MLQ Ch 40

A group of students is studying for a test on traction. The students demonstrate understanding of the types of traction when they identify which of the following as an example of skin traction? A. Buck's B. Crutchfield tongs C. Balanced suspension D. Thomas splint

A

Which would be an inappropriate initial pain relief measure for the client with a cast? A. Application of cold packs B. Application of a new cast C. Elevation of the involved part D. Administration of analgesics

B

A client has a Fiberglass cast on the right arm. Which action should the nurse include in the care plan? A. Avoiding handling the cast for 24 hours or until it is dry B. Assessing movement and sensation in the fingers of the right hand C. Evaluating pedal and posterior tibial pulses every 2 hours D. Keeping the casted arm warm by covering it with a light blanket

B

A client has a cast applied to the leg for treatment of a tibia fracture and also has a wound on the leg that requires dressing changes due to drainage. For what should the nurse prepare the client? A. Insertion of an external fixator B. Cutting a cast window C. Cutting of a bivalve cast D. Removal of the cast

B

A client has a plaster cast applied to the left leg. Which comment by the client following the procedure should the nurse address first? A. "My pain is a 3." B. "My toes are pink." C. "My toes are stiff." D. "My cast is still wet."

C

A client in the emergency department is being treated for a wrist fracture. The client asks why a splint is being applied instead of a cast. What is the best response by the nurse? A. "You would have to stay here much longer because it takes a cast longer to dry." B. "Not all fractures require a cast." C. "A splint is applied when more swelling is expected at the site of injury." D. "It is best if an orthopedic doctor applies the cast."

C

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. Sore and aching B. Similar to "muscle cramps" C. Sharp and piercing D. A dull, deep, boring ache

C

A client is being discharged home with a long arm cast. What education should the nurse include to prevent disuse syndrome in the arm? A. Repositioning the arm in the cast B. Proper use of a sling C. Abduction and adduction of the shoulder D. Use of isometric exercises

D

A group of students is reviewing information about cast composition in preparation for a discussion on the advantages and disadvantages of each. The students demonstrate understanding of the topic when they cite which of the following as an advantage of a plaster cast? A. Better molding to the client B. Quicker drying C. More breathable D. Longer lasting

A

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

A

Which statement is accurate regarding care of a plaster cast? A. The cast can be dented while it is damp. B. A dry plaster cast is dull and gray. C. The cast will dry in about 12 hours. D. The cast must be covered with a blanket to keep it moist during the first 24 hours.

A

A client is having traction applied to a fractured left lower extremity prior to surgery. What outcomes does the nurse expect from the application of the traction for the client? Select all that apply. A. The bones of the left leg will be aligned. B. Surgery will not be required. C. Muscle spasms will be relieved. D. Immobilization of the left leg will be maintained. E. Less pain medication will be required.

A, C, D

A client has just undergone a leg amputation. What will the nurse closely monitor the client for during the immediate postoperative period? A. Neuroma B. Hematoma C. Chronic osteomyelitis D. Unexplainable burning pain (causalgia)

B

A client has severe osteoarthritis in the left hip and is having surgery to replace both articular surfaces of the hip. What type of surgical procedure will the nurse prepare the client for? A. Osteotomy B. Total arthroplasty C. Hemiarthroplasty D. Arthrodesis

B

Which of the following is an inappropriate nursing diagnosis for the client following casting? A. Risk for disuse syndrome B. Risk for deficient knowledge: procedure C. Risk for impaired skin integrity D. Risk for impaired tissue perfusion

B

A client with a tibia fracture was placed in an external fixator 24 hours ago. The nurse is completing pin care and notices redness at the pin site and a small amount of serous drainage. What action by the nurse is appropriate? A. Prepare for surgical removal of the fixator. B. Notify the physician. C. Document the findings. D. Assess the client's hemoglobin and hematocrit.

C

A group of students are reviewing information about cast composition in preparation for a discussion on the advantages and disadvantages of each. The students demonstrate understanding of the topic when they cite which of the following as an advantage of a plaster cast? A. More breathable B. Quicker drying C. Better molding to the client D. Longer-lasting

C

A nurse is caring for a client who recently underwent a total hip replacement. What is the best action by the nurse for client care? A. Allow the client's legs to be crossed at the knees when out of bed. B. Ease the client onto a low toilet seat. C. Limit hip flexion of the client's hip when the client sits up. D. Use soft chairs when the client is sitting out of bed.

