Advanced Med Surg Exam 2
External Fixation - ANS The surgeon inserts metal pins into the bone or bones from outside
the skin surface and then attaches a compression device to the pins.
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? - ANS "We will need to monitor the status of the laceration to be
sure it does not get infected."
A group of students is studying for a test on traction. The students demonstrate understanding
of the types of traction when they identify which of the following as an example of skin traction?
- ANS Buck's
An example of skin traction is Buck's traction. Crutchfield tongs, a Thomas splint, or balanced
suspension traction are types of skeletal traction.
A client with a long arm cast continues to complain of unrelieved throbbing pain even after
receiving opioid pain medication. Which is the priority action by the nurse? - ANS Assess for
complications
Unrelieved pain can be an indicator of a complication, such as compartment syndrome.
A client is about to have a cast applied to the left arm. What will nurse alert the client to as the
cast is applied? - ANS Sensation of warmth or heat with application
A continuous passive motion (CPM) machine is used to promote healing and flexibility in the
knee and hip joint and increase circulation to the operative area. What is true about the use of
CPM? Select all that apply. - ANS The physician orders the amount of extension and flexion
produced by the machine.
The physician orders the frequency of use of the machine.
The amount of flexion for clients with hip replacements should never exceed 30 degrees in the
CPM machine.
A variety of complications can occur after a leg amputation. Which is not a possibility in the
immediate postoperative period? - ANS osteomyelitis
Chronic osteomyelitis may occur after persistent infection in the late postoperative period.
,A nurse would most likely expect the need for open reduction for a client with which of the
following? - ANS Joint fracture
An open reduction is required when soft tissue is caught between the ends of the broken pieces
of bone, the bone has a wide separation, open fractures are evident, comminuted fractures are
present, and the patella or other joints are fractured. It is also done when wound debridement or
internal fixation is needed.
The nurse is caring for a patient who had a total hip replacement. What lethal postoperative
complication should the nurse closely monitor for? - ANS pulmonary embolism
A client's fracture was reduced by surgically exposing the bone and realigning it. What type of
treatment does the nurse identity this as? - ANS Open reduction
Which instruction should the nurse include when teaching the client following hip replacement
surgery? (Select all that apply.) - ANS "Place pillows between your legs when you lay on your
side."
"Avoid bending forward when sitting in a chair."
"Use a raised toilet seat and high-seated chair.
A group of students is reviewing information about cast composition in preparation for a
discussion on the advantages and disadvantages of each. The students demonstrate
understanding of the topic when they cite which of the following as an advantage of a plaster
cast? - ANS Better molding to the client
A client is seen in the orthopedic clinic for complaints of severe pain in the left hip. After a series
of diagnostic tests, the client is diagnosed with severe degenerative joint disease of the left hip
and suggested to have the hip reconstructed. What procedure will the nurse schedule the client
for? - ANS Left hip arthroplasty
The nurse is assisting with the application of a cast. What will the nurse expect to be done first?
- ANS Cleaning the skin surface.
A hip spica cast - ANS encloses the trunk and a lower extremity.
A client has a cast applied to the leg for treatment of a tibia fracture and also has a wound on
the leg that requires dressing changes due to drainage. For what should the nurse prepare the
client? - ANS Cutting a cast window
After the cast dries, a cast window, or opening, may be cut. This usually is done when the client
reports discomfort under the cast or has a wound that requires a dressing change. The window
permits direct inspection of the skin, a means to check the pulse in a casted arm or leg, or a
way to change a dressing.
, Arthrodesis is: - ANS fusion of a joint (most often the wrist or knee) for stabilization and pain
relief.
An older adult patient had a hip replacement. When should the patient begin with assisted
ambulation with a walker? - ANS 24 hours
A client in the emergency department is being treated for a wrist fracture. The client asks why a
splint is being applied instead of a cast. What is the best response by the nurse? - ANS "A
splint is applied when more swelling is expected at the site of injury.
A client's fracture was reduced by surgically exposing the bone and realigning it. What type of
treatment does the nurse identity this as? - ANS Open reduction
A client with a fractured ankle is having a fiberglass cast applied. The client starts yelling, "My
leg is burning, take it off." What action by the nurse is most appropriate? - ANS Explain that the
sensation being felt is normal and will not burn the client.
The nurse is very concerned about the potential debilitating complication of peroneal nerve
injury. What symptom does the nurse recognize as a result of that complication? - ANS foot
drop
A patient had a total left hip arthroplasty. What clinical manifestation would indicate to the nurse
that the prosthesis is dislocated? - ANS The left leg is internally rotated.
Which intervention should the nurse implement with the client who has undergone a hip
replacement? - ANS Instruct the client to avoid internal rotation of the leg.
Which of the following diagnostics are used to evaluate spinal nerve root disorders
(radiculopathies)? - ANS Electromyogram
A nurse is teaching a client who was recently diagnosed with carpal tunnel syndrome. Which
statement should the nurse include? - ANS Ergonomic changes can be incorporated into your
workday to reduce stress on your wrist
Morton neuroma is exhibited by which clinical manifestation? - ANS Swelling of the third
(lateral) branch of the median plantar nerve
Most cases of osteomyelitis are caused by which microorganism? - ANS Staphylococcus
aureus
The provider asks a nurse to test a patient for Tinel's sign to diagnose carpal tunnel syndrome.
