ATI LPN
Timby's Introductory Medical-Surgical Nursing Thirteenth, North American Edition
Chapter 62 : Caring for Clients With Traumatic Musculoskeletal Injuries Questions
Question 1 of 5
A client sustains an injury to the left ankle after a fall. There was immediate swelling and pain from the injury, and the client was taken to the local emergency department. What initial test does the nurse anticipate the physician will order to rule out a fracture?
Correct Answer: C
Rationale: X-rays may show a larger-than-usual joint space and rule out or confirm an accompanying fracture. Arthrography demonstrates asymmetry in the joint as a result of the damaged ligaments, or arthroscopy may disclose trauma in the joint capsule. A CT scan is costly and not used as a first-line diagnostic tool in the initial stage of an ankle injury.
Question 2 of 5
A client sustained a sprained ankle while skiing, and the health care provider prescribed PRICE. Upon discharge, the client asks the nurse what this acronym stands for. How does the nurse respond?
Correct Answer: A
Rationale: Treatment consists of protecting the joint from further injury and applying ice or a chemical cold pack to the area to reduce swelling and relieve pain for the first 24 to 48 hours. Elevation of the part and compression with an elastic bandage also may be recommended. The acronym PRICE refers to protection, rest, ice, compression, and elevation - a method for remembering the treatment for strains, contusions, and sprains.
Question 3 of 5
A client comes to the clinic 2 days after sustaining a sprain to the left ankle. What intervention can the nurse encourage the client to perform that will help improve circulation?
Correct Answer: D
Rationale: After 2 days, when swelling is no longer likely to increase, applying heat reduces pain and relieves local edema by improving circulation. Full use of the injured joint is discouraged temporarily. Nonsteroidal anti-inflammatory drugs will ease discomfort but not improve circulation. Applying cold compresses is only used in the first 24 to 48 hours after an injury to reduce swelling and relieve pain.
Question 4 of 5
A client comes to the emergency department and it is found that the client's radial head is partially dislocated. What is this partially dislocated radial head documented as?
Correct Answer: B
Rationale: A partial dislocation is referred to as a subluxation. A Volkmann contracture is a claw-like deformity that results from compartment syndrome or obstructed arterial blood flow to the forearm and hand. Compartment syndrome is a condition in which a structure such as a tendon or nerve is constricted in a confined space and affects nerve innervation, leading to subsequent palsy. A sprain is injury to the ligaments surrounding the joint.
Question 5 of 5
A client sustains a fractured right humerus in an automobile accident. The arm is edematous, the client reports not being able to feel or move the fingers, and the nurse does not feel a pulse. What condition should the nurse be concerned about that requires emergency measures?
Correct Answer: A
Rationale: Separation of adjacent bones from their articulating joint interferes with normal use and produces a distorted appearance. The injury may disrupt local blood supply to structures such as the joint cartilage, causing degeneration, chronic pain, and restricted movement. Compartment syndrome is a condition in which a structure such as a tendon or nerve is constricted in a confined space. The fractured humerus may also be dislocated but is not the result of the impaired circulatory status. Muscle spasms may occur around the fracture site but are not the cause of circulatory impairment. Subluxation is a partial dislocation.