Question

A client who has a compound fracture of the right tibia has a long-leg fiberglass cast. To reinforce teaching for the client about how to observe and manage his fracture at home, the nurse should include which of the following instructions?

Answer 1

Correct Answers:

Report any worsening or unrelieved pain.

Rationale :

🔴 Pain that is worsening or unrelieved may indicate compartment syndrome, infection, or impaired circulation, which are medical emergencies requiring prompt evaluation.

🔴 Monitoring neurovascular status (pain, sensation, color, movement, and pulses) is essential for clients with long-leg casts to prevent permanent tissue damage.

🔴 Clients should be instructed to report early signs such as increasing swelling, numbness, tingling, or cold extremities, as these can precede serious complications.

🔴 Timely reporting allows the provider to intervene with measures like cast splitting, reduction of pressure, or surgical intervention if needed.

🔴 Reinforcing this teaching ensures client safety at home and prevents delayed recognition of complications.

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Answer 2

Correct Answers:

Pulmonary embolism
Orthostatic hypotension
Deep vein thrombosis

Rationale :

❇️ Pulmonary embolism (PE) can occur when immobility leads to thrombus formation in deep veins, which can dislodge and travel to the lungs.

❇️ Deep vein thrombosis (DVT) is a direct consequence of venous stasis and decreased muscle pump activity during prolonged immobility.

❇️ Orthostatic hypotension develops because immobility decreases venous return, leading to reduced cardiac output when standing.

❇️ These complications are interrelated: DVT can progress to PE, and orthostatic hypotension increases the risk of falls and syncope.

❇️ Early mobilization, leg exercises, and hydration are essential preventive nursing interventions.

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Answer 3

Correct Answers:

Shortening of the affected leg compared to the unaffected leg
External rotation of the affected leg
Pain localized to the hip or groin area
Inability to bear weight on the affected leg

Rationale :

✍️Shortening of the affected leg compared to the unaffected leg; External rotation of the affected leg; Pain localized to the hip or groin area; Inability to bear weight on the affected leg

✍️ Shortening of the affected leg occurs due to displacement of bone fragments in a hip fracture, altering limb length.

✍️ External rotation of the affected leg is a classic sign resulting from muscle spasm and alignment changes after femoral neck or intertrochanteric fractures.

✍️ Pain localized to the hip or groin area is common with hip fractures, especially during movement or palpation, due to direct trauma to bone and surrounding tissues.

✍️ Inability to bear weight on the affected leg results from structural instability and is a key functional indicator of a hip fracture.

✍️ Early recognition of these signs is critical for prompt imaging and orthopedic intervention to prevent complications such as immobility-related issues or avascular necrosis.

✍️ Older adults are at higher risk for hip fractures due to osteoporosis and decreased bone density, making these physical findings highly suggestive.

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Answer 4

Correct Answers:

Remove antiembolic stockings once each day to examine skin integrity.

Rationale :

⭐ Monitoring capillary refill helps assess peripheral perfusion and circulatory status of the affected leg after surgery.

⭐ Early detection of vascular compromise (e.g., decreased blood flow, ischemia, or compartment syndrome) is crucial following open reduction and internal fixation (ORIF).

⭐ Frequent neurovascular assessments include checking color, temperature, pulse, sensation, movement, and capillary refill to ensure no complications develop.

⭐ Older adult clients are at higher risk for postoperative circulatory complications, so hourly or 4-hour checks are essential for safety.

⭐ Prompt identification of changes allows the nurse to notify the provider immediately and prevent permanent tissue damage.

⭐ This intervention is a priority over routine measures such as skin inspections or fluid restrictions in the immediate postoperative period.

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Answer 5

Correct Answers:

Maintain immobilization and alignment for the client.

Rationale :

👉 Immobilization and proper alignment are essential to promote functional healing of the fractured bone and prevent complications such as malunion, nonunion, or deformity.

👉 Maintaining alignment ensures optimal bone apposition, which is critical for osteogenesis and early stabilization.

👉 Pain management and optimal nutrition support healing but do not directly ensure mechanical stabilization of the fracture site, which is the priority.

👉 Promoting independence in activities of daily living aids overall recovery but should not compromise immobilization.

👉 Proper immobilization prevents additional trauma to surrounding tissues, reduces swelling, and maintains vascular and nerve integrity.

👉 This intervention is a high-priority, foundational measure in fracture care, forming the basis for all other supportive interventions.

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Answer 6

Correct Answers:

The condition of the client's skin.
The client's need for assistance with ADLs.
The client's ability to sit.

Rationale :

The condition of the client's skin, the client's need for assistance with ADLs, and the client's ability to sit.

🙌 Skin condition is assessed because mobility limitations can increase the risk of pressure injuries and impaired tissue perfusion.

🙌 Assistance with activities of daily living (ADLs) reflects the client’s functional mobility status and independence level, which is a key part of a mobility assessment.

🙌 Ability to sit provides information about the client's core strength, balance, and postural control, all critical for safe mobility and transfer.

🙌 Collecting health literacy is important for patient education but is not a direct indicator of mobility.

🙌 Daily calcium intake influences bone health but does not directly assess the client’s current mobility or functional status.

