Lewis Chapter 62: Musculoskeletal Trauma and Orthopedic Surgery Questions
and Answers With Verified Solutions 2025
While completing an admission history for a 73-year-old man with osteoarthritis admitted for knee
arthroplasty, the nurse asks about the patient's perception of the reason for admission. The nurse
expects the patient to relate which response to this question?
A Recent knee trauma
B Debilitating joint pain
C Repeated knee infections
D Onset of "frozen" knee joint - ✔✔B Debilitating joint pain
The most common reason for knee arthroplasty is debilitating joint pain despite attempts to manage it
with exercise and drug therapy. Recent knee trauma, repeated knee infections, and onset of "frozen"
knee joint are not primary indicators for a knee arthroplasty.
The nurse is caring for a patient with osteoarthritis who is about to undergo total left knee arthroplasty.
The nurse assesses the patient carefully to be sure that there is no evidence of what in the preoperative
period?
A Pain
B Left knee stiffness
C Left knee infection
D Left knee instability - ✔✔C Left knee infection
It is critical that the patient be free of infection before a total knee arthroplasty. An infection in the joint
could lead to even greater pain and joint instability, requiring extensive surgery. For this reason, the
nurse monitors the patient for signs of infection, such as redness, swelling, fever, and elevated white
blood cell count. Pain, knee stiffness, or instability may be present with osteoarthritis.
The nurse formulates a nursing diagnosis of impaired physical mobility related to decreased muscle
strength for a 78-year-old patient following left total knee replacement. What would be an appropriate
nursing intervention for this patient?
,A Promote vitamin C and calcium intake in the diet.
B Provide passive range of motion to all of the joints q4hr.
C Encourage isometric quadriceps-setting exercises at least qid.
D Keep the left leg in extension and abduction to prevent contractures. - ✔✔C Encourage isometric
quadriceps-setting exercises at least qid.
Emphasis is placed on postoperative exercise of the affected leg, with isometric quadriceps setting
beginning on the first day after surgery along with a continuous passive motion (CPM) machine. Vitamin
C and calcium do not improve muscle strength, but they will facilitate healing. The patient should be
able to do active range of motion to all joints. Keeping the leg in one position (extension and abduction)
potentially will result in contractures.
The nurse is caring for a 76-year-old man who has undergone left knee arthroplasty with prosthetic
replacement of the knee joint to relieve the pain of severe osteoarthritis. Postoperatively the nurse
expects what to be included in the care of the affected leg?
A Progressive leg exercises to obtain 90-degree flexion
B Early ambulation with full weight bearing on the left leg
C Bed rest for 3 days with the left leg immobilized in extension
D Immobilization of the left knee in 30-degree flexion for 2 weeks to prevent dislocation - ✔✔A
Progressive leg exercises to obtain 90-degree flexion
Although early ambulation is not done, the patient is encouraged to engage in progressive leg exercises
until 90-degree flexion is possible. Because this is painful after surgery, the patient requires good pain
management and often the use of a CPM machine. The patient's knee is unlikely to dislocate.
The nurse is caring for a 75-year-old woman who underwent left total knee arthroplasty and has a new
order to be "up in chair today before noon." What action should the nurse take to protect the knee joint
while carrying out the order?
A Administer a dose of prescribed analgesic before completing the order.
B Ask the physical therapist for a walker to limit weight bearing while getting out of bed.
C Keep the continuous passive motion machine in place while lifting the patient from bed to chair.
, D Put on a knee immobilizer before moving the patient out of bed and keep the surgical leg elevated
while sitting. - ✔✔D Put on a knee immobilizer before moving the patient out of bed and keep the
surgical leg elevated while sitting.
The nurse should apply a knee immobilizer for stability before assisting the patient to get out of bed.
This is a standard measure to protect the knee during movement following surgery. Although an
analgesic should be given before the patient gets up in the chair for the first time, it will not protect the
knee joint. Full weight bearing is begun before discharge, so a walker will not be used if the patient did
not need one before the surgery. The CPM machine is not kept in place while the patient is getting up to
the chair.
The nurse is completing discharge teaching with an 80-year-old male patient who underwent right total
hip arthroplasty. The nurse identifies a need for further instruction if the patient states the need to
A avoid crossing his legs.
B use a toilet elevator on toilet seat.
C notify future caregivers about the prosthesis.
D maintain hip in adduction and internal rotation. - ✔✔D maintain hip in adduction and internal
rotation.
The patient should not force hip into adduction or force hip into internal rotation as these movements
could displace the hip replacement. Avoiding crossing the legs, using a toilet elevator on a toilet seat,
and notifying future caregivers about the prosthesis indicate understanding of discharge teaching.
This morning a 21-year-old male patient had a long leg cast applied and wants to get up and try out his
crutches before dinner. The nurse will not allow this. What is the best rationale that the nurse should
give the patient for this decision?
A The cast is not dry yet, and it may be damaged while using crutches.
B The nurse does not have anyone available to accompany the patient.
C Rest, ice, compression, and elevation are in process to decrease pain.
