Nokea
You are caring for a young child with hip dysplasia who is in a spica cast. An important nursing concern is
- A. Assessing circulation to the fingers and hands.
- B. Moving the patient carefully without using the abductor bar.
- C. Keeping the patient's hips elevated above the heart.
- D. Aligning the hips each time the patient is turned.
Correct Answer: B
Rationale: In a spica cast, the abductor bar maintains hip alignment and should not be used to move the patient, as this could disrupt the cast or alignment. Circulation is assessed in the toes, not fingers.
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Which of the following would you include when you teach a patient about using a cane?
- A. Hold the cane on your affected side.
- B. Move the unaffected leg and the cane together, and then move the affected leg.
- C. Lean to the side the cane is on for best support.
- D. Hold the cane on the unaffected side, move it with the unaffected leg, then move the affected leg.
Correct Answer: D
Rationale: The cane is held on the unaffected side, moved with the unaffected leg, then followed by the affected leg for proper support and balance.
A patient who has had a total knee replacement asks you to take off the CPM machine after 1 hour, although it is ordered to be on for 2 hours. How will you respond?
- A. Explain the importance of completing the full 2 hours to promote recovery.
- B. Remove the CPM machine as requested to respect patient autonomy.
- C. Adjust the CPM settings to reduce discomfort.
- D. Contact the provider to modify the order.
Correct Answer: A
Rationale: Explaining the importance of the full 2-hour CPM duration encourages compliance to improve joint mobility and recovery. Other options may undermine the treatment plan.
A common condition that requires a joint replacement is
- A. A hairline fracture.
- B. Osteoarthritis.
- C. A comminuted fracture.
- D. An amputation.
Correct Answer: B
Rationale: Osteoarthritis, a degenerative joint disease, commonly requires joint replacement due to cartilage loss and pain. Hairline and comminuted fractures are treated with immobilization or fixation, and amputation is a procedure, not a condition.
A patient comes into the clinic where you are working for a follow-up visit after breaking her ankle. She has been using crutches for the past 2 weeks and is complaining of pain and tingling in her forearms and hands. What is the most likely cause of these symptoms?
- A. Poor crutch fit causing nerve compression.
- B. Muscle strain from overuse.
- C. Infection from crutch use.
- D. Poor circulation due to immobility.
Correct Answer: A
Rationale: Pain and tingling in the forearms and hands are likely due to poor crutch fit, causing pressure on nerves (e.g., radial or ulnar nerve compression). Muscle strain, infection, or circulation issues are less likely causes.
Which bone components are replaced in a total hip replacement surgery?
- A. The head and neck of the femur and the acetabular cup
- B. The greater trochanter of the femur and the acetabular cup
- C. The ilium and the head of the femur
- D. The distal end of the femur and the head of the tibia
Correct Answer: A
Rationale: In total hip replacement, the femoral head and neck are replaced, and the acetabulum is fitted with a cup-shaped component.