Question 1

A patient experiences a fracture of the lower leg and undergoes a closed reduction and placement of a fiberglass cast. The patient is 65 years old and has a medical 30-year history of diabetes mellitus. Which condition does the nurse recognize as a possible complication for this patient?

Accepted Answer

A)  Delay or absence of healing
B)  Malalignment of healed bones
C)  Development of bone infection
D)  Impaired mobility function A

Question 2

The nurse is assisting with patients on an orthopedic unit. Which is an important factor to remember when caring for patients after a total hip replacement?

Accepted Answer

A)  Side-lying position is permitted with a pillow between the legs.
B)  A triangular pillow is used between the legs to avoid adduction.
C)  Sitting in a bedside chair is permitted if the legs are elevated.
D)  Place three pillows between the legs, one distal and three proximal. B

Question 3

A patient is being prepared for a prosthesis following surgery for an amputation. Which information will the nurse provide to the client regarding the use of a prosthesis?

Accepted Answer

A)  Manual massage will help shape the end of the residual limb.
B)  A prosthesis will not be fitted until the surgery site is healed.
C)  A shrinker sock is worn with the prosthesis to prevent sores.
D)  Skin inspection is performed each time the sock is removed. D

Question 4

The nurse is assisting with the care of patients who have had joint replacement surgery. Which action is unnecessary for the patient after a total knee replacement (TKR)?

Accepted Answer

A)  Monitor for excessive bleeding.
B)  Check for indications of a DVT.
C)  Ambulate as prescribed by HCP.
D)  Maintain proper joint alignment.

Question 5

The nurse is collecting data from a patient suspected of developing a fat embolus from a fracture of the right femur. Which manifestations does the nurse expect? (Select all that apply.)

Accepted Answer

A)  Petechiae
B)  Migraine
C)  Tachycardia
D)  Mental confusion
E)  Numbness in the right leg

Question 6

The nurse is providing care for a patient who experienced a closed reduction to a fracture of the ulna. Which manifestation does the nurse recognize as an early symptom of acute compartment syndrome?

Accepted Answer

A)  Paralysis of the affected limb
B)  Lack of a distal pulse
C)  Pallor with extremity warmth
D)  Poikilothermia of the arm

Question 7

The nurse is providing care for a patient after an above-the-knee amputation because of ischemia related to diabetes mellitus complications. Which nursing care is essential for promoting ambulation?

Accepted Answer

A)  Building upper body strength
B)  Promoting coordination exercises
C)  Maintaining residual limb elevation
D)  Lying on the abdomen as prescribed

Question 8

An older adult patient is postoperative for a total hip joint replacement. Which nursing care is inappropriate for this patient on the day of surgery?

Accepted Answer

A)  Assisted out of bed the evening of surgery
B)  Provided with an elevated toilet seat
C)  Medicated with oral pain medications
D)  Prescribed weight-bearing is maintained

Question 9

The nurse is assisting with the preparation of materials for a health fair aimed at promoting health in women. Which reason does the nurse recognize as a probable cause of an increase in the incidence of osteoporosis?

Accepted Answer

A)  More adults are lactose intolerant.
B)  Adults tend to be more sedentary.
C)  The ages of adults have increased.
D)  There is an increased number of smokers.

Question 10

The nurse is providing care for a patient with external fixation for a fracture involving severe bone damage. Which is the most important focus for the nurse during care of this patient?

Accepted Answer

A)  Monitoring pin and wound sites for signs of infection
B)  Helping the patient achieve a desired level of mobility
C)  Being aware that the patient may experience issues with body image
D)  Providing a caring and supportive attitude during a challenging time

Question 11

A patient with gout has been instructed on the prescribed medication allopurinol (Zyloprim). Which patient statement indicates understanding of the action of this medication?

Accepted Answer

A)  "It excretes proteins."
B)  "It blocks formation of uric acid."
C)  "It increases formation of purines."
D)  "It increases metabolism of purines."

Question 12

The nurse is assisting with the care of a patient with rheumatoid arthritis (RA). The nurse must remember in which way RA care is different from osteoarthritis care. Which nursing care does the nurse specifically provide for the patient with RA?

Accepted Answer

A)  Exercise is poorly tolerated and frequent rest is needed.
B)  Acutely inflamed joints will respond best to heat therapy.
C)  It is essential to monitor all body systems for effects of the disease.
D)  Injury and age are the greatest contributors to disease development.

Question 13

A patient asks the difference between osteoarthritis and RA. Which manifestations does the nurse explain are characteristic of RA? (Select all that apply.)

Accepted Answer

A)  Low-grade fever
B)  Heberden's nodes
C)  Autoimmune disease
D)  Pain increasing by activity
E)  Early morning stiffness

Question 14

The nurse is providing care for a patient being treated after a complicated femur fracture. The nurse has noticed drowsiness, tachycardia, and a low-grade fever. Which additional manifestation alerts the nurse to the possibility of a fat emboli?

Accepted Answer

A)  Respiratory rate of 20 breaths/min
B)  Presence of a petechial rash on chest and neck
C)  An oxygen saturation level of 92 percent on room air
D)  Verbal complaints of nausea with vomiting

Question 15

The nurse is providing care for a patient who is scheduled for joint replacement the next day. Which patient care goals are appropriate at this time?

Accepted Answer

A)  Teach postoperative exercises.
B)  Ask if a consent form was signed.
C)  Explain the use of assistive devices.
D)  Manage preoperative pain.

Question 16

The nurse is contributing to the plan of care for a patient who has an upper extremity amputation. Which factor does the nurse keep in mind about this type of amputation being more debilitating than a lower extremity amputation?

Accepted Answer

A)  The upper extremity is more visible.
B)  Prosthetic fitting is easier for the leg.
C)  The upper extremity is more specialized.
D)  There is greater blood supply to the upper extremity.

Question 17

The nurse is preparing for a home visit to a patient after surgery for a compound fracture. Which specific care does the nurse anticipate for this patient?

Accepted Answer

A)  Monitoring circulatory status
B)  Changing wound dressings
C)  Checking skin integrity
D)  Validating immobilization

Question 18

The home-care nurse is attending to a patient with osteomyelitis in a lower extremity from a traumatic bone fracture. The patient has an open wound that is infected. Which observation prompts the nurse to provide additional information to the patient and family?

Accepted Answer

A)  Clean technique is used when the dressing is changed.
B)  Hand hygiene is performed correctly and appropriately.
C)  Possible side effects of antibiotics are understood.
D)  Children and pets are kept away from the wound.

Question 19

A patient who has a displaced midshaft fracture of the left femur is in balanced suspension skeletal traction with 35 pounds of weight. The patient reports calf pain with right foot dorsiflexion. Which action does the nurse take?

Accepted Answer

A)  Notify the RN.
B)  Check the traction setup.
C)  Reduce by 5 pounds of weight.
D)  Encourage dorsiflexion more frequently.

Question 20

The nurse is providing care for a patient following an open reduction of a compound fracture. Which neurologic finding does the nurse report immediately to the HCP or registered nurse (RN)?

Accepted Answer

A)  The foot on the surgical limb is cool to touch.
B)  Surgical pain is reported at 8 on a 0-to-10 scale.
C)  There exists numbness and tingling sensations.
D)  There are decreased pulses and a dusky color on the surgical limb.

Exam 46: Nursing Care of Patients With Musculoskeletal and Connective Tissue Disorders