Ortho PrepU

A client with a fractured femur is admitted to the nursing unit. Which assessment finding requires follow up by the nurse? a. "I cannot seem to catch my breath." b. "I have a pins-and-needles sensation in my toes." c. dorsoplantar weak and unequal bilaterally d. T 101.2*F, HR 110, R 28, O2 90% e. both feet warm with capillary refill <3 seconds

a. "I cannot seem to catch my breath." b. "I have a pins-and-needles sensation in my toes." c. dorsoplantar weak and unequal bilaterally d. T 101.2*F, HR 110, R 28, O2 90%

The nurse is providing instructions to the client following application of a fiberglass cast. Which statement by the client indicates further education is needed? a. "Under no circumstances should I get my cast wet." b. "The cast should not come in contact with other plastics." c. "I should avoid touching the cast while it is wet." d. "The cast will be hot while it is drying."

a. "Under no circumstances should I get my cast wet."

The client is admitted to the hospital with a diagnosis of left femoral neck fracture. Which treatment modality would the nurse expect the health care provider to order? a. Buck's traction b. casting c. external fixator d. skeletal traction

a. Buck's traction

What areas of the body may be examined when bone densitometry is done? a. hip b. spine c. wrist d. knee

a. hip b. spine c. wrist

Which statements describe open reduction of a fracture? a. it is performed in the OR b. the bone is surgically exposed and realigned c. the client usually receives general or spinal anesthetic d. the bone is restored to its normal position by external manipulation

a. it is performed in the OR b. the bone is surgically exposed and realigned c. the client usually receives general or spinal anesthetic

An older adult client has fallen in the home and is brought to the ED by ambulance with a suspected fractured hip. X-rays confirm a fracture of the left femoral neck. When planning assessments during the client's presurgical care, the nurse should be aware of the client's heightened risk of what complication? a. osteomyelitis b. avascular necrosis (AVN) c. phantom limb d. septicemia

b. avascular necrosis (AVN)

Which interventions would the nurse implement with the client in skeletal traction? a. apply 8lb weight to the rope b. ensure the pins or wires are covered with caps c. remove foam boot and inspect skin daily d. position trapeze within the client's reach e. instruct the client on isometric exercises for immobilized extremity

b. ensure the pins or wires are covered with caps d. position trapeze within the client's reach e. instruct the client on isometric exercises for immobilized extremity

What describes failure of the ends of a fractured bone to unite in normal alignment?

nonunion

A client has had a brace prescribed to facilitate recovery from a knee injury. What are the potential therapeutic benefits of a brace? a. preventing additional injury b. immobilizing prior to surgery c. providing support d. controlling movement e. promoting bone remodeling

a. preventing additional injury c. providing support d. controlling movement

A client who was injured while playing basketball reports an extremely painful elbow, which is very edematous. What type of injury has the client experiences? a. sprain b. strain c. contusion

a. sprain

A nurse is caring for an older adult client who is preparing for discharge following recovery from a total hip replacement. What outcome must be met prior to discharge? a. client is able to perform ADLs independently b. client is able to perform transfers safely c. client is able to weight-bear equally on both legs d. client is able to demonstrate full ROM of the affected hip

b. client is able to perform transfers safely

A client with a short arm cast is suspected to have compartment syndrome. What actions should the nurse include in the plan of care? a. elevate the arm above the heart b. prepare to remove the cast c. provide support to the injured extremity d. assess neuromuscular status every 8hrs e. apply ice to extremity

b. prepare to remove the cast c. provide support to the injured extremity

A client is admitted to the orthopedic unit with a fractured femur after a motorcycle accident. The client has been placed in traction until the femur can be rodded in surgery. For what early complications should the nurse monitor this client? a. systemic infection b. complex regional pain syndrome c. DVT d. compartment syndrome e. fat embolism

c. DVT d. compartment syndrome e. fat embolism

Which is one of the most common causes of death in clients diagnosed with fat emboli syndrome? a. MI b. stroke c. acute respiratory distress syndrome d. pulmonary embolism

c. acute respiratory distress syndrome

The nurse assesses subtle personality changes, restlessness, irritability, and confusion in a client who has sustained a fracture. The nurse suspects which complication? a. compartment syndrome b. hypovolemic shock c. fat embolism syndrome d. reflex sympathetic dystrophy syndrome

c. fat embolism syndrome

A nurse is caring for a client after stabilization of a radial fracture. Which actions by the nurse would be appropriate for the client following arm casting? a. elevate the arm on a plastic-covered pillow b. protect the cast by covering with a sheet c. handle the cast with the palms of hands d. circulate room air with a portable fan e. petal and smooth the edges of the cast

c. handle the cast with the palms of hands d. circulate room air with a portable fan e. petal and smooth the edges of the cast

