Muscular 3

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1/40 Questions

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) The cast will cool in 5 minutes.
- B) The cast should be covered with a towel.
- C) The cast should be supported on a board while drying.
- D) The cast will only have full strength when dry.

About This Quiz

Muscular 3 is a quiz designed for nursing professionals focusing on postoperative care of patients with muscular disorders. It assesses key skills in managing casts, traction, and post-surgical complications, ensuring adherence to best practices and safety standards.

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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) Obstructed arterial blood flow to the forearm and hand
- B) Obstructed venous blood flow from the forearm and hand
- C) The cast being applied too loosely
- D) Muscle spasm of the forearm
Correct Answer

A. A) Obstructed arterial blood flow to the forearm and hand

Explanation

Volkmann's contracture is a condition characterized by the inability to straighten the fingers due to a lack of blood flow to the forearm and hand. This lack of blood flow is caused by obstruction of arterial blood flow. When the blood flow is obstructed, the muscles and tissues in the forearm and hand do not receive enough oxygen and nutrients, leading to muscle and tissue damage. This can result from various causes, such as trauma, compression, or compartment syndrome.

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2
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) Russell's traction
- B) Dunlop's traction
- C) Buck's extension traction
- D) Cervical head halter
Correct Answer

A. C) Buck's extension traction

Explanation

Buck's extension traction is the most appropriate type of traction to apply to a fractured proximal femur. This type of traction involves the use of a boot or traction tape applied to the lower leg, with weights attached to provide a pulling force. It is commonly used for fractures of the femur because it helps to immobilize and align the fractured bone, promoting healing and preventing further damage. Russell's traction is used for fractures of the femur in children, Dunlop's traction is used for fractures of the upper extremities, and a cervical head halter is used for cervical spine injuries.

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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) Do not remove the crusting around the pin insertion site.
- B) Encourage the patient to push up with the elbows when repositioning.
- C) Encourage the patient to perform ankle and calf muscle exercises once a shift.
- D) Assess the pin insertion site every 8 hours.
Correct Answer

A. D) Assess the pin insertion site every 8 hours.

Explanation

To prevent skin breakdown in a patient with skeletal traction, it is important to assess the pin insertion site every 8 hours. This is because regular assessment allows the nurse to identify any signs of infection, inflammation, or skin breakdown early on and take appropriate measures to prevent complications. By closely monitoring the pin insertion site, the nurse can ensure that it remains clean, dry, and free from any complications that could lead to skin breakdown. Regular assessment also allows for timely intervention if any issues are identified, promoting optimal healing and preventing further complications.

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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) Keep the hips in abduction.
- B) Keep hips flexed at 95 degrees.
- C) Elevate the head of the bed to a high Fowler's position.
- D) Seat the patient in a low chair.
Correct Answer

A. A) Keep the hips in abduction.

Explanation

After a hip replacement surgery, it is important to keep the hips in abduction. This means keeping the legs apart and avoiding crossing them. This position helps prevent dislocation of the new hip joint and promotes proper healing. Keeping the hips flexed at 95 degrees or elevating the head of the bed to a high Fowler's position are not specific instructions for hip replacement patients. Seating the patient in a low chair may put strain on the hip joint and should be avoided.

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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) Risk for infection
- B) Risk of peripheral neurovascular dysfunction
- C) Ineffective health maintenance
- D) Self-esteem disturbance
Correct Answer

A. B) Risk of peripheral neurovascular dysfunction

Explanation

The most appropriate nursing diagnosis for this patient would be "Risk of peripheral neurovascular dysfunction." This is because the patient has developed a hematoma at the knee replacement surgical site, which can potentially affect the blood flow and nerve function in the affected leg. The decreased pedal pulse indicates a compromised blood supply to the foot, which can lead to further complications if not addressed promptly. Therefore, the nursing diagnosis of "Risk of peripheral neurovascular dysfunction" accurately reflects the patient's current condition and the potential risk for complications related to impaired blood flow and nerve function.

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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) Maintain the leg in an abducted position.
- B) Maintain the leg in an adducted position.
- C) Maintain the leg in a neutral position.
- D) Maintain the leg with the hip flexed greater than 90 degrees.
Correct Answer

A. A) Maintain the leg in an abducted position.

Explanation

After receiving a right hip prosthesis, the nurse should maintain the leg in an abducted position. This position helps to prevent dislocation of the hip prosthesis by keeping the leg slightly apart from the midline of the body. Maintaining the leg in an abducted position also helps to reduce the risk of postoperative complications such as pressure ulcers and deep vein thrombosis. By keeping the leg in this position, the nurse ensures proper alignment of the prosthesis and promotes optimal healing and recovery for the patient.

