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A client has a cast that extends from below the elbow to the palmar crease and is secured around the base of the thumb. The thumb is also casted. The nurse identifies this as which type of cast?
- A. Short arm cast
- B. Gauntlet cast
- C. Body cast
- D. Spica cast
Correct Answer: B
Rationale: A gauntlet cast is a short arm cast that extends from below the elbow to the palmar crease and is secured around the base of the thumb, with the thumb also being casted. A short arm cast extends from below the elbow to the palmar crease and is secured around the base of the thumb. A body cast is a larger form of a cylinder cast that encircles the trunk from about the nipple line to the iliac crests. A hip spica cast surrounds one or both legs and the trunk.
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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?
- A. Left hip arthroplasty
- B. Left hip arthroscopy
- C. Open reduction and internal fixation of the left hip.
- D. Closed reduction of the left hip.
Correct Answer: A
Rationale: Clients with arthritis, trauma, hip fracture, or a congenital deformity may have an arthroplasty, or reconstruction of the joint. This procedure uses an artificial joint that restores previously lost function and relieves pain. An arthroscopy is not used to reconstruct a diseased hip. A closed reduction is not an invasive surgical procedure and would not be used to reconstruct the hip. An open reduction and internal fixation is not the treatment for reconstruction of the hip related to a diseased hip.
The nurse is caring for a client who had an amputation of the left leg above the knee. What position can the nurse place the client in several times per day to promote stump extension and prevent contractures?
- A. Supine
- B. Left lateral
- C. Prone
- D. Right lateral
Correct Answer: C
Rationale: Place the client with leg amputation in the prone position several times a day. This position promotes stump extension and prevents contractures. The other positions do neither of these things.
The nurse is caring for a patient with a fractured right femur who is not a candidate to repair the femur immediately. What intervention should the nurse anticipate the physician will order to relieve muscle spasm and pain until surgery is performed?
- A. Skeletal traction
- B. Skin traction
- C. Open reduction
- D. External fixator
Correct Answer: B
Rationale: If surgery for a fracture cannot be performed right away, Buck's traction or other skin traction may be applied to relieve muscle spasm and pain until surgery is performed. The other distractors all require surgical intervention.
The nurse is caring for a client in skeletal traction. When performing pin care, which action by the nurse is most important?
- A. Clean the site, working toward the pin.
- B. Use an applicator only once.
- C. Gently remove crusts around pin sites.
- D. Apply an antimicrobial ointment.
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.
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 to 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?
- A. We will need to monitor the status of the laceration to be sure it does not get infected.
- B. The arm does not require the same immobilization that a leg fracture would.
- C. You will be able to wear the splint longer than you would a cast.
- D. The splint is less expensive than the cast.
Correct Answer: A
Rationale: A splint would be used when there is special skin treatment or observation that is required. The arm fracture would require the same form of immobilization that a leg fracture does. The length of time the splint can be worn is equal to that
of a cast to immobilize the fracture. The cost of the splint and cast would be similar.