MED SURG 1020 EXAM 3 (CCRI) 2025 QUESTIONS
WITH COMPLETE SOLUTONS!!
A nurse performs discharge teaching for a patient after a left hip arthroplasty
using the posterior approach. Which statement indicates teaching is
successful?
"Leg-raising exercises are necessary for several months."
"I should not try to drive a motor vehicle for 2 to 3 weeks."
"I will not have any restrictions now on hip and leg movements."
"Blood tests will be done weekly while taking enoxaparin (Lovenox)." Answer -
Correct Answer:
"Leg-raising exercises are necessary for several months."
Rationale:
Exercises designed to restore strength and muscle tone will be done for months
after surgery. The exercises include leg raises in supine and prone positions.
Driving a car is not allowed for 4 to 6 weeks. In the posterior approach hip
arthroplasties, extremes of internal rotation and 90-degree flexion of the hip
must be avoided for 4 to 6 weeks postoperatively. The knees must be kept
apart. The patient should never cross the legs or twist to reach behind. To
prevent thromboembolism, enoxaparin is administered subcutaneously and
can be given at home. Enoxaparin does not require monitoring of the patient's
coagulation status.
,The nurse is caring for a patient with osteoarthritis scheduled for total left knee
arthroplasty. Preoperatively, the nurse assesses for which contraindication to
surgery?
Pain
Left knee stiffness
Left knee infection
Left knee instability Answer - Correct Answer:
Left knee infection
Rationale:
The patient must be free of infection before total knee arthroplasty. An
infection in the joint could lead to even greater pain and joint instability,
requiring more extensive surgery. The nurse must assess the patient for signs of
infection, such as redness, swelling, fever, and elevated white blood cell count.
Pain, knee stiffness, or instability are typical of osteoarthritis.
The patient brought to the emergency department after a car accident is
diagnosed with a femur fracture. What nursing intervention should the nurse
implement at this time to decrease risk of a fat embolus?'
Administer enoxaparin (Lovenox).
Provide range-of-motion exercises.
Apply sequential compression boots.
Immobilize the fracture preoperatively. Answer - Correct Answer:
Immobilize the fracture preoperatively.
Rationale:
,The nurse immobilizes the long bone to reduce movement of the fractured
bone ends and decrease the risk of a fat embolus development before surgical
reduction. Enoxaparin is used to prevent blood clots, not fat emboli. Range of
motion and compression boots will not prevent a fat embolus in this patient.
A patient has a plaster cast applied to the right arm for a Colles' fracture.
Which nursing action is most appropriate?
Elevate the right arm on 2 pillows for 24 hours.
Apply heating pad to reduce muscle spasms and pain.
Limit movement of the thumb and fingers on the right hand.
Place arm in a sling to prevent movement of the right shoulder. Answer -
Correct Answer:
Elevate the right arm on 2 pillows for 24 hours.
Rationale:
The casted extremity should be elevated at or above heart level for 24 hours to
reduce swelling or inflammation. The cast should be supported on pillows
during the drying period to prevent denting and flattening of the cast. Ice (not
heat) should be applied for the first 24 to 36 hours to reduce swelling or
inflammation. Active movement of the thumb and fingers should be
encouraged to reduce edema and increase venous return. A sling may be used
to support and protect the extremity after the cast is completely dry, but the
patient should perform active movements of the shoulder to prevent stiffness
or contracture.
The nurse is caring for a patient who had a left total knee arthroplasty to
relieve the pain of severe osteoarthritis. What care would be expected
postoperatively?
Progressive leg exercises to obtain 90-degree flexion
, Early ambulation with full weight bearing on the left leg
Bed rest for 3 days with the left leg immobilized in extension
Immobilization of the left knee in 30-degree flexion to prevent dislocation
Answer - Correct Answer:
Progressive leg exercises to obtain 90-degree flexion
Rationale:
The patient is encouraged to engage in progressive leg exercises until 90-
degree flexion is possible; continuous passive motion also may be used based
on surgeon preference. Early ambulation is implemented, sometimes the day
of surgery, but orders are likely to indicate weight bearing as tolerated rather
than full weight bearing. Immobilization and bed rest are not indicated. The
patient's knee is unlikely to dislocate.
A patient who had a long leg cast applied this morning asks to crutch walk
before dinner. Which statement explains why the nurse will decline the
patient's request?
"You must ambulate with a physical therapist for the first few days."
"The cast is not dry yet, so it may be damaged while using crutches."
"Rest, ice, compression, and elevation are in process to decrease pain."
"Excess edema and complications are prevented when the leg is elevated for 24
hours." Answer - Correct Answer:
"Excess edema and complications are prevented when the leg is elevated for 24
hours."
Rationale:
For the first 24 hours after a lower extremity cast is applied, the leg should be
elevated on pillows above heart level to avoid excessive edema and
WITH COMPLETE SOLUTONS!!
