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 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.
Correct Answer is B
Explanation
Choice A reason: Complications of immobility, like muscle atrophy or thromboembolism, occur with both ORIF and closed reduction, as both may require immobilization post-procedure. ORIF involves surgery, but modern protocols emphasize early mobilization, similar to closed reduction. This disadvantage is not unique to ORIF, making it an incorrect choice.
Choice B reason: ORIF involves surgical incision and hardware placement, increasing infection risk at the surgical site or deep tissues (osteomyelitis). Closed reduction is non-invasive, avoiding this risk. Infections can delay healing, require antibiotics, or necessitate hardware removal, making this a significant disadvantage of ORIF compared to closed reduction.
Choice C reason: Skin irritation can occur with both ORIF (from incisions or hardware) and closed reduction (from casts or splints). It is not a distinct disadvantage of ORIF, as both methods involve external or internal devices that may irritate skin. This choice is incorrect, as it is not unique to ORIF.
Choice D reason: Nerve impairment risks exist in both ORIF (from surgical manipulation) and closed reduction (from fracture displacement or cast pressure). Neither method uniquely predisposes to nerve damage, and careful technique minimizes this risk. This disadvantage is not specific to ORIF, making it an incorrect choice.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.