Deck 27: Musculoskeletal Care

Question 1

The nurse is providing care for a client with an Ilizarov frame.Which entry will the nurse document in this client's medical record?

A)Rod, wires, and screw ring intact
B)Pedaling applied to outer cast edge
C)Weight suspended at 90 degrees
D)Abduction pillow used as instructed

Answer 1

Rod, wires, and screw ring intact

Question 2

The nurse is providing care for a client after an above-the-knee amputation one day ago.Which nursing care is most important during the initial postoperative period?

A)Providing emotional support to the client
B)Observing the incision site for signs of infection
C)Wrapping the stump with an elastic bandage
D)Assessing the client frequently for pain levels

Answer 2

Wrapping the stump with an elastic bandage

Question 3

The nurse in a rehabilitation facility attends a meeting to discuss client status.For which reason does the nurse recognize attendance by the physical therapist?

A)The physical therapist is a required part of facility's staff to qualify for reimbursement.
B)The physical therapist teaches nurses how to implement exercise and strengthening plans.
C)The physical therapist sets an example for staff about how to physically motivate clients.
D)The physical therapist assesses for musculoskeletal deficiencies and makes a recovery plan.

Answer 3

The physical therapist assesses for musculoskeletal deficiencies and makes a recovery plan.

Question 4

The nurse is preparing a client for a diagnostic procedure on an injured shoulder.The client reports extreme pain with shoulder movement.The client's medical history indicates no significant health issues and no previous surgeries.Which diagnostic testing will the nurse anticipate?

A)Radiographic studies
B)Computed tomography (CT)
C)Magnetic resonance imaging (MRI)
D)Measurements of shoulder mobility

Question 5

The RN on an orthopedic unit is working with the LPN/LVN.Which instruction to the LPN/LVN from the RN is inappropriate?

A)Place the client with a left hip replacement one day ago onto the left side.
B)Assist a client with a knee replacement with continuous passive motion (CPM).
C)Insert an abduction pillow between the legs of a client with right hip replacement.
D)Use sterile technique to provide site care to tongs for a client with cervical traction.

Question 6

The nurse works in an orthopedic unit in the hospital and is providing care for four clients.Which client does the nurse identify as having a potential need for amputation?

A)A young adult client with a comminuted fracture of the left femur from a car accident
B)An adult client with gangrene of the left foot due to decreased circulation
C)An older adult client with a long history of arthritis in both knees
D)A middle age client with a newly developed diabetic foot ulcer

Question 7

The nurse is caring for a client with a newly placed plaster leg cast.Which actions by the nurse are part of the nursing care for this client? Select all that apply.

A)Assess for capillary refill of the toes.
B)Elevate the casted limb on pillows.
C)Handle the cast with the palms of the hand.
D)Lift the cast by gripping the area of the ankle.
E)Teach about safe items for scratching inside the cast.

Question 8

The nurse is caring for a client who had a motor vehicle accident resulting in a comminuted fracture of the right fibula.After healing, the client's right leg is shorter than the left.Treatment to correct the defect involves the placement of an Ilizarov frame.Which process does the nurse expect with the treatment?

A)The left leg will be immobilized until the right leg lengthens.
B)Muscles of the right leg are stretched to lengthen the bone.
C)In small increments, the right leg will become longer.
D)Bone shortening of the left leg will require immobilization.

Question 9

The LPN/LVN is assigned to care for a client who is in skin traction.Which condition does the LPN/LVN expect to observe? Select all that apply.

A)A trapeze in place over the bed
B)A rope attached to a frame on the limb
C)A pin protruding from the limb
D)An elastic bandage wrap on the limb
E)A suspended weight at the foot of the bed

Question 10

The LPN/LVN approaches and asks the RN to check and make sure the continuous passive motion (CPM)machine is set up correctly before it is turned on.Which assessment by the RN is most important?

A)Verify that the sheepskin does not have any folds.
B)Stand at the foot of the bed to inspect the alignment.
C)Check to see whether the CPM machine is plugged in.
D)Validate that the settings are as prescribed by the physician.

Question 11

The nurse is caring for a client who just had a plaster cast applied for a lower leg fracture.The client states, "Why this kind of cast? My friend got a fiberglass cast." The nurse will make which comment to address the client's statement?

A)"The plaster cast is the most effective type of immobilization."
B)"With a plaster cast, it is easier to monitor progress with x-rays."
C)"You will probably have a fiberglass cast in a couple of weeks."
D)"Actually, a plaster cast is lighter and more durable than fiberglass."

