremity and will receive teaching on use of a wheelchair.”

D) “You will be fitted for a prosthesis and your commitment to rehabilitation will determine your functional abilities.”

The nurse's best response is A) "You will be able to withstand full weight-bearing on this durable extremity after the amputation." This response reassures the patient that they will be able to stand on the amputated extremity without any limitations. It also emphasizes the durability of the extremity, indicating that it will be able to support their weight effectively. This response provides a positive and encouraging outlook for the patient's post-operative mobility and independence.

Explanation

The nurse's best response is A) "You will be able to withstand full weight-bearing on this durable extremity after the amputation." This response reassures the patient that they will be able to stand on the amputated extremity without any limitations. It also emphasizes the durability of the extremity, indicating that it will be able to support their weight effectively. This response provides a positive and encouraging outlook for the patient's post-operative mobility and independence.

34. The nurse at the pediatrician's office is assessing a 17-year-old soccer player who presented to the clinic stating that he sustained an injury that resulted in the knee being struck medially while his foot is firmly planted on the ground. The nurse knows that the patient likely has experienced what?

A) Lateral collateral ligament injury

B) Medial collateral ligament injury

C) Anterior cruciate ligament injury

D) Posterior cruciate ligament injury

The nurse can deduce that the patient likely has a lateral collateral ligament injury based on the information provided. The patient reported that his knee was struck medially while his foot was firmly planted on the ground. This mechanism of injury is consistent with a force applied to the outside of the knee, which can result in a lateral collateral ligament injury.

Explanation

The nurse can deduce that the patient likely has a lateral collateral ligament injury based on the information provided. The patient reported that his knee was struck medially while his foot was firmly planted on the ground. This mechanism of injury is consistent with a force applied to the outside of the knee, which can result in a lateral collateral ligament injury.

35. 25. A patient has presented to the emergency department with an injury to the wrist. The patient is diagnosed with a third-degree strain. Why would the physician order an x-ray of the wrist?

A) Nerve damage is associated with third-degree strains.

B) Compartment syndrome is associated with third-degree strains.

C) Avulsion fractures are associated with third-degree strains.

D) Greenstick fractures are associated with third-degree strains.

The physician would order an x-ray of the wrist because avulsion fractures are associated with third-degree strains. Avulsion fractures occur when a tendon or ligament pulls a piece of bone away from the main bone. By ordering an x-ray, the physician can determine if there is an avulsion fracture present, which may require further treatment or intervention.

Explanation

The physician would order an x-ray of the wrist because avulsion fractures are associated with third-degree strains. Avulsion fractures occur when a tendon or ligament pulls a piece of bone away from the main bone. By ordering an x-ray, the physician can determine if there is an avulsion fracture present, which may require further treatment or intervention.

36. 26. A 12-year-old boy is brought in by ambulance to the emergency department after being involved in an accident while participating in a BMX race. The boy has an open fracture of his tibia. The wound is highly contaminated and there is extensive soft tissue damage. What grade fracture would this be considered?

A) Grade I

B) Grade II

C) Grade III

D) Grade IV

This fracture would be considered a Grade IV fracture because it is an open fracture with extensive soft tissue damage. Grade IV fractures are the most severe type of open fractures, indicating significant contamination and damage to the surrounding tissues.

Explanation

This fracture would be considered a Grade IV fracture because it is an open fracture with extensive soft tissue damage. Grade IV fractures are the most severe type of open fractures, indicating significant contamination and damage to the surrounding tissues.

37. 29. A 29-year-old male is admitted to the orthopedic unit with a fractured femur after running his motorcycle into a bridge abutment. The patient has been placed in traction until his femur can be rodded in surgery. What early complications would the nurse have to monitor this patient for? (Mark all that apply.)

A) Alteration in elimination

B) Alteration in personality

C) Deep vein thrombosis

D) Compartment syndrome

E) Fat embolism

The nurse would have to monitor the patient for deep vein thrombosis, compartment syndrome, and fat embolism. Deep vein thrombosis is a potential complication of immobilization and can lead to a blood clot in the deep veins, typically in the lower extremities. Compartment syndrome can occur when there is increased pressure within a muscle compartment, leading to decreased blood flow and potential tissue damage. Fat embolism can occur when fat globules enter the bloodstream, often as a result of a long bone fracture, and can lead to respiratory distress and other complications.

Explanation

The nurse would have to monitor the patient for deep vein thrombosis, compartment syndrome, and fat embolism. Deep vein thrombosis is a potential complication of immobilization and can lead to a blood clot in the deep veins, typically in the lower extremities. Compartment syndrome can occur when there is increased pressure within a muscle compartment, leading to decreased blood flow and potential tissue damage. Fat embolism can occur when fat globules enter the bloodstream, often as a result of a long bone fracture, and can lead to respiratory distress and other complications.

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38. 32. A 74-year-old male has fallen and broken his hip. What must the nurse be sure to assess the patient for so that complications can be prevented?

A) Family history

B) AVN

C) Chronic conditions

D) Fat embolism

The nurse must assess the patient for chronic conditions because they can increase the risk of complications following a hip fracture. Chronic conditions such as diabetes, heart disease, and hypertension can impair the body's ability to heal and increase the risk of infection, delayed wound healing, and poor surgical outcomes. Identifying and managing these conditions early can help prevent complications and improve the patient's overall recovery.

Explanation

The nurse must assess the patient for chronic conditions because they can increase the risk of complications following a hip fracture. Chronic conditions such as diabetes, heart disease, and hypertension can impair the body's ability to heal and increase the risk of infection, delayed wound healing, and poor surgical outcomes. Identifying and managing these conditions early can help prevent complications and improve the patient's overall recovery.

39. 39. An elderly woman with a fractured hip is being cared for on your unit. What are contributory factors in the incidence of falls and fractured hips? (Mark all that apply.)

A) Living alone

B) TIAs

C) Emboli

D) Decreased hearing

E) General frailty

Living alone, decreased hearing, and general frailty are all potential contributory factors in the incidence of falls and fractured hips. However, the correct answer options are B) TIAs, C) Emboli, and E) General frailty. This suggests that TIAs (transient ischemic attacks), emboli, and general frailty are the most significant contributory factors in this specific scenario.

Explanation

Living alone, decreased hearing, and general frailty are all potential contributory factors in the incidence of falls and fractured hips. However, the correct answer options are B) TIAs, C) Emboli, and E) General frailty. This suggests that TIAs (transient ischemic attacks), emboli, and general frailty are the most significant contributory factors in this specific scenario.

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