Deck 32: Orthopedic Care

Question 1

The nurse admits a client from the emergency department (ED)with a newly placed leg cast.Which actions would the nurse perform to prevent neurovascular impairment?

A)Assess the toes for nerve and circulatory impairment every hour for 8 hours.
B)Place the leg on pillows.
C)Apply ice to the site.
D)Elevate the foot of the bed.
E)Report excessive swelling or indications of neurovascular impairment.

Answer 1

Place the leg on pillows.
Apply ice to the site.
Elevate the foot of the bed.
Report excessive swelling or indications of neurovascular impairment.

Question 2

The nurse is caring for a client who is in skin traction.Which nursing actions are appropriate for this client?

A)Assess neurovascular status every 4 hours,once stable.
B)Place sheep skin under pressure areas.
C)Massage the skin with lotion or alcohol every 4 hours if redness is noted.
D)Remove the weight first when removing nonadhesive traction.
E)Use a slipper bedpan to minimize movement during elimination.

Answer 2

Assess neurovascular status every 4 hours,once stable.
Place sheep skin under pressure areas.
Remove the weight first when removing nonadhesive traction.
Use a slipper bedpan to minimize movement during elimination.

Question 3

The nurse working in the emergency department (ED)is assisting the health care provider with cast application.Which nursing action is the most appropriate after the health care provider completes application of the cast?

A)Holding the casted arm from the top of the cast to place it in a splint
B)Holding the casted arm from the top of the cast to place it on pillows
C)Using the palm of the hand to place the casted arm into a splint
D)Using the palm of the hand to place the casted arm on pillows

Answer 3

Using the palm of the hand to place the casted arm on pillows

Question 4

The nurse is caring for a client with a fracture of cervical vertebrae 4.Which piece of equipment connects the client to traction for this type of injury?

A)Pearson attachment
B)Buck's extension
C)Thomas splint
D)Crutchfield tongs

Question 5

The nurse is providing care to a client who has a short arm cast.Which areas does the nurse assess to determine if irritation is occurring?

A)Radial styloid process
B)Ulnar styloid process
C)Joint at base of thumb
D)Olecranon
E)Lateral epicondyle

Question 6

The nurse working in an orthopedic clinic received a call from a client complaining of itching under the cast and asking for advice on how to relieve the discomfort.Which instruction will the nurse provide to this client?

A)Use a back scratcher to scratch under the cast.
B)Use a wooden spoon to scratch inside the cast.
C)Blow air from a hair dryer set to cool under the cast,or apply ice.
D)Take an antihistamine to reduce itching.

Question 7

The nurse would anticipate a plaster cast would be used for which client?

A)The client with a diagnosis of amyotrophic lateral sclerosis (ALS)
B)The client who had a compound fracture and multiple lacerations
C)The older adult client with muscle wasting secondary to cancer
D)The client with a fractured femur who plans to return to construction work before cast removal

Question 8

The nurse is caring for a client who uses an orthotic device.Four days later,the client is noted to have a red area at the edge of the device which is padded and observed for 3 more days.Despite this intervention,the area is growing in size and is now open.Which nursing action is most appropriate in this situation?

A)Removing the orthotic device until the site heals
B)Having the device reshaped to remove the pressure area
C)Notifying the health care provider and orthotist
D)Using a thicker pad over the site

Question 9

The nurse observes the health care provider apply a cast made of strips of open-weave cotton saturated with powdered calcium sulfate crystals.When documenting this procedure,which term will the nurse use for this type of cast?

A)Plaster cast
B)Synthetic cast
C)Fiberglass cast
D)Thermoplastic cast

Question 10

The adolescent client newly placed in traction says,"Laying in this bed all the time is going to turn my body into mush.Is there any way I could exercise while I'm in traction?" Which response by the nurse is the most appropriate?

A)"Many people worry about muscle weakness when they are confined to bed.You could perform range of motion,isometric,and specific exercises."
B)"Don't worry about your muscles,because you can get them back after you get out of traction."
C)"You're young and in great shape.Your muscles won't weaken with a few weeks in bed."
D)"I'll put a referral in for physical therapy to come and work with you."

Question 11

The nurse caring for a client with a plaster cast applied several days ago notes crumbs of plaster on the skin just under the edge of the cast.Which action by the nurse is the most appropriate?

A)Leaving the crumbs there to avoid injuring the skin
B)Using a surgical scrub brush to remove the crumbs
C)Using a dry cloth to remove the crumbs to avoid wetting the cast
D)Using a damp cloth to remove the crumbs and feel for rough edges

Question 12

The nurse caring for a pediatric client who requires orthoses teaches the parent that which is a unique aspect of orthoses for children?

A)The need for a snug fit
B)The importance of skin care and monitoring
C)The importance of careful maintenance of the device to ensure efficacy and safety
D)The need for periodic adjustment of the device

Question 13

The nurse caring for a client in traction inspects the apparatus and determines all is well when noting which finding?

A)The weight is sitting on the floor.
B)The rope is on the side of the pulley.
C)The knots are positioned 5 inches from the pulley.
D)All ropes are intact and connected with slipknots,and short ends are taped.

Question 14

Which task could be safely delegated by the nurse to the unlicensed assistive personnel (UAP)?

A)Caring of the client with the newly placed cast
B)Explaining to the client how to respond to itching under the cast
C)Caring of the insertion site for Crutchfield tongs
D)Caring of the client with a stable cast

Question 15

The nurse working in the emergency department (ED)is providing discharge teaching for a client with a newly applied cast to the left arm.Which statement by the client indicates additional teaching is required?

A)"When I take a shower,I will put a plastic bag over my cast and keep it dry."
B)"When my fingers feel cold,I will cover them with a blanket."
C)"I will go home today and put ice on the cast over the fracture and prop it on pillows."
D)"If I lose sensation in my fingers,I will call my doctor."