Final Exam - Med Surg ACTUAL EXAM
TEST BANK- South College-
QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES
(VERIFIED ANSWERS) |ALREADY GRADED
A+||NEWEST VERSION 2026/2027
2026/2027 Frequently Most Tested Questions and 100%
Accurate From Past papers | Graded A+ , Reviewed and
Updated | 100% Guarantee Pass | Latest Exam and Newest
Version!!!
Question 1
A nurse is caring for a client with a hip fracture who has Buck's extension traction in
place. Which of the following pieces of information should the nurse give the client
about this type of traction? (Select all that apply.)
a. "You'll have considerably less pain with the traction in place."
b. "You'll have the traction in place for a week or so."
c. "The traction will help decrease muscle spasms."
d. "The weights act as a pulling force to keep your leg and hip still."
e. "We have to make sure the weights are just barely touching the floor."
✔ Correct Answer: A, C, D
Rationale:
Buck's extension traction is a form of temporary skin traction used preoperatively for hip
fractures to reduce muscle spasm, maintain alignment, and promote comfort. The
traction applies a continuous pulling force through weights attached to the affected
extremity, which helps immobilize the hip and decrease painful muscle spasms caused by
,the fracture. As a result, clients typically experience improved pain control compared to
being without traction.
Option A is correct because traction reduces muscle spasm and stabilizes the fracture
site, leading to decreased pain. Option C is correct because one of the primary purposes
of Buck's traction is to relax surrounding muscles and reduce spasms. Option D is correct
because the weights provide a constant longitudinal pulling force that maintains
alignment and prevents movement of the injured extremity.
Option B is incorrect because Buck's traction is typically a short-term, temporary measure
used until surgical repair (often within hours to days, not weeks). Option E is incorrect
because weights must always hang freely and must never touch the floor, as this disrupts
the therapeutic traction force and compromises alignment and pain control.
From an NCLEX perspective, this question tests understanding of basic orthopedic
traction principles: continuous pull, free-hanging weights, and prevention of
complications such as pain, spasm, and misalignment. NCLEX focus: orthopedic nursing
and traction care.
A nurse is caring for a client who is scheduled to undergo surgery to repair an open hip
fracture. In which of the following positions should the nurse plan to place the client
postoperatively?
a. With the leg on the affected side adducted
b. With the hip externally rotated on the affected side
c. With the leg on the affected side abducted
d. With the hip flexed to 90° on the affected side
✔ Correct Answer: C
Rationale:
After hip fracture repair or arthroplasty, maintaining proper alignment of the hip joint is
essential to prevent dislocation. Abduction of the affected leg is the correct positioning
because it keeps the femoral head properly aligned within the acetabulum and reduces
stress on the surgical site. Abduction also prevents adduction and internal rotation,
which are the most common movements associated with postoperative hip dislocation.
Options A and B are incorrect because adduction and external rotation place the hip at
high risk for dislocation by disrupting joint alignment. Option D is incorrect because
excessive hip flexion (greater than 90°) increases the risk of prosthesis displacement and
joint instability.
From an NCLEX standpoint, this reflects postoperative orthopedic safety priorities,
,especially preventing hip dislocation after surgical repair. NCLEX focus: orthopedic
postoperative care.
A nurse is assessing a client who has a fractured left femur and is in skeletal traction.
Which of the following findings should the nurse report to the provider?
a. Ecchymosis of the thigh
b. Serous drainage at the pin site
c. Chest petechiae
d. Muscle spasms in the left leg
✔ Correct Answer: C
Rationale:
Chest petechiae in a client with a long bone fracture (such as a femur fracture) is a classic
early sign of fat embolism syndrome (FES), a life-threatening complication. Fat globules
from the bone marrow enter the bloodstream after trauma and lodge in the pulmonary
and systemic circulation. This leads to respiratory distress, neurological changes, and
petechial rash, commonly seen on the chest, neck, and upper body.
Option C is critical because it indicates systemic embolization requiring immediate
intervention to prevent progression to acute respiratory failure. Option A (ecchymosis) is
expected with trauma. Option B (serous drainage) may be normal early postoperative or
post-insertion pin drainage but should still be monitored. Option D (muscle spasms) is
common in fractures due to irritation and immobilization.
From an NCLEX priority standpoint, fat embolism is an emergency requiring immediate
provider notification and respiratory support. NCLEX focus: musculoskeletal
complications and fat embolism syndrome.
