LeMone/Burke/Bauldoff/Gubrud, Medical- y
Surgical Nursing 6th Edition Test Bank Chapter 39
y y y y y y y
Questiony1yT
ype:yMCSA
Theynurseyinstructsyanyadolescentypatientyonytheycareyofyaysprainyatyhome.yWhichypatientystatementyindicatesytheynee
dyforyfurtheryinstruction?
1. “IyshouldyputyayheatingypadyonymyylegyasysoonyasyIygetyhome.”
2. “Iyshouldyavoidyweightybearingyonythisylegyforyaycoupleyofydays.”
3. “Iyshouldymakeysureytoykeepytheyaceybandageyonymyyleg.”
4. “IyshouldypropythisylegyupywhenyI’mysittingyinyaychair.”
CorrectyAnswer:y1
Rationaley1:yHeatyshouldynotybeyappliedytoyaysprain.
Rationaley2:yTheypatientyshouldybeyinstructedytoyrestytheyextremityyfory24–48yhours.
Rationaley3:yTheypatientyshouldybeyinstructedytoyapplyycompressionytoytheyinjuredyextremityyfory24–48yhours.
Rationaley4:yTheypatientyshouldybeyinstructedytoyelevateytheyextremity,ywhichyreducesypainyandyedema,yfory24–48yhours.
GlobalyRationale:yTheypatientyshouldybeyinstructedytoyfollowytheyacronymyRICEyforytreatmentyofyaysprainyatyhome
.yThisyincludesyrestingytheyextremity,yapplyingycompression,yandyelevatingytheyextremity.yTheseytherapiesyshouldyb
eyusedyfory24–
48yhours.yVerbalizingytheyneedyforyayheatingypadywouldyindicateythatytheypatientyrequiresyadditionalyinstruction.
CognitiveyLevel:yAnalyzing
ClientyNeed:yPhysiologicalyIntegrity
ClientyNeedySub:yReductionyofyRiskyPotential
QSENyCompetencies:yI.A.1.yIntegrateyunderstandingyofymultipleydimensionsyofypatientycenteredycare
AACNyEssentialsyCompetencies:yIX.9.Monitoryclientyoutcomesytoyevaluateytheyeffectivenessyofypsychobiologicalyinte
rventions
NLNyCompetencies:yContextyandyEnvironment;yPractice;yconductypopulation-
basedytransculturalyhealthyassessmentsyandyinterventions
Nursing/IntegratedyConcepts:yNursingyProcess:yEvaluation
LearningyOutcome:y1.yCompareyandycontrastytheycauses,yriskyfactors,ypathophysiology,ymanifestations,yinterprof
essionalycare,yandynursingycareyofycontusions,ystrains,ysprains,yjointydislocations,yandyfractures.
MNLyLearningyOutcome:y8.1.3.yDistinguishytheydiagnosisyandytreatmentyofytraumaticymusculoskeletalyinjuries.
PageyNumber:y1235
LeMone/Burke/Bauldoff/Gubrud,yMedical-SurgicalyNursingy6thyEditionyTestyBank
Copyrighty2015ybyyPearsonyEducation,yInc.
,Questiony2yT
ype:yMCSA
Aypatientywithyaylongylegycastyisyexhibitingysignsyofycompartmentysyndrome.yWhatyshouldytheynurseyprepareytoyaidyiny
theytreatmentyofytheypatient?
1. extraypillowsytoyelevateytheycastedyextremityyaboveytheyheart
2. Dopplerytoyassessytheystrengthyofyperipheralypulses
3. strapsytoywrapyaroundytheybivalvedycast
4. percussionyhammerytoyassessyreflexesyforydamage
CorrectyAnswer:y3
Rationaley1:yElevatingytheylegyaboveytheyheartywouldycompromiseycirculation.
Rationaley2:yAyDopplerycouldybeyusedytoyassessypulsesybutythisyisynotyaytherapeuticytreatmentyforycompartmentysyn
drome.
Rationaley3:yCompartmentysyndromeyoccursywhenyexcessypressureyinyaylimitedyspaceyconstrictsytheystructuresywit
hinyaycompartment,yreducingycirculationytoymusclesyandynerves.yTreatmentycanyincludeyremovingytheycastyentirelyy
orybivalvingyity(splittingyityapartywithyaycastycutter)yandysecuringytheytwoysidesywithystraps.
