Practice Questions Flashcards
A patient with rheumatoid arthritis of the hands asks the nurse why resting splints are necessary. The nurse explains that resting splints are used for which purpose? Resting splints
stabilize and immobilize joints in desired position when use of the hand is not required.
What will cause a pressure bandage to become saturated with blood immediately following a below-the-knee amputation?
bleeding from a loosened suture
Which are primary goals for a patient scheduled for orthopedic surgery?
pain relief, tissue perfusion, health maintenance, improved mobility, and improved self-concept
The community health nurse arrives at a patient’s home to find the patient lying on the floor. The patient is oriented to person, time, and place. The patient’s right leg is shorter than the left and is adducted. The nurse suggests that the patient be transported by ambulance to the hospital. What is the rationale for the nursing action?
The nurse suspects a fracture of the femoral neck.
After teaching a patient with osteoporosis about nutritional needs, the nurse determines the patient understands high-calcium foods when the patient selects which meal?
tuna sandwich on whole wheat bread, one cup of fruit yogurt, and one cup of skim milk
Which nursing action should receive priority for a patient who is recovering from a total hip replacement?
Position the patient using an abductor pillow.
Which nursing goal should receive priority for a patient in a full leg cast who is on prolonged bed rest?
Maintain skin integrity.
Two days following multiple fractures, a patient reports shortness of breath and chest pain. Upon assessment, the nurse also finds the patient to be confused. The nurse should suspect which complication?
fat embolism
The nurse teaches an adolescent client about management of scoliosis with a body brace. Which client statement indicates that the teaching was effective?
“Wearing the brace 23 hours a day will be hard for me.”
Which nursing intervention is appropriate to include in a plan of care for a patient in Buck’s traction?
Remove the foam boot and inspect the skin three times daily
Which is an alternative means to reduce the perception of pain?
back massage
Which condition has clinical manifestations similar to those of systemic lupus erythematosus (SLE)?
rheumatoid arthritis
Which laboratory blood test result supports a diagnosis of systemic lupus erythematosus (SLE)?
positive for antinuclear antibodies
Which injury of a child is most suggestive of physical abuse?
spiral fracture of the humerus
A 60-year-old patient is admitted to the hospital with a fracture of the right femur. Which assessment should the nurse be most concerned about?
The patient pulls at the bed covers and talks to the wall.
A nurse is caring for a 29-year-old patient who is admitted with a spiral fracture of the femur resulting from a motor vehicle accident. The patient’s pain seemed to decrease during the night. In the morning, the patient is restless and irritable. What further assessment would be of high priority?
Get an order to obtain blood gas values.
A nurse has given home care instructions to the husband of a 78-year-old woman who is going home after an open reduction and internal fixation of a hip fracture. The nurse realizes that the patient’s husband needs further instruction when the husband makes which comment?
I have put a hospital bed in the dining room so that I do everything for her more easily.
Which is the best indicator of circulatory complications in a patient who underwent a right total hip replacement 3 days ago?
dorsiflexion of the right ankle
The nurse has provided pin site care for a patient in skeletal traction who has a Steinmann pin in place. Which observation should the nurse be certain to include in the nurse’s report?
heat and swelling at the pin site
What is the appearance of normal synovial fluid?
clear and straw-colored
Which discharge instruction should the nurse provide to the parents of an 18-month-old child who is in a hip spica cast?
“Tuck a disposable diaper beneath the entire perineal opening of the cast to keep it clean.”
The presence of a diseased bone would make a patient more prone to which type of fracture?
pathologic
A patient complains of pain in the right great toe 24 hours after a right above-the-knee amputation. What is the nurse’s first action?
Administer the prescribed narcotic analgesic.
Which action should the nurse take when caring for a patient with a newly applied cast?
Keep the cast uncovered.
Which instruction should the nurse give to a patient who is receiving prophylactic probenecid-colchicine (ColBENEMID) therapy?
Drink eight glasses of water a day.