A nurse is preparing to care for a client who is in balanced skeletal traction to stabilize a
femur fracture. Which of the following actions should the nurse include in the client's
plan of care?
a. Offering the client a diet high in fluid and fiber
b. Encouraging active range of motion of the affected leg
c. Removing the weights prior to repositioning the client
d. Inspecting pin sites every 24 hr for drainage
, ✔ Correct Answer: A
Rationale:
Clients in skeletal traction experience prolonged immobility, which places them at high
risk for constipation due to decreased gastrointestinal motility. Increasing fluid intake
and dietary fiber promotes bowel regularity and helps prevent complications such as
fecal impaction.
Option B is incorrect because the affected limb is immobilized in traction, preventing
active range of motion. Option C is unsafe because weights must never be removed
without a provider's prescription, as this disrupts alignment. Option D is incorrect
because pin site care requires more frequent assessment (typically every 8–12 hours) to
detect early infection.
From an NCLEX perspective, this question emphasizes complication prevention in
immobility, particularly gastrointestinal and infection risks. NCLEX focus: traction care
and immobility complications.
A nurse is caring for a client who is in skeletal traction following a femur fracture. On
entering, the nurse finds that the client has slid toward the foot of the bed, and the
traction weight is resting on the floor. Which of the following actions should the nurse
take?
a. Remove the weight temporarily to reposition the client to the correct alignment in bed
b. Have the client use a trapeze to pull himself up while ensuring the weight hangs freely
c. Lift the rope off the pulley while the client rocks back and forth to reposition himself
d. Lift the weight manually while another staff member moves the client up in bed
✔ Correct Answer: B
Rationale:
In skeletal traction, maintaining continuous, uninterrupted traction is essential for proper
bone alignment and pain control. When a client slides down in bed, the priority is to
restore alignment without disrupting the traction force. The safest method is to assist the
client using a trapeze or coordinated repositioning while ensuring the weights remain
freely hanging at all times.
Option B is correct because it maintains traction integrity while correcting alignment.
Options A, C, and D are unsafe because removing or manually manipulating weights
disrupts continuous traction, increases pain, and may worsen misalignment or injury.
NCLEX emphasizes safety, proper maintenance of therapeutic equipment, and
TEST BANK- South College-
QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES
(VERIFIED ANSWERS) |ALREADY GRADED
A+||NEWEST VERSION 2026/2027
2026/2027 Frequently Most Tested Questions and 100%
Accurate From Past papers | Graded A+ , Reviewed and
Updated | 100% Guarantee Pass | Latest Exam and Newest
Version!!!
Question 1
A nurse is caring for a client with a hip fracture who has Buck's extension traction in
place. Which of the following pieces of information should the nurse give the client
about this type of traction? (Select all that apply.)
a. "You'll have considerably less pain with the traction in place."
b. "You'll have the traction in place for a week or so."
c. "The traction will help decrease muscle spasms."
d. "The weights act as a pulling force to keep your leg and hip still."
e. "We have to make sure the weights are just barely touching the floor."
✔ Correct Answer: A, C, D
Rationale:
Buck's extension traction is a form of temporary skin traction used preoperatively for hip
fractures to reduce muscle spasm, maintain alignment, and promote comfort. The
traction applies a continuous pulling force through weights attached to the affected
extremity, which helps immobilize the hip and decrease painful muscle spasms caused by
,the fracture. As a result, clients typically experience improved pain control compared to
being without traction.
Option A is correct because traction reduces muscle spasm and stabilizes the fracture
site, leading to decreased pain. Option C is correct because one of the primary purposes
of Buck's traction is to relax surrounding muscles and reduce spasms. Option D is correct
because the weights provide a constant longitudinal pulling force that maintains
alignment and prevents movement of the injured extremity.
Option B is incorrect because Buck's traction is typically a short-term, temporary measure
used until surgical repair (often within hours to days, not weeks). Option E is incorrect
because weights must always hang freely and must never touch the floor, as this disrupts
the therapeutic traction force and compromises alignment and pain control.
From an NCLEX perspective, this question tests understanding of basic orthopedic
traction principles: continuous pull, free-hanging weights, and prevention of
complications such as pain, spasm, and misalignment. NCLEX focus: orthopedic nursing
and traction care.
