CNUR 204 EXAM QUESTIONS WITH
COMPLETE SOLUTIONS
A client fell off a ladder and the healthcare provider suspects a fracture
| | | | | | | | | | | | |
of the right wrist. Which manifestation should the nurse anticipate
| | | | | | | | | |
observing in the client? (Select all that apply.)
| | | | | | |
A. Crepitus
|
B. Visible deformity
| |
C. Pain |
D. Cyanosis of nail beds
| | | |
E. Absence of radial pulse - CORRECT ANSWER✔✔-Answer: A, B, C
| | | | | | | | | |
Rationale: The manifestations of a fracture include visible deformity,
| | | | | | | | |
swelling, pain, numbness, crepitus, hypovolemic shock, muscle spasms,
| | | | | | | |
or ecchymosis. A complication of a fracture, compartment syndrome,
| | | | | | | | |
may occur if pressure from edema builds within the fascia, leading to
| | | | | | | | | | | |
decreased blood flow and potential muscle and nerve damage.
| | | | | | | | |
Neurovascular changes may be noted when this occurs which can | | | | | | | | | |
include absence of pulse and cyanosis of the nail beds.
| | | | | | | | |
Which client should the nurse identify to be at a greater risk of fractures
| | | | | | | | | | | | |
while reviewing their health records? (Select all that apply.)
| | | | | | | | |
A. The client with leukemia
| | | |
,B. The client with bone neoplasms
| | | | |
C. The client who is malnourished
| | | | |
D. The client with osteoporosis
| | | |
E. The client with hypercalcemia - CORRECT ANSWER✔✔-Answer: B, C,
| | | | | | | | | |
D
Rationale: The primary risk factors associated with bone fractures are
| | | | | | | | | |
age, presence of bone disease, bone cancer, and poor nutrition.
| | | | | | | | | |
Leukemia and hypercalcemia are not risk factors for fractures.
| | | | | | | |
A client sustained a radial fracture and a cast was just applied. The client
| | | | | | | | | | | | |
states that there is unrelieved pain and numbness in the fingers on the
| | | | | | | | | | | | | |
affected side. Which intervention should be a priority?
| | | | | | |
A. Notifying the healthcare provider for cast removal
| | | | | | |
B. Elevating the extremity
| | |
C. Preparing for fasciotomy
| | |
D. Performing frequent neurovascular checks - CORRECT ANSWER✔✔-
| | | | | | |
Answer: A |
Rationale: Compartment syndrome occurs when edema and swelling
| | | | | | | |
cause increased pressure in a muscle compartment, leading to
| | | | | | | | |
decreased blood flow and potential muscle and nerve damage. This
| | | | | | | | | |
leads to dilation of the blood vessels, causing more edema and
| | | | | | | | | | |
increasing pressure in the limb. This is a medical emergency; the first
| | | | | | | | | | | |
step in treatment is to remove the tight cast by notifying the healthcare
| | | | | | | | | | | | |
provider. A fasciotomy is indicated when internal pressure is causing the
| | | | | | | | | |
|symptoms but would not be indicated unless the cast removal did not
| | | | | | | | | | | |
,relieve the pressure. Neurovascular checks would be performed
| | | | | | | |
frequently, but cast removal is the priority. Elevating the extremity is
| | | | | | | | | | |
indicated to prevent compartment syndrome, not to treat the problem
| | | | | | | | | |
if it occurs. This would actually decrease circulation to the extremity.
| | | | | | | | | |
Which statement from the client regarding cast care requires additional
| | | | | | | | | |
teaching by the nurse? | | |
A. "I can use plastic shields around the cast while showering or bathing."
| | | | | | | | | | | |
B. "If the edges become rough and irritating, I can remove the rough
| | | | | | | | | | | | |
edges."
C. "I can apply ice to the cast and elevate my arm to prevent swelling."
| | | | | | | | | | | | | |
D. "I should never place objects in the cast to relieve itching." - CORRECT
| | | | | | | | | | | | |
ANSWER✔✔-Answer: B
| |
Rationale: The client should be taught to protect the cast with plastic
| | | | | | | | | | | |
while showering or bathing. No part of the cast, including rough edges,
| | | | | | | | | | | |
should be removed at any time. Ice and limb elevation may help reduce
| | | | | | | | | | | | |
swelling, and no objects should ever be inserted into the cast for any
| | | | | | | | | | | | |
reason.
