Final answer:
A hip fracture typically presents with the hip externally rotated and shortened. It may also be swollen, bruised, and exhibit abnormal movement, so the correct answer is (D) both a and c. While serious, not all fractures are open fractures that penetrate the skin.
Step-by-step explanation:
When a hip fracture occurs, particularly in the case of elderly individuals with osteoporosis, typical external signs can be present to indicate the nature of the injury. Specifically, the affected hip may appear externally rotated and shortened, which aligns with option (A) from the choices provided. It is also likely to be swollen, bruised, and unable to move normally, thus also including elements from option (C). Therefore, the most comprehensive answer to how a hip might appear if a resident were to fall and fracture it is (D) both a and c: externally rotated and shortened, and swollen, bruised, and unable to move normally.
It is important to note that while a hip fracture can be serious and lead to complications such as deep vein thrombosis, pneumonia, and increase in morbidity and mortality rates, not all fractures penetrate the skin. Such a scenario would be referred to as an open fracture, which was not specifically mentioned in the options provided.