A client has come to the orthopedic clinic for a follow-up appointment 6 weeks after fracturing his ankle. Diagnostic imaging reveals that bone union is not taking place. What factor most likely contributed to this complication?

Inadequate immobilization

Venous thromboembolism

Inadequate vitamin D intake

Bleeding at the injury site

Answer and Explanation

The Correct Answer is A

A. Inadequate immobilization: Proper immobilization is essential for fractured bones to heal correctly. Immobilization, often achieved through casts, splints, or other orthopedic devices, stabilizes the broken bone fragments, allowing them to fuse back together. If the immobilization is not sufficient or if the patient doesn't follow the prescribed immobilization protocol, there can be excessive movement at the fracture site, hindering the healing process.

B. Venous thromboembolism: Venous thromboembolism (VTE) refers to the formation of blood clots in veins, usually in the legs (deep vein thrombosis) that can travel to the lungs (pulmonary embolism). While VTE is a potential complication after a fracture, it is not a direct cause of delayed bone union.

C. Inadequate vitamin D intake: Vitamin D is essential for bone health as it helps the body absorb calcium, which is crucial for bone formation and maintenance. Inadequate vitamin D levels can weaken bones and impair the healing process, but it's not a common cause of delayed bone union unless there are severe deficiencies or underlying medical conditions.

D. Bleeding at the injury site: Bleeding at the injury site occurs immediately after the fracture and is a natural part of the body's response to injury. While excessive bleeding can lead to complications, it is not a likely cause of delayed bone union six weeks after the injury. In the early stages of healing, bleeding is replaced by the formation of a hematoma, which eventually transforms into a callus and aids in the bone healing process.

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Correct Answer is A

Explanation

A. Calcium Oxalate

The most common substance found in the analysis of renal stones is calcium oxalate. Calcium oxalate stones are the most prevalent type of kidney stones, accounting for the majority of cases. These stones can form when there is an excess of calcium or oxalate in the urine, and they can vary in size and shape. Other types of kidney stones include uric acid stones, struvite stones (magnesium-ammonium phosphate), and cystine stones, but calcium oxalate stones are the most common.

A. McBurney's point on the abdomen B. Psoas sign at the knee C. Rovsing's Sign on the abdomen D. costovertebral angle (CVA) on the back

Correct Answer is D

Explanation

A. McBurney's point on the abdomen: McBurney's point is a location in the right lower quadrant of the abdomen that is significant in the assessment for appendicitis. It is not relevant to the assessment of pyelonephritis, which is a kidney infection.

B. Psoas sign at the knee: The psoas sign is a test for appendicitis, not pyelonephritis. It involves the patient lying on their back and lifting their right leg against resistance. If this movement causes pain in the lower right abdomen, it could indicate irritation of the psoas muscle due to an inflamed appendix.

C. Rovsing's Sign on the abdomen: Rovsing's sign is also a test for appendicitis. It involves palpating the left lower quadrant of the abdomen and observing if it causes pain in the right lower quadrant. The presence of pain in the right lower quadrant during palpation of the left lower quadrant can indicate appendicitis. This sign is not specific to pyelonephritis.

D. Costovertebral angle (CVA) on the back: The CVA is located on the back at the angle formed by the 12th rib and the spine. Percussion of the CVA is a common technique used to assess for kidney tenderness. In the case of acute pyelonephritis, infection and inflammation of the kidneys can cause tenderness and pain in the CVA area. Therefore, this area is assessed for pain related to kidney infections like pyelonephritis.

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A client has come to the orthopedic clinic for a follow-up appointment 6 weeks after fracturing his ankle. Diagnostic imaging reveals that bone union is not taking place. What factor most likely contributed to this complication?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which of the following is the most common substance found on analysis of a renal stone?

Correct Answer is A

Explanation

A nurse is caring for a client with acute pyelonephritis. Which area should the nurse percuss to assess for pain related to pyelonephritis?

Correct Answer is D

Explanation

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