The x-ray shows that the patient's fracture is at the remodeling stage. What characteristics of the fracture healing process are happening at this stage (select one that doesn't apply)?

Correct Answer: D

Rationale: In the context of the fracture healing process, the remodeling stage is characterized by the restoration of bone to its preinjury strength and shape. This phase involves the realignment of the bone along lines of stress and the removal of excess bone and tissue to refine the structure. Choice A, radiologic union, refers to the visual confirmation of the healing process through imaging techniques like X-rays. This is a key indicator of progress but not specific to the remodeling stage. Choice B, absorption of excess cells, is part of the remodeling phase where osteoclasts remove excess callus tissue formed during the earlier stages of healing. This process helps refine the bone structure. Choice C, return to preinjury strength and shape, is the hallmark of the remodeling stage. The bone gradually regains its original strength and shape through the remodeling of the callus tissue into mature bone tissue. Choice D, a semisolid blood clot at the ends of fragments, is incorrect because it describes the initial hematoma and inflammatory stage of fracture healing, not the remodeling stage. Understanding the different stages of fracture healing is crucial for healthcare professionals to monitor patients' progress, anticipate complications, and provide appropriate interventions. By grasping these concepts, practitioners can make informed decisions regarding patient care and rehabilitation strategies to optimize outcomes.

Correct Answer: A

Rationale: In understanding why a fat embolism is most likely to occur 24 to 48 hours following a fractured tibia, it is essential to grasp the pathophysiology behind fat embolism syndrome (FES). FES typically presents in long bone fractures, where fat globules from the bone marrow enter the bloodstream and obstruct small vessels, leading to respiratory distress, petechial rash, and neurological symptoms. The onset of symptoms correlates with the timing of fat release into the circulation, which peaks within the first 24 to 48 hours post-injury, making option A the correct choice. Option B (36 to 72 hours following a skull fracture) is incorrect as FES is not commonly associated with skull fractures. The fat embolism phenomenon is primarily seen in long bone fractures due to the abundant bone marrow present in these bones. Option C (4 to 5 days following a fractured femur) and option D (5 to 6 days following a pelvic fracture) are also incorrect because the timeline for fat embolism development is much sooner after injury, typically within the first 48 hours. From an educational perspective, understanding the timeline of fat embolism occurrence in relation to different types of fractures is crucial for healthcare providers in assessing and managing patients with traumatic injuries. Recognizing the signs and symptoms of FES early on can lead to prompt intervention and improved patient outcomes. It underscores the importance of timely assessment and monitoring in patients with long bone fractures to prevent and manage potential complications like fat embolism syndrome.

Correct Answer: B

Rationale: The correct answer is B) Apply an elastic shrinker before applying the prosthesis. Rationale: It is crucial for the patient to apply an elastic shrinker before donning the prosthesis to help reduce swelling, shape the residual limb, and promote proper fitting of the prosthesis. This step aids in maintaining the proper fit and function of the temporary prosthesis, ensuring the patient's comfort and mobility during the rehabilitation process. Incorrect options: A) Inspecting the residual limb daily for irritation is important, but it is not the most critical step when preparing to use a temporary prosthesis. C) Performing range-of-motion exercises to the affected leg is essential for maintaining joint mobility, but it is not directly related to the proper fitting of the prosthesis. D) Applying alcohol to the residual limb can lead to skin irritation and dryness, which is not recommended for individuals with limb loss. Educational context: Educating patients on the proper care and fitting of prostheses is vital in promoting successful rehabilitation and optimal function. Teaching patients the correct steps to prepare for prosthesis wear helps prevent complications and ensures a better overall outcome in their recovery journey.

Correct Answer: C

Rationale: The best description the RN can give to the nursing student when asked about arthroplasty is option C: Reconstruction or replacement of a joint to relieve pain and correct deformity. This option is correct because arthroplasty involves the surgical reconstruction or replacement of a damaged joint with an artificial joint to restore function, relieve pain, and correct deformity. Option A is incorrect because arthroplasty is not a surgical fusion of a joint, but rather involves replacing or reconstructing the joint. Option B is incorrect as it describes osteotomy, where a wedge or slice of bone is removed to correct bone deformity, not joint replacement. Option D is incorrect as it refers to synovectomy, which is the removal of the synovial membrane in rheumatoid arthritis, not arthroplasty. In an educational context, it is important for nursing students to understand the terminology and procedures related to orthopedic surgeries like arthroplasty as they are common interventions for musculoskeletal disorders. Understanding the purpose and process of arthroplasty helps students provide better care for patients undergoing such procedures and enhances their ability to communicate effectively with healthcare providers and patients regarding treatment options and outcomes.

Correct Answer: B

Rationale: In this question, the correct answer is B) Very malignant and metastasizes early. Osteosarcoma is a primary malignant bone tumor that arises from primitive bone-forming mesenchymal cells. It is known for its aggressive behavior, high malignancy, and tendency to metastasize early, commonly to the lungs. This option accurately describes the nature of osteosarcoma, making it the correct choice. Option A) High rate of local recurrence is incorrect because osteosarcoma is more known for its metastatic potential rather than local recurrence. While local recurrence can occur, it is not a defining characteristic of osteosarcoma. Option C) Arises in cancellous ends of long bones is incorrect because osteosarcoma commonly arises in the metaphyseal region of long bones, which is the area between the diaphysis and epiphysis, rather than specifically in the cancellous ends. Option D) Develops in the medullary cavity of long bones is incorrect because osteosarcoma typically arises in the metaphysis rather than within the medullary cavity of long bones. Educationally, understanding the characteristics of osteosarcoma is crucial for healthcare professionals, especially those working in oncology or orthopedics. Recognizing the aggressive nature of osteosarcoma and its typical presentation in long bones can aid in early diagnosis and appropriate management of this challenging condition.