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1
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) Place slight additional tension on the traction cords.
- B) Release the weights and replace them immediately after positioning.
- C) Lift the traction and the patient during repositioning.
- D) Maintain the same degree of traction tension.
Correct Answer

A. D) Maintain the same degree of traction tension.

Explanation

During repositioning, the nurse should maintain the same degree of traction tension. This is important because changing the tension on the traction cords can lead to improper alignment and potential complications for the patient. By maintaining the same degree of traction tension, the nurse ensures that the fractured femur remains properly aligned and stable throughout the repositioning process.

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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) Assume he's anxious about discharge, and administer pain medication.
- B) Assess the surgical site and affected extremity.
- C) Reassure the patient that pain is a direct result of increased activity.
- D) Suspect a wound infection, and monitor the patient's temperature and vital signs.
Correct Answer

A. B) Assess the surgical site and affected extremity.

Explanation

The correct answer is B) Assess the surgical site and affected extremity. This is the most appropriate action for the nurse to take because the patient is experiencing severe pain in the surgical wound after ambulating. Assessing the surgical site and affected extremity will help the nurse determine the cause of the pain and whether there are any signs of infection or other complications. It is important to rule out any potential issues before assuming it is related to anxiety or increased activity. Monitoring the patient's temperature and vital signs may be necessary if there is a suspicion of infection, but this should be done after assessing the surgical site.

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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) Allow the patient to continue to scratch inside the cast with a pencil.
- B) Give the patient a sterile metal object to use for scratching instead of the pencil.
- C) Encourage the patient to avoid scratching, and obtain an order for diphenhydramine (Benadryl) if severe itching persists.
- D) Obtain an order for a sedative, such as diazepam (Valium), to prevent the patient from scratching.
Correct Answer

A. C) Encourage the patient to avoid scratching, and obtain an order for diphenhydramine (Benadryl) if severe itching persists.

Explanation

The instructor would tell the students that it would be appropriate for the nurse to encourage the patient to avoid scratching and obtain an order for diphenhydramine (Benadryl) if severe itching persists. This is because scratching inside the cast can cause skin damage and increase the risk of infection. Providing an alternative object for scratching may still lead to skin damage. By encouraging the patient to avoid scratching and obtaining an order for diphenhydramine, the nurse can address the itching and minimize the risk of complications.

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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) Keep the affected leg in a position of adduction.
- B) Use measures other than turning to prevent pressure ulcers.
- C) Prevent internal rotation of the affected leg.
- D) Keep the hip flexed by placing pillows under the patient's knee.
Correct Answer

A. C) Prevent internal rotation of the affected leg.

Explanation

To prevent dislocation of the new prosthesis after a total hip replacement, it is important to prevent internal rotation of the affected leg. Internal rotation can put stress on the hip joint and potentially cause the prosthesis to dislocate. Therefore, the nurse and other caregivers should ensure that the patient's leg is not rotated inward during routine turning or movement. This can be achieved by using proper positioning techniques and providing support to the leg to maintain it in a neutral or slightly externally rotated position.

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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) Edema
- B) A pressure ulcer
- C) Compartment syndrome
- D) Disuse syndrome
Correct Answer

A. C) Compartment syndrome

Explanation

If the patient's pain is unrelieved even after administering analgesics and elevating the limb, it may be a sign of compartment syndrome. Compartment syndrome occurs when there is increased pressure within a muscle compartment, leading to reduced blood flow and tissue damage. The pain is usually severe and out of proportion to the injury or condition. Prompt medical intervention is necessary to prevent further complications.

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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) Knots in the rope should not be resting against pulleys.
- B) Weights should rest against the bed rails.
- C) The end of the limb in traction should be resting against the bed's footboard.
- D) Skeletal traction may be removed.
Correct Answer

A. A) Knots in the rope should not be resting against pulleys.

Explanation

Proper traction use involves ensuring that knots in the rope are not resting against pulleys. This is important because if the knots were to rest against the pulleys, it could cause friction and potentially interfere with the effectiveness of the traction. Therefore, it is crucial to ensure that the knots are properly positioned away from the pulleys to maintain proper traction.

