Ortho/Neuro Exam 3 with Accurate
Solutions
On admitting a client with acute osteomyelitis, the nurse is not surprised at the client's
complaint of
a. generalized bone pain.
b. localized pain and redness.
c. nausea and vomiting.
d. paresthesias in the affected extremity. - ANSWER-b. localized pain and redness.
A client is being managed for prevention of gout and the nurse is reviewing the client's
medication list and teaching about the medications. The nurse evaluates that the client
understands the medication when the client says
a. "Allopurinol blocks production of uric acid."
b. "Colchicine can be used with probenecid."
c. "Long-term steroids are needed to prevent attacks."
d. "NSAIDs are not effective against the pain of gout." - ANSWER-
A client had a total hip arthroplasty from the posterolateral approach. The nurse ensures
correct positioning by placing the client with the operative leg
a. abducted with a triangular foam pillow.
b. externally rotated to 90 degrees.
c. in a flexed position with pillows between the knees.
d. internally rotated to no more than 60 degrees. - ANSWER-
The nurse is caring for a client with a continuous passive motion (CPM) machine after a
total knee arthroplasty. An important safety measure the nurse should add to the plan of
care is to
a. allow the client to use the machine 10-12 hours daily.
b. keep the head of the bed elevated at least 30 degrees.
c. position the client supine during CPM machine use.
d. remove the CPM machine during meals. - ANSWER-
The nurse is transferring a client with a non cemented total hip arthroplasty (THA) from
bed to walker. In order to assist the client safely, which action will the nurse encourage
before the client uses the walker? The nurse will tell the client to
a. place one foot on floor and hold the walker to stand.
b. push off of the bed with the arms and gain balance on one foot.
c. slowly bear weight on both legs.
d. stand at the bedside on both feet so the nurse can assess for syncope - ANSWER-
,A client is admitted to the emergency department with a complete fracture of the left
radius. The nurse understands that with this type of fracture, the bone is
a. displaced with fragments out of normal position.
b. fractured only through one cortex of bone.
c. fractured through the entire bone.
d. fragmented with multiple pieces of bone. - ANSWER-c. fractured through the entire
bone.
A client with a left lower leg fracture in a cast for 3 days complains to the nurse that the
pain medication does not relieve the pain any more. The priority action by the nurse
would be to
a. administer more analgesics.
b. do a neurovascular assessment.
c. elevate the cast on pillows.
d. notify the physician. - ANSWER-b. do a neurovascular assessment.
Two days after an accident in which a client sustained multiple injuries, including
fractures, the client becomes confused and dyspneic and has a fever of 103.4° F. The
nurse assesses that the client has developed
a. a fat embolism.
b. a pulmonary embolism.
c. compartment syndrome.
d. wound infection - ANSWER-a. a fat embolism.
In the emergent care of a client with a pelvic fracture, the nurse must be especially alert
for indications of the complication of
a. deep vein thrombosis.
b. hyperthermia.
c. hypovolemic shock.
d. infection. - ANSWER-c. hypovolemic shock.
The nursing intervention that would be most appropriate for a client who has entered the
emergency department with a severe strain to the knee is
a. apply a heat pack to reduce swelling.
b. elevate the leg and apply ice.
c. manipulate the knee in the full range of motion.
d. teach the client exercises to speed healing. - ANSWER-b. elevate the leg and apply
ice.
In the application of a plaster cast, the most appropriate nursing intervention is to
a. allow excess casting material to dry on the skin before removal.
b. carefully cut the stockinette to the exact length of the cast.
c. gently support the extremity from underneath.
d. flush plaster-laden water down the toilet rather than the sink. - ANSWER-
, The assessment that would alert the nurse to the possibility of cast syndrome in a client
with a spica cast is
a. abdominal distention.
b. diminished pulses in the foot.
c. "hot spot" felt on cast.
d. musty, unpleasant odor to cast. - ANSWER-a. abdominal distention.
In caring for a client in skeletal traction with a nursing diagnosis of Risk for Injury related
to traction, the nurse should take special care to
a. carefully inspect pin sites every other day to assess for pin site infection.
b. encourage the client to assume a position of comfort to reduce the risk of pressure
ulcers.
c. knot ropes between the client and pulley to prevent weights from touching the floor.
d. position weight ropes to ensure that the weights hang freely from pulleys. -
ANSWER-d. position weight ropes to ensure that the weights hang freely from pulleys.
The nurse notices a stain on a newly dried plaster cast over a client's fracture site. The
most appropriate method to assess this finding is to a. assess for a "hot spot" over the
stain.
b. bivalve the cast and inspect the site.
c. draw around the circumference with a pen and record.
d. dry the stained area of the cast with a hair dryer. - ANSWER-c. draw around the
circumference with a pen and record.
The nurse is teaching a client who has osteoarthritis ways to slow the progression of the
disease. Which statement indicates that the client understands the nurse's instruction?
a. "I will eat more vegetables and less meat."
b. "I will avoid exercising to minimize wear on my joints."
c. "I will take calcium with vitamin D every day."
d. "I will start swimming twice a week." - ANSWER-d. "I will start swimming twice a
week."
The nurse is caring for a postoperative client on the medical-surgical unit following a
total left hip replacement the previous day. During the assessment, the nurse notes that
the client's left leg is cool, with weak pedal pulses. What is the nurse's first action?
a. Assessing the circulatory status of the client's right leg
b. Notifying the surgeon
c. Massaging the leg
d. Checking for Homan's sign - ANSWER-a. Assessing the circulatory status of the
client's right leg
The nurse is caring for a postoperative client who has just come to the medical-surgical
unit after total hip replacement surgery. The client asks when she can get out of bed.
What is the nurse's best response?
a. "You can get out of bed after your Foley catheter is removed."
