NUR 390 Final Exam Questions and Correct
Answers 2025| Actual New Version with
Verified Answers
A nurse is assessing a patient who has just had a total hip replacement. The patient
suddenly reports severe pain in the operated hip, along with swelling and an increased
heart rate. What is the priority action for the nurse to take?
a) Administer the prescribed pain medication and monitor the patient's response.
b) Check the patient's vital signs and compare them to baseline measurements.
c) Notify the healthcare provider immediately about the sudden severe pain and
symptoms.
d) Encourage the patient to perform gentle range-of-motion exercises to alleviate
discomfort. CORRECT ANSWER: Notify the healthcare provider immediately about
the sudden severe pain and symptoms.
Rationale: Severe pain, swelling, and increased heart rate may indicate complications
such as deep vein thrombosis (DVT) or an infection. Immediate notification to the
healthcare provider is crucial for timely intervention and management.
What are some expected assessment findings for fractures? CORRECT ANSWER:
Bruising, Decreased Distal Pulses (Hip)
Edema
Loss of Function
Numbness/Tingling
Tenderness/Pain
Warmth at Site
Wound over injured site
Exposure of bone
What are 5 complications of fractures that a nurse should watch for? CORRECT
ANSWER: Infection
Rhabdomyolysis
Venous Thromboembolism
Fat Embolism Syndrome
Compartment Syndrome
What are the triad of symptoms that indicate Fat Embolism Syndrome? CORRECT
ANSWER: Neurologic Changes
Petechial Rash
Hypoxemia
Which are manifestations of Fat Embolism Syndrome? (Select all that apply)
,ARDS
Pallor
ECG changes
PaO2 < 60mmHg
Adipose cells in blood, urine, sputum CORRECT ANSWER: All of the above
In which types of injuries would you be concerned for compartment syndrome? (Select
all that apply)
Long bone fx
Fractured ribs
Crush injuries
Dislocated shoulder CORRECT ANSWER: Long bone fx
Crush injuries
Which injury has the highest risk of the complications Venous Thromboembolism?
Femur fx
Dislocated knee
Meniscus tear
Hip fracture CORRECT ANSWER:
3 Key indications of Rhabdomyolysis CORRECT ANSWER: Muscle pain
Muscle weakness
Dark urine
Interventions for Compartment Syndrome CORRECT ANSWER: Relieve source of
pressure - cut cast/loosen dressing
Reduce traction weight
Interventions for Venous Thromboembolism CORRECT ANSWER: Anticoagulant -
Warfarin/Heparin/Aspirin -monitor for signs of bleeding
ROM Exercises
Decompression Devices
What nursing actions should be taken immediately for a patient postop from any
procedure for a hip fracture? CORRECT ANSWER: V/S, I&Os
Resp fx - encourage deep breathing & coughing
Assess pain - admin pain meds
Assess dressing for signs of bleeding
Neurovascular assessment
Reduce swelling by elevating leg
Maintain alignment w/pillows between knees
Avoid turning onto affected side
Interventions for Fat Embolism Syndrome CORRECT ANSWER: Oxygenation -
admin O2, tx hypoxia
,ECMO or mechanical ventilation may be an option if a satisfactory PaO2 cannot be
obtained
Cardiac manifestations managed with IV fluids, pulmonary vasodilators, peripheral
vasoconstrictors, and inotropic drugs
A nurse is assessing a client who is 48hrs postop from an ORIF of a fx tibia. Which
finding should the nurse report to the provider?
Toes cold to the touch
Serous drainage from the pin sites
Blanching of the toenail beds w/pressure
Pink tissue around the fixator insertion sites CORRECT ANSWER: a). The nurse
should monitor for and report manifestations of compartment syndrome following
internal fixation. Therefore, the nurse should contact the provider immediately if the
client's toes are cold to the touch.
A nurse is caring for a client who is 3 days postop R total hip arthroplasty. While
transferring to a chair, the client cries out in pain. The nurse should assess the client for
which of the following manifestations of dislocation of the hip prosthesis?
bulging in the area over the surgical incision
shortening of the right leg
sensation of warmth over the surgical incision
pallor following elevation of the right leg CORRECT ANSWER: b) The nurse should
monitor the client for shortening of the affected leg as an indication of dislocation of the
prosthesis. Other findings include increased hip pain, inability to move the extremity,
and rotation of the hip internally or externally.
A nurse is caring for a client immediately following application of a plaster cast. The
nurse should monitor for and report which of the following findings as an indication of
compartment syndrome?
