NSG 430 Exam 3 Questions & Answers –
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For a patient who has had right hip arthroplasty, which nursing action can the nurse delegate
to experienced assistive personnel (AP)?
a. Reposition the patient every 1 to 2 hours.
b. Assess for skin irritation on the patient's back.
c. Teach the patient quadriceps-setting exercises.
d. Determine the patient's pain intensity and tolerance.
Reposition the patient every 1 to 2 hours.
Repositioning of orthopedic patients is within the scope of practice of AP after they have been
trained and evaluated in this skill. The other actions should be done by licensed nursing staff
members.
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A patient who arrives at the emergency department with severe left knee pain is diagnosed
with a patellar dislocation. Which information would the nurse plan to teach the patient first?
a. Use of a knee immobilizer
b. Monitored anesthesia care
c. Physical activity restrictions
d. Performance of gentle knee flexion
Monitored anesthesia care
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The first goal of interprofessional management is realignment of the knee to its original
anatomic position, which will require anesthesia or monitored anesthesia care, formerly called
conscious sedation. Immobilization, gentle range-of-motion exercises, and discussion about
activity restrictions will be implemented after the patella is realigned.
After a motorcycle accident, a patient arrives in the emergency department with severe
swelling of the left lower leg. Which action would the nurse take first?
a. Elevate the leg on 2 pillows.
b. Apply a compression bandage.
c. Assess leg pulses and sensation.
d. Place ice packs on the lower leg.
Assess leg pulses and sensation.
The initial action by the nurse will be to assess circulation to the leg and observe for any
evidence of injury such as fractures or dislocations. After the initial assessment, the other
actions may be appropriate based on what is observed during the assessment.
A pedestrian who was hit by a car is admitted to the emergency department with possible right
lower leg fractures. Which initial action would the nurse take?
a. Elevate the right leg.
b. Splint the lower leg.
c. Assess the pedal pulses.
d. Verify tetanus immunization.
Assess the pedal pulses.
The initial nursing action should be assessment of the neurovascular condition of the injured
leg. After assessment, the nurse may need to splint and elevate the leg based on the
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assessment data. Information about tetanus immunizations should be obtained if there is an
open wound.
A 60-yr-old patient had open reduction and internal fixation (ORIF) for an open, displaced
tibial fracture. Which patient problem would the nurse identify?
a. Fatigue
b. Risk for infection
c. Activity intolerance
d. Impaired bowel elimination
Risk for infection
A patient having ORIF after an open fracture is at risk for problems such as wound infection
and osteomyelitis. After ORIF, patients typically are mobilized starting the first postoperative
day, so risks of immobility such as fatigue, deconditioning, and constipation are not as likely.
The second day after admission with a fractured pelvis, a patient suddenly develops
confusion. Which action would the nurse take first?
a. Take the blood pressure.
b. Check the O2 saturation.
c. Assess patient orientation.
d. Observe for facial asymmetry.
Check the O2 saturation.
The patient's history and clinical manifestations suggest a fat embolism. The most important
assessment is oxygenation. The other actions are also appropriate but will be done after the
nurse assesses O2 saturation.
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The nurse admits a patient to the emergency department with a left femur fracture. Which
assessment finding is most important to report to the health care provider?
a. Bruising of the left thigh
b. Reports of severe thigh pain
c. Slow capillary refill of the left foot
d. Outward pointing toes on the left foot
Slow capillary refill of the left foot
Prolonged capillary refill may indicate complications such as compartment syndrome.
Bruising, pain, and rotation are typical with a femur fracture.
A patient undergoes left above-the-knee amputation with an immediate prosthetic fitting.
Which action would the nurse take when the patient arrives on the orthopedic unit after
surgery?
a. Assess the surgical site for hemorrhage.
b. Remove the prosthesis and wrap the site.
c. Place the patient in a side-lying position.
d. Keep the residual limb elevated on a pillow.
Assess the surgical site for hemorrhage.
The nurse should monitor for postoperative hemorrhage. The prosthesis will not be removed.
To avoid flexion contracture of the hip, the leg should not be elevated on a pillow or flexed in
a side lying position.
The nurse is preparing to assist a patient with ambulation 2 days after total hip arthroplasty.
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