1.
1. The nurse is caring for a patient who has had a plaster leg cast applied. Immediately post-application, the nurse should inform the patient that:
A. 
A) The cast will cool in 5 minutes.
B. 
B) The cast should be covered with a towel.
C. 
C) The cast should be supported on a board while drying.
D. 
D) The cast will only have full strength when dry.
2.
2. An 18-year-old male patient broke his arm in a skateboarding accident. The arm was put in an arm cast. The patient states that he is unable to straighten his fingers. The nurse notes that the patient is experiencing Volkmann's contracture, which is due to what?
A. 
A) Obstructed arterial blood flow to the forearm and hand
B. 
B) Obstructed venous blood flow from the forearm and hand
C. 
C) The cast being applied too loosely
D. 
D) Muscle spasm of the forearm
3.
3. A patient is admitted to the unit in traction for a fractured proximal femur. What is the most appropriate type of traction to apply to a fractured proximal femur?
A. 
B. 
C. 
C) Buck's extension traction
D. 
4.
4. The nurse is caring for a patient who is in skeletal traction. To prevent the complication of skin breakdown in a patient with skeletal traction, what preventive measures would the nurse implement?
A. 
A) Do not remove the crusting around the pin insertion site.
B. 
B) Encourage the patient to push up with the elbows when repositioning.
C. 
C) Encourage the patient to perform ankle and calf muscle exercises once a shift.
D. 
D) Assess the pin insertion site every 8 hours.
5.
5. You are caring for a patient who has had a right hip replacement. What should the nurse follow when caring for a patient who has just had hip replacement surgery?
A. 
A) Keep the hips in abduction.
B. 
B) Keep hips flexed at 95 degrees.
C. 
C) Elevate the head of the bed to a high Fowler's position.
D. 
D) Seat the patient in a low chair.
6.
6. While assessing a patient who has had knee replacement surgery, the nurse notes that the patient has developed a hematoma at the knee replacement surgical site. The affected leg has a decreased pedal pulse. What would be the most appropriate nursing diagnosis for this patient?
A. 
B. 
B) Risk of peripheral neurovascular dysfunction
C. 
C) Ineffective health maintenance
D. 
D) Self-esteem disturbance
7.
7. A patient was brought to the emergency department after a fall. The patient is taken to the operating room to receive a right hip prosthesis. In the immediate postoperative period, what should the nurse do?
A. 
A) Maintain the leg in an abducted position.
B. 
B) Maintain the leg in an adducted position.
C. 
C) Maintain the leg in a neutral position.
D. 
D) Maintain the leg with the hip flexed greater than 90 degrees.
8.
8. A patient with a fractured femur is in balanced suspension traction. The patient needs to be repositioned toward the head of the bed. During repositioning, what should the nurse do?
A. 
A) Place slight additional tension on the traction cords.
B. 
B) Release the weights and replace them immediately after positioning.
C. 
C) Lift the traction and the patient during repositioning.
D. 
D) Maintain the same degree of traction tension.
9.
9. A male patient with a total hip replacement is progressing well and expects to be discharged tomorrow. On returning to bed after ambulating, he complains of severe pain in the surgical wound. Which action should the nurse take?
A. 
A) Assume he's anxious about discharge, and administer pain medication.
B. 
B) Assess the surgical site and affected extremity.
C. 
C) Reassure the patient that pain is a direct result of increased activity.
D. 
D) Suspect a wound infection, and monitor the patient's temperature and vital signs.
10.
10. The nursing instructor is talking with her class about cast care when one of the students asks what the nurse should do if a patient sticks something inside a cast to scratch whatever itched. What action would the instructor tell the students it would be appropriate for the nurse to take?
A. 
A) Allow the patient to continue to scratch inside the cast with a pencil.
B. 
B) Give the patient a sterile metal object to use for scratching instead of the pencil.
C. 
C) Encourage the patient to avoid scratching, and obtain an order for diphenhydramine (Benadryl) if severe itching persists.
D. 
D) Obtain an order for a sedative, such as diazepam (Valium), to prevent the patient from scratching.
11.
11. A patient who underwent a total hip replacement is being routinely turned. What should the nurse and other caregivers do to prevent dislocation of the new prosthesis?
A. 
A) Keep the affected leg in a position of adduction.
B. 
B) Use measures other than turning to prevent pressure ulcers.
C. 
C) Prevent internal rotation of the affected leg.
D. 
D) Keep the hip flexed by placing pillows under the patient's knee.
12.
