Musculoskeletal Care Modalities Ch 40 (Brunner & Suddarth's) NCLEX

What would be an inappropriate initial pain relief measure for the client with a cast? a) Application of a new cast b) Administration of analgesics c) Elevation of the involved part d) Application of cold packs

a) Application of a new cast Most pain can be relieved by elevating the casted part of the body, and by applying cold packs as prescribed and administering analgesics.

Which device is designed specifically to support and immobilize a body part in a desired position? a) Continuous passive motion (CPM) device b) Trapeze c) Splint d) Brace

c) Splint A splint may be applied to a fractured extremity initially until swelling subsides.

Which interventions should a nurse implement as part of initial pain relief for the client with a cast? Select all that apply. a) Elevate the involved part b) Administer analgesics c) Apply cold packs d) Provide passive ROM e) Apply a new cast

a) Elevate the involved part b) administer analgesics c) apply cold packs

Which would be contraindicated as a component of self-care activities for the client with a cast? a) Do not attempt to scratch the skin under a cast b) Cushioning rough edges of the cast with tape c) Cover the cast with plastic to insulate it d) Elevate the casted extremity to heart level frequently

c) Cover the cast with plastic to insulate it The cast should be kept dry, but do not cover it with plastic or rubber because this causes condensation, which dampens the cast and skin.

Meniscectomy refers to the a) removal of a body part b) incision and diversion of the muscle fascia c) replacement of one of the articular surfaces of a joint d) excision of damaged joint fibrocartilage

d) excision of damaged joint fibrocartilage. The m/c site for meniscectomy is the knee; the procedure refers to the excision of damaged joint fibrocartilage.

Which cleansing solution is the most effective for use in completing pin site care? a) Betadine b) Chlorhexidine c)Alcohol d) Hydrogen Peroxide

b) Chlorhexidine Chlorhexidine solution is recommended as the most effective cleansing solution; however water and saline are alternate choices .

Which type of cast encloses the truck and a lower extremity? a) Short-leg b) Hip spica c) Body Cast d) Long-leg

b) Hip spica

Which orthopedic surgery is done to correct and align a fracture after surgical dissection and exposure of the fracture? a) Joint arthroplasty b) Open reduction c) Total join arthroplasty d) Arthrodesis

b) Open reduction

The nurse teaching the client with a cast about home care includes which instruction? a) Cover the cast with plastic or rubber b) Keep the cast below heart level c) Fix a broken cast by applying tape d) Dry a wet fiberglass cast thoroughly to avoid skin problems

d) Dry a wet fiberglass cast thoroughly to avoid skin problems **Teach the client to keep the cast dry, to dry a wet fiberglass cast thoroughly to avoid skin problems, and not to cover it with plastic or rubber. -A cast should be kept dry, but do not cover it with plastic or rubber because this causes condensation, which dampens the cast and skin.

What is an inappropriate use of traction? a) Decrease space between opposing structures b) Reduce deformity c) Minimize muscle spasms d) Immobilize a fracture

a) Decrease space between opposing structures **Traction is done to increase the space between opposing surfaces. Traction is used to minimize muscle spasms, to reduce, align, and immobilize fractures and to reduce deformity.

Which is an inaccurate principle of traction? a) The weights are not removed unless intermittent treatment is prescribed. b) The weights must hang freely c) The client must be in good alignment in the center of the bed d) Skeletal traction is interrupted to turn and reposition the client.

d) Skeletal traction is interrupted to turn and reposition the client. **Skeletal traction is never interrupted.

The nurse teaches the client which intervention to avoid hip dislocation after replacement surgery? a) Avoid placing a pillow between the legs when sleeping b) Keep the knees together at all times c) Bend forward only when seated in a chair d) Never cross the affected leg when seated

d) Never cross the affected leg when seated

Which is a benefit of a continuous passive motion (CPM) device when applied after knee surgery? a) It prevents infection and controls edema and bleeding. b) It promotes healing by immobilizing the knee joint. c) It promotes healing by increasing circulation and movement of the knee joint. d) It provides active ROM.

c) It promotes healing by increasing circulation and mvmt of the knee joint.

Which nursing action would help prevent DVT in a client who has had an orthopedic surgery? a) Apply anti-embolism stockings b) Instruct about exercise, as prescribed c) Instruct about using client-controlled analgesia, if prescribed d) Apply cold packs

a) Apply anti-embolism stockings

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

b) The cast can be dented while it is damp.

Which term describes a surgical procedure to release constricting muscle fascia so as to relieve muscle tissue pressure? a) Fasciotomy b) Arthroplasty c) Arthrodesis d) Osteotomy

a) Fasciotomy -Osteotomy=surgical cutting of bone -Arthroplasty=surgical repair of a joint -Arthrodesis=surgical fusion of a joint