Nokea
A patient comes into the clinic with his arm in a cast. You notice a small amount of thick, light yellow drainage coming from under the cast, and it has an unpleasant odor. There is no drainage staining the cast, and no open areas of skin are visible at the edge of the cast. Which question is most appropriate to ask this patient?
- A. Have you inserted anything under the cast to scratch your arm?
- B. Have you had an upper respiratory infection recently?
- C. Do you have a skin rash anywhere on your body?
- D. Is the edge of the cast irritating your skin?
Correct Answer: A
Rationale: Inserting objects under a cast can cause skin breakdown and infection, which may explain the drainage and odor.
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The purpose of the CPM machine is to provide:
- A. active abduction and adduction
- B. active range of motion to all joints
- C. passive flexion and extension
- D. passive internal and external rotation
Correct Answer: C
Rationale: A CPM machine provides passive flexion and extension to promote joint mobility without active patient effort.
Which surfaces are replaced when a patient has a total hip replacement?
- A. The articular surfaces of the femur and the tibia
- B. The posterior surface of the patella and the tibia
- C. The acetabular cup and head of the tibia and fibula
- D. The head and neck of the femur and the acetabular cup
Correct Answer: D
Rationale: Total hip replacement involves replacing the femoral head and neck and the acetabular cup in the pelvis.
A patient is in skeletal traction for a comminuted fracture of the tibia. While giving pin care, you notice a small amount of serous drainage around each pin site. Which observation is most accurate?
- A. The drainage is a symptom of skin infection
- B. This finding is normal for skeletal traction
- C. This is an indication of pin dislocation
- D. The drainage is an indication of a bone infection
Correct Answer: B
Rationale: A small amount of serous drainage is normal around pin sites in skeletal traction, as long as there are no signs of infection.
You are caring for a patient with a fresh total hip replacement. Which statement would indicate that your patient needs more teaching?
- A. I will sleep with the abductor pillow between my legs every night for several months
- B. I can cross my legs when I am sitting in a chair as long as my feet are elevated on a footstool
- C. I need to use an extension gripper to pick up anything I drop
- D. I will sit in the recliner with the back slightly reclined when I am out of bed
Correct Answer: B
Rationale: Crossing legs after a total hip replacement risks dislocation of the prosthesis, indicating a need for further teaching.
A patient who has chronic lung disease is stimulated to breathe because the chemoreceptors detect:
- A. low oxygen in the blood
- B. high oxygen in the blood
- C. low carbon dioxide in the blood
- D. high carbon dioxide in the blood
Correct Answer: D
Rationale: In chronic lung disease, high carbon dioxide levels drive respiration due to desensitized oxygen chemoreceptors.