1.A client's cast is removed. The client is worried because the skin appears mottled and is
covered with a yellowish crust. What advice should the nurse give the client to address
the skin problem?
A) Consult a skin specialist.
B) Scrub the area vigorously to remove the crust.
C) Apply lotions and take warm baths or soaks.
D) Avoid exposure to direct sunlight.
Ans: C
Feedback:
The client should be advised to apply lotions and take warm baths or soaks. This will help
in softening the skin and removing debris. The client usually sheds this residue in a few
days so the client need not consult a skin specialist. It is not advisable to scrub the area
vigorously. The client need not avoid exposure to direct sunlight because the area is not
photosensitive.
2. The nurse is caring for a client who has had a fracture reduction using a cast. Which
of the following would be most important for the nurse to assess?
A) Cardiac and respiratory status
B) Renal and hepatic function
C) Sleep status
D) Sensation and mobility status
Ans: D
Feedback:
After cast application, the nurse should assess circulation, sensation, and mobility in
exposed fingers and toes every 1 to 2 hours. Assessment of cardiac, respiratory, hepatic,
and renal status would be priorities if the client experienced multiple fractures or had an
open reduction. The client's sleep status would be a low priority.
3. During the assessment of a client scheduled for orthopedic surgery, the nurse discovers
that the client was previously treated for the disorder. In such a case, what additional
data need to be collected?
A) Occurrence of complications or problems during treatment
B) Measures taken to minimize postoperative wound infection
C) Perception of the client about the previous treatment
D) Details of the medical team that handled the previous treatment
Ans: A
Feedback:
If the same disorder has been treated earlier, the nurse needs to determine and document
any complications or problems that occurred during treatment. The nurse can determine
whether the client understands the treatment or not based on the measures taken by the
client to minimize postoperative wound infection. However, this factor can be assessed
later because the nurse needs to explain the new treatment to the client. Although the
client's perceptions of the previous treatment may be helpful, this data would not be as
important. In addition, the nurse does not need to get details about the medical team that
Page 1
, handled the previous treatment, unless specifically asked to do so.
4.A client is scheduled for a joint replacement surgery. Which action would be most
important?
A) Ensure adequate fluid intake before the surgery.
B) Withhold intake of solid food before the surgery.
C) Withhold administration of aspirin before the surgery.
D) Ensure adequate sleep before the
surgery. Ans:C
Feedback:
If a client is scheduled for a joint replacement or other surgery, it is crucial for the nurse
to withhold aspirin before surgery to reduce the risk of excessive bleeding. It is also
essential to monitor the complete blood count, prothrombin time, bleeding, and clotting
time to ensure that the client is able to control bleeding. The impact of fluid or solid food
intake does not have as strong implications as the impact of aspirin intake before surgery.
Having adequate sleep before surgery is helpful but is not the most important action.
5.A client has just undergone a leg amputation. The nurse would closely monitor the client
for which of the following during the immediate postoperative period?
A) Neuroma
B) Hematoma
C) Chronic osteomyelitis
D) Unexplainable burning pain (causalgia)
Ans: B
Feedback:
Hematoma, hemorrhage, and infection are potential complications in the immediate
postoperative period. Sleeplessness, nausea, and vomiting may occur but are adverse
reactions, not complications. Chronic osteomyelitis and causalgia are potential
complications that are likely to arise in the late postoperative period. A neuroma occurs
when the cut ends of the nerves become entangled in the healing scar. This would occur
later in the postoperative course.
6.A 68-year-old female client who had a total hip replacement is to be discharged because
her healing is almost complete. Which of the following would be most important for
this client?
A) Advising the client to avoid red meat
B) Urging her to keep the affected limb in an elevated position
C) Educating the client about the effects of menopause
D) Exploring factors related to the client's home environment
Ans: D
Feedback:
Exploring factors related to the older adult client's home environment and determining a
plan for continued rehabilitation before discharge is most important. The client should be
Page 2
covered with a yellowish crust. What advice should the nurse give the client to address
the skin problem?
