ATI LPN
Timby's Introductory Medical-Surgical Nursing Thirteenth, North American Edition
Chapter 61 : Caring for Clients Requiring Orthopedic Treatment Questions
Question 1 of 5
The nurse is caring for a client in skeletal traction. When performing pin care, which action by the nurse is most important?
Correct Answer: B
Rationale: When performing pin care, the nurse should use at least one applicator per pin and not use an applicator more than once, cleaning the site from the pin outward. Crusts around pin sites should be gently removed, but that is less important than not re-using applicators. Ointment is avoided unless it is specifically ordered.
Question 2 of 5
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?
Correct Answer: B
Rationale: 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. A bivalve cast is when the cast is cut in two if the leg swells or if the client is being weaned from a cast, when a sharp x-ray is needed, or as a splint for immobilizing painful joints when a client has arthritis. The cast should not be removed due to the instability of a fracture. The client's condition does not indicate an external fixator is required.
Question 3 of 5
A client having a cast applied for a fractured leg that extends from below the knee to the base of the toes. The foot is flexed at a right angle in a neutral position. What type of cast is the client having applied?
Correct Answer: A
Rationale: A short leg cast extends from below the knee to the base of the toes. The foot is flexed at a right angle in a neutral position. A long leg cast extends from the junction of the upper and middle third of the thigh to the base of the toes. The knee may be slightly flexed. A walking cast is a short or long leg cast reinforced for strength. A hip spica cast encloses the trunk and a lower extremity.
Question 4 of 5
A client has severe osteoarthritis in the left hip and is having surgery to replace both articular surfaces of the hip. What type of surgical procedure will the nurse prepare the client for?
Correct Answer: C
Rationale: A total arthroplasty is a replacement of both articular surfaces within one joint. An arthrodesis is a fusion of a joint for stabilization and pain relief and is usually done on a wrist or knee. A hemiarthroplasty is the replacement of one of the articular surfaces in a joint, such as the femoral head but not the acetabulum. An osteotomy is the cutting and removal of a wedge of bone to change the bone's alignment, thereby improving function and relieving pain.
Question 5 of 5
A client has a fractured jaw sustained in an automobile accident and has had the fracture surgically reduced and immobilized with a wire loop. What should the nurse ensure is present at the client's bedside in case of vomiting?
Correct Answer: A
Rationale: Ensure that wire cutters are easily accessible at the client's bedside. The nurse should be familiar with how to cut wire loops if the client vomits or chokes. A tracheostomy tray is not necessary when an airway can be obtained by cutting the wires so the client does not aspirate. If vomiting occurs, the client should have nothing by mouth. Antiemetic medication should be administered prior to the client vomiting and should not be kept at the bedside.