Care of Patients with Hip Arthroplasty, Knee Arthroplasty, and Amputations
What is an important health teaching point for a patient with total joint arthroplasty? A. "Do not use the joint" B. "Stress the joint" C. "Protect the joint" D. "Guard the muscles"
C. "Protect the joint"
The nurse is caring for a patient who had hemiarthroplasty and is at risk for hip dislocation. The nurse ensures that the hip is maintained in which position? A. Adduction B. Anatomically neutral C. Abduction D. Extended
C. Abduction
A nurse is caring for a client with a below-the-knee amputation. What should the nurse encourage the client to do prepare the residual limb for a prosthesis? A. Abduct the residual limb when ambulating B. Dangle the residual limb off the bed frequently C. Soak the residual limb off the bed frequently D. Press the end of the residual limb against a pillow periodically
D. Press the end of the residual limb against a pillow periodically
A patient with a right above-the-knee amputation asks the nurse why he has phantom limb pain. What is the nurse's best response? A. "Phantom limb pain is not explained or predicted by any one theory" B. "Phantom limb pain occurs because your body thinks your leg is still present" C. "Phantom limb pain will not interfere with your activities of daily living" D. "Phantom limb pain is not real pain but is remembered pain"
A. "Phantom limb pain is not explained or predicted by any one theory"
When should the nurse begin the process of rehabilitation when a client is scheduled for an amputation? A. Before surgery B. During the convalescent phase C. On discharge from the hospital D. When it is time for a prosthesis
A. Before surgery
The nurse assesses the patient's surgical hip site and measures the drainage every 4 hours. At 0700 there is 30 mL in the drainage container; at 1100 there is 10 mL; at 1500 there is 5 mL; at 1900 there is 20 mL. What should the nurse do? A. Document the drainage and continue to observe the site and drainage every 4 hours B. Take vital signs, observe the site for signs of hemorrhage, and notify the surgeon C. Document the findings but change the assessment frequency to every 2 hours D. Ask the patient if there is increased pain or decreased sensation on the affected side
A. Document the drainage and continue to observe the site and drainage every 4 hours
What instructions should the nurse provide when the client is allowed out of bed after an above-the-knee amputation? A. Keep the hip in extension and alignment B. Keep the hip raised with residual limb elevated C. Life the shoulder and hip of affected side when taking a step D. Use the ordered crutches until the residual limb is completely healed
A. Keep the hip in extension and alignment
Following a total joint arthroplasty, which patients have a higher risk of venous thromboembolism (VTE)? SATA A. Older patient who has trouble with mobility at baseline B. Obese patient with chronic pain associated with rheumatoid arthritis C. Patient with a previous history of VTE related to job as a truck driver D. Thin patient who needs medication for hyperthyroidism E. Patient with compromised circulation secondary to sickle cell disorder F. Patient with a history of osteoarthritis pain that is treated with acetaminophen
A. Older patient who has trouble with mobility at baseline B. Obese patient with chronic pain associated with rheumatoid arthritis C. Patient with a previous history of VTE related to job as a truck driver E. Patient with compromised circulation secondary to sickle cell disorder
The nurse is caring for a patient who had a total joint replacement and administers subcutaneous enoxaparin as ordered. Which outcome statement indicates that the intended goal of the enoxaparin therapy is being met? A. Patient does not show signs or symptoms of venous thromboembolism B. Prothrombin time and International Normalized Ration are within normal range C. Pain is rated at 3/10 within 30 minutes after receiving the medication D. Wound site is free of infection signs and oral temperature is 98.8
A. Patient does not show signs or symptoms of venous thromboembolism
Which patient circumstance would be considered a contraindication for total joint arthroplasty? A. Patient is currently being treated for a persistent urinary tract infection B. Patient reports pain and loss of mobility related to joint dysfunction C. Patient reports her osteopenia is now considered to be osteoporosis D. Patient is elderly and has no one to provide postoperative care
A. Patient is currently being treated for a persistent urinary tract infection
A nurse is caring for a client with a fracture of the head of the femur. the health care provider places the client in a Buck extension. What explanation does the nurse give the client for why traction is being used? A. Reduces muscle spasms B. Prevents soft tissue edema C. Reduces the need for cast application D. Prevents damage to the surrounding nerves
A. Reduces muscle spasms
After an open reduction and internal fixation of a fractured hip, what assessments of the client's affected leg should the nurse make? SATA A. Skin temperature B. Mobility of the hip C. Sensation in the toes D. Condition of the pins E. Presence of pedal pulses
A. Skin temperature C. Sensation in the toes E. Presence of pedal pulses
A patient is reluctant to consider hip surgery because of a fear of blood transfusion reaction. What is the nurse's best response? A. "No one will force you to receive blood if you don't want it" B. "A cell saver can be used to collect your own red blood cells during surgery." C. "It's unlikely that you will need a blood transfusion, please don't worry." D. "Blood products are very safe these days and there are numerous safety protocols."