12. A patient is complaining of pain in her casted leg. The nurse has administered analgesics and elevated the limb. Thirty minutes after administering the analgesics, the patient states the pain is unrelieved. What may this be a sign of?
A. 
B. 
C. 
D. 
13.
13. The nursing instructor in the skills lab at the nursing school is showing a group of nursing students how to apply traction. What is an appropriate example of proper traction use?
A. 
A) Knots in the rope should not be resting against pulleys.
B. 
B) Weights should rest against the bed rails.
C. 
C) The end of the limb in traction should be resting against the bed's footboard.
D. 
D) Skeletal traction may be removed.
14.
14. What statement about skeletal traction is most accurate?
A. 
A) Traction weight is increased as muscles relax.
B. 
B) Often balanced traction is used.
C. 
C) Skeletal traction is used until the fracture is healed.
D. 
D) Pins are attached to the muscle of the affected limb.
15.
15. The nurse assesses the patient in traction frequently. What signs or symptoms would the nurse assess for when assessing for a DVT in a traction patient?
A. 
A) Increased warmth of the calf
B. 
B) Decreased circumference of the calf
C. 
C) Loss of sensation to the calf
D. 
16.
16. The nurse is preparing instructions for a patient who is going home with a cast on his leg. What teaching point is most critical to emphasize in the teaching session?
A. 
A) Using crutches properly
B. 
B) Exercising joints above and below the cast, as ordered
C. 
C) Avoiding walking on a leg cast without the physician's permission
D. 
D) Reporting signs of impaired circulation
17.
17. A patient with a right tibial fracture is being discharged home after having a cast applied. The nurse gives instructions to the patient and his family. What instruction should the nurse provide in relationship to the patient's cast care?
A. 
A) Cover the cast with a blanket until the cast dries.
B. 
B) Keep your right leg elevated above heart level.
C. 
C) Use a knitting needle to scratch itches inside the cast.
D. 
D) A foul smell from the cast is normal.
18.
18. A nurse is admitting an 83-year-old female patient who arrives at the emergency department by ambulance after falling on the ice outside her senior citizens' housing facility. The admitting diagnosis is right hip fracture. What would be most important for the nurse to assess?
A. 
B. 
C. 
C) Neurovascular compromise
D. 
D) Internal or external rotation
19.
19. A patient you are caring for undergoes a total hip replacement. You are getting ready to review the patient teaching that you presented over the past few days. What statement made by the patient would indicate to the nurse that the patient requires further teaching?
A. 
A) "I'll need to keep several pillows between my legs at night."
B. 
B) "I need to remember not to cross my legs. It's such a habit."
C. 
C) "The occupational therapist is showing me how to use a 'sock puller' to help me get dressed."
D. 
D) "I will need my husband to assist me in getting off the low toilet seat at home."
20.
20. The nurse is admitting a patient to the unit who presented with a lower extremity fracture. What signs and symptoms best represent peroneal nerve injury?
A. 
A) Numbness and burning of the foot
B. 
B) Numbness and burning of the hand
C. 
D. 
D) Inadequate capillary refill
21.
21. A patient has suffered a muscle strain and is complaining of severe pain. The nurse knows that most pain can be relieved by what?
A. 
A) Dangling the involved part
B. 
C. 
C) Immobilizing the involved part
D. 
D) Administering anti-inflammatories as prescribed
22.
22. A nurse is caring for a patient who just had skeletal traction removed and a brace applied to their leg. What is a brace used for? (Mark all that apply.)
A. 
A) Prevent additional injury
B. 
C. 
D. 
E. 
23.
23. You are caring for a patient who is in skeletal traction. What is most important to do frequently when caring for a patient in skeletal traction to maintain effective traction?
A. 
A) Check the traction apparatus to see that the ropes are in the wheel grooves of the pulleys.
B. 
B) Make sure that the weights hang freely.
C. 
C) Make sure that the knots in the rope are tied securely.
D. 
D) Evaluate patient's position, because slipping down in bed results in ineffective traction.
24.
24. The physician writes an order to discontinue skeletal traction on your patient. Once the traction is discontinued what occurs to immobilze and support the healing bone?
A. 
A) A walking boot is applied.
B. 
C. 
C) Patient is shown how to use crutches.
D. 
D) Patient is instructed in the use of a cane.
25.
25. As skeletal traction overcomes the shortening spasms of affected muscles what happens to the skeletal traction?
A. 
B. 
B) More weight is added to keep the limb in proper alignment
C. 
C) Weight is removed to promote healing
D. 
D) Weight is balanced between heavier and lighter