NUR 1024: NCLEX :FRACTURES: QUESTIONS WITH ACCURATE
ANSWERS
1) 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 ✔✔ 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.
2) Which statement is correct regarding traction?
A) Traction weights should rest either on the bed or on the floor.
B) Skeletal traction may be used in conjunction with skin traction.
C) Skin traction is contraindicated in older adults with frail skin.
D) Skin traction is used when skeletal traction is contraindicated. -- Correct
Answer ✔✔ B
Rationale: Skeletal traction may be used in conjunction with skin traction
depending on the severity and location of the injury. Skin traction is used when
only a small amount of weight is needed because skin cannot tolerate larger
weights. Skin traction is contraindicated in older adults with frail skin due to
increased risk of skin tearing leading to infection. Traction weights should never
be placed on the bed or the floor, which will cause inadequate force on the bone
and may change the alignments of the fracture causing a malunion. Weights
should hang unencumbered.
, 3) 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
✔✔ 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 tissue damage prevents internal fixation. A
metal bar is attached to pins and screws in external fixation.
4) The nurse is explaining the use of a splint for an ulnar fracture. Which information
should be included? (Select all that apply.)
A) At greater risk for compartment syndrome
B) May be used as a temporary measure until a cast can be applied
C) Easily removed if needed
D) Can be adjusted if swelling occurs
E) Allows some movement of the joint -- Correct Answer ✔✔ B, C, D, E
Rationale: A splint provides less support than a cast does but may be used as a
temporary measure before a cast is applied (to stabilize bone until swelling has
subsided) and can easily be adjusted to accommodate swelling and prevent
compartment syndrome. Splints do allow some movement of the joint and so
may also be used during the reparative phase of healing.
5) The nurse notes that a client with a 2-day postoperative internal fixation femur
fracture is a current two-pack-a-day smoker. Which complication should the nurse
expect due to the client's smoking habit? (Select all that apply.)
A) Osteomyelitis
B) Delayed bone healing
C) Higher incidence of infection
ANSWERS
1) 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 ✔✔ 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.
2) Which statement is correct regarding traction?
A) Traction weights should rest either on the bed or on the floor.
B) Skeletal traction may be used in conjunction with skin traction.
C) Skin traction is contraindicated in older adults with frail skin.
D) Skin traction is used when skeletal traction is contraindicated. -- Correct
Answer ✔✔ B
Rationale: Skeletal traction may be used in conjunction with skin traction
depending on the severity and location of the injury. Skin traction is used when
only a small amount of weight is needed because skin cannot tolerate larger
weights. Skin traction is contraindicated in older adults with frail skin due to
increased risk of skin tearing leading to infection. Traction weights should never
be placed on the bed or the floor, which will cause inadequate force on the bone
and may change the alignments of the fracture causing a malunion. Weights
should hang unencumbered.
, 3) 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
✔✔ 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 tissue damage prevents internal fixation. A
metal bar is attached to pins and screws in external fixation.
4) The nurse is explaining the use of a splint for an ulnar fracture. Which information
should be included? (Select all that apply.)
A) At greater risk for compartment syndrome
B) May be used as a temporary measure until a cast can be applied
C) Easily removed if needed
D) Can be adjusted if swelling occurs
E) Allows some movement of the joint -- Correct Answer ✔✔ B, C, D, E
Rationale: A splint provides less support than a cast does but may be used as a
temporary measure before a cast is applied (to stabilize bone until swelling has
subsided) and can easily be adjusted to accommodate swelling and prevent
compartment syndrome. Splints do allow some movement of the joint and so
may also be used during the reparative phase of healing.
5) The nurse notes that a client with a 2-day postoperative internal fixation femur
fracture is a current two-pack-a-day smoker. Which complication should the nurse
expect due to the client's smoking habit? (Select all that apply.)
A) Osteomyelitis
B) Delayed bone healing
C) Higher incidence of infection