B. "A cell saver can be used to collect your own red blood cells during surgery."
A nurse provides discharge teaching for a client who had a total hip replacement. Which activities to avoid identifies by the client indicate an understanding of the teaching? SATA A. Climbing stairs B. Crossing the legs C. Stretching exercises D. Sitting in a low chair E. Lying prone for 30 minutes
B. Crossing the legs D. Sitting in a low chair
A client had an above-the-knee amputation of the left leg because of trauma from a motor vehicle collision. The health care provider orders ambulation with crutches until the residual limb is healed and the client can be fitted with a prosthesis. What should be the nurse's first intervention? A. Demonstrate the swing-through crutch walking gait B. Determine if the client has ever used crutches before C. Introduce the client to another client who is using cructhes D. Provide a pamphlet that has information about using crutches
B. Determine if the client has ever used crutches before
The patient is a middle-aged man with a history of uncontrolled diabetes. His right foot is a dark brownish-purple color, and there is no palpable dorsalis pedis or posterior tibialis pulse. The nurse prepares the patient for which diagnostic test? A. X-ray of the foot and ankle B. Doppler ultrasound C. Electromyelogram D. Arthrogram
B. Doppler ultrasound
What should be included in the nurse's instructions to help a client prepare for walking with crutches? A. Use of the trapeze to strengthen the bicep muscles B. Exercises with or without weights to strength the muscles of the upper extremities C. The importance of keeping the affected limb in extension and abduction to prevent contractures D. Isometric exercises of the hamstring muscles while sitting in a chair until circulatory status is stable
B. Exercises with or without weights to strength the muscles of the upper extremities
Which crutch gait should the nurse teach the client wearing a prosthesis after a single-leg amputation? A. Tripod B. Four-point C. Three-point D. Swing-through
B. Four-point
Which patients with fractures have factors that put them at risk for developing venous thromboembolism? SATA A. Has type 2 diabetes mellitus B. Had hip surgery that took several hours C. Is obese and smokes 2 packs per day D. Takes oral contraceptives E. Takes steroid medications F. Was bedridden prior to sustaining fracture
B. Had hip surgery that took several hours C. Is obese and smokes 2 packs per day D. Takes oral contraceptives F. Was bedridden prior to sustaining fracture
After an above-the-knee amputation of a leg, a client reports pain in the foot that is no longer there. What should the nurse include about phantom limb pain in a discussion with the client? A. Tactile illusions associated with severed blood vessels B. Nerve endings in the limb are still intact and react to stimuli C. An unconscious phenomenon to aid with grieving over the lost body part D. Hallucinations secondary to emotional symptoms associated with the distress of amputation
B. Nerve endings in the limb are still intact and react to stimuli
Every 2 to 4 hours, the nurse assesses a patient who has a continuous femoral nerve blockade for postoperative pain management following a knee joint replacement. Which findings prompt the nurse to alert the surgeon about untoward systemic effects of the local anesthesia? A. Patient is unable to detect pain with plantar flexion of the affected foot B. Patient reports metallic taste, tinnitus, and a nervous feeling C. Patient says that the affected foot feels warmer than the unaffected foot D. Patient reports nausea and mild abdominal discomfort
B. Patient reports metallic taste, tinnitus, and a nervous feeling
The nurse is caring for a patient with an above-the-knee amputation. To prevent hip flexion contractures, how does the nurse position the patient? A. Supine position with the residual limb elevated on a pillow B. Prone position every 3-4 hours for 20-to-30 minute periods C. Supine position with an abduction pillow placed between the legs D. Head of the bed elevated 30 degrees with bandage snug around the limb
B. Prone position every 3-4 hours for 20-to-30 minute periods
The charge nurse is assigning the nursing care of a patient who had a left below-the-knee amputation 1 day ago to an experienced LPN/LVN, who will function under an RN's supervision. What will the RN tell the LPN/LVN is the major focus for the patients care today? A. To attain pain control over phantom pain B. To monitor for signs of sufficient tissue perfusion C. To assist the patient to ambulate as soon as possible D. To elevate the residual limb when the patient is supine
