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WorksheetsBlailock's FRACTURES PRACTICE QUIZ
Total questions: 55
Worksheet time: 1hrs 23mins
An older adult presents after a fall. The leg is painful and swollen with deformity and limited movement, but the skin is intact. Which provider diagnosis does the nurse anticipate?
Open (compound) fracture of the tibia
Closed (simple) fracture of the tibia
Greenstick fracture of the tibia
Pathologic fracture of the tibia
A patient arrives with an open tibial fracture after a motor vehicle crash. Which action should the nurse perform first?
Manually realign the fractured bone
Cover the wound with a sterile dressing
Apply ice packs directly into the wound
Elevate the leg above heart level
The nurse assesses a client with a suspected fractured femur. Which findings support this diagnosis? Select all that apply.
Localized edema and ecchymosis
Crepitus at the fracture site
Lengthening of the affected extremity
A patient with a fractured femur suddenly develops restlessness, tachypnea, dyspnea, and tachycardia 48 hours after injury. Which additional finding would best support fat embolism syndrome?
Hematuria
Petechial rash on chest and axilla
Severe unilateral calf pain
Diminished bowel sounds
Four hours after casting of a tibial fracture, a patient reports severe, deep, unrelenting pain unrelieved by opioids. The nurse notes pain with passive dorsiflexion and tense, shiny skin over the calf. What is the priority action?
Elevate the leg above heart level
Apply ice packs to the cast
Notify the provider immediately
Administer additional opioid analgesic
The nurse is caring for a patient with a new long leg fiberglass cast. Which assessments are essential components of neurovascular checks?
Capillary refill of toes
Ability to move toes
Presence and quality of distal pulses
Color and temperature of the extremity
Presence of paresthesia
The nurse teaches a patient about a new fiberglass arm cast. Which statement by the patient indicates correct understanding?
This cast will take up to 3 days to dry completely.
I can get this cast slightly wet, but I must dry the skin carefully.
I should handle the cast with my fingertips until it hardens.
This type of cast stays soft and flexible, so I need to be careful.
The nurse is caring for a patient in Buck’s traction for a hip fracture. Which finding requires immediate intervention?
The affected leg is externally rotated and the foot is pale and cool.
The patient reports mild discomfort at the traction site.
The traction weights are hanging freely.
The patient’s skin under the traction boot is intact.
Which nursing action is correct when caring for a patient in Buck's traction?
The weights hang freely at the foot of the bed.
The patient performs ankle dorsiflexion and plantar flexion every hour.
The boot is removed twice daily to inspect the skin.
The nurse supports the weights on a chair while changing linens.
For a patient in skeletal traction with pins in the tibia, which nursing action is most appropriate?
Remove the weights every 4 hours for ROM exercises
Clean all pin sites using the same gauze to conserve supplies
Perform strict hand hygiene before and after pin care
Loosen the traction ropes if the patient complains of muscle spasm
An 82-year-old patient presents after a fall. The leg is shortened, adducted, and externally rotated, with pain in the outer thigh. Which condition does the nurse suspect?
Dislocated knee
Hip fracture
Deep vein thrombosis
Compartment syndrome
A patient is postoperative day 1 following total hip arthroplasty for a fracture. Which statement by the patient indicates a need for further teaching?
I will use the overhead trapeze to help move in bed.
I will keep a pillow between my legs when turning.
I should avoid bending my hip more than 90 degrees.
It’s okay for me to cross my legs to feel more comfortable.
A patient after open tibial fracture repair reports intense, pulsating bone pain worsened by movement and has chills, fever, and malaise. Which condition should the nurse suspect?
Fat embolism syndrome
Osteomyelitis
Deep vein thrombosis
Complex regional pain syndrome
The nurse recognizes that which factors may delay fracture healing?
Cigarette smoking
Early weight bearing before provider approval
Age 25 with good nutrition
Use of long-term corticosteroids
Local infection at the fracture site
A patient with a pelvic fracture complains of calf pain, redness, and increased circumference of the left leg. The nurse also notes low-grade fever. What is the most appropriate action?
Encourage vigorous leg massage to improve circulation
Elevate the leg and notify the provider
Have the patient ambulate frequently to prevent stiffness
Apply a heating pad directly over the calf
A client with a tibial external fixator reports increasing pain and warmth at one pin site with purulent drainage. What is the priority nursing action?
Administer prescribed oral analgesic and reassess in 2 hours
Notify the provider of possible pin site infection
Loosen the pin clamps to relieve pressure
Cover the area with an occlusive dressing and ignore crusts
A patient 2 days after a below-knee amputation reports burning pain in the missing foot. Which response by the nurse is most therapeutic?
