Exam 3 Test Bank: Musculoskeletal care modalities
A client diagnosed w/ a right ulnar fracture asks why the cast needs to go all the way up the arm. What is the best response by the nurse? A) the joint above the fracture and below the fracture must be immobilized B) this method allows for the fastest healing time and the greatest mobility C) this allowed for the strength in the arm to remain consistent D) when a spica cast is ordered, the arm must be immobilized
A
A client in the ED 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) a splint is applied when more swelling is expected at the site of injury B) you would have to stay here much longer because it takes a cast longer to dry C) not all fractures require a cast D) it is best if an orthopedic doctor applies the cast
A
Which is an inaccurate principle of traction? A) skeletal traction is interrupted to turn and reposition the client B) the client must be in good alignment in the center of the bed C) the weights must hand greely D) the weights aren't removed unless intermittent treatment is prescribed
A
Which would be an inappropriate initial pain relief measure for the client with a cast? A) application of a new cast B) application of cold packs C) elevation of the involved part D) administration of analgesics
A
Which actions by the nurse demonstrate an understanding of caring for a client in traction? SATA A) placing a trapeze on the bed B) assessing the client's alignment in the bed C) ensuring that the weights are hanging freely D) removing skeletal traction to turn and reposition the client E) frequently assessing pain level
A, B, C, E
A client is placed in traction for a femur fracture. The nurse would document which expected outcomes of traction? SATA A) minimization of muscle spasms B) reduction of deformity C) decreased pedal pulse D) full ROM to extremity E) increased ability to bear weight F) realignment of the fracture
A, B, F
A client with a fractured ankle is having a fiberglass cast applied. The client starts yelling 'my leg is burning, take it off!" What action by the nurse is most appropriate? A) call for assistance to hold the client in the required position until the cast had dried B) explain that the sensation being felt is normal and will not burn the client C) administer antianxiety and pain medication D) remove the cast immediately, notifying the physician
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) assess the client's HGB and HCT B) document the findings C) notify the physician D) prepare for surgical removal of the fixator
B
An unresponsive client had a plaster cast applied to the right lower leg 8 hours ago. When moving the client, the nurse notices an indentation on the posterior lower portion of the cast. What is the best action by the nurse? A) remove the cast immediately B) notify the physician C) document the finding D) assess for pedal pulses and mobility of the toes
B
The client is scheduled for a meniscetomy of the right knee. The nurse would plan postop care based on what surgical procedure? A) removal of a body part B) excision of damaged joint fibrocartilage C) incision and diversion of the muscle fascia D) replacement of one of the articular surfaces of a joint
B
Which type of cast encloses the trunk and a lower extremity? A) short-leg B) hip-spica C) body cast D) long-leg
B
A client with a short arm cast is suspected to have compartment syndrome. What actions should the nurse include in the plan of care? SATA A) assess neurovascular status q8h B) provide support to the injured extremity C) elevate the arm above the heart D) prepare to remove the cast E) apply ice to the extremity
B, D
What is the best action by the nurse to achieve optimal outcomes when caring for a client with musculoskeletal disorder who is using a cast? A) assess for neurovascular compromise B) provide effective pain control C) educate the client on cast care and complications D) prepare the client for cast application
C
Which device is designed specifically to support and immobilize a body part in a desired position? A) trapeze B) continuous passive motion (CPM) device C) splint D) brace
C
Which is a benefit of a continuous passive motion (CPM) device when applied after knee surgery? A) it promotes healing by immobilizing the knee joint B) it provides active range of motion C) it promotes healing by increasing circulation and movement of the knee joint D) it prevents infection and controls edema and bleeding
C
Which is an inappropriate use of traction? A) immobilize a fracture B) reduce deformity C) decrease space between opposing structures D) minimize muscle
C
Which nursing action would help prevent DVT in a client who has had an orthopedic surgery? A) instruct about exercise, as prescribed B) instruct about using client-controlled analgesia, if prescribed C) apply anti-embolism stockings D) apply cold packs
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) abduction and adduction of the shoulder B) proper use of a sling C) repositioning the arm in the cast D) use of isometric exercises
D
The nurse is teaching the client with a cast about home care includes which instruction? A) keep the cast below heart level B) fix a broken cast by applying tape C) cover the cast with plastic or rubber D) dry a wet fiberglass cast thoroughly to avoid skin problems
D
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
Which cleansing solution is the most effective for use in completing pin site care? A) betadine B) hydrogen peroxide C) alcohol D) chlorhexidine
D
Which statement is accurate regarding care of a plaster cast? A) the cast will dry in about 12 hours B) the cast must be covered w/ a blanket to keep it moist during the first 24 hours C) a dry plaster cast is dull and gray D) the cast can be dented while it is damp
D
Which term describes a surgical procedure to release constricting muscle fascia so as to relieve muscle tissue pressure? A) osteotomy B) arthrodesis C) arthroplasty D) fasciotomy
D
Which would be consistent as a component of self-care activities for the client with a cast? A) use a plastic hanger wrapped in gauze to scratch under the cast B) frequently place the casted extremity in a dependent position C) cover the cast with plastic to insulate it D) cushion rough edges of the cast with tape
D
Which would be contraindicated as a component of self-care activities for the client with a cast? A) elevate the casted extremity to heart level frequently B) cushioning rough edges of the cast w/ tape C) don't attempt to scratch the skin under a cast D) cover the cast with plastic to insulate it
D
A client with a long arm cast continues to complain of unrelieved throbbing pain even after receiving opioid pain medication. Which is the priority action by the nurse? A) assess for complications B) assess for previous opioid drug use C) reposition the client for comfort D) teach relaxation techniques
A
Which interventions should a nurse implement as part of initial pain relief for the client with a cast? SATA A) administer analgesics B) provide passive ROM C) elevate the involved part D) apply cold packs E) apply a new cast
A, C, D
Which orthopedic surgery is done to correct and align a fracture after surgical dissection and exposure of the fracture? A) total joint arthroplasty B) joint arthroplasty C) open reduction D) arthrodesis
C
Which principal applies to the client in traction? A) knots in the ropes should touch the pulley B) weights should rest on the bed C) skeletal traction is never interrupted D) weights are removed routinely
C