B. To monitor for signs of sufficient tissue perfusion
A nurse is caring for a client who had an open reduction internal fixation of a fractured hip. Which nursing assessment of the affected leg is most important after this surgery? A. Femoral pulse B. Toes for mobility C. Condition of the pin D. Range of motion of the knee
B. Toes for mobility
A client has a total hip replacement. Which clinical indicators of pulmonary embolism indicates that the plan to prevent postoperative thrombus formation has been ineffective? SATA A. Flushing of the face B. Unilateral chest pain C. Elevation of temperature D. Sudden onset of shortness of breath E. Pain rating increase from 2 to 8 in the hip
B. Unilateral chest pain D. Sudden onset of shortness of breath
Nursing care of a client with a fractured hip should include the assessment of pedal pulses. The nurse should assess for which important characteristics of the pedal pulses? A. Contractility and rate B. Color of skin and rhythm C. Amplitude and symmetry D. Local temperature and visible pulsations
C. Amplitude and symmetry
When educating a patient about total joint arthroplasty (TJA), what does the nurse do first? A. Ensure that the patient wants the procedure B. Review instructions and ask the patient to repeat back C. Assess the patient's knowledge about TJA D. Ask if the provider has explained the procedure
C. Assess the patient's knowledge about TJA
A young high school athlete had a great toe amputated because of severe injury. The patient is depressed and withdrawn after the health care provider tells him that the amputation will affect balance and gait. What should the nurse do first? A. Explain the role of physical therapy exercises that help with balance and gait B. Involve the parents and patient in a discussion about rehabilitation programs C. Encourage verbalization of feelings and thoughts related to the situation D. Explore how the patient has coped and handled stressful situations in the past
C. Encourage verbalization of feelings and thoughts related to the situation
A client has an amputation of a lower limb. What instructions should the nurse give the client to prevent a hip flexion contracture? A. Turn from side to side every 1 to 2 hours B. Sit in a chair for 30 minutes three times a day C. Lie on the abdomen 30 minutes four times daily D. Perform quadriceps muscle setting exercises twice daily
C. Lie on the abdomen 30 minutes four times daily
A client has surgery to repair a fractured right hip. Where should the nurse stand when assisting the client to ambulate? A. Behind the client B. In front of the client C. On the client's left side D. On the client's right side
C. On the client's left side
Which principle should the nurse consider when assisting a client with crutches to learn the four-point gait? A. Elbows should be kept in ridgid extension B. Most of the weight should be supported by axillae C. The client must be able to bear weight on both legs D. The affected extremity should be kept off the ground
C. The client must be able to bear weight on both legs
An older patient is discharged to home following an orthopedic injury. Which mobilization device would be preferred if the patient is having trouble with balance? A. Crutches B. Cane C. Walker D. Wheelchair
C. Walker
A nurse is teaching crutch walking to a client who had arthroscopic surgery of the knee. On which part of the body should the nurse instruct the client to place weight? A. The upper arms B. The axillary region C.Palms of the hands D. Both lower extremities
C.Palms of the hands
The nurse is caring for a patient who had a total hip replacement. On assessment, the nurse observes shortening of the affected leg and internal rotation. The patient reports increased pain that is not relieved with medication. What should the nurse do? A. Conduct additional pain assessment and obtain new medication orders B. Position the leg in an anatomical position and place pillows for support C. Compare the length of the affected leg to unaffected leg D. Keep the patient in bed and immediately notify the surgeon
D. Keep the patient in bed and immediately notify the surgeon
A nurse is caring for a client who developed aseptic necrosis after a fracture of the head of the femur. The nurse understands that aseptic necrosis is associated with which factor? A. Infection at the site of the wound B. Weight-bearing before the fracture is healed C. Immobilization after reduction of the fracture D. Loss of blood supply to the head of the femur