Sensation of heat on the surface of the cast
Paresthesias of the extremity
Pruritus of the extremity
Musty odor noted from cast materials CORRECT ANSWER: b) The nurse should
identify paresthesias as a finding of compartment syndrome. Compartment syndrome
involves the compression of nerves and blood vessels in an enclosed space, leading to
impaired blood flow and nerve damage. Other findings include numbness, tingling,
weakness, and pain that does not respond to medication.
, A nurse is caring for a client who is postop following a total knee arthroplasty and is
prescribed a continuous passive motion machine and PCA. The client tells the nurse, "I
am in so much pain." Which of the following actions should the nurse take first?
Remind the pt to push the button for the PCA device
Discuss activities the client may use to distract from the pain
Ask the pt to describe the characteristics of the pain
Pause the CPM machine briefly to apply a cold pack to the client's knee CORRECT
ANSWER: c) Ask the client to describe the characteristics of pain
A nurse in the emergency dept is assessing a client who was in a motor-vehicle crash 2
days ago - fx of tibia, ulna and several ribs. Pt is disoriented to time and place, has SaO2
of 87%, nurses note generalized petechiae on pt's skin. Which of the following
complications should the nurse suspect?
Hypovolemic shock
Fat embolism syndrome
Thrombophlebitis
Avascular bone necrosis CORRECT ANSWER: c) The nurse should identify the triad
of neurologic changes, petechial rash, and hypoxemia as findings of fat embolism
syndrome. Risk factors include multiple fractures and fracture of a long bone. Male
clients are also at greater risk. The manifestations occur when fat globules occlude small
blood vessels.
A nurse is planning care for a client who is postoperative following an arthroscopy of the
knee. Which of the following is an appropriate action by the nurse? (Select all that
apply.)
A. Assess color and temperature of the extremity.
B. Apply warm compresses to incision sites.
C. Elevate the extremity.
D. Administer opioid medication.
E. Assess pulse and sensation in the foot. CORRECT ANSWER: A, C, D, E
A nurse is assessing a pt scheduled to undergo a R knee arthroplasty. The nurse should
expect which of the following findings. (Select all that apply)
A skin reddened over the joint
B pain when bearing weight
C joint crepitus
Answers 2025| Actual New Version with
Verified Answers
A nurse is assessing a patient who has just had a total hip replacement. The patient
suddenly reports severe pain in the operated hip, along with swelling and an increased
heart rate. What is the priority action for the nurse to take?
a) Administer the prescribed pain medication and monitor the patient's response.
b) Check the patient's vital signs and compare them to baseline measurements.
c) Notify the healthcare provider immediately about the sudden severe pain and
symptoms.
d) Encourage the patient to perform gentle range-of-motion exercises to alleviate
discomfort. CORRECT ANSWER: Notify the healthcare provider immediately about
the sudden severe pain and symptoms.
Rationale: Severe pain, swelling, and increased heart rate may indicate complications
such as deep vein thrombosis (DVT) or an infection. Immediate notification to the
healthcare provider is crucial for timely intervention and management.
What are some expected assessment findings for fractures? CORRECT ANSWER:
Bruising, Decreased Distal Pulses (Hip)
Edema
Loss of Function
Numbness/Tingling
Tenderness/Pain
Warmth at Site
Wound over injured site
Exposure of bone
What are 5 complications of fractures that a nurse should watch for? CORRECT
ANSWER: Infection
Rhabdomyolysis
Venous Thromboembolism
Fat Embolism Syndrome
Compartment Syndrome
What are the triad of symptoms that indicate Fat Embolism Syndrome? CORRECT
ANSWER: Neurologic Changes
Petechial Rash
Hypoxemia
Which are manifestations of Fat Embolism Syndrome? (Select all that apply)
,ARDS
Pallor
ECG changes
PaO2 < 60mmHg
Adipose cells in blood, urine, sputum CORRECT ANSWER: All of the above
In which types of injuries would you be concerned for compartment syndrome? (Select
all that apply)
Long bone fx
Fractured ribs
Crush injuries
Dislocated shoulder CORRECT ANSWER: Long bone fx
Crush injuries
Which injury has the highest risk of the complications Venous Thromboembolism?
