A patient who fell in the bathroom of the hospital room reports pain in the upper right arm and elbow. Which action would the nurse take first in managing a possible fracture before splinting the injury?
Apply ice to the site.
Elevate the arm
Notify the health care provider
Perform a neurovascular check below the injury
The Correct Answer is D
Choice A reason: Applying ice reduces swelling and pain in a possible fracture, which is beneficial but not the first priority. Ice application does not assess the limb’s viability or detect complications like vascular injury or nerve damage. A neurovascular check is critical to ensure circulation and nerve function before interventions like ice, which could mask symptoms.
Choice B reason: Elevating the arm minimizes swelling by promoting venous return, aiding in pain relief and reducing pressure. However, it is secondary to a neurovascular check, which assesses circulation, sensation, and movement. Elevation without confirming vascular integrity risks missing critical injuries like arterial compression, which could lead to ischemia if untreated.
Choice C reason: Notifying the health care provider is necessary for diagnostic imaging and treatment planning but is not the first action. A neurovascular check provides immediate data on limb status, guiding urgency of notification. Delaying assessment risks missing acute complications like compartment syndrome, which requires prompt intervention to prevent permanent damage.
Choice D reason: Performing a neurovascular check first assesses distal pulses, sensation, movement, and capillary refill, detecting complications like vascular occlusion or nerve injury from a possible fracture. Fractures can compress arteries or nerves, risking ischemia or neuropathy. Early identification ensures timely intervention, making this the priority before splinting or other actions to preserve limb function.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","D","E"]
Explanation
Choice A reason: Applying heat for 10 minutes every hour is insufficient to relieve back strain and may not prevent recurrent pain. Heat therapy requires 15-20 minutes to relax muscles and improve blood flow effectively. This strategy is not a primary recommendation, as it does not address posture, movement, or ergonomic factors critical for back health.
Choice B reason: Padded shoe insoles absorb shock and support proper foot alignment, reducing stress on the spine during standing or walking. By improving biomechanics, insoles help distribute weight evenly, minimizing strain on the lower back. This is a practical strategy for nurses who stand for long periods, preventing repetitive back pain episodes.
Choice C reason: Sleeping on a soft mattress exacerbates back pain by failing to support spinal alignment, causing excessive curvature. A medium-firm mattress maintains neutral spine position, reducing strain on lumbar muscles and ligaments. This strategy is incorrect, as it does not contribute to minimizing back strain or preventing pain.
Choice D reason: Avoiding prolonged sitting reduces pressure on lumbar discs and prevents muscle stiffness. Prolonged sitting compresses spinal structures, weakening core muscles and increasing strain. Regular movement or standing breaks improve circulation and maintain flexibility, making this a key strategy to prevent recurrent low back pain in workplace settings.
Choice E reason: Sleeping in a side-lying position with flexed knees aligns the spine and reduces lumbar strain. This position, often supported by a pillow between the knees, maintains neutral pelvic alignment, minimizing stress on spinal ligaments and discs. It is an effective strategy for preventing back pain during rest, promoting recovery.
Correct Answer is B
Explanation
Choice A reason: Ankylosis, fusion of spinal joints, is associated with ankylosing spondylitis, not osteoporosis. Osteoporosis causes bone density loss, leading to fractures and deformities like kyphosis, not joint fusion. Expecting ankylosis misaligns assessment, potentially overlooking osteoporosis-related vertebral compression fractures critical for managing mobility and pain in older adults.
Choice B reason: Kyphosis, an exaggerated thoracic spine curvature, is common in osteoporosis due to vertebral compression fractures from weakened bones. These fractures collapse anteriorly, causing a hunchback appearance, affecting posture and balance. Recognizing kyphosis guides interventions like bracing or bisphosphonates to prevent further fractures and improve quality of life.
Choice C reason: Scoliosis, lateral spine curvature, is typically congenital or idiopathic, not directly caused by osteoporosis. While osteoporosis may exacerbate existing scoliosis through fractures, it’s not a primary deformity. Expecting scoliosis risks misdiagnosis, diverting focus from osteoporosis-related kyphosis and its management, like calcium supplementation or physical therapy.
Choice D reason: Lordosis, exaggerated lumbar curvature, is not typical in osteoporosis. Osteoporosis primarily affects thoracic vertebrae, causing kyphosis from compression fractures. Lordosis may occur in other conditions like muscular imbalances, but expecting it in osteoporosis misguides assessment, delaying interventions for fracture prevention and spinal stability in older adults.
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