NCLEX RN Questions: Musculoskeletal Injuries (66-70)

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66. A client has undergone fasciotomy to treat compartment syndrome of the leg. The nurse prepares to provide which type of wound care to the fasciotomy site?

a) dry sterile dressings
b) hydrocolloid dressings
c) wet sterile saline dressings
d) one-half strength betadine dressings

67. An older client admitted to the hospital with a hip fracture is placed in Buck's extension traction. The nurse plans to frequently monitor which specimen item?

a) temperature
b) mental state
c) neurovascular status
d) range of motion ability

68. Buck's extension traction is applied to an older client following a hip fracture. The nurse explains to the client that this type of traction is:

a) traction involving the use of a cast
b) skeletal traction involving the use of surgically inserted pins
c) circumferential traction involving the use of a belt around the body
d) skin traction involving the use of traction attached to the skin and soft tissues

69. A client has Buck's extension traction applied to the right leg. The nurse plans which of the following interventions to prevent complications from the device?

a) provide pin care once a shift
b) massage the skin of the right leg with lotion every 8 hours
c) inspect the skin on the right leg at least once every 8 hours
d) release the weights on the right leg for range of motion exercises daily

70. The nurse is caring for a client with a newly applied leg cast. The nurse prevents the development of compartment syndrome by:

a) elevating the limb and applying ice to the affected leg
b) elevating the limb and covering the limb with bath blankets
c) keeping the leg horizontal and applying ice to the affected leg
d) placing the leg in a slight dependent position and applying ice








NCLEX RN Questions:
Answers and Rationale

66) C

- The fasciotomy site is not sutured but is left open to relieve pressure and edema. The site is covered with wet sterile saline dressings. After 3 to 5 days, when perfusion is adequate and edema subsides, the wound is debrided and closed. A hydrocolloid dressing is not indicated for use with clean, open incisions. The incision is clean, not dirty, so there should be no reason to require Betadine. Additionally, Betadine can be irritating to normal tissues.

67) C

- The neurovascular status of the extremity of the client in Buck's extension traction must be assessed frequently. Older clients are especially at risk for neurovascular compromise because many older clients already have disorders that affect the peripheral vascular system. Although the client's temperature is monitored, it is not specific to the use of Buck's extension traction. Although clients in some types of traction do become depressed after a few days or weeks, Buck's extension traction is usually used preoperatively, which typically involves a few hours or 1 to 2 days, at the most. Range of motion of the involved leg is contraindicated in hip fractures.

68) D

- Buck's extension traction is a form of skin traction and involves the use of a belt or boot that is attached to the skin and soft tissues. The purpose of this type of traction is to decrease painful muscle spasms that accompany fractures. The weight that is used as a pulling force is limited (usually 5 to 10 pounds) to prevent injury to the skin. Options A, B, and C are incorrect descriptions.

69) C

Buck's extension traction is a type of skin traction. The nurse inspects the skin of the limb in traction at least once every 8 hours for irritation or inflammation. Massaging the skin with lotion is not indicated. The nurse never releases the weights of traction unless specifically ordered by the physician. There are no pins to care for with skin traction.

70) A

- Compartment syndrome is prevented by controlling edema. This is achieved most optimally with the use of elevation and the application of ice. The use of bath blankets or a dependent or horizontal leg position will not prevent this syndrome.



After you reviewed your answers through its rationale, you can also go back to the first page to start from the beginning:

NCLEX RN Questions about Musculoskeletal Injuries (1-8)


Or proceed to the next set of questions:

NCLEX RN Questions about Musculoskeletal Injuries (71-75)