Prep U for Brunner and Suddarth's Textbook of Medical Surgical Nursing, 13th Edition Chapter 41: Musculoskeletal Care Modalities

A client in the emergency department 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 splint is applied when more swelling is expected at the site of injury." pg. 1105

Following a total knee replacement, the surgeon orders a continuous passive motion (CPM) device. The client asks about the purpose of this treatment. The best response by the nurse is:

"CPM increases range of motion of the joint." pg. 1126

When discussing physical activities with the client who has just undergone a right total hip replacement, which instruction should the nurse provide?

"Limit hip flexion to 90 degrees." pg. 1119

The nurse is providing instructions to the client who is being prepared for skeletal traction. Which statement by the client indicates teaching was effective?

"Metal pins will go through my skin to the bone." pg. 1114

A client has a plaster cast applied to the left leg. Which of the following comments by the client following the procedure should the nurse address first?

"My toes are stiff" pg. 1107

The client who had a total hip replacement was discharged home and developed acute groin pain in the affected leg, shortening of the leg, and limited movement of the fractured leg. The nurse interprets these findings as indicating which of the following complications?

Dislocation of the hip pg. 1119

The client displays manifestations of compartment syndrome. The nurse expects the client to be scheduled for:

A fasciotomy pg. 1107

A patient had a total hip replacement. What recommended leg position should the nurse ensure is maintained to prevent prosthesis dislocation?

Abduction pg. 1123

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?

Assess for complications. pg. 1110

A nurse is caring for a client placed in traction to treat a fractured femur. Which nursing intervention has the highest priority?

Assessing the extremity for neurovascular integrity pg. 1114

A group of students is studying for a test on traction. The students demonstrate understanding of the types of traction when they identify which of the following as an example of skin traction?

Buck's pg. 1113

Which cleansing solution is the most effective for use in completing pin site care?

Chlorhexidine pg. p. 1111,1115.

A client was playing softball and dislocated four of his fingers when diving for a ball. The physician manipulated the fingers into alignment and applied a splint to maintain alignment. What type of procedure does the nurse document this as?

Closed reduction pg. 1162

Which would be contraindicated as a component of self-care activities for the client with a cast?

Cover the cast with plastic to insulate it pg. 1104

What is the best action by the nurse to achieve optimal outcomes when caring for a client with a musculoskeletal disorder who is using a cast?

Educate the client on cast care and complications pg. 1103

A client is reporting pain following orthopedic surgery. Which intervention will help relieve pain?

Elevate the affected extremity and use cold applications pg. 1105

A patient in pelvic traction needs circulatory status assessed. How should the nurse assess for a positive Homans' sign?

Have the patient extend each leg and dorsiflex each foot to determine if pain or tenderness is present in the lower leg. pg. 1121

A 68-year-old female client who had a total hip replacement is to be discharged because her healing is almost complete. Which of the following would be most important for this client?

Exploring factors related to the client's home environment pg. 1123

A nurse is caring for a client with a cast on his left arm after sustaining a fracture. Which assessment finding is most significant for this client?

Fingers on the left hand are swollen and cool pg. 1109

The nurse is very concerned about the potential debilitating complication of peroneal nerve injury. What symptom does the nurse recognize as a result of that complication?

Footdrop pg. 1109

A client has just undergone a leg amputation. The nurse would closely monitor the client for which of the following during the immediate postoperative period?

Hematoma pg. p. 1187-1188.

Which intervention should the nurse implement with the client who has undergone a hip replacement?

Instruct the client to avoid internal rotation of the leg. pg. 1119

Which is a benefit of a continuous passive motion (CPM) device when applied after knee surgery?

It promotes healing by increasing circulation and movement of the knee joint. pg. p. 1113-1126.

The nurse is caring for a client with a spica cast. A priority nursing intervention is to:

Keep the cast clean and dry. pg. 1110

A client's fracture was reduced by surgically exposing the bone and realigning it. The nurse identifies this as which of the following?

Open reduction pg. 1116

Which orthopedic surgery is done to correct and align a fracture after surgical dissection and exposure of the fracture?

Open reduction pg. 1116

A client is about to have a cast applied to his left arm. The nurse would alert the client to which of the following as the cast is applied?

Sensation of warmth or heat with application pg. 1104

A patient arrives in the emergency department with a suspected bone fracture of the right arm. How does the nurse expect the patient to describe the pain?

Sharp and piercing pg. 1106

A client is having a cast applied for a fractured leg that extends from below the knee to the base of the toes. The foot is flexed at a right angle in a neutral position. What type of cast is the client having applied?

Short leg cast pg. 1104

Which is an inaccurate principle of traction?

Skeletal traction is interrupted to turn and reposition the patient. pg. 1114

Which device is designed specifically to support and immobilize a body part in a desired position?

Splint pg. 1105

A client's left leg is in skeletal traction with a Thomas leg splint and Pearson attachment. Which intervention should the nurse include in this client's care plan?

Teach the client how to prevent problems caused by immobility. pg. 1116

A patient had a total left hip arthroplasty. What clinical manifestation would indicate to the nurse that the prosthesis is dislocated?

The left leg is internally rotated. pg. 1123

A client has severe osteoarthritis in the left hip and is having surgery to replace both articular surfaces of the hip. What type of surgical procedure will the nurse prepare the client for?

Total arthroplasty pg. 1116

A client is being discharged home with a long arm cast. What education should the nurse include to prevent disuse syndrome in the arm?

Use of isometric exercises pg. 1108

The nurse is checking the traction apparatus for a client in skin traction. Which finding would require the nurse to intervene?

Weights hanging and touching the floor pg. 1112

A hip spica cast:

encloses the trunk and a lower extremity. pg. 1104

The client with a newly applied cast complains of severe unrelenting pain. Which of the following nursing actions should the nurse do next?

Make the client NPO and notify the physician. pg. 1107