A Review for the Final (NUR 105) Exam
and All Correct Answers 2026
Updated.
THA - Post-Op - Promoting mobility & activity - Answer Be sure to assist the pt the 1st time
he/she gets out of bed to prevent falls & observe for dizziness. When getting the pt out of bed,
stand on the same side of the bed as the affected leg. After the pt sits on the side of the bed,
remind him or her to stand on the unaffected leg & pivot to the chair with guidance. *To avoid
injury, do not lift the pt!*
THA - What should be observed post-procedure? - Answer Observe for possible signs of hip
dislocation, which include severe hip *pain*, shortening of the affected leg, & leg rotation. If
any of these clinical manifestations occur, keep the pt in bed & notify the surgeon immediately!
Total Hip Arthroplasty (THA) - preventing hip dislocation - Answer Teach pts to maintain
correct positioning @ all times. When the pt returns from the PACU, place him/her in a supine
position with the head slightly elevated. Place a regular or abduction pillow b/t the pt's legs to
prevent adduction beyond the midline of the body according to agency policy or surgeon
preference.
Osteoarthritis (OA) - Cold therapy teaching - Answer Teach the pt to use ice packs that are
not too heavy. Do not place them directly on skin; instead, wrap them in a towel or soft cloth.
OA - COX-2 inhibiting drugs & NSAIDs - Considerations, Teaching - Answer All of the COX-2
inhibiting drugs are thought to cause cardiovascular disease, such as MI, & kidney problems.
Older NSAIDs, such as ibuprofen, can cause severe GI side effects, bleeding, & acute kidney
failure. Therefore, they are prescribed @ the lowest effective dose for a short period of time.
Teach your pt about adverse effects from NSAIDs & the need to report them to his or her HCP.
Examples include having dark, tarry stools; SOB; edema; frequent dyspepsia (indigestion);
*hematemesis*; & changes in urinary output.
What is the *primary* drug of choice for OA? Why? - Answer Acetaminophen, bc OA is not a
primary anti-inflammatory disorder.
Acetaminophen - Risk & Teaching - Answer Pts are @ risk for liver damage if they take more
than 3,000 mg daily of acetaminophen, have alcoholism, or have liver disease. Older adults are
particularly @ risk bc of *normal changes of aging*, such as slowed excretion of drug
metabolites. Remind pts to read the labels of OTC or prescription drugs that could contain
acetaminophen before taking them. Teach them that their liver enzyme levels will be monitored
while taking this drug.
,Sprains & strains -immediate tx (RICE) - Answer (a) RICE: Rest, Ice, Compression, Elevation
(b) ICES: Ice, Compression, Elevation, Support
(1) Rest the injured part
(2) Ice immediately (maximum 30 mins @ a time)
(3) Wet elastic bandage for compression
(4) Elevation of the extremity
(5) Immobilization & support (casts or splints)
Fractures - Simple or closed - Answer Fracture does not produce a break in the skin
Fractures - Pathologic or spontaneous - Answer Occur after minimal trauma to a bone that
has been weakened by disease. (EX: pt /c bone cancer or osteoporosis can easily have this
fracture)
Fractures - Fatigue or Stress - Answer Results from excessive strain & stress on the bone;
commonly seen in recreational & professional athletes
Fractures - Compression - Answer Produced by a loading *force applied* to the long axis of
cancellous bone; commonly seen in the vertebrae of older pts with osteoporosis & are
extremely painful
Fractures - Complicated - Answer Bone fragments cause damage to other organs or tissues
Fractures - Comminuted - Answer Small fragments of bone are broken from the fractured
shaft & lie in the surrounding tissue
Fractures - Compound or open - Answer Fractured bone protrudes through the skin
Fractures - Incomplete - Answer When fracture fragments remain attached
Fractures - Complete - Answer When fracture fragments are separated
Fractures - Greenstick - Answer Compressed side of the bone bends but the tension side of
the bone breaks, causing an incomplete fracture (*Most common fracture in children*)
Casts - Synthetic (Fiberglass)
,(Know the differences b/t fiberglass & plaster, why one may be used versus another) - Answer
(•) Lightweight, variety of colors available
(•) More expensive
(•) Dries rapidly in 5 to 30 mins
(•) Rough exterior, which may scratch surfaces & doesn't mold closely to body parts
(•) Permits earlier weight bearing
Casts - Plaster
(Know the differences b/t fiberglass & plaster, why one may be used versus another) - Answer
(•) Inexpensive
(•) Dries in 10 to 72 hrs
(•) Molds closely to body parts
(•) Has a smooth exterior
Fractures - Assessment, How to assess for Ischemia (The 6 P's of Ischemia - Compartment
syndrome) - Answer (1) *Pain*: Not relieved by analgesics or elevation of the limb,
movement that increases pain
(2) *Pulselessness* (distal to the fracture site): Inability to palpate a pulse distal to the fracture
(3) *Pallor*: Pale skin, poor perfusion, capillary refill > 3 secs
(4) *Paresthesia*: Tingling or burning sensation
(5) *Paralysis*: Inability to move extremity or digits
(6) *Pressure*: Involved limb or digits may feel tense & warm, skin is tight, shiny; pressure
within compartment is elevated
Casts - cast care, pt teaching /c casts, handling of wet casts, positioning /c a cast, & potential
complications that can occur /c casts (hot spots, acute compartment syndrome) - Answer (A)
Keep cast uncovered to allow drying from the inside out
(B) Never use heated fans or dryers - cause the cast to dry on the outside & remain wet
underneath; can cause burns to underlying tissue beneath cast
(C) Handle a wet cast /c the palms of the hands to prevent indentation, which can create
pressure areas
(D) After a plaster cast has dried, "hot spots" felt on the cast surface or a foul-smelling odor may
indicate an infection
(E) Monitor for compartment syndrome!
