Deck 11: Orthopedic Measures

Question 1

The patient is in traction and at risk for fat embolism syndrome.Signs and symptoms of fat embolism include which of the following? (Select all that apply.)

A) Chest pain
B) Tachypnea
C) Tachycardia
D) Apprehension
E) None of above

Answer 1

Chest pain
Tachypnea
Tachycardia
Apprehension

Question 2

While in Buck's extension traction,the client may be positioned:

A) On the back, with the head of the bed elevated 45 degrees
B) On the back, turning to the unaffected side for 10 to 15 minute periods
C) On the back, with the buttocks slightly elevated off of the bed
D) On the back, with the bed tilted toward the side that is opposite the traction

Answer 2

On the back, turning to the unaffected side for 10 to 15 minute periods

Question 3

The patient is admitted for a fractured tibia.The nurse is preparing the patient for cast application.She should expect to medicate the patient with:

A) An oral analgesic 10 minutes before the procedure
B) An intramuscular (IM) analgesic 10 minutes before the procedure
C) An intravascular (IV) analgesic 2 minutes before the procedure
D) A muscle relaxant 10 minutes before the procedure

Answer 3

An intravascular (IV) analgesic 2 minutes before the procedure

Question 4

The patient has been in skeletal traction for external fixation of his femur for 2 days.Suddenly,he calls the nurse complaining of chest pain and shortness of breath.The nurse notes that the patient appears anxious,and that his pulse and respirations are elevated.She should do which of the following? (Select all that apply.)

A) Massage the lower extremity.
B) Elevate the head of the bed.
C) Administer oxygen.
D) Notify the physician.

Question 5

An appropriate technique for the nurse to implement for the client who is being casted is to:

A) Apply ice to the top of the cast
B) Maintain the extremity below heart level
C) Handle the wet cast with the fingertips
D) Fold the stockinette or padding over the outer cast edges

Question 6

According to the National Association of Orthopaedic Nurses (NAON),which of the following is possibly the most effective cleansing solution for pin-site care?

A) Normal saline
B) Hydrogen peroxide
C) Chlorhexidine
D) None of the above

Question 7

An appropriate technique for the nurse to implement for a client who is being placed in traction is to:

A) Apply a traction boot tightly
B) Drop the weights after the traction is attached
C) Assess neurovascular status every 1 to 2 hours for the first day
D) Shave the hair off the area where traction is to be placed

Question 8

A nurse anticipates that the type of traction that will be used for an adult client with a fractured humerus is:

A) Bryant's traction
B) Dunlop's traction
C) Gallows traction
D) Buck's extension

Question 9

The patient is confined to bed in traction.To prevent the development of complications,the nurses encourages:

A) A low fluid intake to help control incontinence
B) A low calcium diet to reduce the risk for kidney stones
C) A fluid intake of at least 3 L per day and a high-residue diet
D) A low-fiber diet to help prevent constipation

Question 10

The patient is brought into the Emergency Department after falling on the ice in her driveway.She is suspected of having a fractured hip.After comparing different available types of traction,she anticipates that which of the following will be used?

A) Bryant's traction
B) Dunlop's traction
C) Buck's extension
D) Gallows traction

Question 11

The patient has a broken leg and needs to have a cast applied.When plaster of Paris is compared and contrasted versus the newer synthetic casts,which of the following statements is true?

A) Plaster of Paris can tolerate earlier weight bearing than synthetic casts.
B) Plaster of Paris is more expensive than synthetic casts.
C) Synthetic casts can withstand contact with water better than plaster.
D) Synthetic casts are lighter but take longer to set than plaster of Paris.

Question 12

For a client with a fractured femur,a nurse is alert to the possibility of a fat embolus.The nurse specifically watches for:

A) Bradypnea
B) Restlessness
C) Bradycardia
D) Calf pain

Question 13

The nurse places the patient in traction.Expected outcomes would include which of the following?

A) Alignment of fracture fragments with callous formation within 24 hours
B) Patient verbalizes pain level as a "4" on a scale of 0 to 10
C) Patient verbalizes immediate relief of symptoms
D) Distal skin tissue becomes cooler, and capillary refill is greater than 3 seconds

Question 14

The nurse is caring for a patient who has had a new cast applied.The nurse is performing a neurovascular assessment so as to detect signs of possible compartment syndrome.Which of the following are signs of compartment syndrome? (Select all that apply.)

A) Inability to move body parts distal to cast
B) Pain on passive motion of distal body parts
C) Hyperventilation
D) Tachycardia
E) None of above

Question 15

For a client who is to be placed in Russell's traction,the nurse prepares the:

A) Occipital area
B) Arm and forearm
C) Back and abdomen
D) Lower extremities

Question 16

An expected outcome of cast application that the nurse evaluates is:

A) Skin irritation at the cast edges
B) Decreased capillary refill and pallor
C) Tingling and numbness distal to the cast
D) Slight edema, soreness, and limitation of range of motion

Question 17

For a client in traction who has skeletal pins,a nurse should:

A) Use povidone-iodine to cleanse the pin site
B) Apply antiseptic ointment and cover with a split dressing
C) Use hydrogen peroxide as a rinse before a dressing is applied
D) Do both pin sites at the same time, with the same swab and solution

Question 18

When teaching cast care,the nurse instructs the client to:

A) Blow dry the wet cast on the "hot" setting
B) Report changes in sensation or mobility to the area
C) Use only soft objects to slide down the cast for scratching
D) Cut away the edges of the cast if the skin becomes irritated

Question 19

With an elevated serum ________________,calcitonin from the thyroid gland is released,bone resorption is suppressed,and bone healing is enhanced.

Question 20

For cast removal,the nurse correctly instructs the client that:

A) Discomfort will be felt from the cast saw
B) An enzyme wash may be applied to intact skin
C) The skin will be scrubbed very well after the removal
D) Aggressive range of motion exercises will be performed after removal

Question 21

After application of the cast,the nurse ensures that plaster crumbs are removed and rough edges are _________ to prevent skin breakdown.

Question 22

The patient has fallen and broken her leg.To keep the leg bones aligned and to reduce muscle spasms,the physician orders the patient to be placed in ____________.

Question 23

An immobilization device used to immobilize and protect a body part is known as a _____________.

Question 24

_______________ traction begins externally but continues internally directly through the bone.

Question 25

__________________ involves monitoring for the five P's (Pain,Pallor,Pulselessness,Paresthesia,and Paralysis).

Question 26

When applying a plaster of Paris cast,it is important to keep the cast exposed for at least _____________ minutes.

Question 27

_____________________ applies a pull indirectly to the bone via straps attached to the skin around the structure.

Question 28

____________________ consists of a metal frame that secures pins inserted through the bone above and below the fracture site.It stabilizes a fracture with hardware visible outside the body.

Question 29

After applying a cast,the nurse should be able to insert _______ fingers between the cast and the limb.

Question 30

A _______________ is an externally applied structure that holds musculoskeletal tissues in a specific position to permit healing of injuries or fractures or to align malpositioned tissues.

Question 31

_________________ may occur when pressure within a casted extremity increases.