A 28-year-old female presents to the emergency department with a fractured tibia. The nurse is assessing for signs of compartment syndrome. Which of the following findings is indicative of compartment syndrome?
A. Increased capillary refill
B. Decreased pain with passive movement
C. Diminished pulses below the fracture site
D. Warm and pink extremity
E. Tingling and numbness in the toes
Rationale: Compartment syndrome occurs when increased pressure within a muscle compartment compromises blood flow. Diminished pulses are a critical sign of impaired perfusion. This requires immediate intervention to prevent irreversible damage to nerves and muscles.
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Question 2:
A 45-year-old male is diagnosed with a greenstick fracture in his forearm. What is the characteristic feature of a greenstick fracture?
A. Complete break of the bone
B. Multiple fragments of the bone
C. Break extending across the bone shaft
D. Incomplete fracture with bending on one side
E. Spiral fracture pattern
Rationale: A greenstick fracture is an incomplete break where the bone bends on one side and breaks only on the other. This type of fracture is commonly seen in pediatric populations due to the more pliable nature of their bones.
A 60-year-old male has undergone a hip replacement following a hip fracture. Which nursing intervention is a priority during the postoperative period to prevent complications?
A. Encouraging hip flexion exercises
B. Allowing full weight-bearing immediately
C. Crossing legs while seated to avoid stiffness
D. Applying a warm compress to the surgical site
E. Maintaining hip abduction with a pillow
Rationale: Hip abduction with a pillow helps prevent dislocation of the hip joint postoperatively. This positioning is crucial to avoid stress on the surgical site and reduce the risk of complications, such as dislocation.
A 32-year-old male is brought to the emergency room with a suspected fracture of the humerus. During the assessment, the nurse notices crepitus when palpating the affected area. What does crepitus indicate in a fracture?
A. Adequate bone alignment
B. Presence of joint effusion
C. Displacement of bone fragments
D. Normal muscle spasms
E. Proper neurovascular status
Rationale: Crepitus, a grating sound or sensation, is indicative of bone fragments rubbing against each other. This suggests displacement, and immediate attention is required to realign the bone and prevent further damage or complications.
Question 2:
A 55-year-old female sustains a hip fracture and is scheduled for surgical repair. What is a priority nursing intervention in the preoperative phase to prevent complications?
A. Encouraging weight-bearing on the affected hip
B. Administering pain medication after surgery
C. Placing the patient in a high Fowler’s position
D. Providing anti-embolism stockings
E. Limiting fluid intake to minimize bathroom visits
Rationale: Anti-embolism stockings help prevent deep vein thrombosis (DVT) and enhance blood circulation, reducing the risk of postoperative complications. This intervention is crucial in the preoperative phase to ensure the patient’s safety.
Question 3:
A 40-year-old male presents with a suspected rib fracture following a fall. The nurse is assessing for potential complications. What complication is associated with rib fractures that requires close monitoring?
A. Hypertension
B. Hematuria
C. Respiratory compromise
D. Hyperglycemia
E. Increased bowel sounds
Rationale: Rib fractures can lead to respiratory compromise, especially if there is impaired chest expansion. Monitoring the patient for signs of respiratory distress, such as shallow breathing or decreased oxygen saturation, is crucial to prevent respiratory complications.
A 25-year-old male presents to the emergency room with a suspected femoral shaft fracture following a car accident. The nurse is preparing to assess for neurovascular compromise. Which assessment finding is indicative of neurovascular compromise in the affected leg?
A. Warm and pink foot
B. Capillary refill less than 3 seconds
C. Strong dorsalis pedis pulse
D. Paresthesia and weakened pulses
E. Absence of pain on passive movement
Rationale: Paresthesia and weakened pulses are signs of neurovascular compromise, indicating potential damage to nerves and impaired blood flow. Immediate intervention is necessary to prevent complications such as ischemia and tissue damage.
Question 2:
A 48-year-old female sustains a fractured clavicle. The nurse is providing education on home care. What advice should the nurse give regarding the affected arm?
A. Encourage active range of motion exercises
B. Apply ice directly to the fractured area
C. Support the arm with a sling at the elbow
D. Elevate the arm above heart level
E. Avoid any movement to prevent pain
Rationale: Supporting the arm with a sling at the elbow helps immobilize the fractured clavicle and promotes healing. It also reduces pain and prevents further injury, allowing for optimal recovery.
Question 3:
A 30-year-old male is diagnosed with a stress fracture in the tibia. What activity is commonly associated with stress fractures, and how should the nurse advise the patient?
A. High-impact running; encourage continued running with proper footwear
B. Low-impact cycling; recommend cross-training to maintain fitness
C. Swimming; advise against any weight-bearing activities
D. Weightlifting; suggest incorporating more resistance training
E. Yoga; promote flexibility exercises to alleviate stress on the tibia
Rationale: Stress fractures often result from repetitive impact, and proper footwear can help absorb shock. Advising the patient to continue running with suitable footwear is essential for maintaining fitness while minimizing stress on the fractured tibia.
Question 4:
A 60-year-old female with osteoporosis fractures her wrist after a minor fall. The nurse is discussing strategies to prevent future fractures. What dietary recommendation should the nurse emphasize to enhance bone health?
A. High sodium intake for bone mineralization
B. Calcium-rich foods for bone strength
C. Low vitamin D intake to reduce bone density
D. Caffeine consumption to prevent bone loss
E. Excessive alcohol intake for bone remodeling
Rationale: Calcium is essential for bone strength, and a diet rich in calcium helps prevent osteoporosis-related fractures. Emphasizing calcium-rich foods supports bone health and reduces the risk of further fractures in individuals with osteoporosis.