C

Which of the following would the nurse expect a physician to use on a short-term basis for a client with an injured body part that does not require rigid immobilization? A. Cast B. Skin traction C. Splint D. Brace

C

A client had a total left hip arthroplasty. What clinical manifestation would indicate to the nurse that the prosthesis is dislocated? A. The leg length is the same as the right leg. B. The client has discomfort when moving in bed. C. There are diminished peripheral pulses on the affected extremity. D. The left leg is internally rotated.

D

A nurse is caring for a client placed in traction to treat a fractured femur. Which nursing intervention has the highest priority? A. Keeping the client from sliding to the foot of the bed B. Keeping the ropes over the center of the pulley C. Ensuring that the weights hang free at all times D. Assessing the extremity for neurovascular integrity

D

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. Urinary tract infection D. Pulmonary embolism

D

A variety of complications can occur after a leg amputation. Which is not a possibility in the immediate postoperative period? A. osteomyelitis B. hemorrhage C. infection D. hematoma

A

The client who had a total hip replacement was discharged home and developed acute groin pain in the affected leg, shortening of the leg, and limited movement of the fractured leg. The nurse interprets these findings as indicating which complication? A. Dislocation of the hip B. Avascular necrosis of the hip C. Contracture of the hip D. Re-fracture of the hip

A

The nurse is caring for a client with a spica cast. What is the nurse's priority intervention? A. Keep the cast clean and dry. B. Keep the legs in abduction. C. Position the client on the affected side. D. Promote elimination with a regular bedpan.

A

Which device is designed specifically to support and immobilize a body part in a desired position? A. Splint B. Continuous passive motion (CPM) device C. Trapeze D. Brace

A

A client's cast is removed. The client is worried because the skin appears mottled and is covered with a yellowish crust. What advice should the nurse give the client to address the skin problem? A. Scrub the area vigorously to remove the crust. B. Apply lotions and take warm baths or soaks. C. Avoid exposure to direct sunlight. D. Consult a skin specialist.

B

After undergoing surgery the previous day for a total knee replacement, a client states, "I am not ready to ambulate yet." What should the nurse do? A. Tell the client that this noncompliance will be reported to the health care provider. B. Discuss the complications that the client may experience if there is lack of cooperation with the care plan. C. Do nothing because the client has the ultimate right to determine the degree of participation. D. Document the client's refusal to ambulate.

B

Arthrodesis is: A. replacement of one of the articular surfaces in a joint, such as the femoral head but not the acetabulum. B. fusion of a joint (most often the wrist or knee) for stabilization and pain relief. C. cutting and removal of a wedge of bone (most often the tibia or femur) to change the bone's alignment, thereby improving function and relieving pain. D. total reconstruction or replacement of a joint (most often the knee or hip) with an artificial joint to restore function and relieve pain.

B

The nurse is providing instructions to the client who is being prepared for skeletal traction. Which statement by the client indicates teaching was effective? A. "A belt will go around my pelvis and weights will be attached." B. "Metal pins will go through my skin to the bone." C. "I will wear a boot with weights attached." D. "The traction can be removed once a day so I can shower."

B

Which orthopedic surgery is done to correct and align a fracture after surgical dissection and exposure of the fracture? A. Arthrodesis B. Open reduction C. Total joint arthroplasty D. Joint arthroplasty

B

Which type of cast encloses the trunk and a lower extremity? A. Long-leg B. Hip spica C. Body cast D. Short-leg

B

Which would be an inappropriate initial pain relief measure for the client with a cast? A. Application of cold packs B. Administration of analgesics C. Elevation of the involved part D. Application of a new cast

B

The nurse is caring for a client who lives alone and had a total knee replacement. An appropriate nursing diagnosis for the client is: A. Risk for avascular necrosis of the joint B. Situational low self-esteem C. Risk for ineffective therapeutic regimen management D. Disturbed body image