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14.

14. What statement about skeletal traction is most accurate?
- A) Traction weight is increased as muscles relax.
- B) Often balanced traction is used.
- C) Skeletal traction is used until the fracture is healed.
- D) Pins are attached to the muscle of the affected limb.
Correct Answer

A. B) Often balanced traction is used.

Explanation

Often balanced traction is used in skeletal traction. This means that the traction force is evenly distributed across the affected limb, helping to maintain alignment and prevent further injury. This type of traction is commonly used to treat fractures and dislocations. The other options are not accurate statements about skeletal traction.

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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) Increased warmth of the calf
- B) Decreased circumference of the calf
- C) Loss of sensation to the calf
- D) Pale-appearing calf
Correct Answer

A. A) Increased warmth of the calf

Explanation

When assessing for a DVT in a traction patient, the nurse would assess for signs and symptoms such as increased warmth of the calf. This could indicate inflammation and increased blood flow, which are common signs of a DVT. Other symptoms such as pain, swelling, and redness may also be present, but they are not listed as options in this question. Therefore, the correct answer is A) Increased warmth of the calf.

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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) Using crutches properly
- B) Exercising joints above and below the cast, as ordered
- C) Avoiding walking on a leg cast without the physician's permission
- D) Reporting signs of impaired circulation
Correct Answer

A. D) Reporting signs of impaired circulation

Explanation

The most critical teaching point to emphasize in this teaching session is to report signs of impaired circulation. This is important because impaired circulation can lead to serious complications such as tissue damage or even amputation. It is crucial for the patient to be aware of the signs of impaired circulation, such as increased pain, numbness, tingling, or changes in skin color or temperature, and to report them to the physician immediately for prompt intervention.

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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) Cover the cast with a blanket until the cast dries.
- B) Keep your right leg elevated above heart level.
- C) Use a knitting needle to scratch itches inside the cast.
- D) A foul smell from the cast is normal.
Correct Answer

A. B) Keep your right leg elevated above heart level.

Explanation

The nurse should instruct the patient to keep their right leg elevated above heart level. Elevating the leg helps to reduce swelling and promote proper circulation, which can aid in the healing process. This position also helps to alleviate pain and discomfort.

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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) Leg shortening
- B) Complaints of pain
- C) Neurovascular compromise
- D) Internal or external rotation
Correct Answer

A. C) Neurovascular compromise

Explanation

The most important assessment for the nurse to make in this situation is for neurovascular compromise. A right hip fracture can potentially cause damage to the blood vessels and nerves in the area, leading to complications such as decreased circulation or nerve damage. Assessing for neurovascular compromise is crucial in order to identify any potential complications and provide appropriate interventions to prevent further damage or complications.

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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) "I'll need to keep several pillows between my legs at night."
- B) "I need to remember not to cross my legs. It's such a habit."
- C) "The occupational therapist is showing me how to use a 'sock puller' to help me get dressed."
- D) "I will need my husband to assist me in getting off the low toilet seat at home."
Correct Answer

A. D) "I will need my husband to assist me in getting off the low toilet seat at home."

Explanation

The patient's statement that they will need assistance from their husband to get off the low toilet seat at home indicates that they may not have fully understood the instructions regarding post-operative mobility and independence. The nurse would need to provide further teaching to ensure that the patient is aware of the correct techniques and strategies to safely perform activities of daily living, including using the toilet.

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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) Numbness and burning of the foot
- B) Numbness and burning of the hand
- C) Cyanotic toes
- D) Inadequate capillary refill
Correct Answer

A. A) Numbness and burning of the foot

Explanation

Numbness and burning of the foot are signs and symptoms that best represent peroneal nerve injury. The peroneal nerve supplies sensation to the lower leg, foot, and toes. Injury to this nerve can result in numbness and burning sensations in the affected area. Cyanotic toes and inadequate capillary refill are not specific to peroneal nerve injury and may indicate other vascular or circulatory problems. Numbness and burning of the hand would not be representative of a lower extremity fracture.