D. Loss of blood supply to the head of the femur
A nurse is caring for a client who had an open reduction and internal fixation of a femoral neck fracture. The client has an ordered ambulation with slight weight-bearing on the affected extremity. During the physical assessment the nurse identifies that the client has kyphosis and strong upper arm strength. What assistive device does the nurse expect the health care provider to order for this client? A. Crutches B. Quad cane C. Straight cane D. Standard cane
D. Standard cane
To prevent venous thromboembolism, several types of anticoagulant medications can be ordered. Which drug is most commonly used during hospitalization? A. Oral or parenteral aspirin B. Oral warfarin C. Intravenous tissue plasminogen activator (tPA) D. Subcutaneous low-molecular-weight heparin (LMWH)
D. Subcutaneous low-molecular-weight heparin (LMWH)
The nurse applies bandages to a patient's residual limb in order to help shape and shrink the limb for a prosthesis. What is the proper technique for the nurse to use? A. Reapply the bandages every 8 hours or more often if they become loose B. Use a proximal to distal direction when wrapping C. Use soft, flexible bandage material and pad the area with gauze D. Use a figure-eight wrapping method to prevent restriction of blood flow
D. Use a figure-eight wrapping method to prevent restriction of blood flow
A client is ready to walk with crutches after knee surgery. Which crutch-walking technique will the nurse most likely have to reinforce after the client returns from physical therapy? A. Two-point B. Four-point C. Three-point D. Swing-through
C. Three-point
What should the nurse do to promote early and efficient ambulation after a client has a mid-thigh amputation? A. Keep the head of the bed elevated B. Place the residual limb on a pillow C. Turn the client to the prone position routinely D. Encourage the client to lie on the unaffected side
C. Turn the client to the prone position routinely
To reduce a hip fracture, the client is placed in traction before surgery for an open reduction and internal fixation. Because the client keeps slipping down in bed, increased countertraction is ordered. How does the nurse increase the countertraction? A. Elevate the head of the bed B. Add more weight to the traction C. Use a slight Trendelenburg position D. Tie a chest restraint around the client
C. Use a slight Trendelenburg position
A client is in skin traction while awaiting surgery for repair of a fractured femur. The client reports leg discomfort and asks the nurse to release the traction. Which is the nurse's best initial response? A. "I can't because the weights are needed to keep the bone aligned" B. "I will remove half of the weights and notify your health care provider" C. "I'll get your prescribed pain medications to help relieve your discomfort" D. "I have to follow the healthcare provider's directions, and releasing weights is not ordered"
A. "I can't because the weights are needed to keep the bone aligned"
A patient who has sustained a traumatic amputation of the left leg expresses grief and loss. What resources could the nurse recommend to help the patient adjust to his lost limb? SATA A. Chaplain B. Psychiatric social worker C. Physical therapist D. Orthopedic surgeon E. National amputation foundation F. Other spiritual services
A. Chaplain B. Psychiatric social worker E. National amputation foundation F. Other spiritual services
A nurse is caring for a client in the evening after the client has had a below-the-knee amputation. What action should be implemented by the nurse? A. Elevate the foot of the bed B. Assist the client out of bed to the chair C. Have the client crutch walk in the room D. Reapply the elastic bandage every two hours
A. Elevate the foot of the bed
Which intervention does the nurse implement to improve the mobility for a patient who has undergone a total hip replacement? A. Encourage use of assistive devices such as a walker when ambulating B. Recommend to quickly decrease rest periods between activities C. Instruct to flex and extend the hips at least 90 degrees when doing leg exercises D. Advise to progressively put more weight on the affected side
A. Encourage use of assistive devices such as a walker when ambulating
