ADH2 Orthopedic
A nurse is discussing Russell's traction with a newly licensed nurse. Which of the following statements about this form of traction is appropriate? a) russell's traction uses a sling under the knee to treat a fracture of the femur b) russell's traction uses a cervical halter to decrease cervical muscle spams c) russell's traction uses a pelvic girdle belt to decrease lower back pain d) russell's traction uses skeletal pins to stabilize the fracture
a
a nurse is caring for a client who is in Buck's traction. which of the following nursing interventions is appropriate? (select all that apply) a) monitor peripheral pulses in the affected extremity b) position weights against the foot of the bed c) adjust the prescribed weights every shift d) examine the skin under the traction splint e) assess the temperature of the affected extremity
a d e
A client comes to the clinic reporting shoulder pain. When obtaining the client's history, the nurse suspects a rotator cuff injury. When assessing the client, the nurse expects to find which of the following? a) alteration in the contour of the joint b) inability to abduct the arm at the shoulder c) a negative drop arm test d) a positive Tinel's sign
b
A nurse is caring for a client following a right total hip arthroplasty. Postoperatively the nurse should maintain the right leg in a position of: a) adduction b) external rotation c) internal rotation d) abduction
d
A nurse is teaching a client who has RA about self-care techniques. Which of the following strategies should she include to illustrate the concept of joint protection? a) press water from a sponge rather than wringing it b) lift objects instead of sliding or pushing them c) finish weekly household tasks within 1 or 2 days d) engage in repetitive tasks that keep the joints mobile
A
A nurse in an urgent care center is caring for a child who has a forearm fracture. The parent tells the nurse that the provider said it was a greenstick fracture and asks what that means. The nurse should explain that: a) the bone cracked lengthwise but didn't break all the way through b) fragments of the bone have splintered into the surrounding tissue c) the bone ends have been forced toward each other d) the sharp edge of the bone has broken through the skin
a
A nurse is caring for a client who is 1 day postoperative following spinal fusion. When assessing the client, the nurse should expect which of the following findings? a) log roll the client every 2hr. b) assist the client to sit upright in a chair for 4hr at a time c) expect clear drainage on the spinal dressing d) elevate the client's legs when he is sitting in a chair
a
A nurse is caring for a client who is postoperative following a below-the-knee-amputation and will soon undergo fitting for a leg prosthesis. which of the following is an appropriate intervention for this client at this time? a) wrap the stump with an elastic bandage in a figure-eight configuration b) remove the elastic bandage and re-wrap the stump once a day c) wrap the stump with an elastic bandage in a proximal-to-distal direction d) secure the elastic bandage to the lowest joint
a
a nurse is caring for a client following a left hip arthroplasty. Which of the following should the nurse implement to prevent dislocation? a) maintain foam wedge between legs b) encourage use of elastic stockings c) monitor for shortening of the affected leg d) avoid flexing the hips more than 60 degrees
a
a nurse is caring for a client who has a cast in place for a fractured tibia. Of the following, which nursing action is the priority immediately after the provider has applied the cast? a) checking the cap refill b) discussing cast care c) managing pain d) performing ROM
a
a nurse is providing teaching for a client who is preparing for a below the knee amputation. which of the following statements is appropriate regarding the postoperative placement of a prosthesis? The prosthesis will be in place immediately following surgery to: a) improve your ability to ambulate sooner b) decrease the chance of phantom limb pain c) decrease the frequency of dressing changes d) improve the fit of the prothesis
a
a nurse is talking with a client who has gout. the nurse should teach the client not to drink which of the following beverages? a) alcohol b) orange juice c) milk d) coffee
a
a nurse is teaching a client at high risk for osteoporosis about dietary measures she can take to increase her calcium level. the nurse should advise the client to increase her intake of: a) carrots b) spinach c) cabbage d) potatoes
b
an older adult client on an orthopedic unit has an intracapsular fracture of the right hip following a fall. the client is in Buck's extension traction and will have hip prosthesis surgery in the morning. the nurse should tell the client that this type of traction helps: a) reduce the fracture b) relieve muscle spasms c) maintain alignment of the pins d) allow supported movement of the extremity
b
A nurse is caring for a client following arthroscopic knee surgery. To prevent postoperative complications, the nurse should have the client do which of the following? a) remain on bedrest for the first 24 hr b) keep the leg in a dependent position c) apply ice to the affected area d) begin active ROM
b?