Which finding indicates that drug therapy for a patient with chronic gout has been effective?
normal serum uric acid
Which complication is associated with Paget’s disease of the bone?
pathologic fracture
How should the nurse position a patient immediately following a total left hip replacement?
legs in abduction with a pillow
Why does the nurse use the palms of the hands when handling a wet cast?
To avoid denting the cast
Why might a patient be placed in Buck’s traction prior to surgery for the repair of a fractured hip?
to reduce muscle spasms
While assessing a patient on the first day following a total hip replacement, the nurse notes that the affected leg is shorter than the other leg. Which action should the nurse take?
Notify the physician immediately.
Following replacement surgery, a patient has a dislocated prosthetic hip as a result of a fall. The nurse should take which initial action?
Offer medication for pain relief.
Which suggestion by the nurse is appropriate to improve the self-concept of a patient with systemic lupus erythematosus (SLE)?
Consult a cosmetologist, to select cosmetics to cover the facial rash.
When reviewing discharge instructions for a patient who had a total knee replacement five days ago, the nurse discusses with the patient and family which priority diagnosis?
knowledge deficit related to potential complications
A patient is two days postoperative from a total hip replacement and no longer on a PCA pump. The patient is complaining of moderate pain. What medication should the nurse expect to administer?
oral opioid analgesic
Which procedure determines bone density, erosion, texture, and alterations in bone relationships?
X ray
An emergency department nurse is delivering discharge instructions to the mother of a five-year-old child with a severely sprained ankle. Which would be most appropriate for the nurse to include in the instruction?
Place ice on the injury for the first 24 hours.
The nurse performs daily pin site care for a patient in skeletal traction. Which assessment of the site is most indicative that an infection has developed?
foul odor
Which type of exercise helps to maintain muscle tone in the forearm of a patient who is in a shoulder-to-waist cast?
isometric
Which observation of a 13-year-old patient is most indicative of scoliosis?
One side of the rib cage is higher when the patient bends forward.
The nurse teaches the family of a patient with an above-the-knee amputation about methods to prepare the patient for prosthesis fitting. Which action by the family indicates that the teaching was successful?
wrap the residual limb with elastic dressings.
What should the nurse do to assess a patient for the presence of pain related to carpal tunnel syndrome?
Tap lightly over the medial nerve.
An infant has had bilateral casts applied for the correction of clubfeet. Which nursing measure will help prevent an infection from developing under the casts?
Petal the edges of the casts with adhesive tape or Band-Aids.
Which nursing intervention should be given priority in the plan of care for a patient with osteoporosis? The nurse
explains the need for supplemental calcium.
A patient who has rheumatoid arthritis (RA) is diagnosed with appendicitis. Which laboratory test result should the nurse anticipate?
elevated erythrocyte sedimentation rate (ESR)
Two days after fracturing a femur, a patient exhibits respirations of 32, a shallow pulse of 136, crackles on auscultation, confusion, and production of thick white sputum. What is the nurse’s immediate response?
administers oxygen.
Which finding is normal when a patient’s arm is put in a cast?
There is mild discomfort in the fingers.
When transporting a patient in skeletal traction, the nurse should give the transport team which instruction?
Allow the weights to hang freely when moving the patient.
Which behavior by a patient who has gout indicates the need for further instruction related to the treatment plan?
Patient consumes liver twice a week.
After three weeks of taking naproxen bid for osteoarthritis in the hands, a patient tells the nurse that the medication is not effective in controlling the pain. Which information should the nurse use as a basis for responding to the patient?
Another type of NSAID agent may be indicated due to variations in individual responses to individual medications.
Which assessment of a patient with severe frostbite should receive priority?
neurovascular
Immediately following an above the knee amputation, a patient has a rigid cast dressing applied. Which observation indicates the desired outcome of this treatment?
Uniform compression of stump (early fitting of prosthesis)
Which assessment indicates that a wound is healing by secondary intention?
The wound base contains granulation tissues (forms connective tissue and fills affected areas)