A nurse is caring for a client who is scheduled to undergo surgery to repair an open hip
fracture. In which of the following positions should the nurse plan to place the client
postoperatively?
a. With the leg on the affected side adducted
b. With the hip externally rotated on the affected side
c. With the leg on the affected side abducted
d. With the hip flexed to 90° on the affected side
✔ Correct Answer: C
Rationale:
After hip fracture repair or arthroplasty, maintaining proper alignment of the hip joint is
essential to prevent dislocation. Abduction of the affected leg is the correct positioning
because it keeps the femoral head properly aligned within the acetabulum and reduces
stress on the surgical site. Abduction also prevents adduction and internal rotation,
which are the most common movements associated with postoperative hip dislocation.
Options A and B are incorrect because adduction and external rotation place the hip at
high risk for dislocation by disrupting joint alignment. Option D is incorrect because
excessive hip flexion (greater than 90°) increases the risk of prosthesis displacement and
joint instability.
From an NCLEX standpoint, this reflects postoperative orthopedic safety priorities,
,especially preventing hip dislocation after surgical repair. NCLEX focus: orthopedic
postoperative care.
A nurse is assessing a client who has a fractured left femur and is in skeletal traction.
Which of the following findings should the nurse report to the provider?
a. Ecchymosis of the thigh
b. Serous drainage at the pin site
c. Chest petechiae
d. Muscle spasms in the left leg
✔ Correct Answer: C
Rationale:
Chest petechiae in a client with a long bone fracture (such as a femur fracture) is a classic
early sign of fat embolism syndrome (FES), a life-threatening complication. Fat globules
from the bone marrow enter the bloodstream after trauma and lodge in the pulmonary
and systemic circulation. This leads to respiratory distress, neurological changes, and
petechial rash, commonly seen on the chest, neck, and upper body.
Option C is critical because it indicates systemic embolization requiring immediate
intervention to prevent progression to acute respiratory failure. Option A (ecchymosis) is
expected with trauma. Option B (serous drainage) may be normal early postoperative or
post-insertion pin drainage but should still be monitored. Option D (muscle spasms) is
common in fractures due to irritation and immobilization.
From an NCLEX priority standpoint, fat embolism is an emergency requiring immediate
provider notification and respiratory support. NCLEX focus: musculoskeletal
complications and fat embolism syndrome.
A nurse is preparing to care for a client who is in balanced skeletal traction to stabilize a
femur fracture. Which of the following actions should the nurse include in the client's
plan of care?
a. Offering the client a diet high in fluid and fiber
b. Encouraging active range of motion of the affected leg
c. Removing the weights prior to repositioning the client
d. Inspecting pin sites every 24 hr for drainage
, ✔ Correct Answer: A
Rationale:
Clients in skeletal traction experience prolonged immobility, which places them at high
risk for constipation due to decreased gastrointestinal motility. Increasing fluid intake
and dietary fiber promotes bowel regularity and helps prevent complications such as
fecal impaction.
Option B is incorrect because the affected limb is immobilized in traction, preventing
active range of motion. Option C is unsafe because weights must never be removed
without a provider's prescription, as this disrupts alignment. Option D is incorrect
because pin site care requires more frequent assessment (typically every 8–12 hours) to
detect early infection.
From an NCLEX perspective, this question emphasizes complication prevention in
immobility, particularly gastrointestinal and infection risks. NCLEX focus: traction care
and immobility complications.
A nurse is caring for a client who is in skeletal traction following a femur fracture. On
entering, the nurse finds that the client has slid toward the foot of the bed, and the
traction weight is resting on the floor. Which of the following actions should the nurse
take?
a. Remove the weight temporarily to reposition the client to the correct alignment in bed
b. Have the client use a trapeze to pull himself up while ensuring the weight hangs freely
c. Lift the rope off the pulley while the client rocks back and forth to reposition himself
d. Lift the weight manually while another staff member moves the client up in bed
✔ Correct Answer: B
Rationale:
In skeletal traction, maintaining continuous, uninterrupted traction is essential for proper
bone alignment and pain control. When a client slides down in bed, the priority is to
restore alignment without disrupting the traction force. The safest method is to assist the
client using a trapeze or coordinated repositioning while ensuring the weights remain
freely hanging at all times.
Option B is correct because it maintains traction integrity while correcting alignment.
Options A, C, and D are unsafe because removing or manually manipulating weights
disrupts continuous traction, increases pain, and may worsen misalignment or injury.
NCLEX emphasizes safety, proper maintenance of therapeutic equipment, and
