Question 1

A patient with carpal tunnel syndrome is being treated conservatively. Which information would the nurse provide?

Accepted Answer

Wearing a brace or wrist splint at night and during activities that aggravate the symptoms is a common conservative treatment for carpal tunnel syndrome. This helps to keep the wrist in a neutral position and relieve pressure on the median nerve. While exercise may be recommended, the specific instructions may vary based on the severity of the syndrome and the individual's needs. Casts and external hinge splints are less common treatments for carpal tunnel syndrome.

Question 2

The nurse would immediately report to the surgeon which finding in a patient who had a total knee replacement within the last 24 hours?

Accepted Answer

Capillary refill time of 5 seconds in the toes of the surgical leg is concerning as it may indicate decreased circulation to the affected limb, which is a serious complication following knee replacement surgery. The nurse should report this finding immediately to the surgeon for further assessment and intervention. Diminished sensations in both legs and feet, motor strength of 4 in the unaffected leg, and slight pallor and skin coolness bilaterally may also be of concern, but not as urgent as the capillary refill time in the surgical leg.

Question 3

A patient has had hip replacement surgery. What is the nurse's best plan to address this patient's ambulation needs?

Accepted Answer

Teaching the patient how to use a walker is the most appropriate plan for addressing ambulation needs following hip replacement surgery. Bed rails should not be kept up at all times as this can lead to decreased mobility and increased risk for falls. Log-rolling is a technique used for turning the patient in bed and is not directly related to ambulation. Using a wheelchair until the hip is completely healed may not be necessary and can also lead to decreased mobility.

Question 4

The nurse is caring for a patient who has a grade II open fracture of the humerus. The nurse plans care for this patient based on which understanding?. Select all that apply.

Accepted Answer

- Grade II open fractures involve some crushing of the bone and a moderately high risk for infection.- An inspection and debridement (I&D) procedure is typically required to clean and remove any damaged tissue.

Question 5

The nurse would recognize the need for additional teaching in a patient after posterior hip replacement when observing which activity?

Accepted Answer

After a posterior hip replacement, the patient should use an elevated toilet seat to prevent hip flexion beyond 90 degrees. Using a regular-height toilet seat can place excessive stress on the new hip joint and increase the risk of dislocation. The use of an abductor pillow, keeping the affected leg upright, and using the arms to push up out of bed while keeping the operative leg straight are all appropriate postoperative activities.

Question 6

Which statement by an adolescent patient recovering from a sprain would indicate the need for further instruction by the nurse regarding care at home?

Accepted Answer

Applying heat too soon can increase inflammation and delay healing. Ice should be applied for the first 24-48 hours following a sprain.

Question 7

The nurse explains to a patient who is having a cast removed that the remodeling phase of fracture healing involves which changes?. Select all that apply.

Accepted Answer

The remodeling phase involves applying stress and weight to strengthen the bone, resorption of excess bone at the callus, and strengthening of the new bone at the fracture site.

Question 8

A committee of musculoskeletal care nurses has been meeting to formulate policy changes regarding the proper method for providing pin site care. Based on current research findings, the nurses come to which conclusion?

Accepted Answer

Based on current research findings, chlorhexidine 2 mg/mL solution is the cleanser of choice for pin site care as it has been shown to significantly reduce the risk of infection compared to other types of antiseptics. A critical period for infection control measures extends beyond 48 hours after pin insertion, and pins located in areas of considerable soft tissue are actually at higher risk for infection. Hydrogen peroxide is not recommended as a skin cleanser for pin site care as it can cause tissue damage.

Question 9

Which nursing intervention would be included in pain management of a patient after orthopedic surgery?

Accepted Answer

Anticipatory pain management is the most appropriate intervention for a patient after orthopedic surgery. This involves administering pain medication prior to therapy or any activity that may exacerbate pain. It helps prevent pain from becoming severe and enables the patient to engage in therapy or rehabilitation effectively. Administering pain medications only when the patient is awake (A) is not an appropriate intervention as pain can occur even during sleep. Assessing vital signs to evaluate the degree of pain (C) is useful but should not be the only intervention. Encouraging the patient to lengthen the time intervals between pain medication doses (D) can result in uncontrolled pain, and the patient may experience more discomfort.

Question 10

A patient who has been casted for a fracture of the left ulna asks the nurse when the cast will come off. The nurse's response is based on the knowledge that the cast will be removed when which physiologic parameter has been met?

Accepted Answer

The X-ray of the fractured bone will show if the ends of the bone are well joined, indicating that sufficient healing has occurred for the cast to be removed. The other options are not necessarily accurate indicators for when the cast can be removed. The remodeling phase of bone healing can take months to complete, a cartilage collar may not be relevant to all fractures, and the duration of cast immobilization can vary based on the severity and location of the fracture.