A client comes to the clinic 2 days after sustaining a sprain to the left ankle. What intervention can the nurse encourage the client to perform that will help improve circulation? a. active ROM exercises b. take non steroidal anti-inflammatory drugs c. applying cold compresses d. applying heat

d. applying heat

Lifestyle risk factors for osteoporosis include: a. lack of aerobic exercise b. a low-protein, high-fat diet c. an estrogen deficiency or menopause d. lack of exposure to sunshine

d. lack of exposure to sunshine

A client who has fractured the radial head asks the nurse about factors that will promote bone healing. Which statement should the nurse include when responding to the client? a. "Immobilization of the fracture will promote healing by maximizing contact of bone fragments." b. "Fractured bones require a good blood supply and adequate nutrition for healing." c. "weight bearing stimulates healing of the long bones of the leg, if the fracture is stabilized." d. "Adults heal faster than children because adult bodies are physiologically more mature." e. "Corticosteroids will decrease the bone and soft tissue inflammation associated with the fracture."

a. "Immobilization of the fracture will promote healing by maximizing contact of bone fragments." b. "Fractured bones require a good blood supply and adequate nutrition for healing." c. "weight bearing stimulates healing of the long bones of the leg, if the fracture is stabilized."

A nurse is caring for a client who is being assessed following reports of severe and persistent low back pain. The client is scheduled for diagnostic testing in the morning. Which of the following are appropriate diagnostic tests for assessing low back pain? a. CT b. angiography c. MRI d. ultrasound e. x-ray

a. CT c. MRI d. ultrasound e. x-ray

A client diagnosed with osteoporosis is being discharged home. Which priority education should the nurse provide? a. remove all small rugs from the home b. participate in weight-bearing exercises c. classify medications d. increase calcium and vitamin D in the diet

a. remove all small rugs from the home

What assessment findings of the leg are consistent with a fracture of the femoral neck? a. shortened, adducted, and externally rotated b. shortened, abducted, and internally rotated c. adducted and internally rotated d. abducted and externally rotated

a. shortened, adducted, and externally rotated

A provider asks the nurse to teach a client with low back pain how to sit in order to minimize pressure on the spine. Which teaching points would the nurse include? a. sit in a straight-backed chair with arm rests b. use a firm pillow placed behind the thoracic vertebrae to straighten the small of the back c. avoid hip extension d. place the feet flat on the floor e. sit with the buttocks "tucked under"

a. sit in a straight-backed chair with arm rests c. avoid hip extension d. place the feet flat on the floor e. sit with the buttocks "tucked under"

A client arrives in the ED complaining of severe pain in her left hip after falling out of bed. What indication upon assessment does the nurse recognize as a dislocated left hip? a. the left leg is shorter than the right b. limited ROM of the left hip c. the skin over the left hip is warm d. the skin of the lower left leg is pale e. the client is able to bend the knee but not move toes

a. the left leg is shorter than the right b. limited ROM of the left hip d. the skin of the lower left leg is pale

A physician writes a prescription to discontinue skeletal traction on an orthopedic client. The nurse should anticipate what subsequent intervention? a. application of a walking boot b. application of a cast c. education on how to use crutches d. passive ROM exercises

b. application of a cast

A client is scheduled for a total hip replacement and the surgeon has explained the risks of blood loss associated with orthopedic surgery. The risk of blood loss is the identification for which of the following actions? a. use of cardiopulmonary bypass machine b. postoperative blood salvage c. prophylactic blood transfusion d. autologous blood donation

d. autologous blood donation

A client with an arm cast reports pain. What nursing interventions should the nurse provide in order to reduce the incidence of complications? a. assess the fingers for color and temp 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. assess the fingers for color and temp c. assess for a pressure sore d. determine the exact site of the pain

