A client is brought to the emergency department by ambulance after stepping in a hole and falling. During the assessment, the nurse notes that the right leg is shorter than the left leg the right hip is noticeably deformed and acute pain is noted. Imaging does not reveal a fracture. What is the most likely explanation for this client's signs and symptoms?

Right hip dislocation

Right hip contusion

Right hip strain

Right hip osteoarthritis

Answer and Explanation

The Correct Answer is A

A. Right hip dislocation: In a hip dislocation, the head of the femur is forced out of the acetabulum, which is the socket in the pelvis. This can cause a noticeably shorter leg, hip deformity, and acute pain. Imaging might not show a fracture in the case of a dislocation.

B. Right hip contusion: A hip contusion is a bruise on the hip, usually caused by a direct blow or trauma. While it can cause pain and swelling, it typically does not result in a noticeably shorter leg or hip deformity.

C. Right hip strain: Hip strain refers to damage to the muscles or tendons around the hip joint due to overuse or sudden twisting movements. While it can cause pain, it does not typically lead to a noticeable leg shortening or hip deformity.

D. Right hip osteoarthritis: Osteoarthritis is a degenerative joint disease that can affect the hip joint. It leads to joint pain and stiffness but does not usually cause a noticeable leg shortening or acute deformity unless there are severe complications, which are not mentioned in the scenario.

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Correct Answer is ["A","B","C","E"]

Explanation

A. Applying ice intermittently - Ice application helps reduce swelling and inflammation by constricting blood vessels. It is effective in managing pain and preventing further tissue damage in contusions, strains, and sprains.

B. Elevating the injured limb - Elevating the injured limb above the level of the heart helps reduce swelling by allowing fluids to drain away from the injured area. This is particularly important in managing contusions, strains, and sprains where swelling is a common symptom. Elevation supports the body's natural healing processes.

C. Resting the affected extremity - Rest is essential to allow the injured tissue to heal. Avoiding movement and stress on the affected area prevents further damage and promotes the healing process. Resting the extremity prevents additional strain on the injured muscles, ligaments, or tendons, allowing the body to repair the damaged tissues effectively.

D. Massaging the affected limb - Massaging the affected limb is generally not recommended in the acute phase of musculoskeletal injuries, especially contusions, strains, or sprains. Massaging can potentially worsen the injury, increase swelling, and cause further tissue damage. It is important to wait until the initial acute phase has passed and consult a healthcare professional before considering massage therapy.

E. Compression dressings - Compression helps control swelling by applying pressure to the injured area. Compression dressings or bandages provide support to the injured limb, minimize swelling, and reduce the risk of further injury. However, it's essential to apply compression correctly to avoid cutting off circulation, and it's usually best done under the guidance of a healthcare provider.

A. Malignant hypothermia B. Pulmonary embolism C. Acute compartment syndrome D. Fat embolism syndrome

Correct Answer is C

Explanation

A. Malignant hypothermia: This is a rare but life-threatening reaction to certain medications used during anesthesia. It doesn't typically manifest with calf edema.

B. Pulmonary embolism: While pulmonary embolism can occur as a complication in some cases, it is characterized by symptoms like sudden shortness of breath, chest pain, and may not directly cause calf edema.

C. Acute compartment syndrome
Increasing edema in the calf of a client with multiple fractures of the leg is a manifestation of acute compartment syndrome. Acute compartment syndrome occurs when there is increased pressure within a muscle compartment, which can lead to reduced blood flow, nerve damage, and tissue hypoxia. The edema and increased pressure can compress blood vessels, nerves, and muscle tissue within the compartment, resulting in symptoms such as severe pain, edema, and potential vascular compromise.

D. Fat embolism syndrome: This syndrome can occur in clients with long bone fractures, but it is characterized by respiratory and neurologic symptoms, not isolated calf edema.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse in a busy emergency department provides care for many clients who present with contusions, strains, or sprains. What are treatment modalities that are common to all of these musculoskeletal injuries? Select all that apply.

Correct Answer is ["A","B","C","E"]

Explanation

A nurse notes increasing edema in the calf of a client who has multiple fractures of the leg. The nurse should recognize that increasing edema is a manifestation of which of the following complications?

Correct Answer is C

Explanation

The nurse is caring for a client who is diagnosed with an arterial insufficiency ulcer. The nurse should plan interventions to address which priority issue?

The nurse understands that certain patients are more susceptible to pressure ulcer development. Which clients should the nurse identify as being at an increased risk for this health problem? Select all that apply.

A nurse is providing dietary teaching to a client who has a history of gout and recurring uric acid kidney stones. Which of the following instructions should the nurse include in the teaching?

A client with kidney stones is scheduled for extracorporeal shock wave lithotripsy (ESWL). What should the nurse include in the client's postprocedural care?

A nurse is to administer a 500ml bolus of normal saline to a patient over 1 hour?

A nurse is teaching a client who is scheduled for dual-energy x-ray absorptiometry (DEXA) to screen for osteoporosis. Which of the following instructions should the nurse include in the teaching?

A female client has been experiencing recurrent urinary tract infections. What health education should the nurse provide to this client?

A nurse is teaching a client about preventing osteoporosis. Which of the following statements by the client indicates a need for further teaching?