Med Surg 3 (EXAM 4) - Orthopedics

A client who has been taking Soma at home for a fractured arm is admitted with a BP of 80/50, a pulse of 115, and respirations of 8 BPM. The nurse interprets these findings as indicating which of the following? A) Expected common adverse effects B) Hypersensitivity reaction C) Possible habituating affect D) Hemorrhage from GI irritation

C) Possible habituating affect

The client asks the nurse what activity limitationsa re while in Buck's traction. The nurse should tell the client: A) "You can sit up whenever you want." B) "You must lie flat on your back most of the time." C) "You can turn your body." D) "You must lie on your stomach."

A) "You can sit up whenever you want."

When preparing a client for discharge from the hospital after a total knee replacement, which of the following information should be included in the DC plan? SATA. A) Report signs of infection to the HCP B) Keep the affected leg and foot on the floor when sitting in the chair C) Remove anti embolism stockings when sleeping D) The PT will encourage progressive ambulation with the use of assistive devices E) Change the dressings daily

A) Report signs of infection to the HCP D) The PT will encourage progressive ambulation with the use of assistive devices

The nurse is planning care of the client with a femoral fracture who is in a balanced suspension traction. Which of the following would be least likely to be included in the POC? A) Use of a fracture bedpan B) Check for redness over the ischial tuberosity C) Elevate the HOB no more than 25 degrees D) Personal hygiene with a complete bed bath

D) Personal hygiene with a complete bed bath

The nurse is teaching a client to administer Lovenox following a total hip replacement. The nurse should instruct the client about which of the following? SATA. A) Report promptly any difficulty breathing, rash, or itching B) Notify the HCP of unusual bruising C) Avoid all aspirin-containing products D) Wear or carry a medical ID E) Expel the air bubble from the syringe before injection F) Remove needle immediately after the medication is injected

A) Report promptly any difficulty breathing, rash, or itching B) Notify the HCP of unusual bruising C) Avoid all aspirin-containing products D) Wear or carry a medical ID

The nurse is assessing a client who has a left hip replacement 36 hours ago. Which of the following indicates that the prosthesis is dislocated? SATA. A) The client reports a "popping" sensation in the hip B) The left leg is shorter than the right leg C) The client has sharp pain in the groin D) The client cannot move the right leg E) The client cannot wiggle the toes on the left leg

A) The client reports a "popping" sensation in the hip B) The left leg is shorter than the right leg C) The client has sharp pain in the groin

When developing a teaching plan for the client who is prescribed tylenol for muscle pain, which information should the nurse expect to include? SATA. A) The drug can be used if the person is allergic to aspirin B) Tylenol does not affect platelet aggregation C) This drug causes little or no gastric distress D) Tylenol exerts a strong anti-inflammatory effect E) The client should have the iNR checked often

A) The drug can be used if the person is allergic to aspirin B) Tylenol does not affect platelet aggregation C) This drug causes little or no gastric distress

A client has a Pearson attachment on the traction setup. Which of the following is the purpose of this type of attachment? A) To support the lower portion of the leg B) To support the thigh and upper leg C) To allow attachment of the skeletal pin D) To prevent flexion and deformities in the ankle and foot

A) To support the lower portion of the leg

Following a total hip replacement, the nurse should to which of the following? Select all that apply. A) With the aid of a coworker, turn the client from the supine to prone position every 2 hours B) Encourage the client to use the overhead trapeze to assist with position changes C) For meals, elevate the HOB 90 degrees D) Use a fracture bedpan when needed by the client E) When the client is in bed, prevent thromboembolism by encouraging the client to do toe-pointing exercises

B) Encourage the client to use the overhead trapeze to assist with position changes D) Use a fracture bedpan when needed by the client E) When the client is in bed, prevent thromboembolism by encouraging the client to do toe-pointing exercises

A client who had a total hip replacement 4 days ago is worried about dislocation of the prosthesis. The nurse should respond by saying which of the following. A) "Don't worry. Your new hip is very strong." B) "Use of a cushioned toilet seat helps to prevent dislocation." C) "Activities that tend to cause adduction of the hip tend to cause dislocation, so try to avoid them" D) "Decreasing use of the abductor pillow will strengthen the muscles to prevent dislocation. "

C) "Activities that tend to cause adduction of the hip tend to cause dislocation, so try to avoid them"

The nurse advises the client who has a femoral head prosthesis placement on the type of chair to sit in during the first 6 - 8 weeks after surgery. Which would be the correct type to recommend? A) A desk-type swivel chair B) A padded upholstered chair C) A high backed chair with armrests D) A recliner with an affected footrest

C) A high backed chair with armrests

After surgery and insertion of a total hip prosthesis, a client develops severe sudden pain and an inability to move the extremity. The nurse interprets these findings indicating which of the following? A) A developing infection B) Bleeding in the operative site C) Joint dislocation D) Glue seepage into soft tissue

C) Joint dislocation

A client in balanced suspension traction using a half-ring Thomas splint with a Pearson attachment that suspends the LE and applies direct skeletal traction for a hip fracture. Which of the following would not be appropriate? A) Greater trochanter skin checks B) Pin site inspection C) Neurovascular checks proximal to the splint D) Foot movement evaluation