That pain is not real because the foot is gone now.
This is phantom limb pain, which is common after amputation.
You shouldn’t talk about the pain; it will only make it worse.
This means you’re not coping well with the amputation.
Which nursing interventions best promote wound healing for a patient with a new amputation? Select all that apply.
Handle the residual limb gently during dressing changes
Measure the residual limb circumference every 8–12 hours
Encourage a diet high in protein and vitamins
Remove all compression bandaging to allow swelling
Use aseptic technique when performing dressing changes
A Ballerina reports to the emergency room with severe leg pain, not able to walk on the leg. She states that she was doing a spin and she landed incorrectly, twisting her ankle and leg. Her X-ray does indicate a fracture. What type fracture does she most likely have?
greenstick fracture
spiral fracture
comminuted fracture
compound fracture
This type of fracture is most likely a
greenstick
compound
spiral
transverse
The diagram shows a fracture that has two bones crushing into each other. What type of fracture is this?
Simple
Compound
Impacted
Comminuted
What is the major difference between a closed fracture and an open fracture?
In a closed fracture, the bone doesn't break the skin; in an open fracture, it does.
In a closed fracture the bone breaks all the way through; in an open fracture, it doesn't.
In a closed fracture, the bone breaks the skin; in an open fracture, it doesn't.
In a closed fracture, the bone breaks the skin; in an open fracture, it doesn't.
When a broken bone moves out of its original position, it is ___________.
Closed
Displaced
Rearranged
Opened
A 95 year old patient has an accidental fall while going to the bathroom without assistance. It appears the patient has sustained a bone fracture to the right leg. The leg’s shape is deformed and the patient is unable to move it. The patient is alert and oriented but in pain. What will you do FIRST after confirming the patient is safe and stable?
Apply an ice pack covered with a towel to the site.
Immobilize the fracture with a splint.
Administer pain medication.
Elevate the extremity above heart level.
Closed Reduction
Treating a bone through realignment with one's hands
Treating a bone surgically with pins, rods, screws, and/or wires
Placing the broken bone within a cast, splint, or boot
Immobilization
Treating a bone through realignment with one's hands
Treating a bone surgically with pins, rods, screws, and/or wires
Placing the broken bone within a cast, splint, or boot
Which of the following best defines a fracture?
A. A condition where bones are soft and bend easily.
B. A partial or complete break in a bone.
C. The inflammation of bone tissue.
D. A misalignment of bones at a joint.
Which of the following are major complications of fractures?
A. Infection, compartment syndrome, and fat embolism.
B. Hypertension, diabetes, and obesity.
C. Asthma, bronchitis, and pneumonia.
D. Migraine, epilepsy, and Alzheimer's disease.
Which diagnostic test is most commonly used to identify fractures?
A. X-ray
B. MRI
C. CT scan
D. Ultrasound
Which of the following are key nursing interventions for patients with fractures?
A. Pain management, immobilization, and monitoring for complications.
B. Administering insulin, checking blood glucose, and providing a diabetic diet.
C. Performing wound care, administering antibiotics, and ensuring proper hydration.
D. Monitoring heart rate, managing oxygen therapy, and providing CPR.
A patient presents with severe pain, swelling, and an obvious deformity in the leg after a fall. What is the nurse's priority action?
Apply a cold compress
Immobilize the leg and seek immediate medical evaluation
Administer pain medication
Perform range-of-motion exercises
Which of the following diagnostic tests provides the most detailed image of bone and soft tissue?
X-ray
MRI
CT scan
Bone scan
What is the primary goal of surgical management in fracture treatment?
Relieve pain
Reduce inflammation
Restore anatomical alignment
Prevent infection
A 95 year old patient has an accidental fall while going to the bathroom without assistance. It appears the patient has sustained a bone fracture to the right leg. The leg’s shape is deformed and the patient is unable to move it. The patient is alert and oriented but in pain. What will you do FIRST after confirming the patient is safe and stable?
Apply an ice pack covered with a towel to the site.
Immobilize the fracture with a splint.
Administer pain medication.
Elevate the extremity above heart level.
Which of the pathological condition makes the bone susceptible to fracture.
Old age
Osteoporosis
Malnutrition
All
Signs of fracture include.
Loss of function
Pain or tenderness
Swelling
All
What is the primary purpose of applying a splint to a fractured limb?
To keep the limb warm
To immobilize the limb and prevent further injury
To enhance blood circulation
To reduce swelling
What is a common first step in the management of a suspected fracture?