A client comes to the clinical reporting chronic low back pain. He asks the nurse to recommend specific exercises for him. Which of the following activities should the nurse suggest? a) tennis b) canoeing c) swimming d) archery
c
A client who has a fracture of the right tibia has has a fiberglass cast applies. to teach the client how to observe and manage his casted extremity at home, the nurse should include which of the following instructions? a) use a blow dryer on a moderate heat setting to dry the cast after showering b) use a cotton swab to relieve itching under the cast c) report any worsening or unrelieved pain d) avoid moving the affected leg
c
A nurse is talking with a client who has a new diagnosis of gout. when the client asks the nurse how she got this disorder, the nurse should explain, in terminology that client can understand, that gout develops when a) uric acid levels drop and calcium forms precipitates b) tophi form in the kidneys and their impair the excretion of uric acid c)the intra-articular deposition of the rate crystals cause inflammation d) articular cartilage thins, leading to splitting and fragmentation
c
a client who has undergone a right below-the-knee-amputation due to trauma now has a prosthetic limb. When teaching the client about prosthesis and stump care, the nurse should include which of the following instructions? a) keep the prosthesis in direct contact with the residual limb b) apply a moisturizing lotion or oil to the stump daily c) dry the prosthesis socket completely before applying to the limb d) expect some skin irritation from the prosthesis
c
a nurse at an urgent care center cares for four clients with leg or foot injuries. which of the following client reports should suggest to the nurse that the client has an ankle sprain? a) dropping a 10-lb weight on his lower leg at the health club b) having ankle pain after running a 10-mile race c) twisting his foot while running bases during a baseball game d) getting hit by another soccer player on the field
c
a nurse is caring for a client who is postoperative from a total hip arthroplasty. the nurse assists the client into a supine position. which of the following actions is appropriate to prevent external rotation of the lower extremity? a) place a wedge pillow between the legs b) place a sandbag to the lateral calf c) place a trochanter roll against the thigh d) place a footboard on the bed
c
a nurse is discussing skeletal and skin traction with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicated understanding? a) skeletal traction has less risk for infection than skin traction b) clients with skin traction have more mobility than those with skeletal traction c) skeletal traction is more appropriate than skin traction for reducing a fracture d) clients with skin traction have more discomfort than those with skeletal traction
c
A client is about to undergo electromyography. The nurse should explain to the client that this diagnostic test involves which of the following? a) administration of a radioisotope 2hr before the procedure b) injection of a radiplaque contrast agent or air into a joint cavity c) use of x-rays or ultrasound to approximate bone mineral density d) placement of thin needed into the muscles with recording of responses to stimuli
d
A client is admitted to the rehabilitation unit following a spinal cord injury that resulted in paraplegia. after a week on the unit, the nurse notes that the client is withdrawn and increasingly resistant to rehabilitative efforts by the staff. which of the following actions should the nurse take first? a) inform the client that privileges are related to participation in therapy b) limit visiting hours until the client begins to participate in therapy c) allow the client to control the timing and frequency of therapy d) establish a plan of care with the client with mutually set attainable goals
d
A nurse in a provider's office is talking with a client for whom the provider is considering arthroplasty. when the client asks the nurse what this procedure will do for him, the nurse should explain that the purpose of the procedure is to do which of the following? a) assess the extent of joint damage b) fuse a joint and reduce pain c) prevent further joint damage d) replace the joint and improve function
d
A nurse is assessing a client who has a left lower arm fracture. Which of the following findings indicates impaired venous return in the affected arm? a) bounding distal pulse b) acute pain c) ecchymosis of the surrounding skin d) increasing edema
d
a nurse is assessing the effectiveness of the elastic bandage on the stump of a client who has a right below-the-knee amputation. which of the following findings should alert the nurse to a possible complication? a) pitting edema around the stump dressing b) looseness of the stump dressing c) the dressing forming a cone shape over the stump e) figure-8 wrapping around the stump
a
a nurse is teaching a client who has fibromyalgia about strategies that might help reduce her symptoms. which of the following interventions should the nurse include? a) establish a regular sleep pattern b) avoid exercise during flare-ups c) try jogging or running between flare-ups d) increase calcium intake
a
A client has returned to the surgical unit after a mastectomy. The nurse caring for the client should assist her in performing which of the following exercises on her affected side on the first postoperative day? (select all that apply) a) squeezing a rolled washcloth b) flexing and extending her hand c) flexing and extending her elbow d) rotation of her shoulder e) hand wall climbing
a b c
A nurse is assessing a client who has Paget's disease of the bone. Which of the following findings should the nurse expect? (select all that apply) a) cranial enlargement b) skeletal pain c) waddling gait d) cold extremities e) vision defects
a b c
a nurse is assessing a client who has a herniated cervical intervertebral disc. which of the following findings should the nurse expect? (select all that apply) a) tingling in the arms b) low back pain c) shoulder pain d) hip pain e) stiff neck
a c e
a nurse is educating coworkers about how to minimize back pain and avoid repeated episodes of low back pain. which of the following strategies should the nurse include? a) avoid prolonged sitting b) apply cold packs frequently c) sleep in a side-lying position with flexed knees d) sleep on a soft mattress e) try shoe insoles
