Musculoskeletal Part 2

Which activity does the nurse allow a patient to perform 3 days after the patient underwent a noncemented prosthetic hip implant? A. Full weight bearing (FWB) B. Partial weight bearing (PWB) C. Toe-touch weight bearing (TTWB) D. Weight bearing as tolerated (WBAT)

C

A patient who is scheduled for a total hip arthroplasty (THA) reports taking NSAIDs long term to manage the pain of osteoarthritis. While evaluating the patient, the nurse notifies the health care provider on the basis of which finding? A. Hematemesis B. Headaches C. Indigestion D. Dark yellow urine

A

Which information does the nurse include when providing preoperative education for a patient undergoing a total hip arthroplasty (THA) in 1 week? Select all that apply. A. Freshly laundered sheets the night before surgery. B. Discontinue anticoagulant medication the night before surgery. C. Refrain from applying lotion after the chlorhexidine gluconate baths. D. Apply mupirocin ointment twice daily to both nares until surgery. E. Bathe in chlorhexidine gluconate the night before and the morning of surgery.

A, C, D, E

Which risk factor does the nurse include in an educational session for a group of young adults on the prevention of osteoarthritis? Select all that apply. A. Genetics B. Anorexia C. Active lifestyle D. Injury prevention E. Repetitive motion

A, C, D, E

The nurse is positioning a patient who underwent a total hip arthroplasty (THA) to prevent skin breakdown. Which action does the nurse take when placing the patient on the nonoperative side? A. Apply bilateral heel protectors. B. Elevate the head of the bed 30 degrees. C. Support the operative leg with pillows. D. Give analgesics before positioning.

C

A patient who underwent a total knee arthroplasty (TKA) asks the nurse when a walker will no longer be required for ambulation. Which finding indicates that the patient can walk without an assistive device? A. When returning to work B. When no limp is noticed C. When the patient feels comfortable D. When ambulatory care therapy is completed

B

Which noninvasive measure does the nurse include when discussing pain relief measures with a patient who has osteoarthritis and is waiting for a total hip arthroplasty (THA)? A. Using acupuncture B. Applying heat and cold C. Sitting in a reclining chair D. Propping pillows under knee

B

Which assessment does the nurse perform to monitor neurovascular status for potential circulation compromise during the immediate postoperative period for a patient who had a total hip arthroplasty? Select all that apply. A. Flexion B. Sensation C. Abduction D. Distal pulses E. Temperature F. Capillary refill

B, D, E,F

Which response does the nurse provide to a patient who asks, "Will I still be able to swim and ride my bike with osteoarthritis?" A. "Only exercise on the days that you feel well." B. "You will risk causing further joint damage." C. "Aerobic activities are recommended for you." D. "It is permitted as long as you are with the physical therapist."

C

Which strategy does the nurse incorporate into patient education when learning that the patient who is scheduled to undergo a total knee arthroplasty (TKA) is not able to understand the health care facility's primary language? A. Online websites B. Instructional DVDs C. Interpreter services D. Large-print handouts E. Picture book with simple words

C

The nurse is teaching a patient who underwent a total knee arthroplasty (TKA) how to perform leg exercises to maintain mobility and muscle tone. Which exercise does the nurse include? Select all that apply. A. Adduction B. Abduction C. Plantar flexion D. Straight-leg raises E. Quadriceps-setting

C, D, E

After noticing diminished breath sounds in the lung bases of a patient who underwent a total hip arthroplasty (THA), the nurse takes which action to prevent atelectasis? A. Give corticosteroid inhaler medications. B. Perform percussion and postural drainage. C. Administer oxygen via a nonrebreather mask. D. Encourage incentive spirometer use every 2 hours.

D

Which action does the nurse take when following the Surgical Care Improvement Project (SCIP) Core Measures to prevent infection while preparing a patient to undergo a total knee arthroplasty (TKA)? A. Give a sedative or narcotic analgesic. B. Monitor the white blood cell (WBC) count. C. Provide preoperative patient education. D. Administer cefazolin 1 hour before the incision.

D

Which method of teaching is best to use for an 80-year-old patient to provide information about an upcoming total hip arthroplasty? A. Preorganized surgery notebook B. Surgical DVD C. Demonstration and teach-back method D. Large-print pamphlets

D

Which prescription does the nurse expect to be used during a total knee arthroplasty (TKA) to prevent blood loss in a patient whose religious practices prevent the use of blood transfusions? A. Albumin B. Apixaban C. Enoxaparin D. Tranexamic acid

D

Which intervention does the nurse include in the plan of care for a patient immediately after returning from the operating room after undergoing a total hip arthroplasty (THA)? Select all that apply. A. Manage pain. B. Assess oxygenation. C. Monitor for infection. D. Provide adequate nutrition. E. Ambulate with therapy.

A, B, C

Which information does the nurse provide when teaching a patient about ways to prevent the development of blood clots in the postoperative period after a total joint arthroplasty? Select all that apply. A. Frequent ambulation B. Anticoagulant therapy C. Quadriceps-setting exercises D. Compression stockings E. Sitting with lower extremities dependent

A, B, C, D

The nurse determines a patient who underwent a total knee arthroplasty (TKA) is at an increased risk for thrombotic events. Which intervention does the nurse include in the plan of care to prevent clots from occurring? Select all that apply. A. Administer anticoagulants. B. Encourage frequent ambulation. C. Perform lower extremity exercises. D. Use a continuous passive motion (CPM) machine. E. Wear sequential compression devices (SCDs).

