The nurse is assessing a client with an injury to the knee. What ...

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The nurse is assessing a client with an injury to the knee. What should the nurse do during this assessment?
 
  1. Extend the knee joint to determine injury.
  2. Check the client's gait.
  3. Check capillary proximal to the injury.
  4. Move the joint to the point of pain.

Question 2

A client comes to the clinic with an ankle injury. What question should the nurse ask to determine if the client experienced a strain?
 
  1. Did you twist the ankle?
  2. Did you pull the muscle?
  3. Was there pain with the injury?
  4. Did you fall?

[Pamela.irrgang@yahoo.com]

Answer to Question 1

Answer: 4

1. The nurse would determine the ability to move the joint but not past the point of pain.
2. The nurse should not have the client walk on the injury.
3. Capillary refill is assessed distal to the injury.
4. The nurse moves the joint but stops as soon as the client indicates pain to prevent further injury.

Answer to Question 2

Answer: 2

1. Sprains occur when the limb is twisted causing injury to the ligament.
2. A strain occurs to a muscle and the classic description is pulled.
3. Pain will not help the nurse determine a strain from a sprain as they both hurt.
4. Again, asking the client about a fall does not help distinguish a sprain from a strain.

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Thank you

[Pamela.irrgang@yahoo.com]

No problemo