Rationaley4:yAypercussionyhammeryisyusedytoycheckyreflexes,ybutythisyisynotyaytherapeuticytreatmentyforycompartme
ntysyndrome.
GlobalyRationale:yCompartmentysyndromeyoccursywhenyexcessypressureyinyaylimitedyspaceyconstrictsytheystructures
ywithinyaycompartment, yreducingycirculation ytoymusclesyandynerves. yTreatment ycanyincludeyremovingytheycast yentirel
yyorybivalvingyity(splittingyityapartywithyaycastycutter)yandysecuringytheytwoysidesywithystraps.yElevatingytheylegyaboveyt
heyheartywouldycompromiseycirculation.yAyDopplerycouldybeyusedytoyassessypulses,yandyaypercussionyhammerytoychec
kyreflexes,ybutytheseyareynotytherapeuticytreatmentsyforycompartmentysyndrome.
CognitiveyLevel:yApplying
ClientyNeed:yPhysiologicalyIntegrity
ClientyNeedySub:yReductionyofyRiskyPotential
QSENyCompetencies:yI.A.1.yIntegrateyunderstandingyofymultipleydimensionsyofypatientycenteredycareyAAC
NyEssentialsyCompetencies:yIX.8.Implementyevidence-
basedynursingyinterventionsyasyappropriateyforymanagingytheyacuteyandychronicycareyofypatientsyandypromoting
yhealthyacrossytheylifespan
NLNyCompetencies:yContextyandyEnvironment;yPractice;yconductypopulation-
basedytransculturalyhealthyassessmentsyandyinterventions
Nursing/IntegratedyConcepts:yNursingyProcess:yPlanning
LearningyOutcome:y4.yExplainytheypathophysiology,ymanifestations,yandyrelatedytreatmentyforycomplicationsyofyfractu
res:ycompartmentysyndrome,yfatyembolismysyndrome,ydeepyvenousythrombosis,yinfection,ydelayedyunionyandynonunion,y
LeMone/Burke/Bauldoff/Gubrud,yMedical-SurgicalyNursingy6thyEditionyTestyBank
Copyrighty2015ybyyPearsonyEducation,yInc.
,andycomplexyregionalypainysyndrome.
LeMone/Burke/Bauldoff/Gubrud,yMedical-SurgicalyNursingy6thyEditionyTestyBank
Copyrighty2015ybyyPearsonyEducation,yInc.
, MNLyLearningyOutcome:y8.1.3.yDistinguishytheydiagnosisyandytreatmentyofytraumaticymusculoskeletalyinjuries.
PageyNumber:y1241
Questiony3yT
ype:yMCSA
Aypatientyisyplacedy inyBuck’sytractionyafteryayhipyfracture.yWhatyshouldybeyincludedyinythisypatient’syplanyofycare?
1. providingypinysiteycareyeveryyshiftyasyprescribed
2. placingyanyabductionypillowybetweenytheylegsyforyalignment
3. havingyanotherypersonyholdytheyweightsywhenypullingytheypatientyupyinybed
4. turningytheypatientytoytheyunaffectedysideyeveryy 2yhours
CorrectyAnswer:y3
Rationaley1:yBuck’sytractionyisyskinytraction;ynoyskeletalypinsyareyused.
Rationaley2:yAnyabductionypillowyisyusedypostoperatively.
Rationaley3:yBuck’sytractionyisyusedypreoperativelyytoycontrolymuscleyspasms,yimmobilizeyayfracturedyhip,yandymain
tainyalignmentyofyanyextremity.yOften,ypatientsywilly“scoot”ydownytowardytheyendyofytheybed,yandytheyweightsyareyresti
ngyonytheyfloor.yToyavoidyinjuryyandyaddedypain,yoneypersonyholdsytheyweightsywhileytheyothersyuseyayliftysheetytoyrep
ositionytheypatient.
Rationaley4:yAypatientycannotybeyturnedywithythisytypeyofytherapy.
