NUR 1172 Prep U Module 1, Chapter 40 Musculoskeletal Care Modalities Questions and Correct Answers
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Course
NUR 1172
Institution
NUR 1172
The nurse is assigned to care for a client who has had a total knee arthroplasty yesterday. What type of pharmacologic therapy does the nurse anticipate administering to this client to prevent complications related to the surgery?
a) Anticoagulation therapy b) Antidysrhythmia therapy c) Antiangina...
NUR 1172 Prep U Module 1, Chapter 40
Musculoskeletal Care Modalities
Questions and Correct Answers
The nurse is assigned to care for a client who has had a total knee arthroplasty
yesterday. What type of pharmacologic therapy does the nurse anticipate administering
to this client to prevent complications related to the surgery?
a) Anticoagulation therapy
b) Antidysrhythmia therapy
c) Antianginal therapy
d) Antineoplastic therapy ✅Anticoagulation therapy
Explanation:
Anticoagulation therapy and early ambulation are very important for clients who have
knee or hip replacement to prevent thrombus formation. The other therapy is not
indicated solely for the knee or hip arthroplasty.
The nurse is preparing a client to have his cast cut off after having it for 6 weeks to treat
a fracture tibia. What should the nurse inform the client prior to the cast being removed?
a) The skin may be covered with a yellowish crust that will shed in a few days.
b) The leg will look as it did prior to the cast being applied.
c) The leg will look moist and will have small bumps that will go away in a few days.
d) The leg strength is enforced by the wearing of the cast. ✅The skin may be covered
with a yellowish crust that will shed in a few days.
Explanation:
Once the cast is off, the skin appears mottled and may be covered with a yellowish
crust composed of accumulated body oil and dead skin. The client usually sheds this
residue in a few days. The leg will not look as it did prior to the cast but will regain the
same shape and status as the other leg. There should be no bumps underneath the
cast. The leg may be weak and stiff for some time after the cast is removed, not
stronger.
A variety of complications can occur after a leg amputation. All of the following are
possibilities in the immediate postoperative period, except?
a) Hemorrhage
b) Osteomyelitis
c) Infection
d) Hematoma ✅Osteomyelitis
,Explanation:
Chronic osteomyelitis may occur after persistent infection in the late postoperative
period. Hematoma, hemorrhage, and infection are potential complications in the
immediate postoperative period.
A client is about to have a cast applied to his left arm. The nurse would alert the client to
which of the following as the cast is applied?
a) Increased in pain in left arm
b) Sensation of warmth or heat with application
c) Arm being moved to various positions
d) Sensation of weakness ✅Sensation of warmth or heat with application
Explanation:
When a cast is applied, the client needs to be aware that he may feel a sensation of
warmth or heat due to the material being mixed with water. The client should not feel an
increase in pain during the application. The arm will be held in place to ensure proper
alignment during the application. The client should not feel weakness in the extremity.
This is more commonly experiences after a cast is removed.
A client's cast is removed. The client is worried because the skin appears mottled and is
covered with a yellowish crust. What advice should the nurse give the client to address
the skin problem?
a) Avoid exposure to direct sunlight.
b) Apply lotions and take warm baths or soaks.
c) Scrub the area vigorously to remove the crust.
d) Consult a skin specialist. ✅Apply lotions and take warm baths or soaks.
Explanation:
The client should be advised to apply lotions and take warm baths or soaks. This will
help in softening the skin and removing debris. The client usually sheds this residue in a
few days so the client need not consult a skin specialist. It is not advisable to scrub the
area vigorously. The client need not avoid exposure to direct sunlight because the area
is not photosensitive.
