A patient is admitted with an open fracture of the tibia after a bicycle accident. What information would the nurse obtain when assessing the patient?

The status of tetanus immunization.

Whether the injury was exposed to dirt or gravel.

Any previous injuries to the leg.

The use of antibiotics in the last month.

Answer and Explanation

The Correct Answer is A

Choice A reason: Assessing tetanus immunization status is critical for an open fracture, as wounds exposed to soil or debris risk Clostridium tetani infection. Tetanus prophylaxis (vaccine or immunoglobulin) prevents lockjaw and neuromuscular complications. This ensures timely immunization, reducing life-threatening infection risks in contaminated wounds like those from bicycle accidents.

Choice B reason: Determining exposure to dirt or gravel is essential, as open fractures are prone to bacterial contamination (e.g., Staphylococcus aureus or Pseudomonas). Contaminated wounds require urgent irrigation, debridement, and antibiotics. This assessment guides infection prevention, ensuring prompt surgical and antimicrobial interventions to minimize osteomyelitis or sepsis risks in open tibial fractures.

Choice C reason: Previous leg injuries are relevant for overall musculoskeletal history but not immediate for open fracture management. Current wound contamination and infection risk take precedence. Focusing on past injuries delays critical interventions like tetanus prophylaxis or debridement, potentially worsening outcomes in acute open fractures from bicycle accidents.

Choice D reason: Recent antibiotic use is less urgent than contamination or tetanus status in open fractures. While it may inform antibiotic resistance, it’s not a primary assessment focus. Prioritizing this risks delaying wound cleaning and prophylaxis, increasing infection risks like cellulitis or osteomyelitis in contaminated open tibial fractures.

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Correct Answer is B

Explanation

priority. Protein aids long-term recovery by promoting bone healing, but infection control is critical to prevent systemic spread or bone necrosis. Nutritional support is secondary to addressing the acute bacterial infection driving the condition.

Choice B reason: Administering antibiotics is the priority in acute osteomyelitis, a bacterial bone infection (often Staphylococcus aureus). Prompt antibiotics target the infection, preventing sepsis, abscess formation, or chronic osteomyelitis. Delaying treatment risks bone destruction and systemic complications, making timely antibiotic administration essential to control the infection and preserve bone integrity.

Choice C reason: Teaching relaxation breathing reduces pain perception by calming the nervous system but does not address the underlying infection in osteomyelitis. Pain management is important but secondary to antibiotics, which target the bacterial cause. Without infection control, pain will persist, and complications like bone damage may worsen.

Choice D reason: Providing antipyretic therapy manages fever, a symptom of osteomyelitis, but does not treat the infection itself. Fever reflects the body’s immune response to bacteria, and while comfort is important, antibiotics are the priority to eradicate the pathogen, preventing progression to sepsis or chronic bone infection.

A. The weights are equal on each side. B. The ropes are securely attached to the pins. C. The weights rest against the foot of the bed. D. The ropes are in the center of the wheel grooves.

Correct Answer is C

Explanation

Choice A reason: Equal weights on each side are appropriate in skeletal traction, ensuring balanced force to maintain bone alignment. This finding supports the traction’s purpose of stabilizing the fracture without causing uneven stress on the bone or soft tissues. No correction is needed, as this is a correct setup.

Choice B reason: Securely attached ropes to pins are essential in skeletal traction to transmit consistent force to the bone. Loose attachments could disrupt alignment or cause pin site complications like infection. This finding is correct and does not require correction, as it ensures effective traction and patient safety.

Choice C reason: Weights resting against the bed negate the traction’s pulling force, failing to maintain bone alignment. Weights must hang freely to apply continuous tension, counteracting muscle spasms and stabilizing the fracture. This finding requires correction to restore effective traction and prevent malunion or delayed healing.

Choice D reason: Ropes centered in wheel grooves ensure smooth movement and consistent traction force without fraying or misalignment. This is a correct setup, as misaligned ropes could reduce traction effectiveness or cause mechanical issues. No correction is needed, as this supports proper traction mechanics.

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A patient is admitted with an open fracture of the tibia after a bicycle accident. What information would the nurse obtain when assessing the patient?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has acute osteomyelitis. Which of the following interventions is the nurse’s priority?

Correct Answer is B

Explanation

A nurse is assessing a client who is in skeletal traction. The nurse should correct which of the following findings?

Correct Answer is C

Explanation

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