Which routine interventions would the nurse perform to prevent the life-threatening complication of venous thromboembolism? SATA A. Ensure that sequential compression device is in place and functional B. Administer anticoagulant therapy as ordered C. Roll and secure top of anti-embolic stockings to mid-calf area D. Encourage early ambulation E. Teach patient about leg exercises F. Encourage foods that are rich in iron and protein
A. Ensure that sequential compression device is in place and functional B. Administer anticoagulant therapy as ordered D. Encourage early ambulation E. Teach patient about leg exercises
The care plan for a client with a fractured hip includes nursing actions to prevent which type of contracture? A. Flexion of the hip B. Abduction of the hip C. Hyperextension of the hip D. Internal rotation of the hip
A. Flexion of the hip
A patient who underwent a right above-the-knee amputation 4 days ago also has a diagnosis of depression. Which order would the nurse clarify with the health care provider? A. Give fluoxetine 40 mg once a day B. Administer acetaminophen with codeine 1 or 2 tablets every 4 hours as needed C. Assist the patient to the bedside chair every shift D. Reinforce the dressing to the right residual limb as needed
A. Give fluoxetine 40 mg once a day
Which nursing intervention is best to prevent increased pain in a patient experiencing phantom limb pain? A. Handle the residual limb carefully when assessing the site or changing the dressing B. Advise the patient that the sensation is temporary and will diminish over time C. Remind the patient that the part is not really there, so the pain is not real D. Encourage the patient to mourn the loss of a body part and express grief
A. Handle the residual limb carefully when assessing the site or changing the dressing
A client has a total knee replacement, and a continuous passive motion device is being used. The nurse concludes that the teaching was effective when the client states, "The goal of therapy is to": A. Improve joint flexion B. Maintain muscle tone C. prevent tissue breakdown D. avoid formation of a blood clot
A. Improve joint flexion
An older adult patient has skin traction in place for a hip fracture. Which outcome statement reflects that the goal of the therapy is successful? A. Patient reports a decrease in painful muscle spasms B. X-ray indicates that the fracture shows signs of healing C. Patient can perform activities of daily living with some assistance D. There are no signs/symptoms of compression syndrome
A. Patient reports a decrease in painful muscle spasms
For preoperative care of a patient scheduled for total joint arthroplasty, what does the nurse plan to do? SATA A. Provide written or videotaped information about the procedure B. Assess the patient's understanding of the procedure C. Assess and include the patient's support people or family D. Obtain the patient's signature on the consent form E. Assist in scheduling needed dental procedures after the surgery F. Include interdisciplinary team members, if possible
A. Provide written or videotaped information about the procedure B. Assess the patient's understanding of the procedure C. Assess and include the patient's support people or family F. Include interdisciplinary team members, if possible
A client with a fractured hip is placed in traction until surgery can be performed. What should the nurse explain is the purpose of the traction? A. Relieve muscle spasm and pain B. Prevent contractures from developing C. Keep the client from turning and moving in bed D. Maintain the limb in a position of external rotation
A. Relieve muscle spasm and pain
The nurse assesses a postoperative patient who had a total knee replacement for neurovascular compromise. Which assessments must the nurse document? SATA A. Skin color and temperature B. Presence of absence of distal peripheral pulses C. Full range of motion for operative and nonoperative legs D. Capillary refill of operative leg E. Comparison of operative leg to nonoperative leg F. Ability to use extremity compared to baseline
A. Skin color and temperature B. Presence of absence of distal peripheral pulses D. Capillary refill of operative leg E. Comparison of operative leg to nonoperative leg
When a client is in the right side-lying position after the insertion of a left hip prosthesis, the nurse ensures that the client has a pillow placed between the thighs and that the entire length of the upper leg is supported. What does this pillow prevent? A. Strain on the operative side B. Thrombus formation in the leg C. Flexion of contractures of the hip joint D. Skin surfaces from rubbing together
A. Strain on the operative side
