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* Read the article on page 199.


* Take the test, recording your answers in the test answers section (Section B) of the CE enrollment form. Each question has only one correct answer.


* Complete registration information (Section A) and course evaluation (Section C).


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Registration Deadline: June 4, 2021


Provider Accreditation:


Lippincott Professional Development (LPD) will award 1.5 contact hours for this continuing nursing education activity.


LPD is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.


This activity is also provider approved by the California Board of Registered Nursing, Provider Number CEP 11749 for 1.5 contact hours. LWW is also an approved provider of continuing nursing education by the District of Columbia, Georgia, and Florida #50-1223.


Disclosure: The author and planners have disclosed no potential conflicts of interest, financial or otherwise.


This article has been approved by the Orthopaedic Nurses Certification Board for Category A credit toward recertification as an ONC.


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GENERAL PURPOSE: To provide information on the care of a patient with a clavicle fracture.


LEARNING OBJECTIVES/OUTCOMES: After completing this continuing education activity, you should be able to:


1. Identify characteristics of clavicle fractures and fracture healing.


2. Recognize the signs and symptoms, assessment, diagnosis, and management of a patient with a clavicle fracture.



1. Clavicle fractures are most commonly associated with direct trauma to the


a. shoulder.


b. forearm.


c. elbow.


2. In the vast majority of clavicle fractures, the mechanism of injury is related to


a. twisting of the arm.


b. a fall.


c. being hit by an object.


3. Which statement is true regarding clavicle fractures?


a. They peak during adolescence and again in the elderly.


b. The incidence is slightly higher in females.


c. They usually require surgical repair.


4. The majority of clavicle fractures affect the


a. distal clavicle.


b. middle third of the clavicle.


c. proximal clavicle.


5. As noted in the article, the most common clinical finding in a patient with a clavicle fracture is


a. bruising.


b. swelling.


c. tenderness.


6. During the inflammation stage of fracture healing,


a. organized osteoblastic activity occurs.


b. a hematoma forms.


c. primary callus forms.


7. As noted in the article, the amount of callus is directly related to the


a. quality of circulation.


b. degree of surrounding trauma.


c. extent of immobilization.


8. Which statement is true regarding the remodeling phase of fracture healing?


a. It begins during the inflammation stage.


b. It involves fibroblasts forming granulation tissue.


c. It continues for months after clinical healing.


9. According to Aiyer (2018), what modifiable risk factor can negatively impact bone healing?


a. nicotine use


b. alcohol abuse


c. cocaine use


10. Which comorbid condition does Aiyer (2018) report may impair bone healing?


a. Cushing's disease


b. HIV


c. hypothyroidism


11. The patient in the case described in this article complained of pain when she


a. turned her head to the affected side.


b. elevated her arm.


c. pronated her forearm.


12. This patient had a slight step off deformity just proximal to the


a. manubrium of the sternum.


b. first rib.


c. acromioclavicular joint.


13. Which test was performed on this patient and found to be negative?


a. Eden's test


b. drop arm test


c. Neer impingement test


14. Which of the following radiologic views did the patient have taken?


a. Grashey


b. Coyle


c. Laurine


15. Initial management of this patient included


a. the application of heat.


b. activity modification.


c. opioid pain medication.


16. What range of motion exercises were included in this patient's regimen?


a. pendulums


b. fist clenches


c. towel twists


17. Immobilization for a clavicle fracture typically is accomplished with a


a. Jones dressing.


b. spiral wrap.


c. figure of 8 brace.


18. The author recommends that follow-up after the initial evaluation should take place every


a. week.


b. 2 to 3 weeks.


c. month.


19. With resolution of pain and tenderness on exam, the patient may be progressed to exercises for strengthening the


a. trapezius.


b. sternocleidomastoid.


c. rotator cuff.


20. As noted in the article, findings in a patient with a clavicle fracture that warrant referral to an orthopedic surgeon include


a. significant swelling.


b. discoloration of the skin.


c. any open fracture.