GlobalyRationale:yBuck’sytractionyisyusedypreoperativelyytoycontrolymuscleyspasms,yimmobilizeyayfracturedyhip,yand
ymaintainyalignmentyofyanyextremity. yOften,ypatients ywill y“scoot”ydownytowardytheyendyofytheybed,yandytheyweights yar
eyrestingyonytheyfloor.yToyavoidyinjuryyandyaddedypain,yoneypersonyholdsytheyweightsywhileytheyothersyuseyayliftysheetyt
oyrepositionytheypatient.yBuck’sytractionyisyskinytraction;ynoyskeletalypinsyareyused.yAnyabductionypillowyisyusedyposto
peratively,yandyaypatientycannotybeyturnedywithythisytypeyofytherapy.
CognitiveyLevel:yAnalyzing
ClientyNeed:yPhysiologicalyIntegrity
ClientyNeedySub:yReductionyofyRiskyPotential
QSENyCompetencies:yI.A.1.yIntegrateyunderstandingyofymultipleydimensionsyofypatientycenteredycareyAAC
NyEssentialsyCompetencies:yIX.8.Implementyevidence-
basedynursingyinterventionsyasyappropriateyforymanagingytheyacuteyandychronicycareyofypatientsyandypromoting
yhealthyacrossytheylifespan
NLNyCompetencies:yContextyandyEnvironment;yPractice;yconductypopulation-
basedytransculturalyhealthyassessmentsyandyinterventions
Nursing/IntegratedyConcepts:yNursingyProcess:yImplementation
LearningyOutcome:y1.yCompareyandycontrastytheycauses,yriskyfactors,ypathophysiology,ymanifestations,yinterprof
essionalycare,yandynursingycareyofycontusions,ystrains,ysprains,yjointydislocations,yandyfractures.
MNLyLearningyOutcome:y8.1.3.yDistinguishytheydiagnosisyandytreatmentyofytraumaticymusculoskeletalyinjuries.
LeMone/Burke/Bauldoff/Gubrud,yMedical-SurgicalyNursingy6thyEditionyTestyBank
Copyrighty2015ybyyPearsonyEducation,yInc.
Surgical Nursing 6th Edition Test Bank Chapter 39
y y y y y y y
Questiony1yT
ype:yMCSA
Theynurseyinstructsyanyadolescentypatientyonytheycareyofyaysprainyatyhome.yWhichypatientystatementyindicatesytheynee
dyforyfurtheryinstruction?
1. “IyshouldyputyayheatingypadyonymyylegyasysoonyasyIygetyhome.”
2. “Iyshouldyavoidyweightybearingyonythisylegyforyaycoupleyofydays.”
3. “Iyshouldymakeysureytoykeepytheyaceybandageyonymyyleg.”
4. “IyshouldypropythisylegyupywhenyI’mysittingyinyaychair.”
CorrectyAnswer:y1
Rationaley1:yHeatyshouldynotybeyappliedytoyaysprain.
Rationaley2:yTheypatientyshouldybeyinstructedytoyrestytheyextremityyfory24–48yhours.
Rationaley3:yTheypatientyshouldybeyinstructedytoyapplyycompressionytoytheyinjuredyextremityyfory24–48yhours.
Rationaley4:yTheypatientyshouldybeyinstructedytoyelevateytheyextremity,ywhichyreducesypainyandyedema,yfory24–48yhours.
GlobalyRationale:yTheypatientyshouldybeyinstructedytoyfollowytheyacronymyRICEyforytreatmentyofyaysprainyatyhome
.yThisyincludesyrestingytheyextremity,yapplyingycompression,yandyelevatingytheyextremity.yTheseytherapiesyshouldyb
eyusedyfory24–
48yhours.yVerbalizingytheyneedyforyayheatingypadywouldyindicateythatytheypatientyrequiresyadditionalyinstruction.
