Question 1

A patient has a long-arm plaster cast applied for immobilization of a fractured left radius. Until the cast has completely dried, the nurse should

Accepted Answer

A)   keep the left arm in a dependent position.
B)   handle the cast with the palms of the hands.
C)   place gauze around the cast edge to pad any roughness.
D)   cover the cast with a small blanket to absorb the dampness. B

Question 2

Which of the following observations made by the nurse who is evaluating the crutch-walking technique of a patient who is to have no weight bearing on the right leg indicates that the patient can safely ambulate independently?

Accepted Answer

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

Question 3

Which action will the nurse take in order to evaluate the effectiveness of Buck's traction for a patient who has an intracapsular fracture of the left femur?

Accepted Answer

A)   Assess for hip contractures.
B)   Monitor for hip dislocation.
C)   Check the peripheral pulses.
D)   Ask about left hip pain level. D

Question 4

A patient in the emergency department who is experiencing severe pain is diagnosed with a patellar dislocation. The initial patient teaching by the nurse will focus on the need for

Accepted Answer

A)   a knee immobilizer.
B)   gentle knee flexion.
C)   activity restrictions.
D)   monitored anesthesia care (conscious sedation) .

Question 5

A checkout clerk in a grocery store has repetitive strain syndrome in the left elbow. The nurse will plan to teach the patient about

Accepted Answer

A)   surgical options.
B)   elbow injections.
C)   utilization of a left wrist splint.
D)   modifications in arm movement.

Question 6

The nurse is preparing to assist a patient who has had an open reduction and internal fixation (ORIF) of a hip fracture out of bed for the first time. Which action should the nurse take?

Accepted Answer

A)   Use a mechanical lift to transfer the patient from the bed to the chair.
B)   Check the postoperative orders for the patient's weight-bearing status.
C)   Avoid administration of pain medications before getting the patient up.
D)   Delegate the transfer of the patient out of bed to nursing assistive personnel (NAP) .

Question 7

In which order will the nurse take these actions when caring for a patient with left leg fractures after a motor vehicle accident? Put a comma and space between each solve choice (a, b, c, d, etc.) ____________________
A) Obtain x-rays.
B) Check pedal pulses.
C) Assess lung sounds.
D) Take blood pressure.
E) Apply splint to the leg.
F) Administer tetanus prophylaxis.

Accepted Answer

The answer of In which order will the nurse take...

Question 8

A 20-year-old baseball pitcher has an arthroscopic repair of a rotator cuff injury performed in same-day surgery. When the nurse plans postoperative teaching for the patient, which information will be included?

Accepted Answer

A)   "You have an appointment with a physical therapist for tomorrow."
B)   "You can still play baseball but you will not be able to return to pitching."
C)   "The doctor will use the drop-arm test to determine the success of surgery."
D)   "Leave the shoulder immobilizer on for the first few days to minimize pain."

Question 9

A patient with ulnar drift caused by rheumatoid arthritis ( RA ) is scheduled for an arthroplasty of the hand. Which patient statement to the nurse indicates realistic expectation for the surgery?

Accepted Answer

A)   "I will be able to use my fingers to grasp objects better."
B)   "I will not have to do as many hand exercises after the surgery."
C)   "This procedure will prevent further deformity in my hands and fingers."
D)   "My fingers will appear more normal in size and shape after this surgery."

Question 10

When the nurse is caring for a patient who is on bed rest after having a complex pelvic fracture, which assessment finding is most important to report to the health care provider?

Accepted Answer

A)   The patient states that the pelvis feels unstable.
B)   Abdominal distention is present and bowel tones are absent.
C)   There are ecchymoses on the abdomen and hips.
D)   The patient complains of pelvic pain with palpation.

Question 11

A patient who has a cast in place after fracturing the radius asks when the cast can be removed. The nurse will instruct the patient that the cast will need to remain in place

Accepted Answer

A)   for several months.
B)   for at least 3 weeks.
C)   until swelling of the wrist has resolved.
D)   until x-rays show complete bony union.

Question 12

A patient undergoes a right above-the-knee amputation with an immediate prosthetic fitting. When the patient first arrives on the orthopedic unit after surgery, the nurse should

Accepted Answer

A)   place the patient in a prone position.
B)   check the surgical site for hemorrhage.
C)   remove the prosthesis and wrap the site.
D)   keep the residual leg elevated on a pillow.

Question 13

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)   Keep the right shoulder elevated on a pillow or cushion.
C)   Avoid the use of nonsteroidal anti-inflammatory drugs (NSAIDs)  for the first 48 hours after the injury.
D)   Call the health care provider for increased swelling or numbness.

Question 14

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

Question 15

A patient has hip replacement surgery using the posterior approach. Which patient action requires rapid intervention by the nurse?

Accepted Answer

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

Question 16

The second day after admission with a fractured pelvis, a patient develops acute onset confusion. Which action should the nurse take first?

Accepted Answer

A)   Take the blood pressure.
B)   Assess patient orientation.
C)   Check pupil reaction to light.
D)   Assess the oxygen saturation.

Question 17

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 18

Which information will the nurse include when discharging a patient with a sprained wrist from the emergency department?

Accepted Answer

A)   Keep the wrist loosely wrapped with gauze.
B)   Apply a heating pad to reduce muscle spasms.
C)   Use pillows to elevate the arm above the heart.
D)   Gently move the wrist through the range of motion.

Question 19

When doing discharge teaching for a patient who has had a repair of a fractured mandible, the nurse will include information about

Accepted Answer

A)   when and how to cut the immobilizing wires.
B)   self-administration of nasogastric tube feedings.
C)   the use of sterile technique for dressing changes.
D)   the importance of including high-fiber foods in the diet.

Question 20

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

Exam 63: Nursing Management: Musculoskeletal Trauma and Orthopedic Surgery