A) Consult a skin specialist.
B) Scrub the area vigorously to remove the crust.
C) Apply lotions and take warm baths or soaks.
D) Avoid exposure to direct sunlight.
Ans: C
Feedback:
The client should be advised to apply lotions and take warm baths or soaks. This will help
in softening the skin and removing debris. The client usually sheds this residue in a few
days so the client need not consult a skin specialist. It is not advisable to scrub the area
vigorously. The client need not avoid exposure to direct sunlight because the area is not
photosensitive.
2. The nurse is caring for a client who has had a fracture reduction using a cast. Which
of the following would be most important for the nurse to assess?
A) Cardiac and respiratory status
B) Renal and hepatic function
C) Sleep status
D) Sensation and mobility status
Ans: D
Feedback:
After cast application, the nurse should assess circulation, sensation, and mobility in
exposed fingers and toes every 1 to 2 hours. Assessment of cardiac, respiratory, hepatic,
and renal status would be priorities if the client experienced multiple fractures or had an
open reduction. The client's sleep status would be a low priority.
3. During the assessment of a client scheduled for orthopedic surgery, the nurse discovers
that the client was previously treated for the disorder. In such a case, what additional
data need to be collected?
A) Occurrence of complications or problems during treatment
B) Measures taken to minimize postoperative wound infection
C) Perception of the client about the previous treatment
D) Details of the medical team that handled the previous treatment
Ans: A
Feedback:
If the same disorder has been treated earlier, the nurse needs to determine and document
any complications or problems that occurred during treatment. The nurse can determine
whether the client understands the treatment or not based on the measures taken by the
client to minimize postoperative wound infection. However, this factor can be assessed
later because the nurse needs to explain the new treatment to the client. Although the
client's perceptions of the previous treatment may be helpful, this data would not be as
important. In addition, the nurse does not need to get details about the medical team that
Page 1
, handled the previous treatment, unless specifically asked to do so.
4.A client is scheduled for a joint replacement surgery. Which action would be most
important?
A) Ensure adequate fluid intake before the surgery.
B) Withhold intake of solid food before the surgery.
C) Withhold administration of aspirin before the surgery.
D) Ensure adequate sleep before the
surgery. Ans:C
Feedback:
If a client is scheduled for a joint replacement or other surgery, it is crucial for the nurse
to withhold aspirin before surgery to reduce the risk of excessive bleeding. It is also
essential to monitor the complete blood count, prothrombin time, bleeding, and clotting
time to ensure that the client is able to control bleeding. The impact of fluid or solid food
intake does not have as strong implications as the impact of aspirin intake before surgery.
Having adequate sleep before surgery is helpful but is not the most important action.
5.A client has just undergone a leg amputation. The nurse would closely monitor the client
for which of the following during the immediate postoperative period?
A) Neuroma
B) Hematoma
C) Chronic osteomyelitis
D) Unexplainable burning pain (causalgia)
Ans: B
Feedback:
Hematoma, hemorrhage, and infection are potential complications in the immediate
postoperative period. Sleeplessness, nausea, and vomiting may occur but are adverse
reactions, not complications. Chronic osteomyelitis and causalgia are potential
complications that are likely to arise in the late postoperative period. A neuroma occurs
when the cut ends of the nerves become entangled in the healing scar. This would occur
later in the postoperative course.
6.A 68-year-old female client who had a total hip replacement is to be discharged because
her healing is almost complete. Which of the following would be most important for
this client?
A) Advising the client to avoid red meat
B) Urging her to keep the affected limb in an elevated position
C) Educating the client about the effects of menopause
D) Exploring factors related to the client's home environment
Ans: D
Feedback:
Exploring factors related to the older adult client's home environment and determining a
plan for continued rehabilitation before discharge is most important. The client should be
Page 2
