Nokea
You know a patient's crutches fit correctly when
- A. There is a three-fingerbreadth gap of space between the axillary pad and the patient's axilla.
- B. There is a slight bend in the patient's elbows when standing with the crutches next to his or her feet.
- C. The crutches fit snugly into the axilla when the patient is standing with the crutch tips next to the heels.
- D. There is a 6-inch or larger gap between the patient's axilla and the top of the crutch.
Correct Answer: A,B
Rationale: Correct crutch fit includes a three-finger gap under the axilla and a slight elbow bend (15-30 degrees) for comfort and safety.
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Who is responsible for carrying out ambulation orders for patients?
- A. PT only
- B. Nursing assistants only
- C. All nursing staff and PT staff
- D. PT assistants only
Correct Answer: C
Rationale: Ambulation orders are executed by both nursing staff (including assistants) and physical therapy staff, collaborating to promote mobility.
A type of external fixator composed of metal rings on the outside of the limb with rods and wires attached that penetrate through the skin into the bone is a(n)
- A. External immobilizer.
- B. Buck's traction setup.
- C. Skin traction setup.
- D. Ilizarov frame.
Correct Answer: D
Rationale: An Ilizarov frame is an external fixator with metal rings, rods, and wires penetrating the bone to stabilize fractures. Other options describe different devices.
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.
What is the difference in recovery of a patient who has had a direct anterior approach hip arthroplasty and one who has had a lateral approach hip arthroplasty?
- A. Anterior approach has faster recovery due to less muscle disruption.
- B. Lateral approach has faster recovery due to better visualization.
- C. Both approaches have identical recovery times.
- D. Anterior approach requires longer immobilization.
Correct Answer: A
Rationale: The direct anterior approach involves less muscle disruption, leading to faster recovery and fewer movement restrictions compared to the lateral approach, which involves more muscle cutting.
A patient is admitted with an elevated temperature and complaining of pain under his arm cast. A bad odor is noted coming from the elbow area of the cast. The patient tells you that his arm has been itching a great deal under the cast. What concern do you have?
- A. The patient may have damaged the skin under the cast, causing infection.
- B. The bone is not healing well under the cast, causing the pain.
- C. The skin under the cast is breaking down because of pressure from the cast.
- D. The patient may be developing gangrene (tissue death) under the cast, causing the odor.
Correct Answer: A
Rationale: Fever, pain, odor, and itching suggest a possible infection under the cast, likely from skin damage. Gangrene is less likely without systemic symptoms, and bone healing issues don't cause odor.