A, B, C, D, E

The physical therapist has determined a patient who underwent a left total hip arthroplasty (THA) no longer needs an assistive device to ambulate. The nurse anticipates that the patient will be permitted to resume which activities? Select all that apply. A. Driving a vehicle B. Returning to work C. Using a high toilet seat D. Continuing daily exercises E. Sitting in high-backed chairs

A, B, C, D, E

Which finding assessed in a patient who underwent a total hip arthroplasty (THA) indicates a possible postoperative infection? Select all that apply. A. Temperature 101.2°F (38.4°C) B.Redness at the incision C. Excessive wound drainage D. Decreased level of consciousness E. White blood cell count 18.0 cells/mm3

A, B, C, D, E

Which information does the nurse include in the discharge instructions for a patient who underwent a total hip arthroplasty (THA)? Select all that apply. A. Mobility restrictions B. Care of the hip incision C. Importance of ambulation D. Safe use of assistive device E. Enoxaparin injection technique

A, B, C, D, E

Which type of anesthesia can be used for a total hip arthroplasty (THA)? Select all that apply. A. Spinal B. General C. Epidural D. Combination E. Regional nerve block

A, B, C, D, E

While assisting a patient who underwent an anterior total hip arthroplasty (THA) to transfer from the bed to the chair, the nurse educates the patient on proper body mechanics and precautions to take. Which information does the nurse include? Select all that apply. A. Change position frequently. B. Follow weight-bearing restrictions. C. Avoid sitting with the legs crossed. D. Maintain back alignment when standing. E. Refrain from posterior leg hyperextension.

A, B, C, D, E

Which intervention does the nurse include when developing a pain management plan of care for a patient who underwent a total hip arthroplasty the previous evening? Select all that apply. A. Give NSAIDs. B. Provide distraction. C. Assist with exercises. D. Administer opioid drugs. E. Apply compression stockings.

A, B, D

Which information does the nurse provide to ensure safety for a patient who underwent a total hip arthroplasty (THA) and who is being discharged with new prescriptions, including the anticoagulant warfarin? Select all that apply. A. Use an electric razor. B. Take the medication twice a day. C. Refrain from taking ibuprofen. D. Avoid dark green leafy vegetables. E. Schedule a partial thromboplastin time (PTT).

A, C, D

As the nurse plans care for a patient who underwent a posterolateral total hip arthroplasty (THA), which action does the nurse take to prevent dislocation? A. Use an abduction pillow. B. Keep the heels off the bed. C. Anticipate the patient's need for pain medication. D. Turn the patient every 2 hours.

A

The nurse is assessing a patient who is scheduled for a total hip arthroplasty (THA) in 1 week. Which finding would prevent the patient from undergoing minimally invasive surgery (MIS)? A. Obesity B. Hypertension C. Diabetes mellitus D. Rheumatoid arthritis

A

The nurse is assessing the surgical incision for a patient who underwent a total hip arthroplasty (THA). After determining the wound is not healing well, the nurse correlates which reason for this finding? A. Poor nutrition B. High pain level C. Decreased mobility D. Increased confusion

A

The nurse is reviewing the health records for patients scheduled to undergo total knee arthroplasties (TKA) in the next week. Which patient is at highest risk for poor surgical wound healing? A. 65-year-old woman with a body mass index (BMI) of 16.6 kg/m2 B. 65-year-old man with atrial fibrillation C. 70-year-old man with renal insufficiency D. 70-year-old woman weighing 152 lb

A

Which finding in the health record of a patient scheduled to undergo a total hip arthroplasty leads the nurse to contact the health care provider (HCP) before the procedure? A. Temperature: 100.5°F (38°C) B. Heart rate: 88 beats/min C. Blood pressure: 110/77 mm Hg D. Respirations: 18 breaths/min

A

The nurse is observing the assistive personnel (AP) help a patient who underwent a right total hip arthroplasty (THA) get out of bed. Which action made by the AP requires the nurse to intervene? A. Placing a gait belt on the patient B. Sitting the patient on the side of the bed C. Standing on the left side of the patient D. Having the patient pivot on the left leg

C

Which information does the nurse give to the patient regarding anticoagulant use before total hip arthroplasty? A. Take as usual before surgery. B. Take at a lower dose before surgery. C. Stop the dose several days before surgery. D. Change to an injectable form before surgery.

C

Which patient statement does the nurse clarify after providing discharge education for a patient after total hip arthroplasty? A. "I will use my walker until I am told otherwise." B. "When standing, I will make sure not to twist my body." C. "I will avoid crossing my legs other than to put on my shoes." D. "Due to weight restrictions, I know I can only toe touch on that side for now."

C

The nurse is caring for a patient who underwent a total knee arthroplasty (TKA) with an expected discharge in 2 days. Which finding leads the nurse to suggest a home health care consult? Select all that apply. A. Lives with adult children B. Ambulates with a quad cane C. Takes apixaban D. Uses a continuous passive motion (CPM) machine several times per day E. Requires help for transportation

E