The nurse is supervising a nursing student in the postoperative care of a patient who had total knee replacement and has a continuous passive motion (CPM) device. When would the nurse intervene? A. Student applies hot moist compresses to the incisional area B. Student turns off the CPM while the patient is having a meal in bed C. Student places a cloth between skin of incisional area and ice packs D. Student checks to see that the CPM is well padded to protect the skin
A. Student applies hot moist compresses to the incisional area
A client experiences a traumatic amputation of a leg in a motor vehicle accident. Which nursing intervention initially should receive the lowest priority? A. Teaching residual limb care B. Monitoring hemoglobin levels C. Maintaining the compressing dressing D. Using therapeutic interviewing techniques
A. Teaching residual limb care
A client has a total hip arthroplasty. What should the nurse do when caring for this client after surgery? A. Use a pillow to keep the legs abducted B. Elevate the client's affect limb on a pillow C. Turn the client using the log-rolling technique D. Place a trochanter roll along the entire extremity
A. Use a pillow to keep the legs abducted
Which interventions can the nurse use to prevent or manage infections in patients who have undergone total joint replacement? SATA A. Use aseptic technique for wound care and emptying of drains B. Wash hands thoroughly when caring for patient C. Culture drainage fluid if a change is observed D. Encourage early ambulation along with leg exercises E. Monitor the incision every 4 hours for the first 24 hours and every 8 to 12 hours thereafter F. Advocate that the patient be placed in a private isolation room
A. Use aseptic technique for wound care and emptying of drains B. Wash hands thoroughly when caring for patient C. Culture drainage fluid if a change is observed E. Monitor the incision every 4 hours for the first 24 hours and every 8 to 12 hours thereafter
A nurse is caring for a client who had a total hip replacement. What nursing action should be incorporated into the plan of care to prevent thrombus formation? A. Turning the client from side to side B. Encouraging the client to perform ankle exercises C. Getting the client to sit in a chair for as long as tolerated D. Ambulating the client when the effects of anesthesia subsides
B. Encouraging the client to perform ankle exercises
A nurse caring for a client who had a total hip replacement. What is the priority assessment when monitoring the client for hemorrhage? A. Checking vital signs every four hours B. Examining the bedding under the client C. Measuring the circumference of the thigh D. Observing for ecchymosis at the operative side
B. Examining the bedding under the client
Which is an example of the principles of body mechanics that the nurse uses when caring for immobilized clients? A. Bending at the waist to provide the power for lifiting B. Placing the feet apart to increase the stability of the body C. Keeping the body straight when lifting to reduce pressure on the abdomen D. Relaxing the abdominal muscles while using the extremities to prevent strain
B. Placing the feet apart to increase the stability of the body
A client with a fractured hip is helped from the bed to a chair after surgery. The nurse instructs the client to bear most of the weight on the unaffected leg before sitting in a chair. What should the nurse explain is the benefit of bearing most of the weight on the unaffected leg? A. Can increase circulation in the lower extremities B. Will help maintain the strength of the unaffected side C. Is the quickest method of getting the client to and from the bed D. Reduces the amount of help necessary to life the client from bed to chair
B. Will help maintain the strength of the unaffected side
The nurse is providing care for a patient scheduled for a total hip arthroplasty. Which medication should the patient receive one hour before the surgical incision in accordance with the Surgical Care Improvement Project Core Measures? A. Low-molecular-weight heparin, such as subcutaneous enoxaparin B. Fast-acting opioid, such as IV morphine C. Broad-spectrum antibiotic, such as IV cefazolin D. Routine daily dose of oral antihypertensive
C. Broad-spectrum antibiotic, such as IV cefazolin
A patient is on anticoagulant therapy with dalteparin after total joint arthroplasty. Which laboratory test should the nurse monitor? A. Prothrombin time and International Normalized Ratio B. Oxygen saturation and liver enzymes C. Complete blood cell count and platelet count D. Erythrocyte sedimentation rate and C-reactive protein