Administer pain relief
Apply heat to the area
Immobilize the affected area
Encourage movement of the limb
A 77 year old male patient presents to the ER with tenderness and severe right hip pain after falling inside his house. After having an X-ray and CT scan, Dr.Crooked diagnoses the patient with an extracapsular fracture of his R hip. Following surgery what are your next nursing interventions? Select all that apply.
Monitor I&O's.
Keep patient bed-bound for 48 hours.
Monitor vital signs.
Elevate the surgical leg above the level of the heart.
Administer high dose pain medication.
Mr. Karachi, a 76 year old male is being discharged home after a 2 week hospital stay for surgery on his fractured hip. Which statement by the patient indicates the need for further patient teaching?
"I am glad I only have to wait 5 weeks before I can start hiking again!"
“I need to make sure I drink plenty of fluids”
“I will use a raised toilet seat when going to the restroom”
“I should avoid crossing my legs”
A nurse is answering a call light for a client who reports that their broken arm suddenly hurts. Upon inspecting the arm in the splint, the nurse notes a major increase in swelling. The clients capillary refill is about 5 seconds long. The nurse knows this client is experiencing compartment syndrome and prepares the client for which of the following?
Fasciotomy
Reduction of the bones
Application of a splint
No treatment
What is a late sign of compartment syndrome?
Paralysis
Pain
Parethesia
Pulselessness
Select all the signs and symptoms that will present in compartment syndrome?
Capillary refill less than 2 seconds
Pallor
Pain relief with medication
Feeling of tingling in the extremity
Affected extremity feels cooler to the touch than the unaffected extremity
Your patient is 2 hours post-op from a cast placement on the right leg. The patient has family in the room. Which action by the significant other requires you to re-educate the patient and family about cast care?
Gently moving the cast with the fingertips of the hands every 2 hours to help with drying.
Positioning the cast at heart level with pillows.
Checking the color and temperature of the right foot.
Using a hair dryer on the cool setting to help with drying.
A patient sustained a fracture to the femur. The patient has suddenly become confused, restless, and has a respiratory rate of 30 breaths per minute. Based on the location of fracture and the presenting symptoms, this patient may be experiencing what type of complication?
Compartment Syndrome
Osteomyelitis
Fat embolism
Hypovolemia
Which assessment finding found while assessing a patient with a fracture who has traction requires immediate intervention?
The weights are freely hanging on the floor.
Pin sites are free from drainage
Patient uses the overhead trapeze bar to move around in the bed.
Patient’s extremities have a capillary refill of less than 2 seconds.
A 85 year old patient has an accidental fall while going to the bathroom without assistance. It appears the patient has sustained a bone fracture to the left leg. The leg’s shape is deformed and the patient is unable to move it. The patient is alert and oriented but in pain. What will you do FIRST after confirming the patient is safe and stable?
Apply an ice pack covered with a towel to the site.
Immobilize the fracture with a splint.
Administer pain medication.
Elevate the extremity above heart level.
Sally recently suffered trauma to her tibia. Her dr said she has developed inflammation of the bone caused by pathogens. He prescribed antibiotics. What is her condition?
osteoporosis
osteoarthritis
osteomyelitis
busitis
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?
Loosen the knots on the ropes if the client is experiencing pain.
Ensure the client’s weights are hanging freely from the bed.
Check the client’s bony prominences every 12 hr.
Cleanse the client’s pin sites with povidone-iodine.
A nurse is contributing to the plan of care for an older adult client who is postoperative following a right hip arthroplasty. Which of the following interventions should the nurse include in the plan?
Perform the client's personal care activities for her.
Limit the client’s fluid intake.
Monitor the Homan’s sign.
Maintain abduction of the right hip.
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?
Restrict oral fluid intake to 1,000 mL per day.
Remove antiembolic stockings once each day to examine skin integrity.
Maintain the client on bed rest for 72 hr after surgery.
Check capillary refill in the affected extremity every 4 hr.
A nurse is reinforcing teaching about placement of a prosthesis with a client who is having a below the knee amputation. Which of the following information should the nurse include in the teaching?
"This will improve your ability to ambulate sooner."
"This will decrease the chance of you experiencing phantom limb pain."
"This will help to decrease the frequency of dressing changes."
"Placing this now will improve the fit of the prosthesis."
A nurse is collecting data on a client who has a femur fracture. Which of the following findings is a manifestation of fat embolism syndrome?
Reduced pulses distal to the client's fracture
Swelling below the client's injury
A drop in the client's temperature
Petechiae over the client's chest
What do you check in Neurovascular assessment? Please select all the correct answers.
Pain level
Colour of the limb
Temperature of the limb
Pulse of the limb
Patient's ability to move the limb