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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) Dangling the involved part
- B) Applying cold packs
- C) Immobilizing the involved part
- D) Administering anti-inflammatories as prescribed
Correct Answer

A. B) Applying cold packs

Explanation

Applying cold packs can help relieve pain in a patient with a muscle strain. Cold therapy can reduce inflammation, numb the area, and decrease muscle spasms, all of which can contribute to pain relief. Cold packs can also help to constrict blood vessels, which can reduce swelling and promote healing. Immobilizing the involved part may be necessary in some cases, but it may not directly relieve pain. Administering anti-inflammatories can also help with pain relief, but it is not specified in the question that the patient has been prescribed them.

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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) Prevent additional injury
- B) Align body part
- C) Provide support
- D) Control movement
- E) Prevent deformity
Correct Answer(s)

A. A) Prevent additional injury
A. C) Provide support
A. D) Control movement

Explanation

A brace is used to prevent additional injury by providing support and controlling movement. It helps to stabilize the body part and prevent further damage or strain. Additionally, a brace can also help in aligning the body part and preventing deformity by maintaining proper positioning and preventing any further misalignment.

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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) Check the traction apparatus to see that the ropes are in the wheel grooves of the pulleys.
- B) Make sure that the weights hang freely.
- C) Make sure that the knots in the rope are tied securely.
- D) Evaluate patient's position, because slipping down in bed results in ineffective traction.
Correct Answer

A. D) Evaluate patient's position, because slipping down in bed results in ineffective traction.

Explanation

It is important to evaluate the patient's position frequently when caring for a patient in skeletal traction because if the patient slips down in bed, it can result in ineffective traction. Slipping down can cause the bones to shift and reduce the effectiveness of the traction. Checking the traction apparatus, ensuring that the weights hang freely, and securely tying the knots in the rope are also important, but evaluating the patient's position is the most crucial factor in maintaining effective traction.

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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 walking boot is applied.
- B) A cast is applied.
- C) Patient is shown how to use crutches.
- D) Patient is instructed in the use of a cane.
Correct Answer

A. B) A cast is applied.

Explanation

Once the skeletal traction is discontinued, a cast is applied to immobilize and support the healing bone. A cast provides stability and protection to the bone, allowing it to heal properly. It restricts movement and prevents any further injury or damage to the bone. A walking boot, crutches, or a cane may be used for mobility purposes, but they do not provide the same level of immobilization and support as a cast.

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25.

25. As skeletal traction overcomes the shortening spasms of affected muscles what happens to the skeletal traction?
- A) Nothing changes
- B) More weight is added to keep the limb in proper alignment
- C) Weight is removed to promote healing
- D) Weight is balanced between heavier and lighter
Correct Answer

A. C) Weight is removed to promote healing

Explanation

Skeletal traction is a technique used to immobilize and align fractured bones. It involves the use of weights and pulleys attached to the affected limb. As the skeletal traction helps overcome the shortening spasms of affected muscles, the weight is gradually reduced to promote healing. This is done to prevent excessive tension on the muscles and to allow the bones to heal properly. Therefore, the correct answer is C) Weight is removed to promote healing.

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26.

26. A patient comes to the clinic complaining of pain at the site of their hip replacement. The patient tells the nurse they had their hip replacement surgery 3 years ago. On assessment the nurse notes the area around the surgical scar is erythematous and edematous. What would the nurse suspect?
- A) Infection at the surgical site that has spread from another site in the body
- B) A delayed surgical infection
- C) An acute infection
- D) A host infection
Correct Answer

A. A) Infection at the surgical site that has spread from another site in the body

Explanation

The nurse would suspect that the patient has an infection at the surgical site that has spread from another site in the body. The presence of erythema and edema around the surgical scar indicates an inflammatory response, which is often seen in cases of infection. The fact that the patient had their hip replacement surgery 3 years ago suggests that the infection is not acute or delayed, but rather a chronic infection that has spread from another site in the body.

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27.

27. Patients who do not have mechanical prophylaxis and pharmacologic prophylaxis have a higher incidence of DVT than patients who do. What is mechanical prophylaxis for a DVT?
- A) Pneumatic tourniquet
- B) Anti-embolism stockings
- C) CPM machine
- D) Thigh-high TEDs
Correct Answer

A. B) Anti-embolism stockings

Explanation

Mechanical prophylaxis for a DVT refers to the use of devices or methods that help prevent the formation of blood clots in the legs. Anti-embolism stockings, also known as compression stockings, are one such mechanical prophylaxis. These stockings apply pressure to the legs, helping to improve blood flow and prevent the pooling of blood, which can lead to the formation of clots. By wearing anti-embolism stockings, patients can reduce their risk of developing deep vein thrombosis (DVT) compared to those who do not use any mechanical prophylaxis.