❌ The client's health literacy level

🙌 Health literacy relates to understanding instructions for self-care and medication, not direct mobility assessment.

🙌 While important for overall care planning, it does not measure the client’s physical capability or functional mobility.

❌ The client's daily calcium intake

🙌 Calcium intake affects long-term bone health but does not indicate current functional mobility.

🙌 It is part of nutritional assessment, not a direct mobility assessment.

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Answer 7

Correct Answers:

Ensure the client's weights are hanging freely from the bed.

Rationale :

▶️ Skeletal traction relies on the consistent application of weights to maintain proper alignment of the fractured femur.

▶️ Weights must hang freely without touching the floor or bed to provide continuous tensile force necessary for effective traction.

▶️ Proper traction prevents malalignment, shortening, and deformity of the femur.

▶️ Ensuring free-hanging weights reduces the risk of interrupted traction which could delay healing or increase pain.

▶️ Monitoring the weights is a critical safety intervention and is prioritized over routine checks of skin or pin sites.

▶️ Maintaining proper traction also reduces strain on surrounding muscles and prevents contractures.

▶️ This intervention supports optimal skeletal healing and prevents complications such as neurovascular compromise.

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Answer 8

Correct Answers:

Smoking
Diabetes
Atherosclerosis
Obesity

Rationale :

✅Smoking

✔ Causes vasoconstriction, limiting blood flow to extremities.

✔ Damages endothelial lining of blood vessels, promoting atherosclerosis.

✔ Increases platelet aggregation, raising the risk for clot formation.

✔ Reduces oxygen delivery to peripheral tissues, worsening ischemia.

✔ Promotes chronic inflammation, further impairing circulation.

✅Diabetes

✔ Leads to microvascular complications, reducing capillary perfusion.

✔ Causes macrovascular disease, like peripheral arterial disease (PAD).

✔ Damages nerve function (neuropathy), masking ischemic symptoms.

✔ Contributes to poor wound healing, increasing tissue vulnerability.

✔ Elevated blood glucose levels accelerate vascular damage and atherosclerosis.

✅Atherosclerosis

✔ Plaque buildup in arteries narrows vessels, reducing blood flow.

✔ Decreases tissue oxygenation, risking ischemia and necrosis.

✔ Weakens vessel walls, increasing risk for thrombosis.

✔ Promotes inflammation, which worsens peripheral circulation.

✔ Leads to intermittent claudication and delayed healing in limbs.

✅Obesity

✔ Increases vascular resistance, forcing the heart to work harder.

✔ Associated with hypertension, which damages vessel walls over time.

✔ Promotes metabolic syndrome, worsening endothelial function.

✔ Limits physical activity, reducing peripheral blood flow.

✔ Contributes to a pro-inflammatory state, increasing risk for vascular disease.

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Answer 9

Correct Answers:

Thinner and less resilient cartilage
Decreased range of motion
Decreased bone density
Loss of muscle mass

Rationale :

💠Thinner and less resilient cartilage

✔ Cartilage loses water content and elasticity with age, making it more prone to wear and tear.

✔ Decreased cartilage thickness increases joint stiffness and contributes to osteoarthritis.

✔ Loss of cartilage resilience reduces shock absorption, raising the risk of joint pain.

✔ Degeneration of cartilage limits smooth joint movement, impairing mobility.

✔ Aging cartilage is more susceptible to microtears and damage from everyday activities.

💠Decreased range of motion

✔ Joint stiffness increases due to changes in ligaments and tendons.

✔ Capsular thickening and reduced synovial fluid further limit movement.

✔ Muscle shortening from inactivity or aging contributes to reduced flexibility.

✔ Pain from arthritic changes can discourage full movement, further decreasing ROM.

✔ Reduced ROM can impair balance and functional activities, increasing fall risk.

💠Decreased bone density

✔ Osteopenia and osteoporosis are common in older adults, reducing bone strength.

✔ Loss of calcium and other minerals weakens bones, making fractures more likely.

✔ Hormonal changes, such as decreased estrogen or testosterone, accelerate bone loss.

✔ Weakened bones increase the risk for falls and hip fractures, common in the elderly.

✔ Decreased bone density affects posture, contributing to kyphosis and spinal deformities.

💠Loss of muscle mass

✔ Sarcopenia occurs with aging, reducing muscle size and strength.

✔ Loss of type II (fast-twitch) muscle fibers contributes to decreased power.

✔ Decreased muscle mass reduces overall mobility and endurance.

✔ Muscle atrophy can impair balance, increasing fall risk.

✔ Loss of muscle also diminishes support for joints, adding to skeletal stress.

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Answer 10

Correct Answers:

Osteoporosis

Rationale :

Osteoporosis

💊 Pathologic fractures occur when bones break due to an underlying disease rather than trauma or injury.

💊 Osteoporosis weakens the bone matrix, decreasing bone density and structural integrity, making bones prone to fracture even with minimal stress.

💊The fracture can occur spontaneously or with minimal force, such as bending or coughing.

💊 Common sites include the vertebrae, hip, and wrist, which are most susceptible to weakened bone.

