CH. 67 - MUSCULOSKELETAL TRAUMA AND
ORTHOPEDIC SURGERY
a. "Check and clean the pin insertion sites daily." - ANS-A patient with a right lower leg fracture
will be discharged home with an external fixation device in place. Which statement should the
nurse including in discharge teaching?
a. "Check and clean the pin insertion sites daily."
b. "Remove the external fixator for your shower."
c. "Remain on bed rest until bone healing is complete."
d. "Take prophylactic antibiotics until the fixator is removed."
a. 24 to 48 hours after a fractured tibia - ANS-When is a fat embolism most likely to occur?
a. 24 to 48 hours after a fractured tibia
b. 36 to 72 hours after a skull fracture
c. 4 to 5 days after a fractured femur
d. 5 to 6 days after a pelvic fracture
a. Airway patency
c. Cervical spine injury - ANS-What emergency considerations must be included with facial
fractures (select all that apply)?
a. Airway patency
b. Oral examination
c. Cervical spine injury
d. Cranial nerve assessment
e. Immobilization of the jaw
a. Assess for hip pain. - ANS-Which action should the nurse take to evaluate the effectiveness
of Buck's traction for a patient who has an intracapsular fracture of the right femur?
a. Assess for hip pain.
b. Check for contractures.
c. Palpate peripheral pulses.
d. Monitor for hip dislocation.
a. Assess the surgical site for hemorrhage. - ANS-A patient undergoes left above-the-knee
amputation with an immediate prosthetic fitting. What should the nurse do when the patient
arrives on the orthopedic unit after surgery?
,a. Assess the surgical site for hemorrhage.
b. Remove the prosthesis and wrap the site.
c. Place the patient in a side-lying position.
d. Keep the residual limb elevated on a pillow.
a. Check the patient's prescribed weight-bearing status. - ANS-A patient who has had open
reduction and internal fixation (ORIF) of a hip fracture tells the nurse he is ready to get out of
bed for the first time. Which action should the nurse take?
a. Check the patient's prescribed weight-bearing status.
b. Use a mechanical lift to transfer the patient to the chair.
c. Decrease the pain medication before getting the patient up.
d. Have the unlicensed assistive personnel (UAP) transfer the patient.
a. Fasciotomy - ANS-If surgery is needed, which procedure would the nurse first prepare the
patient for in the presence of compartment syndrome?
a. Fasciotomy
b. Amputation
c. Internal fixation
d. Release of tendons
a. Get the patient up to the chair on the first postoperative day. - ANS-A patient with a fractured
right hip has an anterior ORIF of the fracture. What should the nurse plan to do postoperatively?
a. Get the patient up to the chair on the first postoperative day.
b. Ambulate the patient with partial weight bearing by discharge.
c. Keep the leg abductor pillow on the patient even when bathing.
d. Position the patient only on the back and the nonoperative side.
a. Infection - ANS-What is a disadvantage of open reduction and internal fixation (ORIF) of a
fracture compared to closed reduction?
a. Infection
b. Skin irritation
c. Nerve impairment
d. Complications of immobility
a. Inspect the residual limb daily for irritation. - ANS-A patient who had a below-the-knee
amputation is to be fitted with a temporary prosthesis. What is most important to teach the
patient?
a. Inspect the residual limb daily for irritation.
b. Apply an elastic shrinker before applying the prosthesis.
, c. Perform range-of-motion (ROM) exercises to the affected leg 4 times a day.
d. Apply alcohol to the residual limb every morning and evening to toughen the skin.
a. Intracapsular - ANS-Which kind of hip fracture is usually repaired with a hip prosthesis?
a. Intracapsular
b. Extracapsular
c. Subtrochanteric
d. Intertrochanteric
a. Monitor the patient's vital signs. - ANS-An immediate postoperative prosthetic fitting during
surgery is used for a patient with a traumatic below-the-knee amputation. During the immediate
postoperative period, what is a priority nursing intervention?
a. Monitor the patient's vital signs.
b. Assess the incision for hemorrhage.
c. Elevate the residual limb on pillows.
d. Have the patient flex and extend the knee every hour.
a. Notify the health care provider. - ANS-A patient who had open reduction and internal fixation
(ORIF) of left lower leg fractures continues to report severe pain in the leg 15 minutes after
receiving the prescribed IV morphine. The nurse determines pulses are faintly palpable and the
foot is cool to the touch. Which action should the nurse take next?
a. Notify the health care provider.
b. Assess the incision for redness.
c. Reposition the left leg on pillows.
d. Check the patient's blood pressure.
a. Obtain a keyboard pad to support the wrist. - ANS-What should the occupational health nurse
advise a patient whose job involves many hours of typing?
a. Obtain a keyboard pad to support the wrist.
b. Do stretching exercises before starting work.
c. Wrap the wrists with compression bandages every morning.
d. Avoid using nonsteroidal antiinflammatory drugs (NSAIDS).
a. Ossification - ANS-The patient had a fracture. At 3 weeks to 6 months there is clinical union,
and this is the first stage of healing that is sufficient to prevent movement of the fracture site
when the bones are gently stressed. How is this stage of fracture healing documented?
a. Ossification
b. Remodeling
c. Consolidation
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