Clinical Manifestations of Fracture - Answer (a) Generalized swelling
(b) Pain or tenderness
, (c) Deformity
(d) Diminished functional use of affected limb or digit
(e) May have bruising, severe muscular rigidity, & crepitus
Fractures - Dx, tx - Answer (1) Diagnostic evaluation
(a) X-ray is the *most useful* diagnostic tool
(2) Therapeutic management goals
(a) Splints or casts to immobilize & protect the injured extremity until adequate callus is formed
(b) May need surgical tx for displaced fractures
Purpose of traction? - Answer (a) To provide rest for an extremity
(b) To position for bone healing
(c) To immobilize a fracture until healing is sufficient to permit casting or splinting
(d) To help prevent or improve contracture deformity
(e) To provide immobilization
(f) To reduce muscle spasms
Nursing consideration during cast removal? - Answer (a) Prepare pt for procedure of cast
removal
(b) When removed skin will be caked /c skin & sebaceous secretions
(•) Soak extremity in bathtub for removal & apply mineral oil or lotion
(•) Instruct to avoid vigorous scrubbing - can cause excoriation & bleeding
How do you reduce the chance of compartment syndrome from occurring? - Answer (•)
Elevate the body part, increasing venous return
(•) Permanent muscle & tissue damage can occur within a few hrs, report any swelling of
fingers/toes
Traction - Bryant traction - Answer Skin traction with the legs flexed @ a 90-degree angle @
the hip
Traction - Dunlop traction - Answer An upper-extremity traction used for fractures of the
humerus
Traction - Cervical Traction - Answer (a) Most cervical traction is accomplished with halo
brace or halo vest
(b) Inserted thru burr holes in the skull with wts attached to the hyperextended head
and All Correct Answers 2026
Updated.
THA - Post-Op - Promoting mobility & activity - Answer Be sure to assist the pt the 1st time
he/she gets out of bed to prevent falls & observe for dizziness. When getting the pt out of bed,
stand on the same side of the bed as the affected leg. After the pt sits on the side of the bed,
remind him or her to stand on the unaffected leg & pivot to the chair with guidance. *To avoid
injury, do not lift the pt!*
THA - What should be observed post-procedure? - Answer Observe for possible signs of hip
dislocation, which include severe hip *pain*, shortening of the affected leg, & leg rotation. If
any of these clinical manifestations occur, keep the pt in bed & notify the surgeon immediately!
Total Hip Arthroplasty (THA) - preventing hip dislocation - Answer Teach pts to maintain
correct positioning @ all times. When the pt returns from the PACU, place him/her in a supine
position with the head slightly elevated. Place a regular or abduction pillow b/t the pt's legs to
prevent adduction beyond the midline of the body according to agency policy or surgeon
preference.
Osteoarthritis (OA) - Cold therapy teaching - Answer Teach the pt to use ice packs that are
not too heavy. Do not place them directly on skin; instead, wrap them in a towel or soft cloth.
OA - COX-2 inhibiting drugs & NSAIDs - Considerations, Teaching - Answer All of the COX-2
inhibiting drugs are thought to cause cardiovascular disease, such as MI, & kidney problems.
Older NSAIDs, such as ibuprofen, can cause severe GI side effects, bleeding, & acute kidney
failure. Therefore, they are prescribed @ the lowest effective dose for a short period of time.
Teach your pt about adverse effects from NSAIDs & the need to report them to his or her HCP.
Examples include having dark, tarry stools; SOB; edema; frequent dyspepsia (indigestion);
*hematemesis*; & changes in urinary output.
What is the *primary* drug of choice for OA? Why? - Answer Acetaminophen, bc OA is not a
primary anti-inflammatory disorder.
Acetaminophen - Risk & Teaching - Answer Pts are @ risk for liver damage if they take more
than 3,000 mg daily of acetaminophen, have alcoholism, or have liver disease. Older adults are
particularly @ risk bc of *normal changes of aging*, such as slowed excretion of drug
metabolites. Remind pts to read the labels of OTC or prescription drugs that could contain
acetaminophen before taking them. Teach them that their liver enzyme levels will be monitored
while taking this drug.
