Question 1

Following the application of a hip spica cast for a patient with a fracture of the proximal third of the left femur, an appropriate nursing intervention is to

Accepted Answer

A)   use the cast support bar to reposition the patient every 2 to 3 hours.
B)   ask the patient about any abdominal discomfort or nausea.
C)   discuss the reasons for remaining on bed rest for several weeks.
D)   promote drying of the cast by placing the patient in a prone position every 4 hours. B

Question 2

The nurse provides discharge instructions to a patient with an above-the-knee amputation who will be fitted with a prosthesis when healing is complete and the residual limb is well molded. The nurse determines that teaching has been effective when the patient says,

Accepted Answer

A)   "I should change the limb sock when it becomes soiled or stretched out."
B)   "I should use lotion on the stump to prevent drying and cracking of the skin."
C)   "I should elevate my residual limb on a pillow 2 or 3 times a day."
D)   "I should lay on my abdomen for 30 minutes 3 or 4 times a day."

Question 3

A checkout clerk in a grocery store has muscle and tendon tears that have become inflamed, causing pain and weakness in the left hand and elbow. The nurse identifies these symptoms as related to

Accepted Answer

A)   muscle spasms.
B)   meniscus injury.
C)   repetitive strain injury.
D)   carpal tunnel syndrome. C

Question 4

A patient who has severe peripheral arterial disease and ischemic foot ulcers is upset with the health care provider's recommendation to have an above-the-knee amputation. The patient tells the nurse, "If they want to cut off my leg, they should just shoot me instead." The most appropriate response to the patient's statement is,

Accepted Answer

A)   "Let's talk about how you feel this surgery will affect you."
B)   "If you do not want the surgery, you do not have to have it."
C)   "I understand why you are upset, but there really is no choice because your leg is so badly diseased."
D)   "Many people are able to function normally with a prosthesis after amputation, and you can too."

Question 5

A patient with comminuted fractures of the tibia and fibula is treated with open reduction and application of an external fixator. The next day, the patient complains of severe pain in the leg, which is unrelieved by ordered analgesics. The patient's toes are pink, but the patient complains of numbness and tingling. The most appropriate action by the nurse is to

Accepted Answer

A)   notify the patient's health care provider.
B)   check the patient's blood pressure.
C)   assess the external fixator pins for redness or drainage.
D)   elevate the extremity and apply ice over the wound site.

Question 6

A patient who has a proximal humerus fracture that is immobilized with a left-sided long-arm cast, and a sling is admitted to the medical-surgical unit. Which nursing intervention will be included in the plan of care?

Accepted Answer

A)   Use surgical net dressing to hang the arm from an IV pole.
B)   Immobilize the fingers on the left hand with gauze dressings.
C)   Assess the left axilla and change absorbent dressings as needed.
D)   Assist the patient in passive range of motion (ROM)  for the right arm.

Question 7

When evaluating the crutch-walking technique of a patient with a right-leg long-leg cast and no weight bearing on the right leg, the nurse determines that the patient is prepared to ambulate independently with the crutches on observing that the patient

Accepted Answer

A)   uses the bedside chair to assist in balance as needed when ambulating in the room.
B)   keeps the padded area of the crutch firmly in the axillary area when ambulating.
C)   advances the right leg and both crutches together and then advances the left leg.
D)   moves the left crutch with the left leg and then the right crutch with the right leg.

Question 8

When working with a patient whose job involves many hours of word processing, the nurse will teach the patient about the need to

Accepted Answer

A)   do stretching and warm-up exercises before starting work.
B)   wrap the wrists with a compression bandage every morning.
C)   use acetaminophen (Tylenol)  instead of NSAIDs for wrist pain.
D)   obtain a keyboard pad to support the wrist while word processing.