Question 11

The nurse is caring for a patient whose fractured left femur was surgically managed with intramedullary (I-M) rodding. The nurse would explain which benefits of this type of fixation?. Select all that apply.

Accepted Answer

Intramedullary (I-M) rodding involves inserting a rod into the marrow canal of the bone, which offers several benefits. A) It results in minimal skin scarring because the procedure requires only small incisions. B) It does not interfere with the range of motion as the fixation is internal and does not involve external apparatus that might limit movement. E) It allows for early weight bearing, as the rod provides internal support that can bear weight relatively soon after surgery, facilitating quicker rehabilitation.

Question 12

A patient is admitted after traumatic amputation of the left leg just below the knee. This crushing injury occurred at work while the patient was taking a smoking break. The nurse provides care based on which knowledge?. Select all that apply.

Accepted Answer

Crushing injuries often cause extensive damage, making reattachment difficult. Phantom limb pain is real and common. Smoking impairs healing due to reduced blood flow. Nerve regeneration in reattached limbs often results in poor function.

Question 13

A patient has a dislocated hip as the result of a fall. The nurse recognizes which primary reason to quickly return the femoral head to its normal position?

Accepted Answer

Quickly returning the femoral head to its normal position will help preserve blood flow to the head of the femur. Delay in returning the femoral head to its normal position could lead to avascular necrosis and permanent damage to the hip joint. Avoiding damage to nerves and minimizing damage to affected ligaments are also important factors, but preserving blood flow is the primary concern in this case. Pain relief is important, but it is not the primary reason for quickly returning the femoral head to its normal position.

Question 14

Following hip replacement surgery, which patient statement would the nurse evaluate as indicating additional teaching is necessary?

Accepted Answer

This statement indicates that the patient may be at risk for bending at the hip, which is not recommended after hip replacement surgery. The nurse should provide additional teaching on proper body mechanics to avoid complications. The other statements indicate appropriate measures to promote safety and prevent falls or injury.

Question 15

The nurse cannot palpate a patient's pedal pulse following an open reduction internal fixation (ORIF) procedure for a fractured tibia. Which action is the priority intervention?

Accepted Answer

Using a Doppler to find the pedal pulse is the priority intervention because it helps determine if there is blood flow to the extremity, which is crucial after an ORIF procedure.

Question 16

A patient wearing a long leg cast has assessment findings of compartment syndrome in the extremity. The nurse demonstrates understanding of the complication and its specific treatment by gathering which equipment?

Accepted Answer

The answer of A patient wearing a long leg cast...

Question 17

A patient experienced a cerebral spinal fluid leak after spinal surgery. The leak has just been treated with a blood patch. What is the nurse's priority action?

Accepted Answer

Keeping the patient flat in bed for 2 hours is the priority action after a blood patch is performed to ensure that the patch stays in place and allows for adequate healing time. Administering a bolus of IV fluids may be done but is not the priority. Positioning the patient on the left side or initiating strict isolation procedures are not necessary in this situation.

Question 18

Assessment of a patient postarthroplasty reveals tachypnea, air hunger, hypoxia, O₂ sat of 86%, declining mental status, and petechiae. What is the nurse's priority action?

Accepted Answer

The patient is exhibiting signs of acute respiratory distress syndrome (ARDS) which can occur after surgery such as arthroplasty. Immediate intervention is necessary to prevent respiratory failure and potential cardiac arrest. The nurse should prepare the patient for intubation and mechanical ventilation with PEEP to improve oxygenation and prevent further harm. Other actions such as applying oxygen and raising the HOB may provide temporary relief but will not address the underlying issue of severe hypoxia and respiratory distress.

Question 19

Which findings would indicate possible compromise of ulnar nerve integrity following surgical repair of a patient's elbow?

Accepted Answer

Inability to make the "OK" sign by bringing the thumb to the fourth or fifth finger indicates compromised ulnar nerve integrity as this nerve innervates the muscles responsible for this action. Edema in the forearm and slight flexion limitation do not specifically indicate compromise of the ulnar nerve, while pain radiating from the wrist to the middle finger could suggest compromise of the median or ulnar nerve.

Question 20

The nurse is planning care for a patient who had an above-the-knee amputation 2 days ago. Which position should the nurse include in this patient's plan of care?

Accepted Answer

The answer of The nurse is planning care for a...

Quiz 50: Caring for the Patient With Musculoskeletal Trauma and Surgical Procedures