MS E4 CH 67

Which information would the nurse teach older adults at a community recreation center about ways to prevent fractures?

Buy supportive nonskid shoes that are comfortable to wear.

A factory line worker has developed repetitive strain injury in the left elbow. Which topic would the nurse plan to include in patient teaching?

Modifying arm movements

Which recommendation would the occupational health nurse provide to a patient whose job involves many hours of typing?

Obtain a keyboard pad to support the wrist

Which discharge instruction would the emergency department nurse include for a patient with a sprained ankle?

Use pillows to elevate the ankle above the heart.

A tennis player has an arthroscopic repair of a rotator cuff injury performed in same-day surgery. Which information will the nurse include in postoperative teaching?

"You will begin exercises with a physical therapist tomorrow."

The nurse would instruct a patient with a nondisplaced fractured left radius that the cast will need to remain in place for what amount of time?

At least six weeks

The nurse is caring for a patient who has a pelvic fracture and an external fixation device. Which method would the nurse use to assess pressure areas and provide skin care to the patient's back and sacrum?

Have the patient lift the back and buttocks using a trapeze bar.

Which patient statement indicates understanding of the nurse's teaching about a new short-arm synthetic cast?

"I will apply an ice pack to the cast over the fracture site off and on for 24 hours."

A patient who is to have no weight bearing on the left leg is learning to use crutches. Which observation by the nurse indicates the patient can safely ambulate independently?

The patient advances the left leg and both crutches together and then advances the right leg

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 would the nurse take next?

Notify the health care provider.

A patient with a complex pelvic fracture from a motor vehicle crash is on bed rest. Which assessment finding indicates a potential complication of the fracture?

Abdomen is distended and bowel sounds are absent.

Which action would the nurse take to evaluate the effectiveness of Buck's traction for a patient who has a fracture of the right femur?

Assess for hip pain.

A patient who has a right lower leg fracture will be discharged home with an external fixation device in place. Which statement would the nurse including in discharge teaching?

"Check and clean the pin insertion sites daily."

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 would the nurse take?

Check the patient's prescribed weight-bearing status.

Which information would the nurse include in discharge teaching for a patient who has had a repair of a fractured mandible?

How and when to cut the immobilizing wires

After the HCP recommends amputation for a patient who has non-healing ischemic foot ulcers, the patient tells the nurse that he would rather die than have an amputation. Which initial response would the nurse provide?

"Tell me what you know about your options for treatment."

The day after a having a right below-the-knee amputation, a patient reports pain in the missing right foot. Which action is most important for the nurse to take?

Administer prescribed analgesics

Which statement by a patient who has had an above-the-knee amputation indicates the nurse's discharge teaching has been effective?

“I should lie flat on my abdomen for 30 minutes 3 or 4 times a day.”

A patient is to be discharged from the hospital 4 days after insertion of a femoral head prosthesis using a posterior approach. Which patient statement to the nurse indicates that additional teaching is needed

"I can sleep in any position that is comfortable for me."

Which action would the nurse include in the plan of care for a patient who had a cemented right total knee arthroplasty?

Start progressive knee exercises to obtain 90-degree flexion.

A patient with ulnar drift caused by rheumatoid arthritis (RA) is scheduled for arthroplasty of several joints in the left hand. Which patient statement to the nurse indicates a realistic expectation for the surgery?

"I will be able to use my fingers with more flexibility to grasp things."

Which information would the nurse include in discharge instructions for a patient with comminuted left forearm fractures and a long-arm cast?

Call the health care provider for numbness of the hand.

A patient who slipped and fell in the shower at home has a proximal left humerus fracture immobilized with a sling. Which intervention would the nurse include in the plan of care?

Assess the left axilla and change absorbent dressings as needed

A patient is being discharged 4 days after hip arthroplasty using the posterior approach. Which patient action requires intervention by the nurse?

Leaning over to pull on shoes and socks

After being hospitalized for 2 days with a right femur fracture, a patient suddenly develops shortness of breath and tachypnea. The patient tells the nurse, "I feel like I am going to die! "Which action would the nurse take first?

Administer prescribed PRN O2 at 4 L/min.

A patient arrived at the emergency department after tripping over a rug and falling at home. Which finding would the nurse identify as most important to communicate to the health care provider?

The right arm appears shorter than the left

A young adult arrives in the emergency department with ankle swelling and severe pain after twisting the ankle playing basketball. Which prescribed action will the nurse implement first?

Elevate the ankle and apply an ice pack

For a patient who has had right hip arthroplasty, which nursing action can the nurse delegate to experienced assistive personnel (AP)?

Reposition the patient every 1 to 2 hours

A patient who arrives at the emergency department with severe left knee pain is diagnosed with a patellar dislocation. Which information would the nurse plan to teach the patient first?

