** .A nurse is caring for a client with a closed fracture.
Which clinical presentation should the nurse expect in this client?
"I can feel a crunching sensation when I touch the area.”
"My skin around the fracture is warm and red.”
"I can't move my limb due to the pain.”
"The bone is sticking out of my skin.”
The Correct Answer is C
Choice A rationale:
If the client states, "I can feel a crunching sensation when I touch the area," it suggests crepitus, which is a common clinical finding in fractures.
Crepitus is caused by the rubbing of bone fragments against each other.
However, it is not specific to closed fractures and can also occur in open fractures.
Therefore, it is not the most reliable indicator of a closed fracture.
Choice B rationale:
"My skin around the fracture is warm and red" is indicative of inflammation, which can occur in response to any type of injury, including fractures.
While warmth and redness may be present in closed fractures due to the inflammatory response, they are not specific to closed fractures and can also occur in open fractures or other injuries.
This symptom alone does not confirm a closed fracture.
Choice C rationale:
"I can't move my limb due to the pain" is a key clinical presentation expected in a client with a closed fracture.
Closed fractures typically result in severe pain, swelling, and loss of function in the affected limb.
The pain and immobility are due to the disruption of the bone and surrounding tissues without any open wound.
This presentation is highly characteristic of a closed fracture.
Choice D rationale:
"The bone is sticking out of my skin" is not consistent with a closed fracture but rather suggests an open fracture.
In an open fracture, the bone pierces through the skin, leading to exposure to the external environment.
This is a distinct clinical presentation from a closed fracture and requires immediate attention for infection control and wound care.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale:
The patient's favorite food and drink preferences.
Rationale: The patient's food and drink preferences are not a priority during the initial assessment of a suspected fracture.
The focus should be on medical assessments and relevant clinical information.
Choice B rationale:
The patient's past travel history.
Rationale: The patient's past travel history is unrelated to the assessment of a suspected fracture and should not be prioritized during this context.
Choice C rationale:
The site and type of fracture.
Rationale: This is the correct response.
During the initial assessment of a suspected fracture, the nurse should prioritize assessing the site and type of fracture to determine the severity of the injury and the appropriate interventions.
Choice D rationale:
The patient's social media usage patterns.
Rationale: The patient's social media usage patterns are not relevant to the assessment of a suspected fracture and should not be a priority during the initial evaluation.
Questions
Correct Answer is D
Explanation
Choice A rationale:
Responding with "That's a closed fracture" would be incorrect because the client's statement indicates an incomplete fracture, specifically a greenstick fracture.
Greenstick fractures are incomplete fractures where the bone bends but does not break completely.
They are different from closed fractures, which involve a complete break in the bone without an open wound.
Choice B rationale:
"You may need surgery for this fracture" is not the most appropriate response in this context.
While some greenstick fractures may require surgery, the client's statement is primarily seeking clarification about the nature of the fracture.
Surgery is not the immediate concern.
Choice C rationale:
"It's common to have bruising with this fracture" would be an inaccurate response because greenstick fractures typically do not result in significant bruising.
Bruising is more common in fractures with greater displacement or soft tissue injury.
Greenstick fractures are often associated with minimal or no bruising.
Choice D rationale:
"You're correct; it's an incomplete fracture" is the most appropriate nursing response.
This response validates the client's understanding of the fracture and provides accurate information.
Greenstick fractures are indeed incomplete fractures where the bone is bent but not completely broken.
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