Orthopedic MCQs Quiz With Answers

1. An appropriate technique for the nurse to implement for a client being placed in traction is to:

Apply a traction boot tightly.

Drop the weights after the traction is attached.

Assess the neurovascular status every 1 to 2 hours for the first day.

Shave the hair off the area where the traction is to be placed.

The appropriate technique for the nurse to implement for a client being placed in traction is to assess the neurovascular status every 1 to 2 hours for the first day. This is important to monitor the client's circulation, sensation, and movement in the affected limb. Assessing the neurovascular status helps to identify any potential complications such as impaired blood flow or nerve damage, which can be critical in preventing further injury or complications. Regular assessment allows for prompt intervention if any changes are detected, ensuring the client's safety and well-being.

Explanation

The appropriate technique for the nurse to implement for a client being placed in traction is to assess the neurovascular status every 1 to 2 hours for the first day. This is important to monitor the client's circulation, sensation, and movement in the affected limb. Assessing the neurovascular status helps to identify any potential complications such as impaired blood flow or nerve damage, which can be critical in preventing further injury or complications. Regular assessment allows for prompt intervention if any changes are detected, ensuring the client's safety and well-being.

2. An appropriate technique for the nurse to implement for the client who is being cast is to:

Apply ice to the top of the cast.

Maintain the extremity below heart level.

Handle the wet cast with the fingertips.

Fold the stockinette or padding over the outer cast edges.

When a client is being cast, folding the stockinette or padding over the outer cast edges is an appropriate technique for the nurse to implement. This helps to ensure that the edges of the cast are protected and do not cause any discomfort or irritation to the client. It also helps to secure the stockinette or padding in place and prevents it from slipping or bunching up underneath the cast. By folding the stockinette or padding over the outer cast edges, the nurse is promoting the client's comfort and safety during the casting process.

Explanation

When a client is being cast, folding the stockinette or padding over the outer cast edges is an appropriate technique for the nurse to implement. This helps to ensure that the edges of the cast are protected and do not cause any discomfort or irritation to the client. It also helps to secure the stockinette or padding in place and prevents it from slipping or bunching up underneath the cast. By folding the stockinette or padding over the outer cast edges, the nurse is promoting the client's comfort and safety during the casting process.

3. An expected outcome of the cast application that the nurse evaluates is:

Skin irritation at the cast edges.

Decreased capillary refill and pallor.

Tingling and numbness distal to the cast.

Slight edema, soreness, and limitation of range of motion.

The nurse evaluates for slight edema, soreness, and limitation of range of motion as an expected outcome of the cast application. This is because the application of a cast can cause some swelling (edema) in the affected area, as well as soreness and a temporary limitation in the range of motion due to immobilization. These symptoms are considered normal and expected after a cast application.

Explanation

The nurse evaluates for slight edema, soreness, and limitation of range of motion as an expected outcome of the cast application. This is because the application of a cast can cause some swelling (edema) in the affected area, as well as soreness and a temporary limitation in the range of motion due to immobilization. These symptoms are considered normal and expected after a cast application.

4. For a client who is to be placed in Russell’s traction, the nurse prepares the:

Occipital area

Arm and forearm

Back and abdomen

Lower extremities

The nurse prepares the lower extremities for a client who is to be placed in Russell's traction. Russell's traction is a type of traction used to immobilize and align fractures of the femur or tibia. By applying traction to the lower extremities, the nurse can stabilize the fractured bones and promote proper healing. This involves carefully positioning and securing the client's legs in the traction apparatus, ensuring that the traction is evenly distributed and the client is comfortable.

Explanation

The nurse prepares the lower extremities for a client who is to be placed in Russell's traction. Russell's traction is a type of traction used to immobilize and align fractures of the femur or tibia. By applying traction to the lower extremities, the nurse can stabilize the fractured bones and promote proper healing. This involves carefully positioning and securing the client's legs in the traction apparatus, ensuring that the traction is evenly distributed and the client is comfortable.

5. A nurse anticipates that the type of traction that will be used for a 32-lb child with a fractured femur is:

Bryant’s traction

Dunlop’s traction

Weil sling

Buck’s extension traction

Bryant's traction is the most appropriate type of traction for a 32-lb child with a fractured femur. This type of traction is commonly used for children under the age of 2 and involves elevating the legs at a 90-degree angle to the body. It is effective in immobilizing the fractured femur and promoting proper alignment and healing. Dunlop's traction is typically used for cervical spine injuries, Weil sling is used for forearm fractures, and Buck's extension traction is used for lower leg fractures.

Explanation

Bryant's traction is the most appropriate type of traction for a 32-lb child with a fractured femur. This type of traction is commonly used for children under the age of 2 and involves elevating the legs at a 90-degree angle to the body. It is effective in immobilizing the fractured femur and promoting proper alignment and healing. Dunlop's traction is typically used for cervical spine injuries, Weil sling is used for forearm fractures, and Buck's extension traction is used for lower leg fractures.

