Chapter 43 Brunner & Suddarth’s Textbook of Medical-Surgical Nursing 13Th Edition


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Chapter 43  Brunner & Suddarth’s Textbook of Medical-Surgical Nursing 13Th Edition



Complete Chapter Questions And Answers

Sample Questions


1. A nurse admits a patient who has a fracture of the nose that has resulted in a skin tear and involvement of the mucous membranes of the nasal passages. The orthopedic nurse is aware that this description likely indicates which type of fracture?

  1. A)  Compression
  2. B)  Compound
  3. C)  Impacted
  4. D)  Transverse

Ans: B


A compound fracture involves damage to the skin or mucous membranes and is also called an open fracture. A compression fracture involves compression of bone and is seen in vertebral fractures. An impacted fracture occurs when a bone fragment is driven into another bone fragment. A transverse fracture occurs straight across the bone shaft.

2. A patient has sustained a long bone fracture and the nurse is preparing the patient’s care plan. Which of the following should the nurse include in the care plan?

  1. A)  Administer vitamin D and calcium supplements as ordered.
  2. B)  Monitor temperature and pulses of the affected extremity.
  3. C)  Perform passive range of motion exercises as tolerated.
  4. D)  Administer corticosteroids as ordered.

Ans: B


The nurse should include monitoring for sufficient blood supply by assessing the color, temperature, and pulses of the affected extremity. Weight-bearing exercises are encouraged, but passive ROM exercises have the potential to cause pain and inhibit healing. Corticosteroids, vitamin D, and calcium are not normally administered.

3. A nurse’s assessment of a patient’s knee reveals edema, tenderness, muscle spasms, and ecchymosis. The patient states that 2 days ago he ran 10 miles and now it “really hurts to stand up.” The nurse should plan care based on the belief that the patient has experienced what?

  1. A)  A first-degree strain
  2. B)  A second-degree strain
  3. C)  A first-degree sprain
  4. D)  A second-degree sprain

Ans: B


A second-degree strain involves tearing of muscle fibers and is manifested by notable loss of load-bearing strength with accompanying edema, tenderness, muscle spasm, and ecchymosis. A first-degree strain reflects tearing of a few muscle fibers and is accompanied by minor edema, tenderness, and mild muscle spasm, without noticeable loss of function. However, this patient states a loss of function. A sprain normally involves twisting, which is inconsistent with the patient’s overuse injury.

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4. A nurse is preparing to discharge a patient from the emergency department after receiving treatment for an ankle sprain. While providing discharge education, the nurse should encourage which of the following?

  1. A)  Apply heat for the first 24 to 48 hours after the injury.
  2. B)  Maintain the ankle in a dependent position.
  3. C)  Exercise hourly by performing rotation exercises of the ankle.
  4. D)  Keep an elastic compression bandage on the ankle.

Ans: D


Treatment of a sprain consists of resting and elevating the affected part, applying cold, and using a compression bandage. After the acute inflammatory stage (usually 24 to 48 hours after injury), heat may be applied intermittently. Rotation exercises would likely be painful.

5. A nurse is writing a care plan for a patient admitted to the emergency department (ED) with an open fracture. The nurse will assign priority to what nursing diagnosis for a patient with an open fracture of the radius?

  1. A)  Risk for Infection
  2. B)  Risk for Ineffective Role Performance
  3. C)  Risk for Perioperative Positioning Injury
  4. D)  Risk for Powerlessness

Ans: A


The patient has a significant risk for osteomyelitis and tetanus due to the fact that the fracture is open. Powerlessness and ineffective role performance are psychosocial diagnoses that may or may not apply, and which would be superseded by immediate physiologic threats such as infection. Surgical positioning injury is not plausible, since surgery is not likely indicated.

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6. A nurse is caring for a patient who has suffered a hip fracture and who will require an extended hospital stay. The nurse should ensure that the patient does which of the following in order to prevent common complications associated with a hip fracture?

  1. A)  Avoid requesting analgesia unless pain becomes unbearable.
  2. B)  Use supplementary oxygen when transferring or mobilizing.
  3. C)  Increase fluid intake and perform prescribed foot exercises.
  4. D)  Remain on bed rest for 14 days or until instructed by the orthopedic surgeon.

Ans: C


Deep vein thrombosis (DVT) is among the most common complications related to a hip fracture. To prevent DVT, the nurse encourages intake of fluids and ankle and foot exercises. The patient should not be told to endure pain; a proactive approach to pain control should be adopted. While respiratory complications commonly include atelectasis and pneumonia, the use of deep-breathing exercises, changes in position at least every 2 hours, and the use of incentive spirometry help prevent the respiratory complications more than using supplementary oxygen. Bed rest may be indicated in the short term, but is not normally required for 14 days.

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