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28.

28. When using cementless components in a joint replacement surgery what must the patient have for the surgery to be successful?
- A) Inaccurate fitting
- B) Faulty cement
- C) Presence of healthy bone
- D) Inadequate blood supply
Correct Answer

A. C) Presence of healthy bone

Explanation

In order for a joint replacement surgery using cementless components to be successful, the patient must have the presence of healthy bone. Cementless components rely on the bone to grow and integrate with the implant, providing stability and long-term success of the joint replacement. If the patient has weak or compromised bone, the implant may not be able to properly integrate, leading to complications and potential failure of the surgery. Therefore, the presence of healthy bone is crucial for the success of the surgery.

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29.

29. A patient is scheduled for a total knee replacement. The surgeon explains the technique of creating a “bloodless” field for the surgery to the patient. What does this entail?
- A) Intermittent autotransfusion
- B) Postoperative blood salvage
- C) Intraoperative blood salvage with reinfusion
- D) Use of a pneumatic tourniquet
Correct Answer

A. D) Use of a pneumatic tourniquet

Explanation

The correct answer is D) Use of a pneumatic tourniquet. When the surgeon explains the technique of creating a "bloodless" field for the surgery to the patient, it means that they will be using a pneumatic tourniquet. This device is applied to the patient's limb and inflated to temporarily stop the blood flow to that area. By doing so, it reduces bleeding during the surgery, allowing for better visualization and control of the surgical site.

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30.

30. You are working with a student nurse to set up traction on a patient with Buck's traction. How often do you need to assess circulation to the affected leg?
- A) Within 30 minutes, then every 1 to 2 hours
- B) Within 30 minutes, then every 4 hours
- C) Within 30 minutes, then every 8 hours
- D) Within 30 minutes, then every shift
Correct Answer

A. A) Within 30 minutes, then every 1 to 2 hours

Explanation

When setting up traction on a patient with Buck's traction, it is important to assess circulation to the affected leg regularly. The correct answer suggests that circulation should be assessed within 30 minutes of setting up the traction, and then every 1 to 2 hours thereafter. This is necessary to monitor for any signs of compromised blood flow, such as decreased pulses, coolness, or pallor in the affected leg. Regular assessment allows for early detection of any circulation issues and prompt intervention if needed.

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31.

31. What does plantar flexion demonstrate?
- A) Function of the plantar nerve
- B) Function of the tibial nerve
- C) Function of the radial nerve
- D) Function of the peroneal nerve
Correct Answer

A. B) Function of the tibial nerve

Explanation

Plantar flexion is the movement of the foot that involves pointing the toes downward. This movement is primarily controlled by the tibial nerve, which innervates the muscles responsible for plantar flexion. The tibial nerve is a branch of the sciatic nerve and provides motor and sensory innervation to the posterior compartment of the leg and the sole of the foot. Therefore, the correct answer is B) Function of the tibial nerve.

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32.

32. You are caring for a patient in skeletal traction. What do you caution the patient about to prevent bony fragments from moving against one another?
- A) Removing the traction for bathing
- B) Repositioning with assistance
- C) Turning side to side
- D) Coughing
Correct Answer

A. C) Turning side to side

Explanation

To prevent bony fragments from moving against one another in a patient in skeletal traction, caution the patient against turning side to side. This movement can cause the bones to shift and potentially lead to further injury or complications. It is important for the patient to remain as still as possible to ensure proper healing and alignment of the bones. Removing the traction for bathing, repositioning with assistance, and coughing do not directly relate to preventing bony fragments from moving against one another.

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33.

33. A student nurse is helping with the initial assessment of an 85-year-old patient. What can the student do to ensure that shearing forces are avoided? (Mark all that apply.)
- A) Puts on foam boots three or more times a day.
- B) Inspect and provide skin care q shift.
- C) Palpate the area of the traction tapes daily.
- D) Provides back care at least q 2 hours.
- E) Give massage q shift.
Correct Answer(s)

A. B) Inspect and provide skin care q shift.
A. C) Palpate the area of the traction tapes daily.
A. D) Provides back care at least q 2 hours.