A client who was treated for a long bone fracture suddenly has a
| | | | | | | | | | | | |
respiratory rate of 28 breaths/ min with an oxygen saturation of 86% on
| | | | | | | | | | | | |
room air. The client is confused and restless. Which collaborative
| | | | | | | | | |
intervention is appropriate? | |
A. Applying oxygen and continuing to assess respiratory status
| | | | | | | |
B. Intubating the client immediately
| | | |
, C. Immediately immobilizing the pelvic area
| | | | |
D. Administering corticosteroids as ordered - CORRECT ANSWER✔✔-
| | | | | | |
Answer: A |
Rationale: This client is showing signs of fat embolism syndrome (FES).
| | | | | | | | | | |
Priority treatment is to administer oxygen and continue to assess
| | | | | | | | | |
respiratory status to try to prevent intubation. Approximately 50% of
| | | | | | | | | |
the clients will have to be intubated eventually, but the goal is to
| | | | | | | | | | | | |
prevent this invasive treatment. Corticosteroids and immobilization of
| | | | | | | |
the injured area may reduce the risk of FES but will not treat the
| | | | | | | | | | | | | |
syndrome once it occurs. | | |
The nurse is discussing open reduction and internal fixation with a client
| | | | | | | | | | |
who is considering surgery to correct a bone fracture. Which statement
| | | | | | | | | | | |
by the nurse is correct?
| | | |
A. "Internal fixation is performed when soft tissue damage prevents
| | | | | | | | | |
external fixation." |
B. "A longer hospital stay will be required."
| | | | | | |
C. "A metal bar will be placed outside the skin to stabilize the bone."
| | | | | | | | | | | | |
D. "Internal fixation allows earlier return to full function." - CORRECT
| | | | | | | | | | |
ANSWER✔✔-Answer: D |
Rationale: The two main types of surgical repair are external fixation
| | | | | | | | | | |
and internal fixation. Internal fixation allows for shorter hospital stays
| | | | | | | | | |
and earlier return to full function, as well as fewer instances of
| | | | | | | | | | | |
nonunion and malunion. External fixation is often performed if soft
| | | | | | | | | |
COMPLETE SOLUTIONS
A client fell off a ladder and the healthcare provider suspects a fracture
| | | | | | | | | | | | |
of the right wrist. Which manifestation should the nurse anticipate
| | | | | | | | | |
observing in the client? (Select all that apply.)
| | | | | | |
A. Crepitus
|
B. Visible deformity
| |
C. Pain |
D. Cyanosis of nail beds
| | | |
E. Absence of radial pulse - CORRECT ANSWER✔✔-Answer: A, B, C
| | | | | | | | | |
Rationale: The manifestations of a fracture include visible deformity,
| | | | | | | | |
swelling, pain, numbness, crepitus, hypovolemic shock, muscle spasms,
| | | | | | | |
or ecchymosis. A complication of a fracture, compartment syndrome,
| | | | | | | | |
may occur if pressure from edema builds within the fascia, leading to
| | | | | | | | | | | |
decreased blood flow and potential muscle and nerve damage.
| | | | | | | | |
Neurovascular changes may be noted when this occurs which can | | | | | | | | | |
include absence of pulse and cyanosis of the nail beds.
| | | | | | | | |
Which client should the nurse identify to be at a greater risk of fractures
| | | | | | | | | | | | |
while reviewing their health records? (Select all that apply.)
| | | | | | | | |
A. The client with leukemia
| | | |
,B. The client with bone neoplasms
| | | | |
C. The client who is malnourished
| | | | |
D. The client with osteoporosis
| | | |
E. The client with hypercalcemia - CORRECT ANSWER✔✔-Answer: B, C,
| | | | | | | | | |
D
Rationale: The primary risk factors associated with bone fractures are
| | | | | | | | | |
age, presence of bone disease, bone cancer, and poor nutrition.
| | | | | | | | | |
Leukemia and hypercalcemia are not risk factors for fractures.
| | | | | | | |
A client sustained a radial fracture and a cast was just applied. The client
| | | | | | | | | | | | |
states that there is unrelieved pain and numbness in the fingers on the
| | | | | | | | | | | | | |
affected side. Which intervention should be a priority?
