Chapter 45: Fractures
Linton: Medical-Surgical Nursing, 7th Edition
MULTIPLE CHOICE
1. A patient with bilateral avascular necrosis of the hips is to walk with crutches using a
four-point gait for 6 weeks after her bone decompression surgeries: Which statement
would indicate that the patient understands this technique?
a. “The axillary bars on the crutches should support my weight when I walk:”
b. “I will move both crutches and then swing my legs to the crutches—2 and 2
equals 4!”
c. “I will move my right crutch and then my left leg and then the left crutch and my
right leg:”
d. “I will move both crutches and then swing my legs through the crutches together:”
ANS: C
This option describes the correct sequence for a four-point gait, which allows bearing
of weight and one foot to be placed in front of the other:
DIF: Cognitive Level: Comprehension REF: p: 889 OBJ: 5
TOP: Crutch Walking KEY: Nursing Process Step: Evaluation
MSC: NCLEX: Psychosocial Integrity: Physiological Adaptation
2. What action should a nurse implement when caring for a patient diagnosed with a
compound fracture?
a. Limit narcotics for 8 hours after surgery:
b. Monitor the patient’s respirations every hour:
c. Assess for pulses distal to the injury:
d. Verify that the patient is not allergic to sulfa:
ANS: C
Assessing for pulses distal to the injury is performed to monitor for inadequate
circulation:
, DIF: Cognitive Level: Application REF: p: 884 OBJ: 6
TOP: Care of the Patient after Surgery for a Fracture
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early
Detection of Disease
3. Assistive devices such as canes, crutches, and walkers are used for people who need to
limit weight-bearing activities on joints: Which statement by a nurse best illustrates an
understanding of the appropriate use of these devices?
a. “Canes provide minimal support and balance and are carried on the unaffected
side:”
b. “When using a cane, slide it as you go to decrease the arm strain:”
c. “A three-point gait is used when walking with a walker:”
d. “When using crutches, the unaffected leg goes down the steps first:”
ANS: A
“Canes provide minimal support and balance and are carried on the unaffected side”
is the only true statement:
DIF: Cognitive Level: Comprehension REF: p: 890 OBJ: 5 3
TOP: Assistive Devices KEY: Nursing Process Step: Evaluation
MSC: NCLEX: Psychosocial Integrity: Basic Care and Comfort
4. Which patient is most appropriate for a nurse to refer to home health care?
a. A married man with a laundry room on the first floor
b. A single woman with a bedroom in a rooming house
c. A student living in a college dormitory but going home to stay with parents
d. A woman staying with her daughter and son-in-law at their one-story home
ANS: B
The patient will need help with laundry and other activities of daily living:
DIF: Cognitive Level: Analysis REF: p: 891 OBJ: 6
TOP: Nursing Assessment of a Patient with a Fracture
KEY: Nursing Process Step: Assessment
MSC: NCLEX: Safe, Effective Care Environment: Safety and Infection
Linton: Medical-Surgical Nursing, 7th Edition
MULTIPLE CHOICE
1. A patient with bilateral avascular necrosis of the hips is to walk with crutches using a
four-point gait for 6 weeks after her bone decompression surgeries: Which statement
would indicate that the patient understands this technique?
a. “The axillary bars on the crutches should support my weight when I walk:”
b. “I will move both crutches and then swing my legs to the crutches—2 and 2
equals 4!”
c. “I will move my right crutch and then my left leg and then the left crutch and my
right leg:”
d. “I will move both crutches and then swing my legs through the crutches together:”
ANS: C
This option describes the correct sequence for a four-point gait, which allows bearing
of weight and one foot to be placed in front of the other:
DIF: Cognitive Level: Comprehension REF: p: 889 OBJ: 5
TOP: Crutch Walking KEY: Nursing Process Step: Evaluation
MSC: NCLEX: Psychosocial Integrity: Physiological Adaptation
2. What action should a nurse implement when caring for a patient diagnosed with a
compound fracture?
a. Limit narcotics for 8 hours after surgery:
b. Monitor the patient’s respirations every hour:
c. Assess for pulses distal to the injury:
d. Verify that the patient is not allergic to sulfa:
ANS: C
Assessing for pulses distal to the injury is performed to monitor for inadequate
circulation:
, DIF: Cognitive Level: Application REF: p: 884 OBJ: 6
TOP: Care of the Patient after Surgery for a Fracture
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early
Detection of Disease
3. Assistive devices such as canes, crutches, and walkers are used for people who need to
limit weight-bearing activities on joints: Which statement by a nurse best illustrates an
understanding of the appropriate use of these devices?
a. “Canes provide minimal support and balance and are carried on the unaffected
side:”
b. “When using a cane, slide it as you go to decrease the arm strain:”
c. “A three-point gait is used when walking with a walker:”
d. “When using crutches, the unaffected leg goes down the steps first:”
ANS: A
“Canes provide minimal support and balance and are carried on the unaffected side”
is the only true statement:
DIF: Cognitive Level: Comprehension REF: p: 890 OBJ: 5 3
TOP: Assistive Devices KEY: Nursing Process Step: Evaluation
MSC: NCLEX: Psychosocial Integrity: Basic Care and Comfort
4. Which patient is most appropriate for a nurse to refer to home health care?
a. A married man with a laundry room on the first floor
b. A single woman with a bedroom in a rooming house
c. A student living in a college dormitory but going home to stay with parents
d. A woman staying with her daughter and son-in-law at their one-story home
ANS: B
The patient will need help with laundry and other activities of daily living:
DIF: Cognitive Level: Analysis REF: p: 891 OBJ: 6
TOP: Nursing Assessment of a Patient with a Fracture
KEY: Nursing Process Step: Assessment
MSC: NCLEX: Safe, Effective Care Environment: Safety and Infection
