Deck 61: Caring Forclients Requiring Orthopedic Treatment

Question 1

The nurse is checking the traction apparatus for a client in skin traction. Which finding would require the nurse to intervene?

A) Body aligned opposite to line of traction pull
B) Weights hanging and touching the floor
C) Pulleys without evidence of the obstruction
D) Ropes freely moving over pulleys

Answer 1

Weights hanging and touching the floor

Question 2

A group of students is studying for a test on traction. The students demonstrate understanding of the types of traction when they identify which of the following as an example of skin traction?

A) Crutchfield tongs
B) Thomas splint
C) Buck's
D) Balanced suspension

Answer 2

Buck's

Question 3

A client is scheduled for a joint replacement surgery. Which action would be most important?

A) Ensure adequate fluid intake before the surgery.
B) Withhold intake of solid food before the surgery.
C) Withhold administration of aspirin before the surgery.
D) Ensure adequate sleep before the surgery.

Answer 3

Withhold administration of aspirin before the surgery.

Question 4

During the assessment of a client scheduled for orthopedic surgery, the nurse discovers that the client was previously treated for the disorder. In such a case, what additional data need to be collected?

A) Occurrence of complications or problems during treatment
B) Measures taken to minimize postoperative wound infection
C) Perception of the client about the previous treatment
D) Details of the medical team that handled the previous treatment

Question 5

A client has a cast that extends from below the elbow to the palmar crease and is secured around the base of the thumb. The thumb is also casted. The nurse identifies this as which type of cast?

A) Short arm cast
B) Gauntlet cast
C) Body cast
D) Spica cast

Question 6

A male client is to have an amputation. He is acutely ill and diagnosed with a gangrenous limb and related fever, disorientation, and electrolyte imbalances. Which of the following would be most important for the nurse to monitor in this client?

A) Signs of sepsis
B) Signs of nausea and vomiting
C) Occurrence of allergic reactions
D) Reduced urine output

Question 7

A 68-year-old female client who had a total hip replacement is to be discharged because her healing is almost complete. Which of the following would be most important for this client?

A) Advising the client to avoid red meat.
B) Urging her to keep the affected limb in an elevated position.
C) Educating the client about the effects of menopause.
D) Exploring factors related to the client's home environment.

Question 8

A client has undergone an external fixation. Which actions would be the priority for this client?

A) Maintaining pin care.
B) Planning the client's diet.
C) Monitoring the client's urine output.
D) Monitoring the client's blood pressure.

Question 9

A client who is undergoing skeletal traction complains of pressure on bony areas. Which action would be most appropriate to provide comfort for the client?

A) Assisting with range-of-motion and isometric exercises.
B) Changing the client's position within prescribed limits.
C) Administering prescribed analgesics.
D) Applying warm compresses.

Question 10

Which action would be most important postoperatively for a client who has had a knee or hip replacement?

A) Providing crutches to the client.
B) Assisting in early ambulation.
C) Using a continuous passive motion (CPM) machine.
D) Encouraging expressions of anxiety.

Question 11

A client's cast is removed. The client is worried because the skin appears mottled and is covered with a yellowish crust. What advice should the nurse give the client to address the skin problem?

A) Consult a skin specialist.
B) Scrub the area vigorously to remove the crust.
C) Apply lotions and take warm baths or soaks.
D) Avoid exposure to direct sunlight.

Question 12

A client has just undergone a leg amputation. The nurse would closely monitor the client for which of the following during the immediate postoperative period?

A) Neuroma
B) Hematoma
C) Chronic osteomyelitis
D) Unexplainable burning pain (causalgia)

Question 13

A nurse would most likely expect the need for open reduction for a client with which of the following?

A) Closed fracture
B) Little bone separation
C) Soft tissue free of bone ends
D) Joint fracture

Question 14

When performing pin care, which of the following would be most appropriate?

A) Clean the site, working toward the pin
B) Use an applicator only once
C) Remove any crusts that appear
D) Apply an antimicrobial ointment

Question 15

The nurse is caring for a client who has had a fracture reduction using a cast. Which of the following would be most important for the nurse to assess?

A) Cardiac status
B) Renal function
C) Sleep status
D) Neurovascular status

Question 16

The nurse is assisting with the application of a cast. Which of the following would the nurse expect to be done first?

A) Covering the skin with a stockinette.
B) Applying strips of the cast material evenly.
C) Arranging for an x-ray to check bone alignment.
D) Cleaning the skin surface.

Question 17

Which of the following would the nurse expect a physician to use on a short-term basis for a client with an injured body part that does not require rigid immobilization?

A) Cast
B) Brace
C) Splint
D) Skin traction

Question 18

A client is about to have a cast applied to his left arm. The nurse would alert the client to which of the following as the cast is applied?

A) Increased in pain in left arm
B) Sensation of warmth or heat with application
C) Arm being moved to various positions
D) Sensation of weakness

Question 19

A group of students are reviewing information about cast composition in preparation for a discussion on the advantages and disadvantages of each. The students demonstrate understanding of the topic when they cite which of the following as an advantage of a plaster cast?

A) Better molding to the client
B) Quicker drying
C) Longer-lasting
D) More breathable

Question 20

A client's fracture was reduced by surgically exposing the bone and realigning it. The nurse identifies this as which of the following?

A) Buck's traction
B) Skeletal traction
C) Internal fixation
D) Open reduction

Question 21

A client is scheduled for surgery to fuse a joint. The nurse identifies this as which of the following?

A) Osteotomy
B) Arthrodesis
C) Arthroplasty
D) Open reduction internal fixation

Question 22

A nurse is caring for a client who is scheduled to have a below the knee amputation. The client is visibly upset and angry and shouts at the nurse. Which of the following responses would be most appropriate?

A) "You can yell at me all you want. I still need to take your vital signs."
B) "Be quiet. Your shouting is going to upset the other clients."
C) "It's okay to be angry and upset. Is there anything I can do to help?"
D) "The physician has ordered you a sedative. Let me get it now."

Question 23

A client is being discharged after a total knee replacement. The nurse is reviewing the client's discharge instructions. Which client statement indicates that the client has understood the instructions?

A) "I can gradually increase my activity as I feel able to do so."
B) "I need to call my physician if I experience sudden pain or swelling."
C) "I need to limit the amount of fluids I drink for the first week."
D) "I need to avoid any exercise for the first few weeks."

Question 24

A female client has had a total hip replacement. Which of the following would the nurse do to minimize the client's risk for subluxation?

A) Keep the client's legs together.
B) Maintain the client in a high-Fowler's position.
C) Have the client sit on an elevated chair.
D) Ensure the client sits with the knees higher than the hip.

Question 25

A continuous passive motion (CPM) machine is being used with a client who has had a hip replacement. The nurse would ensure that the setting for flexion on the device should not exceed which of the following?

A) 30º
B) 45º
C) 60º
D) 90º