The nurse asked the patient to: - ANS Hold his palm up while the nurse percussed over the
median nerve
External Fixation - ANS The surgeon inserts metal pins into the bone or bones from outside
the skin surface and then attaches a compression device to the pins.
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? - ANS "We will need to monitor the status of the laceration to be
sure it does not get infected."
A group of students is studying for a test on traction. The students demonstrate understanding
of the types of traction when they identify which of the following as an example of skin traction?
- ANS Buck's
An example of skin traction is Buck's traction. Crutchfield tongs, a Thomas splint, or balanced
suspension traction are types of skeletal traction.
A client with a long arm cast continues to complain of unrelieved throbbing pain even after
receiving opioid pain medication. Which is the priority action by the nurse? - ANS Assess for
complications
Unrelieved pain can be an indicator of a complication, such as compartment syndrome.
A client is about to have a cast applied to the left arm. What will nurse alert the client to as the
cast is applied? - ANS Sensation of warmth or heat with application
A continuous passive motion (CPM) machine is used to promote healing and flexibility in the
knee and hip joint and increase circulation to the operative area. What is true about the use of
CPM? Select all that apply. - ANS The physician orders the amount of extension and flexion
produced by the machine.
The physician orders the frequency of use of the machine.
The amount of flexion for clients with hip replacements should never exceed 30 degrees in the
CPM machine.
A variety of complications can occur after a leg amputation. Which is not a possibility in the
immediate postoperative period? - ANS osteomyelitis
Chronic osteomyelitis may occur after persistent infection in the late postoperative period.
,A nurse would most likely expect the need for open reduction for a client with which of the
following? - ANS Joint fracture
An open reduction is required when soft tissue is caught between the ends of the broken pieces
of bone, the bone has a wide separation, open fractures are evident, comminuted fractures are
present, and the patella or other joints are fractured. It is also done when wound debridement or
internal fixation is needed.
The nurse is caring for a patient who had a total hip replacement. What lethal postoperative
complication should the nurse closely monitor for? - ANS pulmonary embolism
A client's fracture was reduced by surgically exposing the bone and realigning it. What type of
treatment does the nurse identity this as? - ANS Open reduction
Which instruction should the nurse include when teaching the client following hip replacement
surgery? (Select all that apply.) - ANS "Place pillows between your legs when you lay on your
side."
"Avoid bending forward when sitting in a chair."
"Use a raised toilet seat and high-seated chair.
A group of students is reviewing information about cast composition in preparation for a
discussion on the advantages and disadvantages of each. The students demonstrate
understanding of the topic when they cite which of the following as an advantage of a plaster
cast? - ANS Better molding to the client
A client is seen in the orthopedic clinic for complaints of severe pain in the left hip. After a series
of diagnostic tests, the client is diagnosed with severe degenerative joint disease of the left hip
and suggested to have the hip reconstructed. What procedure will the nurse schedule the client
for? - ANS Left hip arthroplasty
The nurse is assisting with the application of a cast. What will the nurse expect to be done first?
- ANS Cleaning the skin surface.
A hip spica cast - ANS encloses the trunk and a lower extremity.
A client has a cast applied to the leg for treatment of a tibia fracture and also has a wound on
the leg that requires dressing changes due to drainage. For what should the nurse prepare the
client? - ANS Cutting a cast window
After the cast dries, a cast window, or opening, may be cut. This usually is done when the client
reports discomfort under the cast or has a wound that requires a dressing change. The window
permits direct inspection of the skin, a means to check the pulse in a casted arm or leg, or a
way to change a dressing.
, Arthrodesis is: - ANS fusion of a joint (most often the wrist or knee) for stabilization and pain
relief.
An older adult patient had a hip replacement. When should the patient begin with assisted
ambulation with a walker? - ANS 24 hours
A client in the emergency department is being treated for a wrist fracture. The client asks why a
splint is being applied instead of a cast. What is the best response by the nurse? - ANS "A
splint is applied when more swelling is expected at the site of injury.
A client's fracture was reduced by surgically exposing the bone and realigning it. What type of
treatment does the nurse identity this as? - ANS Open reduction
A client with a fractured ankle is having a fiberglass cast applied. The client starts yelling, "My
leg is burning, take it off." What action by the nurse is most appropriate? - ANS Explain that the
sensation being felt is normal and will not burn the client.
The nurse is very concerned about the potential debilitating complication of peroneal nerve
injury. What symptom does the nurse recognize as a result of that complication? - ANS foot
drop
A patient had a total left hip arthroplasty. What clinical manifestation would indicate to the nurse
that the prosthesis is dislocated? - ANS The left leg is internally rotated.
Which intervention should the nurse implement with the client who has undergone a hip
replacement? - ANS Instruct the client to avoid internal rotation of the leg.
Which of the following diagnostics are used to evaluate spinal nerve root disorders
(radiculopathies)? - ANS Electromyogram
A nurse is teaching a client who was recently diagnosed with carpal tunnel syndrome. Which
statement should the nurse include? - ANS Ergonomic changes can be incorporated into your
workday to reduce stress on your wrist
Morton neuroma is exhibited by which clinical manifestation? - ANS Swelling of the third
(lateral) branch of the median plantar nerve
Most cases of osteomyelitis are caused by which microorganism? - ANS Staphylococcus
aureus
The provider asks a nurse to test a patient for Tinel's sign to diagnose carpal tunnel syndrome.
The nurse asked the patient to: - ANS Hold his palm up while the nurse percussed over the
median nerve