Explanation

To ensure that shearing forces are avoided, the student nurse can do the following:

B) Inspect and provide skin care q shift: By regularly inspecting the patient's skin and providing appropriate care, the student nurse can identify and address any areas of potential shearing or skin breakdown.

C) Palpate the area of the traction tapes daily: By palpating the area of the traction tapes daily, the student nurse can assess for any signs of shearing or pressure on the skin caused by the traction.

D) Provides back care at least q 2 hours: Regularly providing back care, such as repositioning the patient and ensuring proper alignment, can help prevent shearing forces on the skin.

These actions help in preventing shearing forces and maintaining the patient's skin integrity.

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34.

34. Orthopedic surgery can be used to correct a variety of orthopedic conditions. What conditions can be corrected by orthopedic surgery? (Mark all that apply.)
- A) Joint disease
- B) Stable fractures
- C) Tumors
- D) Inflammed tissue
- E) Nectotic tissue
Correct Answer(s)

A. A) Joint disease
A. C) Tumors

Explanation

Orthopedic surgery can be used to correct joint disease and tumors. Joint disease refers to conditions such as arthritis, where the joints become inflamed and damaged. Orthopedic surgery can help to repair or replace the affected joints, improving mobility and reducing pain. Tumors, on the other hand, can be benign or malignant growths that affect the bones or soft tissues. Orthopedic surgery can be used to remove these tumors and restore normal function. Stable fractures, inflamed tissue, and necrotic tissue are not specifically mentioned as conditions that can be corrected by orthopedic surgery.

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35.

35. A patient is undergoing preoperative respiratory testing to provide baselines of respiratory function for the postoperative period. A patient you are caring for has preoperative testing that indicates he is at increased risk for respiratory complications. What therapy would you initiate to aid in the prevention of respiratory complications for your patient?
- A) Respiratory exercises
- B) Incentive spirometer
- C) Chest percussion
- D) Broad-spectrum antibiotics
Correct Answer

A. B) Incentive spirometer

Explanation

The correct answer is B) Incentive spirometer. Incentive spirometry is a therapy that helps improve lung function and prevent respiratory complications by encouraging deep breathing and the expansion of the lungs. It helps to prevent atelectasis, a common postoperative complication, by promoting lung expansion and clearing secretions. Respiratory exercises may be beneficial, but they do not specifically target lung expansion. Chest percussion is a technique used to loosen and mobilize secretions, but it may not be appropriate for every patient. Broad-spectrum antibiotics are used to treat infections, not to prevent respiratory complications.

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36.

36. As an orthopedic nurse you know that there are several immobility-related complications that a patient can acquire when they are placed in traction. What complications might a patient in traction acquire?
- A) Anorexia
- B) Thromboemboli
- C) Urinary stasis
- D) Diarrhea
- E) Lactose intolerance
Correct Answer

A. C) Urinary stasis

Explanation

Patients in traction may experience urinary stasis, which refers to the inability to empty the bladder completely. Immobility can lead to decreased bladder tone and muscle weakness, making it difficult for the patient to fully empty their bladder. This can result in urinary retention, urinary tract infections, and other urinary complications. Anorexia, thromboemboli, diarrhea, and lactose intolerance are not directly related to immobility or traction.

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37.

37. A patient has been in skeletal traction for 3 weeks. The nurse caring for the patient knows to assess what every 4 to 8 hours?
- A) Bladder
- B) Respiratory status
- C) Neurovascular status
- D) Skin
Correct Answer

A. B) Respiratory status

Explanation

The nurse needs to assess the patient's respiratory status every 4 to 8 hours because being in skeletal traction for an extended period of time can increase the risk of respiratory complications such as pneumonia or atelectasis. Regular assessment of respiratory status allows the nurse to monitor for any signs of respiratory distress or decreased lung function, and take appropriate interventions if needed.

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38.

38. You are assuming care of a 16-year-old patient who is in skeletal traction following a motor vehicle accident. You take shift report and find out that the patient avoids using the urinal and bedpan because they “embarrass him.” When you assess the patient you find that the patient's temperature is 101.5°F and his blood pressure and pulse are elevated. What would the nurse suspect?
- A) Sacral skin breakdown
- B) Infected pin sites
- C) Urinary infection
- D) Urinary incontinence
Correct Answer

A. C) Urinary infection

Explanation

The nurse would suspect a urinary infection because the patient's elevated temperature and elevated blood pressure and pulse could be signs of an infection. The patient's avoidance of using the urinal and bedpan may indicate discomfort or pain while urinating, which could be a symptom of a urinary infection. Additionally, the patient's age and the fact that they are in skeletal traction following a motor vehicle accident may increase their risk for developing a urinary infection.