Which of the following nursing actions would help prevent deep vein thrombosis in a
patient who has had an orthopedic surgery?
a) Instructing about exercise, as prescribed
b) Instructing about using patient-controlled analgesia, if prescribed
c) Applying cold packs
d) Applying antiembolism stockings ✅Applying antiembolism stockings
Explanation:
,Applying antiembolism stockings helps prevent deep vein thrombosis (DVT) in a patient
who is immobilized due to orthopedic surgery. Regular administration of analgesics
controls and prevents escalation of pain while ROM exercises help in maintaining
muscle strength and tone and prevent contractions. On the other hand, cold packs are
applied to help reduce swelling and this does not prevent deep vein thrombosis.
A client is seen in the emergency department for an injury acquired from falling off of a
bicycle and fracturing the arm. The client also has a long laceration that has been
sutured in the same area. The client asks the nurse why a splint is applied and not a
cast. What is the best explanation by the nurse?
a) "The splint is less expensive than the cast."
b) "You will be able to wear the splint longer than you would a cast."
c) "We will need to monitor the status of the laceration to be sure it does not get
infected."
d) "The arm does not require the same immobilization that a leg fracture would."
✅"We will need to monitor the status of the laceration to be sure it does not get
infected."
Explanation:
A splint would be used when there is special skin treatment or observation that is
required. The arm fracture would require the same form of immobilization that a leg
fracture does. The length of time the splint can be worn is equal to that of a cast to
immobilize the fracture. The cost of the splint and cast would be similar.
A 12-year-old client fractured her right leg several weeks ago while skiing and is
returning to the orthopedist to have her cast removed. What would you expect the
physician to prescribe as further treatment?
a) Apply cold compresses to leg for swelling.
b) No options are correct.
c) Discontinue use of crutches.
d) Physical therapy ✅Physical therapy
Explanation:
For some time, the limb will need support. An elastic bandage may be wrapped on a
leg, the client may use a cane, and an arm may be kept in a sling until progressive
active exercise and physical therapy help the client regain normal strength and motion.
A patient with a short arm cast is suspected to have compartment syndrome. What
actions should the nurse include in the plan of care? Select all that apply.
a) Prepare for cast removal.
b) Assess neurovascular status every 8 hours.
c) Provide support to the injured extremity.
d) Apply ice to extremity.
, e) Elevate the arm above the heart. ✅• Prepare for cast removal.
• Provide support to the injured extremity.
Explanation:
The nurse should anticipate immediate removal of the cast and provide support to the
injured extremity. Neurovascular status should be assessed more frequently than every
8 hours. If the patient is not showing improvement in the neurovascular status, then a
fasciotomy may be needed. Waiting 8 hours to assess neurovascular status may cause
permanent damage to the extremity. To promote arterial blood flow, the arm should be
elevated to the heart level, not above. Ice should not be used as it could further
decrease blood flow to the extremity.
A patient diagnosed with a right ulnar fracture asks why the cast needs to go all the way
up the arm. What is the best response by the nurse?
a) "The method will allow for the fastest healing time and the greatest mobility."
b) "This will allow for the strength in the arm to remain consistent."
c) "The joint above the fracture and below the fracture must be immobilized."
d) "When a spica cast is ordered, the arm must be immobilized." ✅"The joint above
the fracture and below the fracture must be immobilized."
Explanation:
Generally, the joints proximal and distal to the fracture are immobilized to promote
healing. The purpose is not for the strength to remain consistent, most patients will lose
strength. A spica cast would not be ordered for an ulnar fracture. Although immobilizing
the joints above and below fractures may aide in healing time, it does not allow for
increased mobility.
A client has undergone an external fixation. Which actions would be the priority for this
client?
a) Planning the client's diet.
b) Monitoring the client's urine output.
c) Monitoring the client's blood pressure.
d) Maintaining pin care. ✅Maintaining pin care.
Correct
Explanation:
Pin care is a priority for a client with external fixation, because pin sites are entry points
for infection. The nurse should also monitor redness, drainage, and tenderness at the
site. Planning the client's diet and monitoring the client's urine output and blood
pressure, although necessary, are not as important as maintaining pin care.
Which term describes a surgical procedure to release constricting muscle fascia so as
to relieve muscle tissue pressure?
a) Osteotomy
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