Chapter 50 Medical Surgical Nursing Preparation For Practice 2nd Edition

Chapter 50  Medical Surgical Nursing Preparation For Practice 2nd Edition

Complete Chapter Questions And Answers
 

Sample Questions

Question 1
Type: MCSA
A patient who has been casted for a fracture of the left ulna asks the nurse when the cast will come off. The nurse’s response is based on the knowledge that the cast will be removed when which physiologic parameter has been met?
1. The remodeling phase of the bone healing process has been completed, allowing for application of mechanical stress.
2. A cartilage collar can be clearly felt at the site of the original break.
3. A specific amount of time has passed, predetermined by the severity of the break.
4. The X-ray of the fractured bone shows that the ends are well joined.
Correct Answer: 4
Rationale 1: Remodeling of the bone occurs after the cast is removed.
Rationale 2: During cellular proliferation and callus formation, a cartilage “collar” is evident around the fracture site, but this does not signify that the bone has healed sufficiently to remove the cast.
Rationale 3: While the amount of time a fracture requires casting varies, the severity of the fracture is only one factor that is considered.
Rationale 4: Ossification is the final laying down of bone after the fracture has been bridged and the fragments are united. Mature bone replaces the callus, and the fracture site feels firm and appears united on radiograph. It is at this point that a cast may be removed.
Global Rationale:

Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Physiological Adaptation
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 50-3

Question 2
Type: MCSA
A patient has a dislocated hip as the result of a fall. The nurse recognizes which primary reason to quickly return the femoral head to its normal position?
1. To preserve blood flow to the head of the femur
2. To avoid damage to nerves in the affected area
3. To minimize the damage to affected ligaments
4. To eliminate the severe pain the patient is experiencing
Correct Answer: 1
Rationale 1: A dislocation is a displacement of a bone from its normal position in a joint. While the dislocation requires reduction as soon as possible to reduce damage, the primary concern is interference with blood supply to the femoral head. This can lead to severe complications such as avascular necrosis (AVN).
Rationale 2: Damage to nerves in the affected area is a potential complication of dislocation. This is a serious situation but is not the highest priority.
Rationale 3: Damage to ligaments is a potential complication of dislocation. This is a serious situation but is not the highest priority.
Rationale 4: Pain occurs with dislocation. This is a serious situation but is not the highest priority.
Global Rationale:

Cognitive Level: Analyzing
Client Need: Physiological Integrity
Client Need Sub: Physiological Adaptation
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 50-4

Question 3
Type: MCMA
The nurse explains to a patient who is having a cast removed that the remodeling phase of fracture healing involves which changes?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1. Creation of the cartilage collar at the fracture sight
2. Application of stress and weight to the affected bone
3. Granulation of new bone tissue to form the connective bridge
4. Resorption of excess new bone at the site of the callus
5. Strengthening of the new bone at the site of the fracture
Correct Answer: 2,4,5
Rationale 1: A cartilage collar does form, but not in the remodeling phase.
Rationale 2: The remodeling process is directed by mechanical stress and weight bearing, causing the bone to become stronger in relation to its function.
Rationale 3: Granulation is involved in the formation of a connective bridge, but this does not occur in the remodeling phase.
Rationale 4: The remodeling process involves resorption of the excess callus in the marrow space and the external aspect of the fracture.
Rationale 5: The remodeling process involves resorption of the excess callus in the marrow space and the external aspect of the fracture. The process is directed by mechanical stress and weight bearing, causing the bone to become stronger in relation to its function.
Global Rationale:

Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Physiological Adaptation
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 50-3