Question 9

A patient with a comminuted fracture of the right femur has Buck's traction in place while waiting for surgery. To assess for pressure areas on the patient's back and sacral area and to provide skin care, the nurse should

Accepted Answer

A)   have the patient lift the buttocks by bending and pushing with the left leg.
B)   turn the patient partially to each side with the assistance of another nurse.
C)   place a pillow between the patient's legs and turn gently to each side.
D)   loosen the traction and have the patient turn onto the unaffected side.

Question 10

The nurse observes a patient doing all these activities after having a hip-replacement surgery. Which patient action requires that the nurse intervene immediately?

Accepted Answer

A)   The patient sits straight up on the edge of the bed.
B)   The patient leans over to pull shoes and socks on.
C)   The patient bends over the sink while brushing the teeth.
D)   The patient uses crutches with a swing-to gait.

Question 11

A patient who has been hospitalized for 3 days with a hip fracture and Buck's traction has sudden onset shortness of breath and tachypnea. The patient tells the nurse, "I feel like I am going to die!" Which action should the nurse take first?

Accepted Answer

A)   Stay with the patient and offer reassurance.
B)   Administer oxygen at 4 L/min by a nasal cannula.
C)   Notify the health care provider about the patient's symptoms.
D)   Check the patient's legs for swelling or tenderness.

Question 12

When preparing a patient to ambulate the day after an ORIF for a hip fracture, which action is most important for the nurse to take?

Accepted Answer

A)   Administering the ordered oral opioid pain medication
B)   Instructing the patient about the benefits of ambulation
C)   Ensuring that the incisional drain has been discontinued
D)   Changing the hip dressing and document the appearance of the site

Question 13

All these medications are ordered at 9:00 AM for a patient who has had a right-hip replacement the previous day and is scheduled to ambulate with the physical therapist for the first time at 9:45. Which medication should be given first?

Accepted Answer

A)   Oxycodone (Roxicodone)  5 mg PO
B)   Ceftriaxone (Rocephin)  500 mg IV
C)   Enoxaparin (Lovenox)  30 mg SC
D)   Psyllium (Metamucil)  1 tsp PO

Question 14

A patient with severe osteoarthritis of the left knee has undergone left-knee arthroplasty with replacement of the total knee joint with a plastic prosthesis. Postoperatively, the nurse expects care of the leg to include

Accepted Answer

A)   bed rest for 3 days with the left leg immobilized in an extended position.
B)   use of a compression bandage to hold the left knee in a flexed position.
C)   progressive leg exercises to obtain 90-degree flexion.
D)   early ambulation with full weight bearing on the left leg.

Question 15

Following x-rays of an injured wrist, the patient is informed that it is badly sprained. In teaching the patient to care for the injury, the nurse tells the patient to

Accepted Answer

A)   apply a heating pad to reduce muscle spasms.
B)   wear an elastic compression bandage continuously.
C)   use pillows to keep the arm elevated above the heart.
D)   gently exercise the joint to prevent muscle shortening. C

Question 16

A patient has a short-arm plaster cast applied at the outpatient center for a wrist fracture. An understanding of discharge teaching is apparent when the patient says,

Accepted Answer

A)   "I can get the cast wet as long as I dry it right away with a hair dryer."
B)   "I should avoid moving my fingers and elbow until the cast is removed."
C)   "I will apply an ice pack to the cast over the fracture site for the next 24 hours."
D)   "I can rub lotion on any itching areas under the cast with a cotton-tipped applicator."

Question 17

When giving home-care instructions to a patient who has multiple forearm fractures and a long-arm cast on the right arm, which information should the nurse include?

Accepted Answer

A)   Keep the hand immobile to prevent soft tissue swelling.
B)   Call the health care provider for increased swelling or numbness.
C)   Keep the right shoulder elevated on a pillow or cushion.
D)   Avoid the use of NSAIDs for the first 48 hours after the injury.

