Review test question

[amynye]

My professor posted a practice question of "A client with a compound fracture of the radius has a plaster cast applied in the ER. The nurse tells the client to to seek medical attention if which of the following occurs?"

Would an open fracture EVER be covered initially with a plaster cast? Isn't this an infection issue?

[AnnieOaklyRN, BSN, RN, EMT-P]

This is a very stupid question!!

1) An open fracture would NEVER be discharged home from an ER, that is a surgical case that requires immediate attention!

2) We don't use plaster any longer, except as slabs for splinting, nor do we put casts on in the ER. The rare exception would be if an ortho surgeon comes in to do a closed reduction and puts the cast on because the fracture would be to unstable otherwise, and even then they will usually bivalve it and wrap it with an ace.

This is by far the dumbest question ever, and if she got it from a book it must be from the 1980s! The patent would not need to seek medical care because they would be in the hospital for at least a couple of days if not more!

If this client is discharged from the ER they should seek medical care at a different hospital promptly!

Annie

[medbullet]

Many questions are written in a manner that is focused more on testing your knowledge of a specific area and less focused on clinical accuracy. The answer to this question is the same regardless of whether or not your hypothetical patient was treated correctly in the ED.

In the ED, casting material is frequently used to splint fractures, however; the term 'cast' does imply that it is a device that fully surrounds and stabilizes the fracture. Generally speaking, the ED staff is unlikely to use a cast for a fracture post reduction (being an open fracture and a fracture involving the radius makes this even less likely). Infection and compartment syndrome are major concerns in the period immediately following initial management and because of this, splinting is generally best performed initially to keep the fracture stable while awaiting surgery or followup appointments with a specialist.

[JKL33]

Many questions are written in a manner that is focused more on testing your knowledge of a specific area and less focused on clinical accuracy. The answer to this question is the same regardless of whether or not your hypothetical patient was treated correctly in the ED.

True as that may be, it's rather shameful.

:)

Would've been just as easy to say "fracture of the radius" and "splint."

[KelRN215, BSN, RN]

It's a dumb question, sure, as the patient needs to go to the OR but the answer they're looking for is probably something about compartment syndrome.

[OldDude]

Is this a real nursing school professor or it is a substitute floated from the lawn maintenance department?

[NuGuyNurse2b]

Just curious - what were the selections provided?