A client with a tibia fracture was placed in an external fixator 24hrs 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. notify the physician b. document the findings c. prepare for surgical removal of the fixator d. assess the client's hemoglobin and hematocrit

b. document the findings

The nurse providing care for a client who has had a BKA. The nurse enters the client's room and finds the client resting in bed with the residual limb supported on a pillow. What is the nurse's most appropriate action? a. inform the surgeon of this finding b. explain the risks of flexion contracture to the client c. transfer the client to a sitting position d. encourage the client to perform active ROM exercises with the residual limb

b. explain the risks of flexion contracture to the client

A client has just begun receiving skeletal traction and the nurse is aware that muscles in the client's affected limb are spastic. How does this change in muscle tone affect the client's traction prescription? a. traction must temporarily be aligned in a slightly different direction b. extra weight is needed initially to keep the limb in proper alignment c. a lighter weight should be initially used d. weight will temporarily alternate between heavier and lighter weights

b. extra weight is needed initially to keep the limb in proper alignment

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? a. surgery will not be required b. muscle spasms will be relieved c. the bones of the left leg will be aligned d. immobilization of the left leg will be maintained e. less pain medication will be required

b. muscle spasms will be relieved c. the bones of the left leg will be aligned d. immobilization of the left leg will be maintained

A client has undergone a leg amputation. What teachings should the nurse offer such a client to prevent abduction deformity? a. advise the client to use a trochanter roll b. advise the client to adduct the stump so it presses against the other leg when the client is lying on the stomach c. advise the client to use anti embolism stockings on both legs d. advise the client to place pillows between the legs

a. advise the client to use a trochanter roll b. advise the client to adduct the stump so it presses against the other leg when the client is lying on the stomach

Emergency medical technicians transport a client to the ED and inform the nurse that the client fell from a two-story building. The comatose client has a large contusion on the left side of the chest, a hematoma in the left parietal area, and a compound fracture of the left femur. The client was intubated and is maintaining an arterial oxygen saturation of 92% by pulse oximeter with a manual-reuscutation bag. Which intervention by the nurse has the highest priority? a. assess the left leg b. assess the pupils c. place the client in Trendelenburg d. assess LOC

a. assess the left leg

A client has low back pain and the HCP needs to rule out the presence of a tumor. Which diagnostic procedure would the nurse anticipate to be ordered for the client? a. bone scan b. CT c. MRI d. electromyogram

a. bone scan

The health care provider is preparing to bivalve the client's cast. Which supplies should the nurse assemble? a. elastic compression bandages b. gauze bandages and tape c. sterile saline and basin d. stockinette and cotton padding

a. elastic compression bandages

A 75yo client had surgery for a left hip fracture yesterday. When completing the plan of care, the nurse should include assessment for which complications? a. pneumonia b. necrosis of the humerus c. skin breakdown d. sepsis e. delirium

a. pneumonia c. skin breakdown d. sepsis e. delirium

The nurse is caring for the client with chronic osteomyelitis of the jaw with a draining wound. Which client goal is a priority for the client? a. the client will experience a tolerable level of pain b. the client will demonstrate wound care c. the client will maintain adequate nutritional intake d. the client will remain free from injury e. the client will maintain effective airway clearance

a. the client will experience a tolerable level of pain b. the client will demonstrate wound care c. the client will maintain adequate nutritional intake

Which of the following are associated with compartment syndrome? a. trauma from accidents b. surgery c. casts d. tight bandages e. crushing injuries

a. trauma from accidents b. surgery c. casts d. tight bandages e. crushing injuries

A client has a cast that extends from below the elbow to the palmar crease and is secured around the base of he thumb. The thumb is also casted. The nurse identifies this as which type of cast? a. short arm cast b. Gauntlet cast c. body cast d. spica cast

b. Gauntlet cast

Which assessment findings would the nurse expect to find in the client with osteomyelitis? a. WBC 6,000/cu mm, ESR 12mm/h, Calcium 7.2 mg/dL, Phosphorus 5.3mg/dL, Alkaline phosphatase 125u/L b. WBC 12,000 /cu mm, ESR 3 2mm/h, Calcium 9.2 mg/dL, Phosphorus 3.1 mg/dL, Alkaline phosphatase 88 u/L c. WBC 15,000 /cu mm, ESR 9 mm/h, Calcium 11.2 mg/dL, Phosphorus 3.0 mg/dL, Alkaline phosphatase 96 u/L d. WBC 9,000 /cu mm, ESR 45 mm/h, Calcium 5.3 mg/dL, Phosphorus 4.8 mg/dL, Alkaline phosphatase 45 u/L

b. WBC 12,000 /cu mm, ESR 3 2mm/h, Calcium 9.2 mg/dL, Phosphorus 3.1 mg/dL, Alkaline phosphatase 88 u/L

A client has suffered a muscle strain and is reporting pain at 6 on a 10 point scale. The nurse should recommend what action? a. taking an opioid analgesic as prescribed b. applying a cold pack to the injured site c. performing passive ROM exercises d. applying a heating pad to the affected muscle

b. applying a cold pack to the injured site

With fractures of the femoral neck, the leg is:

shortened, adducted, and externally rotated