6. For a client with a fractured femur, a nurse is alert to the possibility of a fat embolus. The nurse specifically watches for:

Bradypnea

Restlessness

Bradycardia

Hypertension

Restlessness is a common sign of a fat embolus in a client with a fractured femur. Fat embolism syndrome occurs when fat globules enter the bloodstream and travel to the lungs, causing respiratory distress and decreased oxygenation. Restlessness can be an early manifestation of this condition, indicating inadequate oxygenation and increased anxiety. Bradypnea (abnormally slow breathing), bradycardia (abnormally slow heart rate), and hypertension (high blood pressure) are not typically associated with fat embolus and would not be the nurse's primary focus in this situation.

Explanation

Restlessness is a common sign of a fat embolus in a client with a fractured femur. Fat embolism syndrome occurs when fat globules enter the bloodstream and travel to the lungs, causing respiratory distress and decreased oxygenation. Restlessness can be an early manifestation of this condition, indicating inadequate oxygenation and increased anxiety. Bradypnea (abnormally slow breathing), bradycardia (abnormally slow heart rate), and hypertension (high blood pressure) are not typically associated with fat embolus and would not be the nurse's primary focus in this situation.

7. A nurse anticipates that the type of traction that will be used for an adult client with a fractured humerus is:

Bryant’s traction

Dunlop’s traction

Weil sling

Buck’s extension traction

Dunlop's traction is the correct answer for an adult client with a fractured humerus. Dunlop's traction is a type of skeletal traction that is commonly used for fractures of the humerus. It involves the use of a halo vest or a sling to support the affected arm and maintain proper alignment of the fractured bone. This type of traction allows for better immobilization and alignment of the fractured bone, promoting healing and preventing further injury.

Explanation

Dunlop's traction is the correct answer for an adult client with a fractured humerus. Dunlop's traction is a type of skeletal traction that is commonly used for fractures of the humerus. It involves the use of a halo vest or a sling to support the affected arm and maintain proper alignment of the fractured bone. This type of traction allows for better immobilization and alignment of the fractured bone, promoting healing and preventing further injury.

8. For cast removal, the nurse correctly instructs the client that:

Discomfort will be felt from the cast saw.

An enzyme wash may be applied to intact skin.

The skin will be scrubbed very well after the removal.

Aggressive range-of-motion exercises will be performed after removal.

An enzyme wash may be applied to intact skin because it helps to remove any residual adhesive or residue left behind from the cast. This can help to prevent irritation or discomfort when the cast is removed.

Explanation

An enzyme wash may be applied to intact skin because it helps to remove any residual adhesive or residue left behind from the cast. This can help to prevent irritation or discomfort when the cast is removed.

9. For a client in traction who has skeletal pins, a nurse should:

Use povidone-iodine to cleanse the pin site.

Apply antiseptic ointment and cover with a split dressing.

Use hydrogen peroxide as a rinse before a dressing is applied.

Do both pin sites at the same time, with the same swab and solution.

The correct answer is to apply antiseptic ointment and cover with a split dressing. This is the appropriate action because it helps prevent infection at the pin site. Using povidone-iodine to cleanse the pin site may cause skin irritation and delay healing. Hydrogen peroxide is not recommended as it can damage healthy tissue. Doing both pin sites at the same time with the same swab and solution increases the risk of cross-contamination.

Explanation

The correct answer is to apply antiseptic ointment and cover with a split dressing. This is the appropriate action because it helps prevent infection at the pin site. Using povidone-iodine to cleanse the pin site may cause skin irritation and delay healing. Hydrogen peroxide is not recommended as it can damage healthy tissue. Doing both pin sites at the same time with the same swab and solution increases the risk of cross-contamination.

10. While in Buck’s extension traction, the client may be positioned as:

On the back, with the knees flexed 45 degrees.

On the back, turning to the unaffected side for 10- to 15-minute periods.

On the back, with the buttocks slightly elevated off the bed.

On the back, with the bed tilted toward the side that is opposite the traction.

In Buck's extension traction, the client is positioned on their back and is encouraged to turn to the unaffected side for short periods of time. This position helps to relieve pressure on the affected side and promotes comfort and circulation. It also allows for periodic assessment of the client's skin integrity and overall well-being. This positioning strategy is important to prevent complications such as pressure ulcers and muscle atrophy.

Explanation

In Buck's extension traction, the client is positioned on their back and is encouraged to turn to the unaffected side for short periods of time. This position helps to relieve pressure on the affected side and promotes comfort and circulation. It also allows for periodic assessment of the client's skin integrity and overall well-being. This positioning strategy is important to prevent complications such as pressure ulcers and muscle atrophy.