Question 12

The nurse is caring for a client admitted after plaster cast placement for a comminuted fracture of the lower leg.Which nursing intervention is most important for the nurse to perform?

A)Position the casted limb on pillows to enhance drying.
B)Monitor the client's pain level and medicate as needed.
C)Assist the client to walk to the bathroom using crutches.
D)Perform neurovascular checks every 2 hours for the first 24 hours.

Question 13

The LPN/LVN works at a physical rehabilitation clinic.The LPN/LVN is aware of many clients who use assistive devices for mobilization.Which client is the LPN/LVN aware to be unsuitable for the use of a knee walker?

A)The client who is one week postoperative for a total knee replacement.
B)The client who had a below-the-knee amputation and is waiting for a prosthesis.
C)The client who is being treated for a prolonged and severe case of gout.
D)The client who has internal fixation for repair of a broken ankle and foot.

Question 14

The nurse is caring for clients on an orthopedic unit.Which client will be the nurse's immediate concern after receiving report?

A)A client reporting pain at a 3 on a 0 to 10 scale
B)A client reporting warmth and itching under a plaster cast
C)A client with redness and purulent drainage at an external pin site
D)A client with a hip replacement who needs assistance when ambulating

Question 15

The nurse is preparing discharge teaching for a client who is going home after a total knee replacement.Which home safety assessment should the nurse make?

A)Ask the client about plans for meal preparation during recovery.
B)Check whether the client has arranged for an elevated toilet seat.
C)Inquire whether the client needs to go up steps for sleeping and the bathroom.
D)Determine the client's understanding about follow-up appointments.

Question 16

The nurse is providing care for a client with cervical skeletal traction following surgery.Which action is contraindicated when caring for this client?

A)Make sure that weights are hanging freely and off the floor.
B)Ensure that ropes are not crossed and pull in a straight line.
C)Remove weights when turning the client and then replace.
D)Provide pin care or assessment as ordered by the physician.

Question 17

The nurse is caring for a client recently admitted to the unit after a right knee replacement.Which assessment finding is most concerning to the nurse?

A)Pedal pulses on the operative foot are weak compared to the non-operative side.
B)The surgical dressing exhibits a moderate amount of serosanguineous drainage.
C)A patient-controlled analgesia pump is set up according to physician orders.
D)The client has an indwelling urinary catheter draining clear straw-colored urine.

Question 18

The nurse is caring for a client after total hip replacement surgery.The nurse knows it is important that the client not move the affected leg to or beyond the midline of the body.Which important piece of equipment for this purpose does the nurse identify?

A)Abductor pillow
B)Immobilizer
C)Splint
D)Elastic bandage

Question 19

The nurse is caring for a high school football player who is diagnosed with a serious sprain to the ankle.Which part of the anatomy does the nurse associate with this type of injury?

A)Torn ligaments
B)A fine crack in the anklebone
C)Injury to a long bone
D)Damage to cartilage tissue

Question 20

The nurse is caring for a client with mild left-sided weakness who is using a walker for the first time.Which assessments indicate to the nurse that the client is using the walker correctly? Select all that apply.

A)The walker is the height of the client's hip joint.
B)The client grips the handles with elbows at a 90-degree angle.
C)The client stands behind the back legs of the walker.
D)The hand brakes are set before the client sits in the seat if provided.
E)The client moves the affected leg forward with the walker.

Question 21

The nurse works in a rehabilitation facility.Which action by the nurse will help promote mobility so a client can be discharged home? Select all that apply.

A)Use the continuous passive motion (CPM)machine.
B)Evaluate the client's mobility deficits.
C)Move joints beyond 90 degrees as tolerated.
D)Diligently follow the physician's activity orders.
E)Encourage the client to lie down at set intervals.

Question 22

The nurse is providing care for a client who is four days postoperative for a lower limb amputation.The nurse wraps the stump with an elastic bandage.Which additional actions will the nurse perform? Select all that apply.

A)Monitor circulation using capillary refill.
B)Assess for the presence of pain or numbness.
C)Slip two fingers under the proximal end of the wrap.
D)Dangle the limb on the side of the bed for 20 minutes.
E)Encourage the client to soak the limb in warm water.

Question 23

Which actions should the nurse perform when performing a neurovascular check on a client? Select all that apply.

A)Ask the client about numbness, burning, or tingling in the affected limb.
B)Compare sensations by touching an affected and unaffected limb with a paper clip.
C)Ambulate the client in order to assess an affected limb for function.
D)Ask the client to move the fingers or toes of the affected extremity.
E)Test capillary refill of the fingers or toes distal to the surgical site or cast.