C) Neurovascular checks proximal to the splint

The client is in balanced suspension traction is transported to surgery for closed reduction and internal fixation of a fractured femur. Which of the following should the nurse do when transporting the client to the OR? A) Transfer the client to a car with manually suspended traction B) Call the surgeon to request a prescription to temporarily remove the traction C) Send the client on a bed with extra help to stabilize the traction D) Remove the traction and send the client on a cart

C) Send the client on a bed with extra help to stabilize the traction

A client with a fracture develops compartment syndrome. Which of the following signs should alert the nurse to impending organ failure? A) Crackles B) Jaundice C) Generalized edema D) Dark, scanty urine

D) Dark, scanty urine

When a client has a Thomas splint, the nurse should assess the client regularly for which of the following? A) Signs of skin pressure in the groin area B) Evidence of decreased breath sounds C) Skin breakdown behind the heel D) Urine retention

A) Signs of skin pressure in the groin area

A client has an intracapsular hip fracture. The nurse should conduct a focused assessment to detect: A) Internal rotation B) Muscle flaccidity C) Shortening of the affected leg D) Absence of pain in the fracture area

C) Shortening of the affected leg

A client is to have a total hip replacement. The preoperative plan should include which of the following? Select all that apply. A) Administer AB as prescribed to ensure therapeutic blood levels B) Apply leg compression device C) Request a trapeze be added to the bed D) Teach isometric exercises of the quadriceps and gluteal muscles E) Demonstrate crutch walking with a 3-point-gait F) Place Buck's traction on the bed

A) Administer AB as prescribed to ensure therapeutic blood levels C) Request a trapeze be added to the bed D) Teach isometric exercises of the quadriceps and gluteal muscles

Which information should the nurse include when performing DC teaching for a client who had an anterolateral approach for total hip replacement? Select all that apply. A) Avoid turning the toes or knees outward B) Use an abduction pillow between the legs when in bed C) Use an elevated toilet seat and shower chair D) Do not extend the operative leg backwards E) Restrict motion for two weeks after surgery

A) Avoid turning the toes or knees outward C) Use an elevated toilet seat and shower chair E) Restrict motion for two weeks after surgery

A client returns from the first session of PT following knee replacement surgery. The nurse assesses that the client's knee is swollen, slightly erythematous, and painful. The client rates the pain as 7/10 and has not had any scheduled or PRN pain medication today. WHich of the following are appropriate nursing interventions? Select all that apply. A) Gently massage the area to increase circulation to reduce pain B) Administer pain meds as prescribed C) Elevate the leg and apply a cold pack D) Notify the MD E) Call PT to cancel the next appointment

B) Administer pain meds as prescribed C) Elevate the leg and apply a cold pack

Which of the following interventions would be the least appropriate for a client who is in a double hip spica cast? A) Encourage the intake of cranberry juice B) Advising the client to eat large amounts of cheese C) Establishing regular times for elimination D) Having the client dangle at the bedside

B) Advising the client to eat large amounts of cheese

The nurse has established a goal with a client to improve mobility following a hip replacement. Which of the following is a realistic outcome at the time of discharge? A) The client can walk throughout the hospital with a walker B) The client can walk the length of the hospital hallway with minimal pain C) The client has increased independence and transfers from bed to chair D) The client can release the affected leg 6 inches with assistance

C) The client has increased independence and transfers from bed to chair

Prior to surgery, the nurse is instructing a client who will have a total hip replacement tomorrow. WHich of the following information is most important to include in the teaching plan at this time? A) Teaching how to prevent hip flexion B) Demonstrating coughing and deep-breathing techniques C) Showing the client what an actual hip prosthesis looks like D) Assessing the client's fears about the procedure

D) Assessing the client's fears about the procedure

The nurse is assessing a client's left leg for neurovascular changes following a total knee replacement. Which of the following are expected normal findings. SATA. A) Reduced edema of the left knee B) Skin warm to touch C) Capillary refill response D) Moves toes E) Pain absent F) Pulse on left leg weaker than right leg

A) Reduced edema of the left knee B) Skin warm to touch C) Capillary refill response D) Moves toes

The nurse is preparing a client who has had a knee replacement with a metal joint to go home. The nurse should instruct the eclient about which of the following? Select all that apply. A) Notify the MD about the joint prior to invasive procedures B) Avoid the use of MRI scans C) Notify airport security that the joint may set off alarms on metal detectors D) Refrain from carrying items weighing more than 5 lb E) Limit fluid intake to 1,000 mL/day

A) Notify the MD about the joint prior to invasive procedures B) Avoid the use of MRI scans C) Notify airport security that the joint may set off alarms on metal detectors

WHich of the following is the priority for a client with a fractured femur who is in traction at this time? A) Prevent the effects of immobility while in traction B) Develop skills to cope with prolonged immobility C) Choose appropriate diversional activities during prolonged recovery D) Adapt to inactivity from impaired mobility

A) Prevent the effects of immobility while in traction

In preparation for total knee surgery, a 200-lb client with osteoarthritis must lose weight. Which of the following exercises should the nurse recommend as best if the client has no contraindications? A) Weight lifting B) Walking C) Aquatic exercise D) Tai chi exercise

C) Aquatic exercise