Exam #2 (CH 41 Musculoskeletal Care)

b. Have the patient extend each leg and dorsiflex each foot to determine if pain or tenderness is present in the lower leg.

8. A patient in pelvic traction needs circulatory status assessed. How should the nurse assess for a positive Homans' sign? a. Have the patient extend both hands while the nurse compares the volume of both radial pulses. b. Have the patient extend each leg and dorsiflex each foot to determine if pain or tenderness is present in the lower leg. c. Have the patient plantar flex both feet while the nurse performs the blanch test on all of the patient's toes. d. Have the patient squeeze the nurse's hands with his or her hands to evaluate any difference in strength.

a. 24 hours

9. An older adult patient had a hip replacement. When should the patient begin with assisted ambulation with a walker? a. 24 hours b. 72 hours c. 1 week d. 2 to 3 weeks

a. Assess the fingers for color and temperature. c. Assess for a pressure sore d. Determine the exact site of the pain.

1. A patient with an arm cast complains of pain. What nursing interventions should the nurse provide in order to reduce the incidence of complications? (Select all that apply.) a. Assess the fingers for color and temperature. b. Administer a prescribed analgesic to promote comfort and allay anxiety. c. Assess for a pressure sore d. Determine the exact site of the pain. e. Cut the cast with a cast saw

a. 45 degrees onto the un-operated side if the affected hip is kept abducted

11. The nurse is caring for a patient with a total hip replacement. How should the nurse allow the patient to turn? a. 45 degrees onto the un-operated side if the affected hip is kept abducted b. From the prone to the supine position only, and the patient must keep the affected hip extended and abducted c. To any comfortable position as long as the affected leg is extended d. To the operative side if the affected hip remains extended

c. Pulmonary embolism

12. The nurse is caring for a patient who had a total hip replacement. What lethal postoperative complication should the nurse closely monitor for? a. Atelectasis b. Hypovolemia c. Pulmonary embolism d. Urinary tract infection

a. The left leg is internally rotated.

13. A patient had a total left hip arthroplasty. What clinical manifestation would indicate to the nurse that the prosthesis is dislocated? a. The left leg is internally rotated. b. The leg length is the same as the right leg. c. The patient has discomfort when moving in the bed. d. Diminished peripheral pulses on the affected extremity

a. Abduction

10. A patient had a total hip replacement. What recommended leg position should the nurse ensure is maintained to prevent prosthesis dislocation? a. Abduction b. Adduction c. Flexion d. Internal rotation

b. Notify the physician.

14. The nurse assesses a patient after total right hip arthroplasty and observes a shortening of the extremity, and the patient complains of severe pain in the right side of the groin. What is the priority action of the nurse? a. Apply Buck's traction. b. Notify the physician. c. Externally rotate the extremity. d. Bend the knee and rotate the knee internally.

c. Fat emboli syndrome

15. The nurse is caring for a patient postoperatively following orthopedic surgery. The nurse assesses an oxygen saturation of 89%, confusion, and a rash on the upper torso. What does the nurse suspect is occurring with this patient? a. Polyethylene-induced infection b. Pneumonia c. Fat emboli syndrome d. Disseminated intravascular coagulation

b. Sharp and piercing

2. A patient arrives in the emergency department with a suspected bone fracture of the right arm. How does the nurse expect the patient to describe the pain? a. A dull, deep, boring ache b. Sharp and piercing c. Similar to "muscle cramps" d. Sore and aching

a. Decreased sensory function b. Excruciating pain c. Loss of motion

3. The nurse suspects "compartment syndrome" for a casted extremity. What characteristic symptoms would the nurse assess that would confirm these suspicions? (Select all that apply.) a. Decreased sensory function b. Excruciating pain c. Loss of motion d. Capillary refill less than 3 seconds e. 2+ peripheral pulses in the affected distal pulse

d. Ulna styloid

4. The nurse suspects that a patient with an arm cast has developed a pressure ulcer. Where should the nurse assess for the presence of the ulcer? a. Lateral malleolus b. Olecranon c. Radial styloid d. Ulna styloid

a. Apply an emollient lotion to soften the skin. b. Control swelling with elastic bandages, as directed. c. Gradually resume activities and exercise.

5. A patient has a cast removed after bone healing takes place. What should the nurse instruct the patient to do after removal? (Select all that apply.) a. Apply an emollient lotion to soften the skin. b. Control swelling with elastic bandages, as directed. c. Gradually resume activities and exercise. d. Use friction to remove dead surface skin by rubbing the area with a towel. e. Use a razor to shave the dead skin off.

b. Peroneal nerve

6. A patient has a long leg cast applied. Where does the nurse understand a common pressure problem may occur? a. Dorsalis pedis b. Peroneal nerve c. Popliteal artery d. Posterior tibialis

b. Footdrop

7. The nurse is very concerned about the potential debilitating complication of peroneal nerve injury. What symptom does the nurse recognize as a result of that complication? a. Permanent paresthesias b. Footdrop c. Deep vein thrombosis (DVT) d. Infection