CognitiveyLevel:yAnalyzing
ClientyNeed:yPhysiologicalyIntegrity
ClientyNeedySub:yReductionyofyRiskyPotential
QSENyCompetencies:yI.A.1.yIntegrateyunderstandingyofymultipleydimensionsyofypatientycenteredycare
AACNyEssentialsyCompetencies:yIX.9.Monitoryclientyoutcomesytoyevaluateytheyeffectivenessyofypsychobiologicalyinte
rventions
NLNyCompetencies:yContextyandyEnvironment;yPractice;yconductypopulation-
basedytransculturalyhealthyassessmentsyandyinterventions
Nursing/IntegratedyConcepts:yNursingyProcess:yEvaluation
LearningyOutcome:y1.yCompareyandycontrastytheycauses,yriskyfactors,ypathophysiology,ymanifestations,yinterprof
essionalycare,yandynursingycareyofycontusions,ystrains,ysprains,yjointydislocations,yandyfractures.
MNLyLearningyOutcome:y8.1.3.yDistinguishytheydiagnosisyandytreatmentyofytraumaticymusculoskeletalyinjuries.
PageyNumber:y1235
LeMone/Burke/Bauldoff/Gubrud,yMedical-SurgicalyNursingy6thyEditionyTestyBank
Copyrighty2015ybyyPearsonyEducation,yInc.
,Questiony2yT
ype:yMCSA
Aypatientywithyaylongylegycastyisyexhibitingysignsyofycompartmentysyndrome.yWhatyshouldytheynurseyprepareytoyaidyiny
theytreatmentyofytheypatient?
1. extraypillowsytoyelevateytheycastedyextremityyaboveytheyheart
2. Dopplerytoyassessytheystrengthyofyperipheralypulses
3. strapsytoywrapyaroundytheybivalvedycast
4. percussionyhammerytoyassessyreflexesyforydamage
CorrectyAnswer:y3
Rationaley1:yElevatingytheylegyaboveytheyheartywouldycompromiseycirculation.
Rationaley2:yAyDopplerycouldybeyusedytoyassessypulsesybutythisyisynotyaytherapeuticytreatmentyforycompartmentysyn
drome.
Rationaley3:yCompartmentysyndromeyoccursywhenyexcessypressureyinyaylimitedyspaceyconstrictsytheystructuresywit
hinyaycompartment,yreducingycirculationytoymusclesyandynerves.yTreatmentycanyincludeyremovingytheycastyentirelyy
orybivalvingyity(splittingyityapartywithyaycastycutter)yandysecuringytheytwoysidesywithystraps.
Rationaley4:yAypercussionyhammeryisyusedytoycheckyreflexes,ybutythisyisynotyaytherapeuticytreatmentyforycompartme
ntysyndrome.
GlobalyRationale:yCompartmentysyndromeyoccursywhenyexcessypressureyinyaylimitedyspaceyconstrictsytheystructures
ywithinyaycompartment, yreducingycirculation ytoymusclesyandynerves. yTreatment ycanyincludeyremovingytheycast yentirel
yyorybivalvingyity(splittingyityapartywithyaycastycutter)yandysecuringytheytwoysidesywithystraps.yElevatingytheylegyaboveyt
heyheartywouldycompromiseycirculation.yAyDopplerycouldybeyusedytoyassessypulses,yandyaypercussionyhammerytoychec
kyreflexes,ybutytheseyareynotytherapeuticytreatmentsyforycompartmentysyndrome.
CognitiveyLevel:yApplying
ClientyNeed:yPhysiologicalyIntegrity
ClientyNeedySub:yReductionyofyRiskyPotential
QSENyCompetencies:yI.A.1.yIntegrateyunderstandingyofymultipleydimensionsyofypatientycenteredycareyAAC
NyEssentialsyCompetencies:yIX.8.Implementyevidence-
basedynursingyinterventionsyasyappropriateyforymanagingytheyacuteyandychronicycareyofypatientsyandypromoting
yhealthyacrossytheylifespan
NLNyCompetencies:yContextyandyEnvironment;yPractice;yconductypopulation-
basedytransculturalyhealthyassessmentsyandyinterventions
Nursing/IntegratedyConcepts:yNursingyProcess:yPlanning
LearningyOutcome:y4.yExplainytheypathophysiology,ymanifestations,yandyrelatedytreatmentyforycomplicationsyofyfractu
res:ycompartmentysyndrome,yfatyembolismysyndrome,ydeepyvenousythrombosis,yinfection,ydelayedyunionyandynonunion,y
LeMone/Burke/Bauldoff/Gubrud,yMedical-SurgicalyNursingy6thyEditionyTestyBank
Copyrighty2015ybyyPearsonyEducation,yInc.