Question 18

In developing a care plan for a patient with an open reduction and internal fixation (ORIF)  of an open, displaced fracture of the tibia, the priority nursing diagnosis is

Accepted Answer

A)   risk for constipation related to prolonged bed rest.
B)   activity intolerance related to deconditioning.
C)   risk for infection related to disruption of skin integrity.
D)   risk for impaired skin integrity related to immobility.

Question 19

A patient with a fractured pelvis is initially treated with bed rest with no turning from side to side permitted. The second day after admission, the patient develops chest pain, tachypnea, and tachycardia. The nurse determines that the patient's symptoms are most likely related to fat embolism when assessment of the patient reveals

Accepted Answer

A)   a blood pressure of 100/65 mm Hg.
B)   anxiety, restlessness, and confusion.
C)   warm, reddened areas in the calf.
D)   pinpoint red areas on the upper chest.

Question 20

Following a motor-vehicle accident, a patient arrives in the emergency department with massive right lower-leg swelling. Which action will the nurse take first?

Accepted Answer

A)   Elevate the leg on pillows.
B)   Apply a compression bandage.
C)   Place ice packs on the lower leg.
D)   Check leg pulses and sensation.

Exam 63: Nursing Management: Musculoskeletal Trauma and Orthopedic Surgery

Following the application of a hip spica cast for a patient with a fracture of the proximal third of the left femur, an appropriate nursing intervention is to

Correct Answer
verified
B

The nurse provides discharge instructions to a patient with an above-the-knee amputation who will be fitted with a prosthesis when healing is complete and the residual limb is well molded. The nurse determines that teaching has been effective when the patient says,

Correct Answer
verified

A checkout clerk in a grocery store has muscle and tendon tears that have become inflamed, causing pain and weakness in the left hand and elbow. The nurse identifies these symptoms as related to

Correct Answer
verified
C

Correct Answer
verified

Correct Answer
verified

A patient who has a proximal humerus fracture that is immobilized with a left-sided long-arm cast, and a sling is admitted to the medical-surgical unit. Which nursing intervention will be included in the plan of care?

Correct Answer
verified

When evaluating the crutch-walking technique of a patient with a right-leg long-leg cast and no weight bearing on the right leg, the nurse determines that the patient is prepared to ambulate independently with the crutches on observing that the patient

Correct Answer
verified

When working with a patient whose job involves many hours of word processing, the nurse will teach the patient about the need to

Correct Answer
verified

A patient with a comminuted fracture of the right femur has Buck's traction in place while waiting for surgery. To assess for pressure areas on the patient's back and sacral area and to provide skin care, the nurse should

Correct Answer
verified

The nurse observes a patient doing all these activities after having a hip-replacement surgery. Which patient action requires that the nurse intervene immediately?

Correct Answer
verified

A patient who has been hospitalized for 3 days with a hip fracture and Buck's traction has sudden onset shortness of breath and tachypnea. The patient tells the nurse, "I feel like I am going to die!" Which action should the nurse take first?

Correct Answer
verified

When preparing a patient to ambulate the day after an ORIF for a hip fracture, which action is most important for the nurse to take?

Correct Answer
verified

All these medications are ordered at 9:00 AM for a patient who has had a right-hip replacement the previous day and is scheduled to ambulate with the physical therapist for the first time at 9:45. Which medication should be given first?

Correct Answer
verified

A patient with severe osteoarthritis of the left knee has undergone left-knee arthroplasty with replacement of the total knee joint with a plastic prosthesis. Postoperatively, the nurse expects care of the leg to include

Correct Answer
verified

Following x-rays of an injured wrist, the patient is informed that it is badly sprained. In teaching the patient to care for the injury, the nurse tells the patient to

Correct Answer
verified
C

A patient has a short-arm plaster cast applied at the outpatient center for a wrist fracture. An understanding of discharge teaching is apparent when the patient says,

Correct Answer
verified

When giving home-care instructions to a patient who has multiple forearm fractures and a long-arm cast on the right arm, which information should the nurse include?

