Nursing 354 Orthopedic Nursing
Practice Exam Questions And Correct
Answers (Verified Answers) Plus
Rationales 2026 Q&A Instant Download
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1. A nurse is caring for a patient with a newly applied plaster cast on the lower
extremity. Which assessment is the priority?
A. Skin temperature proximal to the cast
B. Presence of edema around the cast
C. Neurovascular status of the affected extremity
D. Patient's ability to move the unaffected leg
Answer: C. Neurovascular status of the affected extremity
Rationale: Neurovascular assessment is the priority because swelling or a
restrictive cast can impair circulation and nerve function, potentially leading to
compartment syndrome or tissue ischemia.
2. A patient with a fractured femur suddenly reports severe pain that is not
relieved by prescribed analgesics. The nurse notes pain with passive
movement of the extremity. What complication should the nurse suspect?
,A. Osteoarthritis
B. Compartment syndrome
C. Osteoporosis
D. Muscle strain
Answer: B. Compartment syndrome
Rationale: Severe pain disproportionate to the injury and pain with passive
stretching are early findings of compartment syndrome and require immediate
intervention.
3. A patient is admitted with a hip fracture. Which nursing intervention is most
appropriate while awaiting surgical repair?
A. Encourage unrestricted ambulation
B. Maintain prescribed immobilization and alignment
C. Massage the affected hip
D. Place the patient in a prone position
Answer: B. Maintain prescribed immobilization and alignment
Rationale: Maintaining alignment and immobilization helps prevent further
tissue damage, reduces pain, and decreases the risk of complications while the
patient awaits definitive treatment.
4. A nurse is caring for a patient with skeletal traction. Which action is
appropriate?
A. Allow the weights to rest on the floor
B. Remove the weights during repositioning
C. Ensure the weights hang freely
D. Place the weights directly on the bed
Answer: C. Ensure the weights hang freely
,Rationale: Skeletal traction must provide continuous, properly directed force.
Weights should hang freely and should not rest on the floor or bed.
5. Which finding in a patient with skeletal traction requires immediate nursing
attention?
A. Mild discomfort at the pin site
B. Warm toes with brisk capillary refill
C. Numbness and increasing pain in the affected extremity
D. Slight muscle weakness after prolonged immobility
Answer: C. Numbness and increasing pain in the affected extremity
Rationale: Increasing pain and sensory changes may indicate neurovascular
compromise or compartment syndrome and require immediate assessment and
intervention.
6. A patient with a fractured tibia is receiving pain medication. Which
additional intervention can help reduce swelling during the acute phase?
A. Elevating the extremity as prescribed
B. Applying continuous heat
C. Massaging the injured area
D. Placing the extremity below heart level
Answer: A. Elevating the extremity as prescribed
Rationale: Elevation promotes venous return and can help reduce edema.
Excessive elevation or positioning should be avoided if it compromises
prescribed fracture alignment or circulation.
7. Which assessment finding is most concerning in a patient with a casted
arm?
, A. Mild itching beneath the cast
B. Slight swelling during the first few hours
C. Fingers that are pale, cool, and numb
D. Mild discomfort relieved by medication
Answer: C. Fingers that are pale, cool, and numb
Rationale: Pallor, coolness, and numbness indicate possible impaired circulation
and nerve function. This requires prompt neurovascular assessment and
intervention.
8. A patient has undergone total hip arthroplasty. Which action should the
nurse teach the patient to avoid?
A. Using an elevated toilet seat
B. Keeping the legs properly aligned
C. Crossing the legs
D. Using assistive devices as instructed
Answer: C. Crossing the legs
Rationale: Crossing the legs can cause excessive hip adduction and increase the
risk of prosthetic hip dislocation.
9. Which position is generally appropriate for a patient following total hip
arthroplasty when specifically prescribed to maintain hip alignment?
