Question 1

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

Accepted Answer

Weights hanging and touching the floor indicate that there is no tension on the traction, which could mean the client is not receiving the intended treatment. The other options refer to correct and functional aspects of the traction apparatus.

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?

Accepted Answer

Buck's traction is an example of skin traction because the traction force is applied to the skin, usually on the lower leg, using adhesive tape or a bandage. Crutchfield tongs and Thomas splint are examples of skeletal traction, where the traction force is applied directly to a bone using pins or wires. Balanced suspension is also a type of skeletal traction where the limb is suspended in a balanced manner using a sling and weights.

Question 3

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

Accepted Answer

Withholding administration of aspirin (and other blood-thinning medications) before joint replacement surgery is important to reduce the risk of excessive bleeding during and after the surgery. Adequate fluid intake is important, but not the most important action. Withholding solid food before the surgery is also important, but not the most important action. Ensuring adequate sleep before the surgery is important for general health, but not specifically related to the joint replacement 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?

Accepted Answer

Knowing about any complications or problems the client experienced during the previous treatment can help the healthcare team anticipate potential issues during the upcoming surgery and take appropriate measures to prevent or minimize them. It is important to note that B, C, and D may also be relevant in certain cases, but A is the most important additional data to collect in this scenario.

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?

Accepted Answer

A gauntlet cast extends below the elbow to the palmar crease and includes the thumb, which is also casted. A short arm cast only extends to just below the elbow and does not include the thumb. A body cast is used for trunk and hip immobilization, while a spica cast is used for immobilizing the hip and thigh.

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?

Accepted Answer

Signs of sepsis are most important to monitor in a client with a gangrenous limb and related symptoms such as fever and disorientation, as these indicate a systemic infection that can be life-threatening.

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?

Accepted Answer

Exploring factors related to the client's home environment is the most important as the client is being discharged and will be returning home. The client's home environment should be assessed for any potential hazards and modifications should be made if necessary to ensure the client's safety and promote healing. Advising the client to avoid red meat and educating the client about the effects of menopause may be important for the client's overall health but are not specifically related to her recent hip replacement surgery. Urging her to keep the affected limb in an elevated position may be important for a period immediately after the surgery but is not necessarily relevant at this stage in her healing process.

Question 8

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

Accepted Answer

Maintaining pin care is a priority for a client who has undergone external fixation, as infections can develop at the insertion sites of the pins. Planning the client's diet, monitoring urine output, and blood pressure are important aspects of overall care, but they are not the priority in this situation.

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?

Accepted Answer

Changing the client's position within prescribed limits would be the most appropriate action to relieve pressure on bony areas. This can help distribute weight and relieve discomfort. The other options may be appropriate for other types of discomfort or pain, but for pressure on bony areas, changing position would be the most effective.

Question 10

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

Accepted Answer

Assisting in early ambulation is the most important action postoperatively for a client who has had a knee or hip replacement. This helps prevent complications such as blood clots, promotes healing, and improves joint mobility. Providing crutches and using a CPM machine may also be helpful, but early ambulation is the priority. Encouraging expressions of anxiety is important for emotional support, but it is not the most important action postoperatively.

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?

Accepted Answer

The mottled skin and yellowish crust may be due to dead skin cells and dried exudate that have accumulated under the cast. The skin may also be dry and itchy. The client should be advised to apply lotions and take warm baths or soaks to moisturize the skin, soften the crust, and promote the shedding of dead skin cells. Scrubbing the area vigorously may cause further skin irritation and damage. Consulting a skin specialist may not be necessary unless the skin problem persists or worsens. Avoiding exposure to direct sunlight may be recommended for other reasons (e.g., to prevent sunburn or skin cancer) but is not specifically related to the skin problem caused by the cast.

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?

Accepted Answer

Hematoma is a potential complication of any surgery, including amputation. The nurse would closely monitor for signs of bleeding or hematoma formation at the surgical site. The other options (neuroma, chronic osteomyelitis, and causalgia) are potential long-term complications that may develop after the initial postoperative period.

Question 13

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

Accepted Answer

Open reduction is usually needed for a joint fracture where bones are displaced from the joint. Closed fractures, little bone separation, and soft tissue free of bone ends may not require open reduction.

Question 14

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

Accepted Answer

Using an applicator only once during pin care helps to prevent infection by ensuring that bacteria are not introduced to the site from a used applicator. This is a standard infection control practice.

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?

Accepted Answer

Neurovascular status is essential to assess in a client who has had a fracture reduction using a cast, as it helps determine whether there is adequate blood flow to the affected area and whether the nerves are functioning correctly. This assessment includes checking for color, temperature, sensation, pulse, and movement of the affected limb. It is crucial to identify any neurovascular compromise early to prevent permanent damage. While cardiac and renal status are essential assessments, they are not usually affected directly by a fracture or cast. Sleep status is also not a priority assessment related to fracture reduction using a cast.

Question 16

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

Accepted Answer

Before a cast can be applied, the skin surface must be cleaned to prevent infection or skin irritation from occurring. Once the skin is cleaned and dried, a stockinette is typically placed over the affected limb to protect the skin from the rough edges of the cast material. Strips of the casting material are then applied evenly, and an x-ray may be performed to ensure proper bone alignment before the cast hardens.

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?

Accepted Answer

A splint can be used for short-term immobilization of an injured body part that does not require rigid immobilization like a cast. A brace is typically used for longer-term support and stabilization. Skin traction is used to provide continuous, low-level pulling on a body part to immobilize and reduce pain, but is not appropriate for short-term use.

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?

Accepted Answer

A sensation of warmth or heat with application is a common sensation that clients report when a cast is applied. This is due to the exothermic reaction that occurs as the cast sets. The other options, such as increased pain, arm movement, and weakness, are not normal sensations that a client should experience during cast application and should be reported to the healthcare provider immediately.

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?

Accepted Answer

A plaster cast can be better molded to the shape of the client's body, providing a better fit and stability.

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?

Accepted Answer

Open reduction is the surgical exposure of a fracture and realignment of the bone. Buck's traction and skeletal traction are both methods of immobilizing a fracture but do not involve surgical intervention. Internal fixation involves the use of hardware such as pins, screws, or plates to hold a fracture in place but does not necessarily involve a surgical exposure of the bone.

Quiz 61: Caring Forclients Requiring Orthopedic Treatment