Nokea
A nurse is providing discharge education to a patient who is going home with a cast on his leg. What teaching point should the nurse emphasize in the teaching session?
- A. Using crutches efficiently
- B. Exercising joints above and below the cast, as ordered
- C. Removing the cast correctly at the end of the treatment period
- D. Reporting signs of impaired circulation
Correct Answer: D
Rationale: Reporting signs of impaired circulation is critical; signs of impaired circulation must be reported to the physician immediately to prevent permanent damage. For this reason, this education is a priority over exercise and crutch use. The patient does not independently remove the cast.
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A patient has just begun been receiving skeletal traction and the nurse is aware that muscles in the patient's affected limb are spastic. How does this change in muscle tone affect the patient's traction prescription?
- A. Traction must temporarily be aligned in a slightly different direction.
- B. Extra weight is needed initially to keep the limb in proper alignment.
- C. A lighter weight should be initially used.
- D. Weight will temporarily alternate between heavier and lighter weights.
Correct Answer: B
Rationale: The traction weights applied initially must overcome the shortening spasms of the affected muscles. As the muscles relax, the traction weight is reduced to prevent fracture dislocation and to promote healing. Weights never alternate between heavy and light.
A nurse is assessing a patient who is receiving traction. The nurse's assessment confirms that the patient is able to perform plantar flexion. What conclusion can the nurse draw from this finding?
- A. The leg that was assessed is free from DVT.
- B. The patient's tibial nerve is functional.
- C. Circulation to the distal extremity is adequate.
- D. The patient does not have peripheral neurovascular dysfunction.
Correct Answer: B
Rationale: Plantar flexion demonstrates function of the tibial nerve. It does not demonstrate the absence of DVT and does not allow the nurse to ascertain adequate circulation. The nurse must perform more assessments on more sites in order to determine an absence of peripheral neurovascular dysfunction.
A patient was brought to the emergency department after a fall. The patient is taken to the operating room to receive a right hip prosthesis. In the immediate postoperative period, what health education should the nurse emphasize?
- A. Make sure you don't bring your knees close together.
- B. Try to lie as still as possible for the first few days.
- C. Try to avoid bending your knees until next week.
- D. Keep your legs higher than your chest whenever you can.
Correct Answer: A
Rationale: After receiving a hip prosthesis, the affected leg should be kept abducted. Mobility should be encouraged within safe limits. There is no need to avoid knee flexion and the patient's legs do not need to be higher than the level of the chest.
A patient has had a brace prescribed to facilitate recovery from a knee injury. What are the potential therapeutic benefits of a brace? Select all that apply.
- A. Preventing additional injury
- B. Immobilizing prior to surgery
- C. Providing support
- D. Controlling movement
- E. Promoting bone remodeling
Correct Answer: A,C,D
Rationale: Braces (i.e., orthoses) are used to provide support, control movement, and prevent additional injury. They are not used to immobilize body parts or to facilitate bone remodeling.
A nurse is admitting a patient to the unit who presented with a lower extremity fracture. What signs and symptoms would suggest to the nurse that the patient may have a peroneal nerve injury?
- A. Numbness and burning of the foot
- B. Pallor to the dorsal surface of the foot
- C. Visible cyanosis in the toes
- D. Inadequate capillary refill to the toes
Correct Answer: A
Rationale: Peroneal nerve injury may result in numbness, tingling, and burning in the feet. Cyanosis, pallor, and decreased capillary refill are signs of inadequate circulation.