Radiographs were ordered for a 5-year-old boy who had his right arm injured. The radiographs show that the radius and ulna appear to be fractured on one side and slightly bent on the other.
What type of fracture is this an example of?
Impacted.
Greenstick.
Compression.
Compound.
The Correct Answer is B
Choice A rationale
An impacted fracture occurs when one bone fragment is driven into another, often due to significant axial compression forces. This mechanism results in a stable fracture but can be challenging to reduce due to the interdigitation of the bone ends, potentially causing localized pain and limited range of motion.
Choice B rationale
A greenstick fracture is an incomplete fracture typically seen in children, where one side of the bone cortex is broken and the other side is bent. This occurs because children's bones are more flexible and cartilaginous than adult bones, allowing them to bend rather than completely break under stress.
Choice C rationale
A compression fracture results from a compressive force that causes a bone to collapse, commonly observed in the vertebrae. This type of fracture often occurs in osteoporotic bone due to reduced bone mineral density, leading to loss of vertebral body height and potential neurological deficits if spinal cord compression ensues.
Choice D rationale
A compound fracture, also known as an open fracture, involves a break in the bone where the bone fragments pierce through the skin, exposing the bone to the external environment. This significantly increases the risk of infection and requires immediate surgical debridement and antibiotic therapy to prevent osteomyelitis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Hypothyroidism, particularly if untreated, can contribute to bone loss, but levothyroxine therapy typically normalizes thyroid function, mitigating this risk. While age is a risk factor, other choices present more significant and direct risks for accelerated bone demineralization and osteoporosis development.
Choice B rationale
Estrogen plays a crucial role in bone density maintenance by inhibiting osteoclast activity and promoting osteoblast activity. A bilateral salpingo-oophorectomy removes the primary source of estrogen, leading to premature menopause and rapid bone loss, significantly increasing osteoporosis risk if hormone therapy is refused.
Choice C rationale
Prednisone, a corticosteroid, is a potent cause of secondary osteoporosis. It directly inhibits osteoblast function, promotes osteoclast activity, and impairs calcium absorption, leading to significant bone density loss. Long-term use post-transplant makes this patient at exceptionally high risk.
Choice D rationale
Excessive alcohol intake (more than 2-3 drinks daily) is a risk factor for osteoporosis by impairing bone formation and nutrient absorption. Limiting sun exposure can cause vitamin D deficiency, also contributing to reduced bone density. However, this patient's alcohol intake is moderate, and vitamin D deficiency is more easily corrected.
Correct Answer is D
Explanation
Choice A rationale
A ventricular pacemaker is designed to pace the ventricles, not the atria. Therefore, a pacemaker spike appearing before each P wave would indicate atrial pacing, which is not the primary function of a ventricular pacemaker. P waves represent atrial depolarization, and a ventricular pacemaker's stimulus is delivered to the ventricles to initiate a QRS complex.
Choice B rationale
A pacemaker spike appearing after each QRS complex suggests either oversensing, undersensing with competitive rhythms, or a malfunction. The purpose of a pacemaker spike is to *initiate* depolarization, not to follow it. If the spike occurs after the QRS, it indicates that the ventricle has already depolarized, and the spike is not contributing to ventricular contraction.
Choice C rationale
A pacemaker spike appearing with each T wave would be inappropriate and potentially dangerous. The T wave represents ventricular repolarization, a vulnerable period during which an electrical stimulus can induce life-threatening arrhythmias like ventricular fibrillation (R-on-T phenomenon). Pacing should occur before ventricular depolarization, not during repolarization.
Choice D rationale
A ventricular pacemaker functions by delivering an electrical impulse to the ventricle when its intrinsic rate falls below a programmed threshold. This impulse, seen as a pacemaker spike on the ECG, should precede ventricular depolarization, thus initiating a QRS complex. This indicates that the pacemaker is effectively stimulating ventricular contraction at the appropriate time.
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