C. Complete blood cell count and platelet count
A client is admitted with a fracture of the neck of the femur. In what position should the nurse maintain the client's affected extremity? A. Internal rotation with flexion of the knee and hip B. External rotation with flexion of the knee and hip C. Internal rotation with extension of the knee and hip D. External rotation with extension of the knee and hip
C. Internal rotation with extension of the knee and hip
A patient reports dramatic changes in color and temperature of the skin over the left foot with intense burning pain, sensitive skin, excessive sweating, and edema. The health care provider makes a preliminary medical diagnosis of complex regional pain syndrome. What is the priority for nursing care? A. Patient education B. Prevention of skin breakdown C. Management of pain D. Assessment of circulation
C. Management of pain
Which outcome statement indicates that the therapeutic goal of continuous passive motion (CPM) therapy is being met? A. Patient has no signs or symptoms of venous thromboembolism B. Stress and strain on the knee joint are reduced C. Mobility of the patient's prosthetic knee is maintained D. Patient uses the CPM device while ambulating
C. Mobility of the patient's prosthetic knee is maintained
Which factor presents the greatest risk for hip fracture? A. Decreased visual acuity B. Joint stiffness C. Osteoporosis D. Cardiac drug regimen
C. Osteoporosis
Which position should a nurse avoid placing a client who had surgery for a total hip replacement? A. Supine B. Lateral C. Othropenic D. Semi-fowler
C. Othropenic
A patient with rheumatoid arthritis (RA) may need to undergo general anesthesia for a hip replacement. Which information needs to be brought to the immediate attention of the surgeon before the procedure is scheduled? A. Patient has a previous history of joint surgery on the affected side B. Patient has been taking vitamin C and non-steroidal anti-inflammatory drugs for years C. Patient has cervical spine disease and has not had any recent spinal x-rays D. Patient fears that the procedure will cause complications because of RA
C. Patient has cervical spine disease and has not had any recent spinal x-rays
A patient is postoperative for a total hip arthroplasty and needs to get out of bed for the first time. What should the nurse do? A. Schedule an appointment for the therapist to assist the patient B. Caution unlicensed assistive personnel about fall prevention and instruct to observe for dizziness C. Put a gait belt on the patient and stand on the same side of the bed as the affected leg D. Ask the patient how much assistance is needed to stand and pivot into the chair
C. Put a gait belt on the patient and stand on the same side of the bed as the affected leg
What should the nurse do to control edema of the residual limb 1 week after a client has an above-the-knee amputation? A. Administer the prescribed diuretic B. Restrict the client's oral fluid intake C. Rewrap the elastic bandage as necessary D. Keep the residual limb elevated on a pillow
C. Rewrap the elastic bandage as necessary
Which clinical indicator should the nurse expect to identify when assessing a client with a fracture of the neck of the femur? A. Adduction with internal rotation B. Abduction with external rotation C. Shortening of the affected extremity with external rotation D. Lengthening of the affected extremity with internal rotation
C. Shortening of the affected extremity with external rotation
A patient injured a lower extremity and has been placed in running traction. What instructions does the nurse give to the unlicensed assistive personnel? A. Support the weight when turning the patient every 2 hours B. Ask the patient to turn and move himself, so that he is in control of painful stimuli C. Defer hygienic care and moving the patient until traction is removed D. Do not move the patient or the bed because countertraction can be altered
D. Do not move the patient or the bed because countertraction can be altered
On the first postoperative day after a total hip replacement a client asks for assistance onto the bedpan. What should the nurse instruct the client to do? A. Use the elbows and hands to life the pelvis off the bed B. Extend both legs and pull on the trapeze to lift the pelvis C. Turn gently toward the operative side while lifting the pelvis off the bed D. Flex the knee on the unoperated leg and pull on the trapeze to lift the pelvis
D. Flex the knee on the unoperated leg and pull on the trapeze to lift the pelvis