💊 Early detection and management of osteoporosis can reduce the risk of pathologic fractures, including lifestyle changes, calcium and vitamin D supplementation, and medications.

❌ Car accident

💊 A car accident is a traumatic cause of fracture, not a pathologic one.

💊 The bone breaks due to external force, not due to weakened bone structure.

❌ Sports injury

💊 Sports injuries are classified as traumatic fractures, occurring from sudden impact or overuse.

💊 They do not indicate underlying bone disease.

❌ Muscle strain

💊 Muscle strain affects muscles or tendons, not bone.

💊 It does not cause pathologic fractures.

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QLexNursing

1 :
A client who has a compound fracture of the right tibia has a long-leg fiberglass cast. To reinforce teaching for the client about how to observe and manage his fracture at home, the nurse should include which of the following instructions?

2 :
Which of the following are potential cardiovascular complications of immobility? (Select all that apply.)

3 :
A nurse is assessing an older adult patient who has sustained a hip fracture. Which of the following signs and symptoms should the nurse recognize as indicative of a hip fracture? (Select all that apply.)

4 :
A nurse is assisting with the plan of care for an older adult client who is 4 hr postoperative following an open reduction and internal fixation of a fractured femur. Which of the following interventions should the nurse include in the plan of care?

5 :
A nurse is contributing to the plan of care for a client to achieve the outcome of functional healing of a fracture. Which of the following nursing interventions is the highest priority to assist in meeting this outcome?

6 :
A nurse is assisting in performing a mobility assessment on a client. Which of the following data should the nurse collect as part of this assessment? (Select all that apply.)

7 :
A nurse is assisting with the care of a client who has a femur fracture and is in skeletal traction. Which of the following actions should the nurse take?

8 :
A nurse is caring for a client who has suspected compromised blood flow to a limb. Which of the following factors contribute to poor circulation to the limb? (Select all that apply.)

✅Diabetes

✅Atherosclerosis

✅Obesity

9 :
Which of the following are age-related changes that can occur in the musculoskeletal system? (Select all that apply.)

💠Decreased range of motion

💠Decreased bone density

💠Loss of muscle mass

10 :
Which of the following is a cause of a pathologic fracture?

QLexNursing

1 : A client who has a compound fracture of the right tibia has a long-leg fiberglass cast. To reinforce teaching for the client about how to observe and manage his fracture at home, the nurse should include which of the following instructions?

2 : Which of the following are potential cardiovascular complications of immobility? (Select all that apply.)

3 : A nurse is assessing an older adult patient who has sustained a hip fracture. Which of the following signs and symptoms should the nurse recognize as indicative of a hip fracture? (Select all that apply.)

4 : A nurse is assisting with the plan of care for an older adult client who is 4 hr postoperative following an open reduction and internal fixation of a fractured femur. Which of the following interventions should the nurse include in the plan of care?

5 : A nurse is contributing to the plan of care for a client to achieve the outcome of functional healing of a fracture. Which of the following nursing interventions is the highest priority to assist in meeting this outcome?

6 : A nurse is assisting in performing a mobility assessment on a client. Which of the following data should the nurse collect as part of this assessment? (Select all that apply.)

7 : A nurse is assisting with the care of a client who has a femur fracture and is in skeletal traction. Which of the following actions should the nurse take?

8 : A nurse is caring for a client who has suspected compromised blood flow to a limb. Which of the following factors contribute to poor circulation to the limb? (Select all that apply.)

✅Diabetes

✅Atherosclerosis

✅Obesity

9 : Which of the following are age-related changes that can occur in the musculoskeletal system? (Select all that apply.)

💠Decreased range of motion

💠Decreased bone density

💠Loss of muscle mass

10 : Which of the following is a cause of a pathologic fracture?

1 :
A client who has a compound fracture of the right tibia has a long-leg fiberglass cast. To reinforce teaching for the client about how to observe and manage his fracture at home, the nurse should include which of the following instructions?

2 :
Which of the following are potential cardiovascular complications of immobility? (Select all that apply.)

3 :
A nurse is assessing an older adult patient who has sustained a hip fracture. Which of the following signs and symptoms should the nurse recognize as indicative of a hip fracture? (Select all that apply.)

4 :
A nurse is assisting with the plan of care for an older adult client who is 4 hr postoperative following an open reduction and internal fixation of a fractured femur. Which of the following interventions should the nurse include in the plan of care?

5 :
A nurse is contributing to the plan of care for a client to achieve the outcome of functional healing of a fracture. Which of the following nursing interventions is the highest priority to assist in meeting this outcome?

6 :
A nurse is assisting in performing a mobility assessment on a client. Which of the following data should the nurse collect as part of this assessment? (Select all that apply.)

7 :
A nurse is assisting with the care of a client who has a femur fracture and is in skeletal traction. Which of the following actions should the nurse take?

8 :
A nurse is caring for a client who has suspected compromised blood flow to a limb. Which of the following factors contribute to poor circulation to the limb? (Select all that apply.)

9 :
Which of the following are age-related changes that can occur in the musculoskeletal system? (Select all that apply.)

10 :
Which of the following is a cause of a pathologic fracture?