A. Legs crossed at the knees
B. Hip flexed beyond 90 degrees
C. Affected leg maintained in proper alignment with an abduction device if
ordered
D. Affected leg internally rotated
Answer: C. Affected leg maintained in proper alignment with an abduction
device if ordered
Practice Exam Questions And Correct
Answers (Verified Answers) Plus
Rationales 2026 Q&A Instant Download
1. A nurse is caring for a patient with a newly applied plaster cast on the lower
extremity. Which assessment is the priority?
A. Skin temperature proximal to the cast
B. Presence of edema around the cast
C. Neurovascular status of the affected extremity
D. Patient's ability to move the unaffected leg
Answer: C. Neurovascular status of the affected extremity
Rationale: Neurovascular assessment is the priority because swelling or a
restrictive cast can impair circulation and nerve function, potentially leading to
compartment syndrome or tissue ischemia.
2. A patient with a fractured femur suddenly reports severe pain that is not
relieved by prescribed analgesics. The nurse notes pain with passive
movement of the extremity. What complication should the nurse suspect?
,A. Osteoarthritis
B. Compartment syndrome
C. Osteoporosis
D. Muscle strain
Answer: B. Compartment syndrome
Rationale: Severe pain disproportionate to the injury and pain with passive
stretching are early findings of compartment syndrome and require immediate
intervention.
3. A patient is admitted with a hip fracture. Which nursing intervention is most
appropriate while awaiting surgical repair?
A. Encourage unrestricted ambulation
B. Maintain prescribed immobilization and alignment
C. Massage the affected hip
D. Place the patient in a prone position
Answer: B. Maintain prescribed immobilization and alignment
Rationale: Maintaining alignment and immobilization helps prevent further
tissue damage, reduces pain, and decreases the risk of complications while the
patient awaits definitive treatment.
4. A nurse is caring for a patient with skeletal traction. Which action is
appropriate?
A. Allow the weights to rest on the floor
B. Remove the weights during repositioning
C. Ensure the weights hang freely
D. Place the weights directly on the bed
Answer: C. Ensure the weights hang freely
,Rationale: Skeletal traction must provide continuous, properly directed force.
Weights should hang freely and should not rest on the floor or bed.
5. Which finding in a patient with skeletal traction requires immediate nursing
attention?
A. Mild discomfort at the pin site
B. Warm toes with brisk capillary refill
C. Numbness and increasing pain in the affected extremity
D. Slight muscle weakness after prolonged immobility
Answer: C. Numbness and increasing pain in the affected extremity
Rationale: Increasing pain and sensory changes may indicate neurovascular
compromise or compartment syndrome and require immediate assessment and
intervention.
6. A patient with a fractured tibia is receiving pain medication. Which
additional intervention can help reduce swelling during the acute phase?
A. Elevating the extremity as prescribed
B. Applying continuous heat
C. Massaging the injured area
D. Placing the extremity below heart level
Answer: A. Elevating the extremity as prescribed
Rationale: Elevation promotes venous return and can help reduce edema.
Excessive elevation or positioning should be avoided if it compromises
prescribed fracture alignment or circulation.
7. Which assessment finding is most concerning in a patient with a casted
arm?
, A. Mild itching beneath the cast
B. Slight swelling during the first few hours
C. Fingers that are pale, cool, and numb
D. Mild discomfort relieved by medication
Answer: C. Fingers that are pale, cool, and numb
Rationale: Pallor, coolness, and numbness indicate possible impaired circulation
and nerve function. This requires prompt neurovascular assessment and
intervention.
8. A patient has undergone total hip arthroplasty. Which action should the
nurse teach the patient to avoid?
A. Using an elevated toilet seat
B. Keeping the legs properly aligned
C. Crossing the legs
D. Using assistive devices as instructed
Answer: C. Crossing the legs
Rationale: Crossing the legs can cause excessive hip adduction and increase the
risk of prosthetic hip dislocation.
9. Which position is generally appropriate for a patient following total hip
arthroplasty when specifically prescribed to maintain hip alignment?
A. Legs crossed at the knees
B. Hip flexed beyond 90 degrees
C. Affected leg maintained in proper alignment with an abduction device if
ordered
D. Affected leg internally rotated
Answer: C. Affected leg maintained in proper alignment with an abduction
device if ordered
