Musculoskeletal Trauma and Orthopedic Surgery Lewis: Medical-Surgical Nursing Test Bank

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MULTIPLE CHOICE 1. Which information will the nurse teach seniors at a community recreation center about ways to prevent fractures? a. Tack down scatter rugs in the home. b. Expect most falls to h... appen outside the home. c. Buy shoes that provide good support and are comfortable to wear. d. Get instruction in range-of-motion exercises from a physical therapist. ANS: C Comfortable shoes with good support will help decrease the risk for falls. Scatter rugs should be eliminated, not just tacked down. Activities of daily living provide range of motion exercise; these do not need to be taught by a physical therapist. Falls inside the home are responsible for many injuries. DIF: Cognitive Level: Apply (application) REF: 1463 TOP: Nursing Process: Implementation MSC: NCLEX: Safe and Effective Care Environment 2. A factory line worker has repetitive strain syndrome in the left elbow. The nurse will plan to teach the patient about a. surgical options. c. wearing a left wrist splint. b. elbow injections. d. modifying arm movements. ANS: D Treatment for repetitive strain syndrome includes changing the ergonomics of the activity. Elbow injections and surgery are not initial options for this type of injury. A wrist splint might be used for hand or wrist pain. DIF: Cognitive Level: Apply (application) REF: 1465 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity 3. The occupational health nurse will teach the patient whose job involves many hours of typing to 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) for pain. ANS: A Repetitive strain injuries caused by prolonged work at a keyboard can be prevented by using a pad to keep the wrists in a straight position. Stretching exercises during the day may be helpful, but these would not be needed before starting work. Use of a compression bandage is not needed, although a splint may be used for carpal tunnel syndrome. NSAIDs are appropriate to decrease swelling. DIF: Cognitive Level: Apply (application) REF: 1465 TOP: Nursing Process: Implementation MSC: NCLEX: Health Promotion and Maintenance 4. Which discharge instruction will the emergency department nurse include for a patient with a sprained ankle? a. Keep the ankle loosely wrapped with gauze. b. Apply a heating pad to reduce muscle spasms. c. Use pillows to elevate the ankle above the heart. d. Gently move the ankle through the range of motion. ANS: C Elevation of the leg will reduce swelling and pain. Compression bandages are used to decrease swelling. For the first 24 to 48 hours, cold packs are used to reduce swelling. The ankle should be rested and kept immobile to prevent further swelling or injury. DIF: Cognitive Level: Apply (application) REF: 1472 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity 5. A tennis player has an arthroscopic repair of a rotator cuff injury performed in same-day surgery. When the nurse plans postoperative teaching for the patient, which information will be included? a. “You will not be able to serve a tennis ball again.” b. “You will begin work with a physical therapist tomorrow.” c. “Keep the shoulder immobilizer on for the first 4 days to minimize pain.” d. “The surgeon will use the drop-arm test to determine the success of surgery.” ANS: B Physical therapy after a rotator cuff repair begins on the first postoperative day to prevent “frozen shoulder.” A shoulder immobilizer is used immediately after the surgery, but leaving the arm immobilized for several days would lead to loss of range of motion. The drop-arm test is used to test for rotator cuff injury but not after surgery. The patient may be able to return to tennis after rehabilitation. DIF: Cognitive Level: Apply (application) REF: 1467 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity 6. The nurse will instruct the patient with a fractured left radius that the cast will need to remain in place a. for several months. b. for at least 3 weeks. c. until swelling of the wrist has resolved. d. until x-rays show complete bony union. ANS: B Bone healing starts immediately after the injury, but because ossification does not begin until 3 weeks after injury, the cast will need to be worn for at least 3 weeks. Complete union may take up to 1 year. Resolution of swelling does not indicate bone healing. DIF: Cognitive Level: Apply (application) REF: 1477 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity 7. A patient with a fracture of the left femoral neck has Buck’s traction in place while waiting for surgery. To assess for pressure areas on the patient’s back and sacral area and to provide skin care, the nurse should [Show More]

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