a c e
an occupation health nurse is instructing workers at an industrial facility in emergency procedures in the event of a traumatic amputation. which of the following guidelines should the nurse included for preserving part of the possible surgical reattachment? (select all that apply) a) wrap the part in dry sterile gauze b) place the severed end of the part into crushed ice c) put the severed part in a dry, waterproof plastic bag d) wrap the covered part in an elastic bandage e) prevent contact of the severed party with water
a c e
A nurse in an urgent care center is caring for a client who fell and injured her ankle. the ankle appears swollen and ecchymotic. while the client waits for the technician to take x-rays, which of the following are appropriate nursing interventions? (select all that apply) a) apply ice to the ankle b) encourage ROM of the foot c) provide the client with a light snack d) apply a compression bandage e) elevate the foot
a d e
a nurse in an urgent care center is caring for a client who has an ankle sprain. which of the following interventions are appropriate? (select all that apply) a) rest b) movement c) heat application d) compression e) elevation
a d e
A client returns to the surgical unit from post anesthesia care unit in skeletal traction. The nurse should take action to correct which of the following problems with the traction setup? a) the ropes are in the center of the wheel grooves b) the weights rest against the foot of the bed c) the weights are equal on each side d) the ropes attach securely attached to the pin
b
A client tells a nurse at the clinic that she thinks she might be developing RA because she has some stiffness in her joints. which other early manifestation of RA should the nurse expect to find when she assesses the client? a) muscle atrophy b) fatigue c) temporomandibular joint pain d) decreased ROM
b
A client who has had RA for 3 years reports increasing pain and stiffness in her hands, especially in the morning. on physical examination, the nurse in the clinic should expect which of the following findings? a) anorexia b) knuckle deformity c) low-grade fever d) reddened joints
b
A nurse is caring for a client who has just undergone insertion of a femoral head prosthesis. The nurse should instruct the client to avoid which of the following activities? a) placing a large pillow between the legs when turning b) putting on shoes and socks c) using a raised toilet seat d) using a walker
b
A nurse is caring for a client who is 1 day postoperative following hip open reduction with internal fixation. It is 0830 and the client will begin physical therapy (PT) at 0900. Which of the following is an appropriate nursing intervention for this client at this time? a) assist the client out of bed into the wheelchair b) identify the client's pain level and medicate if needed c) teach the client which positions to avoid during PT d) complete the client's usual morning care
b
A nurse is planning care for a client who is postoperative from a total hip arthroplasty. which of the following is appropriate to include in the plan of care? a) instruct the client to avoid movement of the affected leg b) prevent hip flexion of the affected extremity c) position the lower extremities so that they are touching d) ensure that the client's heels are touching the bed
b
a nurse assessing a client who has multiple fractures in his left leg notes increasing edema. because this is often the first sign of a serious complication of fractures, the nurse should suspect which of the following? a) fat embolism syndrome b) acute compartment syndrome c) pulmonary embolism d) osteomyelitis
b
a nurse assigns an AP to apply a footplate to the bed of a client who has his left leg in Buck's traction. the nurse correctly explains that the purpose of this action is to: a) anchor the traction b) prevent foot drop c) keep the client from sliding down in bed d) prevent pressure areas on the foot
b
a nurse is caring for a client who has a femur fracture suspects fat embolism syndrome. Which of the following findings is the nurse's earliest warning that this complication is developing? a) petechiae b) confusion c) tachycardia d) crackles
b
a nurse is giving discharge instructions to a client who had an internal repair of a right hip fracture. the nurse knows that teaching has been effective when the client tells her that he will rest during the day sitting on which of the following pieces of furniture? a) a reclining chair with an ottoman b) a straight-backed chair with an elevated seat c) a couch with plush cushions d) a rocking chair with a curved back
b
a nurse is giving instructions to a client who has a surgical correction of hallux values (a bunion). which of the following should the nurse include? a) expect the foot to be numb for several days post b) rest frequently with the foot elevated c) expect the foot to take at least 3 weeks to heal walk primarily on the heel to relieve pressure on the toes
b
a client comes to the clinical reporting wrist pain. when obtaining the client's history, the nurse suspects carpal tunnel syndrome. when assessing the client, the nurse should expect to find which of the following? a) decreased radial pulse b) positive Ckvostek's sign c) cool extremities d) positive Phalen's sign
d
a nurse is caring for a client who has a fractured femur. which of the following techniques should the nurse use when performing a assessment of circulatory status? a) ask the client to cough and deep-breathe b) observe the client's ability to turn himself in bed c) assist the client in performing biceps exercises d) instruct the client to wiggle his toes
d
a nurse is caring for a client who is 2 days postoperative following an above-the-knee-amputation. when of the following is an appropriate nursing intervention for this client at this time? a) elevate the foot of the bed b) encourage sitting up as much as possible c) elevate the stump on a pillow d) have the client lie prone several times a day
d
a nurse is completing discharge instructions with a client following hospitalization for an acute onset of gout. which of the following client statements should indicate to the nurse that the client understands the treatment regimen? a) i will closely follow a high-purine diet b) i will limit my fluid intake to 1 liter per day c) i will take one enteric-coated aspirin every day d) i will drink one one beer, at most, a night
d