Solutions
On admitting a client with acute osteomyelitis, the nurse is not surprised at the client's
complaint of
a. generalized bone pain.
b. localized pain and redness.
c. nausea and vomiting.
d. paresthesias in the affected extremity. - ANSWER-b. localized pain and redness.
A client is being managed for prevention of gout and the nurse is reviewing the client's
medication list and teaching about the medications. The nurse evaluates that the client
understands the medication when the client says
a. "Allopurinol blocks production of uric acid."
b. "Colchicine can be used with probenecid."
c. "Long-term steroids are needed to prevent attacks."
d. "NSAIDs are not effective against the pain of gout." - ANSWER-
A client had a total hip arthroplasty from the posterolateral approach. The nurse ensures
correct positioning by placing the client with the operative leg
a. abducted with a triangular foam pillow.
b. externally rotated to 90 degrees.
c. in a flexed position with pillows between the knees.
d. internally rotated to no more than 60 degrees. - ANSWER-
The nurse is caring for a client with a continuous passive motion (CPM) machine after a
total knee arthroplasty. An important safety measure the nurse should add to the plan of
care is to
a. allow the client to use the machine 10-12 hours daily.
b. keep the head of the bed elevated at least 30 degrees.
c. position the client supine during CPM machine use.
d. remove the CPM machine during meals. - ANSWER-
The nurse is transferring a client with a non cemented total hip arthroplasty (THA) from
bed to walker. In order to assist the client safely, which action will the nurse encourage
before the client uses the walker? The nurse will tell the client to
a. place one foot on floor and hold the walker to stand.
b. push off of the bed with the arms and gain balance on one foot.
c. slowly bear weight on both legs.
d. stand at the bedside on both feet so the nurse can assess for syncope - ANSWER-
,A client is admitted to the emergency department with a complete fracture of the left
radius. The nurse understands that with this type of fracture, the bone is
a. displaced with fragments out of normal position.
b. fractured only through one cortex of bone.
c. fractured through the entire bone.
d. fragmented with multiple pieces of bone. - ANSWER-c. fractured through the entire
bone.
A client with a left lower leg fracture in a cast for 3 days complains to the nurse that the
pain medication does not relieve the pain any more. The priority action by the nurse
would be to
a. administer more analgesics.
b. do a neurovascular assessment.
c. elevate the cast on pillows.
d. notify the physician. - ANSWER-b. do a neurovascular assessment.
Two days after an accident in which a client sustained multiple injuries, including
fractures, the client becomes confused and dyspneic and has a fever of 103.4° F. The
nurse assesses that the client has developed
a. a fat embolism.
b. a pulmonary embolism.
c. compartment syndrome.
d. wound infection - ANSWER-a. a fat embolism.
In the emergent care of a client with a pelvic fracture, the nurse must be especially alert
for indications of the complication of
a. deep vein thrombosis.
b. hyperthermia.
c. hypovolemic shock.
d. infection. - ANSWER-c. hypovolemic shock.
The nursing intervention that would be most appropriate for a client who has entered the
emergency department with a severe strain to the knee is
a. apply a heat pack to reduce swelling.
b. elevate the leg and apply ice.
c. manipulate the knee in the full range of motion.
d. teach the client exercises to speed healing. - ANSWER-b. elevate the leg and apply
ice.
In the application of a plaster cast, the most appropriate nursing intervention is to
a. allow excess casting material to dry on the skin before removal.
b. carefully cut the stockinette to the exact length of the cast.
c. gently support the extremity from underneath.
d. flush plaster-laden water down the toilet rather than the sink. - ANSWER-
, The assessment that would alert the nurse to the possibility of cast syndrome in a client
with a spica cast is
a. abdominal distention.
b. diminished pulses in the foot.
c. "hot spot" felt on cast.
d. musty, unpleasant odor to cast. - ANSWER-a. abdominal distention.
In caring for a client in skeletal traction with a nursing diagnosis of Risk for Injury related
to traction, the nurse should take special care to
a. carefully inspect pin sites every other day to assess for pin site infection.
b. encourage the client to assume a position of comfort to reduce the risk of pressure
ulcers.
c. knot ropes between the client and pulley to prevent weights from touching the floor.
d. position weight ropes to ensure that the weights hang freely from pulleys. -
ANSWER-d. position weight ropes to ensure that the weights hang freely from pulleys.
The nurse notices a stain on a newly dried plaster cast over a client's fracture site. The
most appropriate method to assess this finding is to a. assess for a "hot spot" over the
stain.
b. bivalve the cast and inspect the site.
c. draw around the circumference with a pen and record.
d. dry the stained area of the cast with a hair dryer. - ANSWER-c. draw around the
circumference with a pen and record.
The nurse is teaching a client who has osteoarthritis ways to slow the progression of the
disease. Which statement indicates that the client understands the nurse's instruction?
a. "I will eat more vegetables and less meat."
b. "I will avoid exercising to minimize wear on my joints."
c. "I will take calcium with vitamin D every day."
d. "I will start swimming twice a week." - ANSWER-d. "I will start swimming twice a
week."
The nurse is caring for a postoperative client on the medical-surgical unit following a
total left hip replacement the previous day. During the assessment, the nurse notes that
the client's left leg is cool, with weak pedal pulses. What is the nurse's first action?
a. Assessing the circulatory status of the client's right leg
b. Notifying the surgeon
c. Massaging the leg
d. Checking for Homan's sign - ANSWER-a. Assessing the circulatory status of the
client's right leg
The nurse is caring for a postoperative client who has just come to the medical-surgical
unit after total hip replacement surgery. The client asks when she can get out of bed.
What is the nurse's best response?
a. "You can get out of bed after your Foley catheter is removed."