D Excess edema and other problems are prevented when the leg is elevated for 24 hours - ✔✔D Excess
edema and other problems are prevented when the leg is elevated for 24 hours
and Answers With Verified Solutions 2025
While completing an admission history for a 73-year-old man with osteoarthritis admitted for knee
arthroplasty, the nurse asks about the patient's perception of the reason for admission. The nurse
expects the patient to relate which response to this question?
A Recent knee trauma
B Debilitating joint pain
C Repeated knee infections
D Onset of "frozen" knee joint - ✔✔B Debilitating joint pain
The most common reason for knee arthroplasty is debilitating joint pain despite attempts to manage it
with exercise and drug therapy. Recent knee trauma, repeated knee infections, and onset of "frozen"
knee joint are not primary indicators for a knee arthroplasty.
The nurse is caring for a patient with osteoarthritis who is about to undergo total left knee arthroplasty.
The nurse assesses the patient carefully to be sure that there is no evidence of what in the preoperative
period?
A Pain
B Left knee stiffness
C Left knee infection
D Left knee instability - ✔✔C Left knee infection
It is critical that the patient be free of infection before a total knee arthroplasty. An infection in the joint
could lead to even greater pain and joint instability, requiring extensive surgery. For this reason, the
nurse monitors the patient for signs of infection, such as redness, swelling, fever, and elevated white
blood cell count. Pain, knee stiffness, or instability may be present with osteoarthritis.
The nurse formulates a nursing diagnosis of impaired physical mobility related to decreased muscle
strength for a 78-year-old patient following left total knee replacement. What would be an appropriate
nursing intervention for this patient?
,A Promote vitamin C and calcium intake in the diet.
B Provide passive range of motion to all of the joints q4hr.
C Encourage isometric quadriceps-setting exercises at least qid.
D Keep the left leg in extension and abduction to prevent contractures. - ✔✔C Encourage isometric
quadriceps-setting exercises at least qid.
Emphasis is placed on postoperative exercise of the affected leg, with isometric quadriceps setting
beginning on the first day after surgery along with a continuous passive motion (CPM) machine. Vitamin
C and calcium do not improve muscle strength, but they will facilitate healing. The patient should be
able to do active range of motion to all joints. Keeping the leg in one position (extension and abduction)
potentially will result in contractures.
The nurse is caring for a 76-year-old man who has undergone left knee arthroplasty with prosthetic
replacement of the knee joint to relieve the pain of severe osteoarthritis. Postoperatively the nurse
expects what to be included in the care of the affected leg?
A Progressive leg exercises to obtain 90-degree flexion
B Early ambulation with full weight bearing on the left leg
C Bed rest for 3 days with the left leg immobilized in extension
D Immobilization of the left knee in 30-degree flexion for 2 weeks to prevent dislocation - ✔✔A
Progressive leg exercises to obtain 90-degree flexion
Although early ambulation is not done, the patient is encouraged to engage in progressive leg exercises
until 90-degree flexion is possible. Because this is painful after surgery, the patient requires good pain
management and often the use of a CPM machine. The patient's knee is unlikely to dislocate.
The nurse is caring for a 75-year-old woman who underwent left total knee arthroplasty and has a new
order to be "up in chair today before noon." What action should the nurse take to protect the knee joint
while carrying out the order?
A Administer a dose of prescribed analgesic before completing the order.
B Ask the physical therapist for a walker to limit weight bearing while getting out of bed.
C Keep the continuous passive motion machine in place while lifting the patient from bed to chair.
, D Put on a knee immobilizer before moving the patient out of bed and keep the surgical leg elevated
while sitting. - ✔✔D Put on a knee immobilizer before moving the patient out of bed and keep the
surgical leg elevated while sitting.
The nurse should apply a knee immobilizer for stability before assisting the patient to get out of bed.
This is a standard measure to protect the knee during movement following surgery. Although an
analgesic should be given before the patient gets up in the chair for the first time, it will not protect the
knee joint. Full weight bearing is begun before discharge, so a walker will not be used if the patient did
not need one before the surgery. The CPM machine is not kept in place while the patient is getting up to
the chair.
The nurse is completing discharge teaching with an 80-year-old male patient who underwent right total
hip arthroplasty. The nurse identifies a need for further instruction if the patient states the need to
A avoid crossing his legs.
B use a toilet elevator on toilet seat.
C notify future caregivers about the prosthesis.
D maintain hip in adduction and internal rotation. - ✔✔D maintain hip in adduction and internal
rotation.
The patient should not force hip into adduction or force hip into internal rotation as these movements
could displace the hip replacement. Avoiding crossing the legs, using a toilet elevator on a toilet seat,
and notifying future caregivers about the prosthesis indicate understanding of discharge teaching.
This morning a 21-year-old male patient had a long leg cast applied and wants to get up and try out his
crutches before dinner. The nurse will not allow this. What is the best rationale that the nurse should
give the patient for this decision?
A The cast is not dry yet, and it may be damaged while using crutches.
B The nurse does not have anyone available to accompany the patient.
C Rest, ice, compression, and elevation are in process to decrease pain.
D Excess edema and other problems are prevented when the leg is elevated for 24 hours - ✔✔D Excess
edema and other problems are prevented when the leg is elevated for 24 hours
