Ortho NCLEX Questions and Answers with complete solutions

Ortho NCLEX Questions and Answers with complete solutions A patient complains of tingling and numbness in his right leg following application of a long leg cast. The patient's discomfort is most likely the result of: A. Reduced venous return B. Bone healing C. Arterial insufficiency D. Nerve compression - ANS -Rationale: Answer D is correct. Numbness and tingling in a n extremity immobilized by a cast are most likely the result of nerve compression. Answer A is incorrect because reduced venous return results in swelling in the extremity. Answer B is incorrect because numbness and tingling are not associated with bone healing. Answer C is incorrect because arterial insufficiency results in diminished or absent pulses in the extremity. A patient has been diagnosised with osteomalacia. What symptoms does the nurse recognize that correlate with the diagnosis? A. Bone fractures and kyphosis B. Bone pain and tenderness C. Muscle Weakness and spasms D. Softened and compressed vertebrae - ANS -Rationale: Answer B is correct. A patient is admitted for an MRI, a CT scan, and a myelogram. Which of the following medication orders should be questioned for the patient who is to have a myelogram? A. Ampicillin 250mg PO q6H B. Motrin 400mg PO q4h PRN for headache C. Seconal 50mg HS PRN sleep D. Darvon 65mg PO q4h for pain - ANS -Rationale: Answer C is correct. Seconal is a barbiturate, and CNS depressants and stimulants, as well as phenothiazines, should not be given for 48 hours prior to a mylegram because they decrease the sizure threshold. Ampicillin is an antibiotic, Motrin is an NSAID, and Darvon is an analgesic, so they can all be given, making answers A,B, and D wrong. A patient with a total knee replacement returns from surgery. Which findings require immediate nursing intervention? A. The is 30ml bloody drainage from the surgical drain B. The continuous passive motion machine is set on 90-degree flexion C. The patient is unable to ambulate to the bathroom D. The patient is complaining of muscle spasm - ANS -Answer B is correct. The CPM machine should not be set at 90-degree flexion until the fifth postoperative day. Answers A, C, and D are expected findings and do not require immediate nursing intervention, so they are incorrect A patient with an open reduction and internal fixation for a fractured hip is to being ambulation. The hip was repaired using a compression plate and screws. The patient will most likely begin ambulation with: A. Full weight bearing on the affected leg B. Nonweight bearing on the affected leg C. Toe touch weight bearing on the affected leg D. Weight bearing as tolerated on the affected leg - ANS -Answer C is correct. The patient with ORIF of a fractured hip will begin ambulation with toe touch weight bearing on the affected leg. Answer A is incorrect because it places to much weight on the newly repaired hip. Answer B is incorrect because the patient allowed to bear minimal weight on the affected leg. Answer D is incorrect because it can place too much or too little pressure on the newly repaired hip. A patient with osteoporosis has been advised to increase the amount of calcium in her diet. Which food provides the most calcium? An 8- oz glass of milk An ounce of cheddar cheese A half cup of raw broccoli A 4- ounce salmon croquette - ANS -Answer A is correct. An 8-ounce glass of milk contains 290mg of calcium. Answers B, C, and D contain lesser amounts; therefore, they are incorrect. (Note: An ounce of cheddar cheese contains 205 mg of calcium; half a cup of raw broccoli contains 175mg of calcium; and 4 ounces of salmon croquette contains 165 mg of calcium). A retired 66- year- old female patient is being evaluated for osteoporosis as part of a yearly physical exam. The patient states that she is a smoker, watches television for most of the day, and has been hospitalized twice with fractures within the last year. Based on this information, the nurse suspects which condition? A.Low bone mass leading to increased bone fragility B.Degeneration of the articular cartilage C.Recurrent attacks of acute arthritis D.Personality changes caused by chronic nature of illness - ANS -A. Low bone mass leading to increased bone fragility ' Low bone mass, structural deterioration of bone tissue leading to bone fragility, and increased susceptibility to fractures are seen with osteoporosis. The patient also has risk factors associated with osteoporosis: smoking, sedentary lifestyle, and being female and menopausal. Degenerative changes are associated with frequent exacerbations of arthritis. There is no indication of personality change in this patient. Alendronate (Fosamax) is ordered for a patient with osteoporosis. Which information should the nurse teach the patient about the medication? A. Acts as a selective estrogen receptor modulator B. Reduces risk of invasive breast cancer C. May be obtained as a nasal spray D. Inhibits bone resorption - ANS -Alendronate (Fosamax), a bisphosphonate, is a potent inhibitor of bone resorption that preserves bone mass and increases bone density. Raloxifene (Evista) is an example of a selective estrogen receptor modulator that is used to treat osteoporosis, and which also reduces the risk of invasive breast cancer. Calcitonin (Miacalcin) is dispensed as a nasal spray. An elderly female is admitted with a fractured right femoral neck. Which assessment finding is expected? A. Free movement of the right leg B. Abduction of the right leg C. Internal rotation of the right hip D. Shortening of the right leg - ANS -Rationale: Answer D is correct. The symptoms of this fracture include shortened, adducted, and external rotation. Answer A is incorrect because the patient usually is unable to move the leg due to pain. Answer B is incorrect because the symptom is adduction, not abduction. Answer C is wrong because it's external rotation, not internal rotation. An elderly patient with a fractured hip is placed in Buck's traction. The primary purpose for Buck's traction for the patient is: A. To decrease muscle spasm B. To prevent the need for surgery C. To alleviate the pain associated with the fracture D. To prevent bleeding associated with the hip fractures - ANS -Rationale: Answer A is correct. Buck's traction is a skin traction used to decrease muscle spasms. Buck's traction will not prevent the need for surgery, making answer B wrong. It also will not alleviate the pain associated with the fracture or prevent bleeding, so answers C and D are wrong. An expected outcome of an older patient with acute osteomyelitis is: A. Pain B. Fatigue C. Low-grade fever D. Elevated leukocyte count - ANS -Answer: C Rationale: Common presenting symptoms of osteomyelitis are pain, fever, edema, elevated leukocyte count, fatigue, and general malaise. However, older adults may not have an extreme temperature elevation because of lower core body temperature and compromised immune system that occur with normal aging. An important question to ask a patient with low back pain is: A. "How does your back pain affect your activities of daily living?" B. "Tell me about your pain and what interventions are helpful in managing your pain." C. "How long have you had back pain?"