| | | | | | |
A. Notifying the healthcare provider for cast removal
| | | | | | |
B. Elevating the extremity
| | |
C. Preparing for fasciotomy
| | |
D. Performing frequent neurovascular checks - CORRECT ANSWER✔✔-
| | | | | | |
Answer: A |
Rationale: Compartment syndrome occurs when edema and swelling
| | | | | | | |
cause increased pressure in a muscle compartment, leading to
| | | | | | | | |
decreased blood flow and potential muscle and nerve damage. This
| | | | | | | | | |
leads to dilation of the blood vessels, causing more edema and
| | | | | | | | | | |
increasing pressure in the limb. This is a medical emergency; the first
| | | | | | | | | | | |
step in treatment is to remove the tight cast by notifying the healthcare
| | | | | | | | | | | | |
provider. A fasciotomy is indicated when internal pressure is causing the
| | | | | | | | | |
|symptoms but would not be indicated unless the cast removal did not
| | | | | | | | | | | |
,relieve the pressure. Neurovascular checks would be performed
| | | | | | | |
frequently, but cast removal is the priority. Elevating the extremity is
| | | | | | | | | | |
indicated to prevent compartment syndrome, not to treat the problem
| | | | | | | | | |
if it occurs. This would actually decrease circulation to the extremity.
| | | | | | | | | |
Which statement from the client regarding cast care requires additional
| | | | | | | | | |
teaching by the nurse? | | |
A. "I can use plastic shields around the cast while showering or bathing."
| | | | | | | | | | | |
B. "If the edges become rough and irritating, I can remove the rough
| | | | | | | | | | | | |
edges."
C. "I can apply ice to the cast and elevate my arm to prevent swelling."
| | | | | | | | | | | | | |
D. "I should never place objects in the cast to relieve itching." - CORRECT
| | | | | | | | | | | | |
ANSWER✔✔-Answer: B
| |
Rationale: The client should be taught to protect the cast with plastic
| | | | | | | | | | | |
while showering or bathing. No part of the cast, including rough edges,
| | | | | | | | | | | |
should be removed at any time. Ice and limb elevation may help reduce
| | | | | | | | | | | | |
swelling, and no objects should ever be inserted into the cast for any
| | | | | | | | | | | | |
reason.
A client who was treated for a long bone fracture suddenly has a
| | | | | | | | | | | | |
respiratory rate of 28 breaths/ min with an oxygen saturation of 86% on
| | | | | | | | | | | | |
room air. The client is confused and restless. Which collaborative
| | | | | | | | | |
intervention is appropriate? | |
A. Applying oxygen and continuing to assess respiratory status
| | | | | | | |
B. Intubating the client immediately
| | | |
, C. Immediately immobilizing the pelvic area
| | | | |
D. Administering corticosteroids as ordered - CORRECT ANSWER✔✔-
| | | | | | |
Answer: A |
Rationale: This client is showing signs of fat embolism syndrome (FES).
| | | | | | | | | | |
Priority treatment is to administer oxygen and continue to assess
| | | | | | | | | |
respiratory status to try to prevent intubation. Approximately 50% of
| | | | | | | | | |
the clients will have to be intubated eventually, but the goal is to
| | | | | | | | | | | | |
prevent this invasive treatment. Corticosteroids and immobilization of
| | | | | | | |
the injured area may reduce the risk of FES but will not treat the
| | | | | | | | | | | | | |
syndrome once it occurs. | | |
The nurse is discussing open reduction and internal fixation with a client
| | | | | | | | | | |
who is considering surgery to correct a bone fracture. Which statement
| | | | | | | | | | | |
by the nurse is correct?
| | | |
A. "Internal fixation is performed when soft tissue damage prevents
| | | | | | | | | |
external fixation." |
B. "A longer hospital stay will be required."
| | | | | | |
C. "A metal bar will be placed outside the skin to stabilize the bone."
| | | | | | | | | | | | |
D. "Internal fixation allows earlier return to full function." - CORRECT
| | | | | | | | | | |
ANSWER✔✔-Answer: D |
Rationale: The two main types of surgical repair are external fixation
| | | | | | | | | | |
and internal fixation. Internal fixation allows for shorter hospital stays
| | | | | | | | | |
and earlier return to full function, as well as fewer instances of
| | | | | | | | | | | |
nonunion and malunion. External fixation is often performed if soft
| | | | | | | | | |