,Sprains & strains -immediate tx (RICE) - Answer (a) RICE: Rest, Ice, Compression, Elevation
(b) ICES: Ice, Compression, Elevation, Support
(1) Rest the injured part
(2) Ice immediately (maximum 30 mins @ a time)
(3) Wet elastic bandage for compression
(4) Elevation of the extremity
(5) Immobilization & support (casts or splints)
Fractures - Simple or closed - Answer Fracture does not produce a break in the skin
Fractures - Pathologic or spontaneous - Answer Occur after minimal trauma to a bone that
has been weakened by disease. (EX: pt /c bone cancer or osteoporosis can easily have this
fracture)
Fractures - Fatigue or Stress - Answer Results from excessive strain & stress on the bone;
commonly seen in recreational & professional athletes
Fractures - Compression - Answer Produced by a loading *force applied* to the long axis of
cancellous bone; commonly seen in the vertebrae of older pts with osteoporosis & are
extremely painful
Fractures - Complicated - Answer Bone fragments cause damage to other organs or tissues
Fractures - Comminuted - Answer Small fragments of bone are broken from the fractured
shaft & lie in the surrounding tissue
Fractures - Compound or open - Answer Fractured bone protrudes through the skin
Fractures - Incomplete - Answer When fracture fragments remain attached
Fractures - Complete - Answer When fracture fragments are separated
Fractures - Greenstick - Answer Compressed side of the bone bends but the tension side of
the bone breaks, causing an incomplete fracture (*Most common fracture in children*)
Casts - Synthetic (Fiberglass)
,(Know the differences b/t fiberglass & plaster, why one may be used versus another) - Answer
(•) Lightweight, variety of colors available
(•) More expensive
(•) Dries rapidly in 5 to 30 mins
(•) Rough exterior, which may scratch surfaces & doesn't mold closely to body parts
(•) Permits earlier weight bearing
Casts - Plaster
(Know the differences b/t fiberglass & plaster, why one may be used versus another) - Answer
(•) Inexpensive
(•) Dries in 10 to 72 hrs
(•) Molds closely to body parts
(•) Has a smooth exterior
Fractures - Assessment, How to assess for Ischemia (The 6 P's of Ischemia - Compartment
syndrome) - Answer (1) *Pain*: Not relieved by analgesics or elevation of the limb,
movement that increases pain
(2) *Pulselessness* (distal to the fracture site): Inability to palpate a pulse distal to the fracture
(3) *Pallor*: Pale skin, poor perfusion, capillary refill > 3 secs
(4) *Paresthesia*: Tingling or burning sensation
(5) *Paralysis*: Inability to move extremity or digits
(6) *Pressure*: Involved limb or digits may feel tense & warm, skin is tight, shiny; pressure
within compartment is elevated
Casts - cast care, pt teaching /c casts, handling of wet casts, positioning /c a cast, & potential
complications that can occur /c casts (hot spots, acute compartment syndrome) - Answer (A)
Keep cast uncovered to allow drying from the inside out
(B) Never use heated fans or dryers - cause the cast to dry on the outside & remain wet
underneath; can cause burns to underlying tissue beneath cast
(C) Handle a wet cast /c the palms of the hands to prevent indentation, which can create
pressure areas
(D) After a plaster cast has dried, "hot spots" felt on the cast surface or a foul-smelling odor may
indicate an infection
(E) Monitor for compartment syndrome!
Clinical Manifestations of Fracture - Answer (a) Generalized swelling
(b) Pain or tenderness
, (c) Deformity
(d) Diminished functional use of affected limb or digit
(e) May have bruising, severe muscular rigidity, & crepitus
Fractures - Dx, tx - Answer (1) Diagnostic evaluation
(a) X-ray is the *most useful* diagnostic tool
(2) Therapeutic management goals
(a) Splints or casts to immobilize & protect the injured extremity until adequate callus is formed
(b) May need surgical tx for displaced fractures
Purpose of traction? - Answer (a) To provide rest for an extremity
(b) To position for bone healing
(c) To immobilize a fracture until healing is sufficient to permit casting or splinting
(d) To help prevent or improve contracture deformity
(e) To provide immobilization
(f) To reduce muscle spasms
Nursing consideration during cast removal? - Answer (a) Prepare pt for procedure of cast
removal
(b) When removed skin will be caked /c skin & sebaceous secretions
(•) Soak extremity in bathtub for removal & apply mineral oil or lotion
(•) Instruct to avoid vigorous scrubbing - can cause excoriation & bleeding
How do you reduce the chance of compartment syndrome from occurring? - Answer (•)
Elevate the body part, increasing venous return
(•) Permanent muscle & tissue damage can occur within a few hrs, report any swelling of
fingers/toes
Traction - Bryant traction - Answer Skin traction with the legs flexed @ a 90-degree angle @
the hip
Traction - Dunlop traction - Answer An upper-extremity traction used for fractures of the
humerus
Traction - Cervical Traction - Answer (a) Most cervical traction is accomplished with halo
brace or halo vest
(b) Inserted thru burr holes in the skull with wts attached to the hyperextended head