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39.

39. You are caring for a patient admitted to the orthopedic unit in skeletal traction. You know that this patient is at increased risk for a DVT. What would you do to decrease the risk of DVT in this patient?
- A) Pretend to ride a bicycle while you lay in bed.
- B) Allow the patient to assist with passive range-of-motion exercises.
- C) Encourage the patient to perform active ROM exercises on the affected leg.
- D) Do foot and ankle exercises every 1 to 2 hours while awake.
Correct Answer

A. D) Do foot and ankle exercises every 1 to 2 hours while awake.

Explanation

To decrease the risk of deep vein thrombosis (DVT) in a patient in skeletal traction, it is important to promote blood circulation in the lower extremities. Doing foot and ankle exercises every 1 to 2 hours while awake helps to prevent blood clots by increasing blood flow and preventing stasis. This exercise stimulates the calf muscles, which helps to pump blood back to the heart and reduces the risk of DVT. Pretending to ride a bicycle while lying in bed may not provide enough movement to prevent DVT. Allowing the patient to assist with passive range-of-motion exercises or encouraging active ROM exercises on the affected leg may not provide adequate circulation to prevent DVT.

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40.

40. When caring for a patient who underwent orthopedic surgery, the goals would include what?
- A) Improving function
- B) Restoring immobility
- C) Giving anti-inflammatory medications
- D) Doing passive range-of motion exercises
Correct Answer

A. A) Improving function

Explanation

When caring for a patient who underwent orthopedic surgery, the goals would include improving function. This means that the focus of the care is to help the patient regain their ability to perform daily activities and tasks, such as walking, dressing, and bathing, with as little difficulty or pain as possible. This may involve physical therapy, pain management, and providing support and guidance to the patient during their recovery process. The goal is to help the patient regain their independence and quality of life after the surgery.

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Mar 20, 2023

Quiz Edited by
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Mar 13, 2012

Quiz Created by
Justin82

Muscular 3

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:

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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?

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?

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?

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?

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?

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?

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?

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?

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?

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?

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?

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?

14. What statement about skeletal traction is most accurate?

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?

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?

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?

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?

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?

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?

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?

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.)

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?

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?

25. As skeletal traction overcomes the shortening spasms of affected muscles what happens to the skeletal traction?

26. A patient comes to the clinic complaining of pain at the site of their hip replacement. The patient tells the nurse they had their hip replacement surgery 3 years ago. On assessment the nurse notes the area around the surgical scar is erythematous and edematous. What would the nurse suspect?

27. Patients who do not have mechanical prophylaxis and pharmacologic prophylaxis have a higher incidence of DVT than patients who do. What is mechanical prophylaxis for a DVT?

28. When using cementless components in a joint replacement surgery what must the patient have for the surgery to be successful?

29. A patient is scheduled for a total knee replacement. The surgeon explains the technique of creating a “bloodless” field for the surgery to the patient. What does this entail?

30. You are working with a student nurse to set up traction on a patient with Buck's traction. How often do you need to assess circulation to the affected leg?

31. What does plantar flexion demonstrate?

32. You are caring for a patient in skeletal traction. What do you caution the patient about to prevent bony fragments from moving against one another?

33. A student nurse is helping with the initial assessment of an 85-year-old patient. What can the student do to ensure that shearing forces are avoided? (Mark all that apply.)

34. Orthopedic surgery can be used to correct a variety of orthopedic conditions. What conditions can be corrected by orthopedic surgery? (Mark all that apply.)

36. As an orthopedic nurse you know that there are several immobility-related complications that a patient can acquire when they are placed in traction. What complications might a patient in traction acquire?

37. A patient has been in skeletal traction for 3 weeks. The nurse caring for the patient knows to assess what every 4 to 8 hours?

39. You are caring for a patient admitted to the orthopedic unit in skeletal traction. You know that this patient is at increased risk for a DVT. What would you do to decrease the risk of DVT in this patient?

40. When caring for a patient who underwent orthopedic surgery, the goals would include what?