Correct Answer
verified

In developing a care plan for a patient with an open reduction and internal fixation (ORIF) of an open, displaced fracture of the tibia, the priority nursing diagnosis is

Correct Answer
verified

Correct Answer
verified

Following a motor-vehicle accident, a patient arrives in the emergency department with massive right lower-leg swelling. Which action will the nurse take first?

Correct Answer
verified

Exam 63: Nursing Management: Musculoskeletal Trauma and Orthopedic Surgery

Following the application of a hip spica cast for a patient with a fracture of the proximal third of the left femur, an appropriate nursing intervention is to

Correct AnswerverifiedB

The nurse provides discharge instructions to a patient with an above-the-knee amputation who will be fitted with a prosthesis when healing is complete and the residual limb is well molded. The nurse determines that teaching has been effective when the patient says,

Correct AnswerverifiedShow Answer

A checkout clerk in a grocery store has muscle and tendon tears that have become inflamed, causing pain and weakness in the left hand and elbow. The nurse identifies these symptoms as related to

Correct AnswerverifiedC

Correct AnswerverifiedShow Answer

Correct AnswerverifiedShow Answer

A patient who has a proximal humerus fracture that is immobilized with a left-sided long-arm cast, and a sling is admitted to the medical-surgical unit. Which nursing intervention will be included in the plan of care?

Correct AnswerverifiedShow Answer

When evaluating the crutch-walking technique of a patient with a right-leg long-leg cast and no weight bearing on the right leg, the nurse determines that the patient is prepared to ambulate independently with the crutches on observing that the patient

Correct AnswerverifiedShow Answer

When working with a patient whose job involves many hours of word processing, the nurse will teach the patient about the need to

Correct AnswerverifiedShow Answer

A patient with a comminuted fracture of the right femur has Buck's traction in place while waiting for surgery. To assess for pressure areas on the patient's back and sacral area and to provide skin care, the nurse should

Correct AnswerverifiedShow Answer

The nurse observes a patient doing all these activities after having a hip-replacement surgery. Which patient action requires that the nurse intervene immediately?

Correct AnswerverifiedShow Answer

A patient who has been hospitalized for 3 days with a hip fracture and Buck's traction has sudden onset shortness of breath and tachypnea. The patient tells the nurse, "I feel like I am going to die!" Which action should the nurse take first?

Correct AnswerverifiedShow Answer

When preparing a patient to ambulate the day after an ORIF for a hip fracture, which action is most important for the nurse to take?

Correct AnswerverifiedShow Answer

All these medications are ordered at 9:00 AM for a patient who has had a right-hip replacement the previous day and is scheduled to ambulate with the physical therapist for the first time at 9:45. Which medication should be given first?

Correct AnswerverifiedShow Answer

A patient with severe osteoarthritis of the left knee has undergone left-knee arthroplasty with replacement of the total knee joint with a plastic prosthesis. Postoperatively, the nurse expects care of the leg to include

Correct AnswerverifiedShow Answer

Following x-rays of an injured wrist, the patient is informed that it is badly sprained. In teaching the patient to care for the injury, the nurse tells the patient to

Correct AnswerverifiedC

A patient has a short-arm plaster cast applied at the outpatient center for a wrist fracture. An understanding of discharge teaching is apparent when the patient says,

Correct AnswerverifiedShow Answer

When giving home-care instructions to a patient who has multiple forearm fractures and a long-arm cast on the right arm, which information should the nurse include?

Correct AnswerverifiedShow Answer

In developing a care plan for a patient with an open reduction and internal fixation (ORIF) of an open, displaced fracture of the tibia, the priority nursing diagnosis is

Correct AnswerverifiedShow Answer

Correct AnswerverifiedShow Answer

Following a motor-vehicle accident, a patient arrives in the emergency department with massive right lower-leg swelling. Which action will the nurse take first?

Correct AnswerverifiedShow Answer

Correct Answer
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B

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C

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Correct Answer
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Correct Answer
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Correct Answer
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C

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