C

The nurse is caring for a client who sustained rib fractures in an automobile accident. What symptoms does the nurse recognize as a complication of rib fractures and should immediately be reported to the physician? A. Client complains of pain in the affected rib area when taking a deep breath B. Heart rate of 94 beats/minute C. Crackles in the lung bases D. Blood pressure of 140/90 mm Hg

C

What is the best action by the nurse to achieve optimal outcomes when caring for a client with a musculoskeletal disorder who is using a cast? A. Prepare the client for cast application B. Provide effective pain control C. Educate the client on cast care and complications D. Assess for neurovascular compromise

C

A client in the emergency department is being treated for a wrist fracture. The client asks why a splint is being applied instead of a cast. What is the best response by the nurse? A. "Not all fractures require a cast." B. "It is best if an orthopedic doctor applies the cast." C. "You would have to stay here much longer because it takes a cast longer to dry." D. "A splint is applied when more swelling is expected at the site of injury."

D

A client presents at the emergency department with a compound fracture of the right femur. Skeletal traction is applied to align the bones. What type of traction would be used? A. Thomas splint B. Buck's traction C. Russell traction D. Steinmann traction

D

A client undergoes an open reduction of a femur fracture, and returns to the orthopedic unit with a cast in place. What is the rationale for frequently assessing the client's pedal pulses? A. typical postoperative nursing management B. ensuring surgery was successful C. ensuring there wasn't nerve damage during surgery D. maintaining adequate circulation

D

A client was playing softball and dislocated four of his fingers when diving for a ball. The physician manipulated the fingers into alignment and applied a splint to maintain alignment. What type of procedure does the nurse document this as? A. External fixation B. Open reduction with internal fixation C. Open reduction D. Closed reduction

D

A hip spica cast: A. is a short or long leg cast reinforced for strength. B. extends from the junction of the upper and middle third of the thigh to the base of the toes. The knee may be slightly flexed. C. encircles the trunk. D. encloses the trunk and a lower extremity.

D

The client displays manifestations of compartment syndrome. What treatment will the nurse expect the client to be scheduled for? A. An open reduction B. A total hip replacement C. A total knee replacement D. A fasciotomy

D

The client returns to the nursing unit following an open reduction with internal fixation of the right hip. Nursing assessment findings include temperature 100.8 degrees Fahrenheit, heart rate 112 beats per minute, respiratory rate 28 breaths per minute, and blood pressure 86/58. There is no urine in the Foley catheter collection bag. The nurse interprets these findings as indicating which complication? A. Atelectasis B. Osteomyelitis C. Urinary retention D. Hypovolemic shock

D

The client who had a total hip replacement was discharged home and developed acute groin pain in the affected leg, shortening of the leg, and limited movement of the fractured leg. The nurse interprets these findings as indicating which complication? A. Re-fracture of the hip B. Avascular necrosis of the hip C. Contracture of the hip D. Dislocation of the hip

D

The nurse is caring for a client with an external fixator that requires pin care twice a day. The nurse observes that there is a new purulent drainage around one of the pins. What intervention should the nurse anticipate doing? A. Scrubbing the drainage from around the pin site B. Apply ointment to the pin site. C. Applying iodine-based solution D. Obtaining a culture

D

The nurse is checking the traction apparatus for a client in skin traction. Which finding would require the nurse to intervene? A. Pulleys without evidence of the obstruction B. Body aligned opposite to line of traction pull C. Ropes freely moving over pulleys D. Weights hanging and touching the floor

D

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. Deep vein thrombosis (DVT) B. Infection C. Permanent paresthesias D. Foot drop

D

Which orthopedic surgery is done to correct and align a fracture after surgical dissection and exposure of the fracture? A. Joint arthroplasty B. Arthrodesis C. Total joint arthroplasty D. Open reduction

D

Which statement by a staff nurse on the orthopedic floor indicates the need for further staff education? A. "The continuous passive motion device can decrease the development of adhesions." B. "Bleeding is a complication associated with the continuous passive motion device." C. "Monitoring skin integrity is important while the continuous passive motion device is in place." D. "The client is receiving physical therapy twice per day, so the client doesn't need a continuous passive motion device."

D