Question 1

Which statement by a 62-year-old patient who has had an above-the-knee amputation indicates that the nurse's discharge teaching has been effective?

Accepted Answer

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

Question 2

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

Accepted Answer

A)   "This procedure will correct the deformities in my fingers."
B)   "I will not have to do as many hand exercises after the surgery."
C)   "I will be able to use my fingers with more flexibility to grasp things."
D)   "My fingers will appear more normal in size and shape after this surgery." C

Question 3

A 22-year-old tennis player 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 will not be able to serve a tennis ball again."
B)   "You will work with a physical therapist tomorrow."
C)   "The doctor will use the drop-arm test to determine the success of surgery."
D)   "Leave the shoulder immobilizer on for the first 4 days to minimize pain." B

Question 4

A patient who slipped and fell in the shower at home has a proximal humerus fracture immobilized with a left-sided long-arm cast and a sling.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 of 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 5

A patient arrived at the emergency department after tripping over a rug and falling at home.Which finding is most important for the nurse to communicate to the health care provider?

Accepted Answer

A)   There is bruising at the shoulder area.
B)   The patient reports arm and shoulder pain.
C)   The right arm appears shorter than the left.
D)   There is decreased shoulder range of motion.

Question 6

When a patient arrives in the emergency department with a facial fracture,which action will the nurse take first?

Accepted Answer

A)   Assess for nasal bleeding and pain.
B)   Apply ice to the face to reduce swelling.
C)   Use a cervical collar to stabilize the spine.
D)   Check the patient's alertness and orientation.

Question 7

A patient who is to have no weight bearing on the left leg is learning to walk using crutches.Which observation by the nurse indicates that the patient can safely ambulate independently?

Accepted Answer

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

Question 8

Which statement by the patient indicates a good understanding of the nurse's teaching about a new short-arm plaster cast?

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 off and on for 24 hours."
D)   "I can use a cotton-tipped applicator to rub lotion on any dry areas under the cast."

Question 9

After the health care provider has recommended amputation for a patient who has nonhealing ischemic foot ulcers,the patient tells the nurse that he would rather die than have an amputation.Which response by the nurse is best?

Accepted Answer

A)   "You are upset, but you may lose the foot anyway."
B)   "Many people are able to function with a foot prosthesis."
C)   "Tell me what you know about your options for treatment."
D)   "If you do not want an amputation, you do not have to have it."

Question 10

A patient with a complex pelvic fracture from a motor vehicle crash is on bed rest.Which nursing assessment finding is important to report to the health care provider?

Accepted Answer

A)   The patient states that the pelvis feels unstable.
B)   Abdomen is distended and bowel sounds are absent.
C)   There are ecchymoses across the abdomen and hips.
D)   The patient complains of pelvic pain with palpation.

Question 11

A patient undergoes a left above-the-knee amputation with an immediate prosthetic fitting.When the patient 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 12

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 dependent position.
B)   avoid handling the cast using fingertips.
C)   place gauze around the cast edge to pad any roughness.
D)   cover the cast with a small blanket to absorb the dampness.

Question 13

A 32-year-old patient who has had an open reduction and internal fixation (ORIF)of left lower leg fractures continues to complain of severe pain in the leg 15 minutes after receiving the prescribed IV morphine.Pulses are faintly palpable and the foot is cool.Which action should the nurse take next?

Accepted Answer

A)   Notify the health care provider.
B)   Assess the incision for redness.
C)   Reposition the left leg on pillows.
D)   Check the patient's blood pressure.

Question 14

Which action will the urgent care nurse take when caring for a patient who has a possible knee meniscus injury?

Accepted Answer

A)   Encourage bed rest for 24 to 48 hours.
B)   Avoid palpation or movement of the knee.
C)   Apply a knee immobilizer to the affected leg.
D)   Administer intravenous narcotics for pain relief.

Question 15

A 42-year-old patient is admitted to the emergency department with a left femur fracture.Which information obtained by the nurse is most important to report to the health care provider?

Accepted Answer

A)   Ecchymosis of the left thigh
B)   Complaints of severe thigh pain
C)   Slow capillary refill of the left foot
D)   Outward pointing toes on the left foot

Question 16

Which nursing intervention will be included in the plan of care after a patient with a right femur fracture has a hip spica cast applied?

Accepted Answer

A)   Avoid placing the patient in prone position.
B)   Ask the patient about abdominal discomfort.
C)   Discuss remaining on bed rest for several weeks.
D)   Use the cast support bar to reposition the patient.

Question 17

A patient who arrives at the emergency department experiencing severe left knee 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)   monitored anesthesia care.
D)   physical activity restrictions.

Question 18

The nurse is caring for a patient who is to be discharged from the hospital 5 days after insertion of a femoral head prosthesis using a posterior approach.Which statement by the patient indicates a need for additional instruction?

Accepted Answer

A)   "I should not cross my legs while sitting."
B)   "I will use a toilet elevator on the toilet seat."
C)   "I will have someone else put on my shoes and socks."
D)   "I can sleep in any position that is comfortable for me."

Question 19

The day after a having a right below-the-knee amputation,a patient complains of pain in the right foot.Which action is best for the nurse to take?

Accepted Answer

A)   Explain the reasons for the phantom limb pain.
B)   Administer prescribed analgesics to relieve the pain.
C)   Loosen the compression bandage to decrease incisional pressure.
D)   Inform the patient that this phantom pain will diminish over time.

Question 20

Which action will the nurse take in order to evaluate the effectiveness of Buck's traction for a 62-year-old patient who has an intracapsular fracture of the right femur?

Accepted Answer

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

Exam 59: Nursing Management: Musculoskeletal Trauma and Orthopaedic Surgery