Practice Questions

Question 1

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

Answer 1

stabilize and immobilize joints in desired position when use of the hand is not required.

Question 2

What will cause a pressure bandage to become saturated with blood immediately following a below-the-knee amputation?

Answer 2

bleeding from a loosened suture

Question 3

Which are primary goals for a patient scheduled for orthopedic surgery?

Answer 3

pain relief, tissue perfusion, health maintenance, improved mobility, and improved self-concept

Question 4

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?

Answer 4

The nurse suspects a fracture of the femoral neck.

Question 5

After teaching a patient with osteoporosis about nutritional needs, the nurse determines the patient understands high-calcium foods when the patient selects which meal?

Answer 5

tuna sandwich on whole wheat bread, one cup of fruit yogurt, and one cup of skim milk

Question 6

Which nursing action should receive priority for a patient who is recovering from a total hip replacement?

Answer 6

Position the patient using an abductor pillow.

Question 7

Which nursing goal should receive priority for a patient in a full leg cast who is on prolonged bed rest?

Answer 7

Maintain skin integrity.

Question 8

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?

Answer 8

fat embolism

Question 9

The nurse teaches an adolescent client about management of scoliosis with a body brace. Which client statement indicates that the teaching was effective?

Answer 9

“Wearing the brace 23 hours a day will be hard for me.”

Question 10

Which nursing intervention is appropriate to include in a plan of care for a patient in Buck’s traction?

Answer 10

Remove the foam boot and inspect the skin three times daily

Question 11

Which is an alternative means to reduce the perception of pain?

Answer 11

back massage

Question 12

Which condition has clinical manifestations similar to those of systemic lupus erythematosus (SLE)?

Answer 12

rheumatoid arthritis

Question 13

Which laboratory blood test result supports a diagnosis of systemic lupus erythematosus (SLE)?

Answer 13

positive for antinuclear antibodies

Question 14

Which injury of a child is most suggestive of physical abuse?

Answer 14

spiral fracture of the humerus

Question 15

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?

Answer 15

The patient pulls at the bed covers and talks to the wall.

Question 16

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?

Answer 16

Get an order to obtain blood gas values.

Question 17

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?

Answer 17

I have put a hospital bed in the dining room so that I do everything for her more easily.

Question 18

Which is the best indicator of circulatory complications in a patient who underwent a right total hip replacement 3 days ago?

Answer 18

dorsiflexion of the right ankle

Question 19

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?

Answer 19

heat and swelling at the pin site

Question 20

What is the appearance of normal synovial fluid?

Answer 20

clear and straw-colored

Question 21

Which discharge instruction should the nurse provide to the parents of an 18-month-old child who is in a hip spica cast?

Answer 21

“Tuck a disposable diaper beneath the entire perineal opening of the cast to keep it clean.”

Question 22

The presence of a diseased bone would make a patient more prone to which type of fracture?

Answer 22

pathologic

Question 23

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?

Answer 23

Administer the prescribed narcotic analgesic.

Question 24

Which action should the nurse take when caring for a patient with a newly applied cast?

Answer 24

Keep the cast uncovered.

Question 25

Which instruction should the nurse give to a patient who is receiving prophylactic probenecid-colchicine (ColBENEMID) therapy?

Answer 25

Drink eight glasses of water a day.

Question 26

Which finding indicates that drug therapy for a patient with chronic gout has been effective?

Answer 26

normal serum uric acid

Question 27

Which complication is associated with Paget's disease of the bone?

Answer 27

pathologic fracture

Question 28

How should the nurse position a patient immediately following a total left hip replacement?

Answer 28

legs in abduction with a pillow

Question 29

Why does the nurse use the palms of the hands when handling a wet cast?

Answer 29

To avoid denting the cast

Question 30

Why might a patient be placed in Buck's traction prior to surgery for the repair of a fractured hip?

Answer 30

to reduce muscle spasms

Question 31

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?

Answer 31

Notify the physician immediately.

Question 32

Following replacement surgery, a patient has a dislocated prosthetic hip as a result of a fall. The nurse should take which initial action?

Answer 32

Offer medication for pain relief.

Question 33

Which suggestion by the nurse is appropriate to improve the self-concept of a patient with systemic lupus erythematosus (SLE)?

Answer 33

Consult a cosmetologist, to select cosmetics to cover the facial rash.

Question 34

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?

Answer 34

knowledge deficit related to potential complications

Question 35

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?

Answer 35

oral opioid analgesic

Question 36

Which procedure determines bone density, erosion, texture, and alterations in bone relationships?

Answer 36

X ray

Question 37

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?

Answer 37

Place ice on the injury for the first 24 hours.

Question 38

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?

Answer 38

foul odor

Question 39

Which type of exercise helps to maintain muscle tone in the forearm of a patient who is in a shoulder-to-waist cast?

Answer 39

isometric

Question 40

Which observation of a 13-year-old patient is most indicative of scoliosis?

Answer 40

One side of the rib cage is higher when the patient bends forward.

Question 41

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?

Answer 41

wrap the residual limb with elastic dressings.

Question 42

What should the nurse do to assess a patient for the presence of pain related to carpal tunnel syndrome?

Answer 42

Tap lightly over the medial nerve.

Question 43

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?

Answer 43

Petal the edges of the casts with adhesive tape or Band-Aids.

Question 44

Which nursing intervention should be given priority in the plan of care for a patient with osteoporosis? The nurse

Answer 44

explains the need for supplemental calcium.

Question 45

A patient who has rheumatoid arthritis (RA) is diagnosed with appendicitis. Which laboratory test result should the nurse anticipate?

Answer 45

elevated erythrocyte sedimentation rate (ESR)

Question 46

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?

Answer 46

administers oxygen.

Question 47

Which finding is normal when a patient's arm is put in a cast?

Answer 47

There is mild discomfort in the fingers.

Question 48

When transporting a patient in skeletal traction, the nurse should give the transport team which instruction?

Answer 48

Allow the weights to hang freely when moving the patient.

Question 49

Which behavior by a patient who has gout indicates the need for further instruction related to the treatment plan?

Answer 49

Patient consumes liver twice a week.

Question 50

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?

Answer 50

Another type of NSAID agent may be indicated due to variations in individual responses to individual medications.

Question 51

Which assessment of a patient with severe frostbite should receive priority?

Answer 51

neurovascular

Question 52

Immediately following an above the knee amputation, a patient has a rigid cast dressing applied. Which observation indicates the desired outcome of this treatment?

Answer 52

Uniform compression of stump (early fitting of prosthesis)

Question 53

Which assessment indicates that a wound is healing by secondary intention?

Answer 53

The wound base contains granulation tissues (forms connective tissue and fills affected areas)