A nurse performs discharge teaching for a patient after a left hip arthroplasty
using the posterior approach. Which statement indicates teaching is
successful?
"Leg-raising exercises are necessary for several months."
"I should not try to drive a motor vehicle for 2 to 3 weeks."
"I will not have any restrictions now on hip and leg movements."
"Blood tests will be done weekly while taking enoxaparin (Lovenox)." Answer -
Correct Answer:
"Leg-raising exercises are necessary for several months."
Rationale:
Exercises designed to restore strength and muscle tone will be done for months
after surgery. The exercises include leg raises in supine and prone positions.
Driving a car is not allowed for 4 to 6 weeks. In the posterior approach hip
arthroplasties, extremes of internal rotation and 90-degree flexion of the hip
must be avoided for 4 to 6 weeks postoperatively. The knees must be kept
apart. The patient should never cross the legs or twist to reach behind. To
prevent thromboembolism, enoxaparin is administered subcutaneously and
can be given at home. Enoxaparin does not require monitoring of the patient's
coagulation status.
,The nurse is caring for a patient with osteoarthritis scheduled for total left knee
arthroplasty. Preoperatively, the nurse assesses for which contraindication to
surgery?
Pain
Left knee stiffness
Left knee infection
Left knee instability Answer - Correct Answer:
Left knee infection
Rationale:
The patient must be free of infection before total knee arthroplasty. An
infection in the joint could lead to even greater pain and joint instability,
requiring more extensive surgery. The nurse must assess the patient for signs of
infection, such as redness, swelling, fever, and elevated white blood cell count.
Pain, knee stiffness, or instability are typical of osteoarthritis.
The patient brought to the emergency department after a car accident is
diagnosed with a femur fracture. What nursing intervention should the nurse
implement at this time to decrease risk of a fat embolus?'
Administer enoxaparin (Lovenox).
Provide range-of-motion exercises.
Apply sequential compression boots.
Immobilize the fracture preoperatively. Answer - Correct Answer:
Immobilize the fracture preoperatively.
Rationale:
,The nurse immobilizes the long bone to reduce movement of the fractured
bone ends and decrease the risk of a fat embolus development before surgical
reduction. Enoxaparin is used to prevent blood clots, not fat emboli. Range of
motion and compression boots will not prevent a fat embolus in this patient.
A patient has a plaster cast applied to the right arm for a Colles' fracture.
Which nursing action is most appropriate?
Elevate the right arm on 2 pillows for 24 hours.
Apply heating pad to reduce muscle spasms and pain.
Limit movement of the thumb and fingers on the right hand.
Place arm in a sling to prevent movement of the right shoulder. Answer -
Correct Answer:
Elevate the right arm on 2 pillows for 24 hours.
Rationale:
The casted extremity should be elevated at or above heart level for 24 hours to
reduce swelling or inflammation. The cast should be supported on pillows
during the drying period to prevent denting and flattening of the cast. Ice (not
heat) should be applied for the first 24 to 36 hours to reduce swelling or
inflammation. Active movement of the thumb and fingers should be
encouraged to reduce edema and increase venous return. A sling may be used
to support and protect the extremity after the cast is completely dry, but the
patient should perform active movements of the shoulder to prevent stiffness
or contracture.
The nurse is caring for a patient who had a left total knee arthroplasty to
relieve the pain of severe osteoarthritis. What care would be expected
postoperatively?
Progressive leg exercises to obtain 90-degree flexion
, Early ambulation with full weight bearing on the left leg
Bed rest for 3 days with the left leg immobilized in extension
Immobilization of the left knee in 30-degree flexion to prevent dislocation
Answer - Correct Answer:
Progressive leg exercises to obtain 90-degree flexion
Rationale:
The patient is encouraged to engage in progressive leg exercises until 90-
degree flexion is possible; continuous passive motion also may be used based
on surgeon preference. Early ambulation is implemented, sometimes the day
of surgery, but orders are likely to indicate weight bearing as tolerated rather
than full weight bearing. Immobilization and bed rest are not indicated. The
patient's knee is unlikely to dislocate.
A patient who had a long leg cast applied this morning asks to crutch walk
before dinner. Which statement explains why the nurse will decline the
patient's request?
"You must ambulate with a physical therapist for the first few days."
"The cast is not dry yet, so it may be damaged while using crutches."
"Rest, ice, compression, and elevation are in process to decrease pain."
"Excess edema and complications are prevented when the leg is elevated for 24
hours." Answer - Correct Answer:
"Excess edema and complications are prevented when the leg is elevated for 24
hours."
Rationale:
For the first 24 hours after a lower extremity cast is applied, the leg should be
elevated on pillows above heart level to avoid excessive edema and
