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
The nurse in an orthopedic clinic is caring for a new client. What sign or symptom would lead a nurse to suspect that a client has a rotator cuff tear?
Correct Answer: B
Rationale: Clients with a rotator cuff tear experience pain with movement and limited mobility of the shoulder and arm. They especially have difficulty with activities that involve stretching their arm above their head. Many clients find that the pain is worse at night and that they are unable to sleep on the affected side.
Question 2 of 5
A client is diagnosed with a first-degree strain of the left ankle related to running 5 miles daily. How would the nurse differentiate the first-degree strain from other strains and sprains?
Correct Answer: A
Rationale: A first-degree strain involves mild stretching of the muscle or tendon, causing some edema and muscle spasm, but no real loss of function. The second-degree strain is partial tearing of muscle or tendon, leading to inability to bear weight and causing edema, muscle tenderness, muscle spasm, and ecchymosis. The third-degree tear is severe muscle and/or tendon tearing, causing severe pain, muscle/spasm ecchymosis, edema, and loss of function. A first-degree sprain involves stretching of the ligament fibers characterized by mild edema, tenderness, and pain if the joint is moved.
Question 3 of 5
A client was playing softball and was hit in the right ankle by the ball, sustaining a contusion. What is the first action the nurse takes to help alleviate pain and swelling?
Correct Answer: B
Rationale: Applying cold packs helps to alleviate local pain, swelling, and bruising. Heat is not used initially after injury, because it can dilate the blood vessels, causing increased bruising and pain. Ibuprofen (Advil) would not be a priority action at this time. The client should not walk on the injured foot or ankle until serious injury is ruled out.
Question 4 of 5
A client is a passenger in a vehicle that was hit in the rear by another vehicle. The client is complaining of pain in the neck from the head rapidly moving toward and then back against the headrest. What type of injury does the nurse suspect the client sustained in the accident?
Correct Answer: C
Rationale: A sprain of the cervical spine is commonly called a whiplash injury and results from sudden, unusual movement or stretching around a joint, which is common with falls or other accidental injuries. A strain results from excessive stress, overuse, or overstretching. An avulsion fracture is when the ligament is torn or ruptured completely, with possible detachment of a fragment to bone. In a contusion, the injury is confined to the soft tissues and does not affect the musculoskeletal structure.
Question 5 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.