Femur fx
Dislocated knee
Meniscus tear
Hip fracture CORRECT ANSWER:
3 Key indications of Rhabdomyolysis CORRECT ANSWER: Muscle pain
Muscle weakness
Dark urine
Interventions for Compartment Syndrome CORRECT ANSWER: Relieve source of
pressure - cut cast/loosen dressing
Reduce traction weight
Interventions for Venous Thromboembolism CORRECT ANSWER: Anticoagulant -
Warfarin/Heparin/Aspirin -monitor for signs of bleeding
ROM Exercises
Decompression Devices
What nursing actions should be taken immediately for a patient postop from any
procedure for a hip fracture? CORRECT ANSWER: V/S, I&Os
Resp fx - encourage deep breathing & coughing
Assess pain - admin pain meds
Assess dressing for signs of bleeding
Neurovascular assessment
Reduce swelling by elevating leg
Maintain alignment w/pillows between knees
Avoid turning onto affected side
Interventions for Fat Embolism Syndrome CORRECT ANSWER: Oxygenation -
admin O2, tx hypoxia
,ECMO or mechanical ventilation may be an option if a satisfactory PaO2 cannot be
obtained
Cardiac manifestations managed with IV fluids, pulmonary vasodilators, peripheral
vasoconstrictors, and inotropic drugs
A nurse is assessing a client who is 48hrs postop from an ORIF of a fx tibia. Which
finding should the nurse report to the provider?
Toes cold to the touch
Serous drainage from the pin sites
Blanching of the toenail beds w/pressure
Pink tissue around the fixator insertion sites CORRECT ANSWER: a). The nurse
should monitor for and report manifestations of compartment syndrome following
internal fixation. Therefore, the nurse should contact the provider immediately if the
client's toes are cold to the touch.
A nurse is caring for a client who is 3 days postop R total hip arthroplasty. While
transferring to a chair, the client cries out in pain. The nurse should assess the client for
which of the following manifestations of dislocation of the hip prosthesis?
bulging in the area over the surgical incision
shortening of the right leg
sensation of warmth over the surgical incision
pallor following elevation of the right leg CORRECT ANSWER: b) The nurse should
monitor the client for shortening of the affected leg as an indication of dislocation of the
prosthesis. Other findings include increased hip pain, inability to move the extremity,
and rotation of the hip internally or externally.
A nurse is caring for a client immediately following application of a plaster cast. The
nurse should monitor for and report which of the following findings as an indication of
compartment syndrome?
Sensation of heat on the surface of the cast
Paresthesias of the extremity
Pruritus of the extremity
Musty odor noted from cast materials CORRECT ANSWER: b) The nurse should
identify paresthesias as a finding of compartment syndrome. Compartment syndrome
involves the compression of nerves and blood vessels in an enclosed space, leading to
impaired blood flow and nerve damage. Other findings include numbness, tingling,
weakness, and pain that does not respond to medication.
, A nurse is caring for a client who is postop following a total knee arthroplasty and is
prescribed a continuous passive motion machine and PCA. The client tells the nurse, "I
am in so much pain." Which of the following actions should the nurse take first?
Remind the pt to push the button for the PCA device
Discuss activities the client may use to distract from the pain
Ask the pt to describe the characteristics of the pain
Pause the CPM machine briefly to apply a cold pack to the client's knee CORRECT
ANSWER: c) Ask the client to describe the characteristics of pain
A nurse in the emergency dept is assessing a client who was in a motor-vehicle crash 2
days ago - fx of tibia, ulna and several ribs. Pt is disoriented to time and place, has SaO2
of 87%, nurses note generalized petechiae on pt's skin. Which of the following
complications should the nurse suspect?
Hypovolemic shock
Fat embolism syndrome
Thrombophlebitis
Avascular bone necrosis CORRECT ANSWER: c) The nurse should identify the triad
of neurologic changes, petechial rash, and hypoxemia as findings of fat embolism
syndrome. Risk factors include multiple fractures and fracture of a long bone. Male
clients are also at greater risk. The manifestations occur when fat globules occlude small
blood vessels.
A nurse is planning care for a client who is postoperative following an arthroscopy of the
knee. Which of the following is an appropriate action by the nurse? (Select all that
apply.)
A. Assess color and temperature of the extremity.
B. Apply warm compresses to incision sites.
C. Elevate the extremity.
D. Administer opioid medication.
E. Assess pulse and sensation in the foot. CORRECT ANSWER: A, C, D, E
A nurse is assessing a pt scheduled to undergo a R knee arthroplasty. The nurse should
expect which of the following findings. (Select all that apply)
A skin reddened over the joint
B pain when bearing weight
C joint crepitus