Monitored anesthesia care

After a motorcycle accident, a patient arrives in the emergency department with severe swelling of the left lower leg. Which action would the nurse take first?

Assess leg pulses and sensation

A pedestrian who was hit by a car is admitted to the emergency department with possible right lower leg fractures. Which initial action would the nurse take?

Assess the pedal pulses.

A 60-yr-old patient had open reduction and internal fixation (ORIF) for an open, displaced tibial fracture. Which patient problem would the nurse identify?

Risk for infection

The second day after admission with a fractured pelvis, a patient suddenly develops confusion. Which action would the nurse take first?

Check the O2 saturation.

The nurse admits a patient to the emergency department with a left femur fracture. Which assessment finding is most important to report to the health care provider?

Slow capillary refill of the left foot

A patient undergoes left above-the-knee amputation with an immediate prosthetic fitting. Which action would the nurse take when the patient arrives on the orthopedic unit after surgery?

Assess the surgical site for hemorrhage.

The nurse is preparing to assist a patient with ambulation 2 days after total hip arthroplasty. Which action is most important for the nurse to take?

Administer prescribed pain medication.

A patient has possible carpal tunnel syndrome. Which symptom would the nurse expect with a positive Tinel's sign?

Tingling in the thumb and index finger

Which action would the urgent care nurse take for a patient with a possible knee meniscus injury?

Apply an immobilizer to the affected leg.

Which finding in a patient with a Colles' fracture of the left wrist would the nurse identify as most important to communicate immediately to the health care provider?

Capillary refill to the fingers is slow.

Which information about a patient with a lumbar vertebral compression fracture would the nurse immediately report to the health care provider?

Patient has been incontinent of urine and stool

When a patient arrives in the emergency department with a facial fracture, which action would the nurse take first?

Use a cervical collar to stabilize the spine.

After change-of-shift report, which patient would the nurse assess first?

Patient with repaired right femoral shaft fracture who reports tightness in the calf

The nurse is caring for a patient who is using Buck's traction after a hip fracture. Which action can the nurse delegate to experienced assistive personnel (AP)?

Ensure the weight for the traction is hanging freely.

HPI: 23 y/o presents to ED with RLE injury

Assessment: Reports severe RLE pain and SOB; the bone is protruding from the leg.

Diagnostic Exams: WBC 9400, Hgb 11.6; RLE XR confirms R tibial FX.

Which action would the nurse take first?

Check the patient's O2 saturation using pulse oximetry.

The nurse is completing a neurovascular assessment on the patient with a tibial fracture and a cast. The feet are pulseless, pale, and cool. The patient says they are numb. What should the nurse suspect is occurring?

Compartment syndrome

In which order will the nurse take these actions when caring for a patient with left leg fractures after a motor vehicle accident? Put a comma and space between each answer choice (a, b, c, d, etc.) ____________________
a. Obtain x-rays.
b. Check pedal pulses.
c. Assess lung sounds.
d. Take blood pressure.
e. Apply splint to the leg.
f. Administer tetanus prophylaxis.

C, D, B, E, A, F

A 54-year-old patient admitted with cellulitis and probable osteomyelitis received an injection of radioisotope at 9:00 AM before a bone scan. The nurse should plan to send the patient for the bone scan at what time?

11:00 AM

A 54-year-old patient is about to have a bone scan. In teaching the patient about this procedure, the nurse should include what information?

The patient will be asked to drink increased fluids after the procedure.

The nurse is caring for patients in a primary care clinic. Which individual is most at risk to develop osteomyelitis caused by Staphylococcus aureus?

32-year-old male with type 1 diabetes mellitus and a stage IV pressure ulcer

The nurse receives report from the licensed practical nurse about care provided to patients on the orthopedic surgical unit. It is most important for the nurse to follow up on which statement?

"The patient who had spinal surgery 3 hours ago is complaining of a headache and has clear drainage on the dressing."

The nurse is caring for a patient admitted to the nursing unit with osteomyelitis of the tibia. Which symptom will the nurse most likely find on physical examination of the patient?

Localized pain and warmth

A 54-year-old patient with acute osteomyelitis asks the nurse how this problem will be treated. Which response by the nurse is most appropriate?

"IV antibiotics are usually required for several weeks."

A 67-year-old patient hospitalized with osteomyelitis has an order for bed rest with bathroom privileges with the affected foot elevated on two pillows. The nurse would place highest priority on which intervention?

Perform frequent position changes and ROM exercises.

A patient with osteomyelitis is treated with surgical debridement with implantation of antibiotic beads. When the patient asks why the beads are used, the nurse answers Select all that apply.

"The beads are used to directly deliver antibiotics to the site of the infection."

"The beads are an adjunct to debridement and oral and IV antibiotics for deep infections."