,andycomplexyregionalypainysyndrome.
LeMone/Burke/Bauldoff/Gubrud,yMedical-SurgicalyNursingy6thyEditionyTestyBank
Copyrighty2015ybyyPearsonyEducation,yInc.
, MNLyLearningyOutcome:y8.1.3.yDistinguishytheydiagnosisyandytreatmentyofytraumaticymusculoskeletalyinjuries.
PageyNumber:y1241
Questiony3yT
ype:yMCSA
Aypatientyisyplacedy inyBuck’sytractionyafteryayhipyfracture.yWhatyshouldybeyincludedyinythisypatient’syplanyofycare?
1. providingypinysiteycareyeveryyshiftyasyprescribed
2. placingyanyabductionypillowybetweenytheylegsyforyalignment
3. havingyanotherypersonyholdytheyweightsywhenypullingytheypatientyupyinybed
4. turningytheypatientytoytheyunaffectedysideyeveryy 2yhours
CorrectyAnswer:y3
Rationaley1:yBuck’sytractionyisyskinytraction;ynoyskeletalypinsyareyused.
Rationaley2:yAnyabductionypillowyisyusedypostoperatively.
Rationaley3:yBuck’sytractionyisyusedypreoperativelyytoycontrolymuscleyspasms,yimmobilizeyayfracturedyhip,yandymain
tainyalignmentyofyanyextremity.yOften,ypatientsywilly“scoot”ydownytowardytheyendyofytheybed,yandytheyweightsyareyresti
ngyonytheyfloor.yToyavoidyinjuryyandyaddedypain,yoneypersonyholdsytheyweightsywhileytheyothersyuseyayliftysheetytoyrep
ositionytheypatient.
Rationaley4:yAypatientycannotybeyturnedywithythisytypeyofytherapy.
GlobalyRationale:yBuck’sytractionyisyusedypreoperativelyytoycontrolymuscleyspasms,yimmobilizeyayfracturedyhip,yand
ymaintainyalignmentyofyanyextremity. yOften,ypatients ywill y“scoot”ydownytowardytheyendyofytheybed,yandytheyweights yar
eyrestingyonytheyfloor.yToyavoidyinjuryyandyaddedypain,yoneypersonyholdsytheyweightsywhileytheyothersyuseyayliftysheetyt
oyrepositionytheypatient.yBuck’sytractionyisyskinytraction;ynoyskeletalypinsyareyused.yAnyabductionypillowyisyusedyposto
peratively,yandyaypatientycannotybeyturnedywithythisytypeyofytherapy.
CognitiveyLevel:yAnalyzing
ClientyNeed:yPhysiologicalyIntegrity
ClientyNeedySub:yReductionyofyRiskyPotential
QSENyCompetencies:yI.A.1.yIntegrateyunderstandingyofymultipleydimensionsyofypatientycenteredycareyAAC
NyEssentialsyCompetencies:yIX.8.Implementyevidence-
basedynursingyinterventionsyasyappropriateyforymanagingytheyacuteyandychronicycareyofypatientsyandypromoting
yhealthyacrossytheylifespan
NLNyCompetencies:yContextyandyEnvironment;yPractice;yconductypopulation-
basedytransculturalyhealthyassessmentsyandyinterventions
Nursing/IntegratedyConcepts:yNursingyProcess:yImplementation
LearningyOutcome:y1.yCompareyandycontrastytheycauses,yriskyfactors,ypathophysiology,ymanifestations,yinterprof
essionalycare,yandynursingycareyofycontusions,ystrains,ysprains,yjointydislocations,yandyfractures.
MNLyLearningyOutcome:y8.1.3.yDistinguishytheydiagnosisyandytreatmentyofytraumaticymusculoskeletalyinjuries.
LeMone/Burke/Bauldoff/Gubrud,yMedical-SurgicalyNursingy6thyEditionyTestyBank
Copyrighty2015ybyyPearsonyEducation,yInc.
