NCLEX Secrets about Musculoskeletal Injuries (46-50)

NCLEX Secrets about Musculoskeletal Injuries

46. A client is treated in physician's office for a sprained ankle after a fall. Radiographic examination has ruled out a fracture. Before sending the client home, the nurse plans to teach the client to avoid which of the following in the next 24 hours?

a) resting the foot
b) applying a heating pad
c) applying an elastic compression bandage
d) elevating the ankle on a pillow while sitting or lying down

47. A nurse is conducting health screening for osteoporosis. Which of the following client is at greatest risk of developing this disorder?

a) a 25-year old woman who jogs
b) a 36-year old man who has asthma
c) a 70-year old man who consumes excess alcohol
d) a sedentary 65-year old woman who smokes cigarettes



48. A nurse has given instructions to a client returning home after knee arthroscopy. The nurse determines that the client understands the instructions if the client states that he or she will:

a) resume regular exercise the following day
b) stay off the leg entirely for the rest of the day
c) report fever or site inflammation to the physician
d) refrain from eating food for the remainder of the day

49. A client with possible rib fracture has never had a chest radiograph. The nurse would plan to tell the client which of the following items about the procedure?

a) the x-rays stimulate a small amount of pain
b) removal of jewelry and any other metal objects is necessary
c) the client will be asked to breathe in and out as the x-ray is taken
d) the x-ray technologist will stand next to the client during the procedure

50. A nurse is one of several persons who witness a vehicle hit a pedestrian at fairly low speed on a small street. The person is dazed and tries to get up. The leg appears fractured. The nurse would plna to:

a)  try to reduce the fracture manually
b) assist the person to get up and walk to the sidewalk
c) leave the person for a few moments to call an ambulance
d) stay with the person and encourage the person to remain still





ANSWERS AND RATIONALE

46) B

- Soft tissue injuries such as sprains are treated by RICE (rest, ice, compression, and elevation) for the first 24 hours after the injury. Ice is applied intermittently for 20 to 30 minutes at a time. Heat is not used in the first 24 hours because it could increase venous congestion, which would increase edema and pain.

47) D

- Risk factors for osteoporosis include female gender, postmenopausal, advanced age, low-calcium diet, excessive alcohol intake, being sedentary, and smoking cigarettes. Long-term use of corticosteroids, anticonvulsants, and/or furosemide (Lasix) also increases risk.

48) C

- After arthroscopy, the client usually can walk carefully on the leg once sensation has returned. The client is instructed to avoid strenuous exercise for at least a few days. The client may resume the usual diet. Signs and symptoms of infection should be reported to the physician.

49) B

- A radiograph is a photographic image of part of the body on a special film, which is used to diagnose a wide variety of conditions. Radiography itself is painless; any discomfort would arise from repositioning a painful part for filming. The nurse may want to premedicate a client who is at risk for pain. Any radiopaque objects such as jewelry or other metal must be removed. The client is asked to breathe in deeply and then hold the breath while the chest radiograph is taken. To minimize risk of radiation exposure, the x-ray technologist stands in a separate area protected by a lead wall. The client also wears a lead shield over his or her gonads.

50) D

- With a suspected fracture, the client is not moved unless it is dangerous to remain in that spot. The nurse should remain with the client and have someone else call for emergency help. A fracture is not reduced at the scene. Before the client is moved, the site of fracture is immobilized to prevent further injury.




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