• NURS EXAM QUESTIONS WITH ANSWERS ASSURED A+WEEK 1 SUMMER
A patient is suspected of having rheumatoid arthritis and her diagnostic regimen
The nurse is caring for a patient who underwent a total hip replacement yesterday.
What should the nurse do to prevent the dislocation of the new prosthesis?
A. Keep the affected leg in a position of adduction.
B. Have the patient reposition himself independently.
C. Protect the affected leg from internal rotation.
D. Keep the hip flexed by placing pillows under the patient's knee.
Ans: Abduction of the hip helps to prevent the dislocation of a new hip joint. Rotation and adduction
should be avoided. While the hip may be flexed slightly, it shouldnt exceed 90 degrees and
maintenance of flexion isn't necessary. The patient may not be capable of safe independent
repositioning at this early stage of recovery.
• the patient is complaining of pain in her casted leg. The nurse has administered analgesics
and elevated the limb. Thirty minutes after administering the analgesics, the patient states
the pain is unrelieved. The nurse should identify the warning signs of what complication?
A. Subcutaneous emphysema
B. Skin breakdown
C. Compartment syndrome
D. Disuse syndrome
Ans: C. Compartment syndrome may manifest as unrelenting, uncontrollablthe e pain. This
presentation of pain is not suggestive of disuse syndrome or skin breakdown. Subcutaneous
emphysema is not a complication of cas,ting.
• The nurse educator on an orthopedic trauma unit is reviewing the safe and effective use
of traction with some recent nursing graduates. What principle should the educator
, promote?
A. Knots in the rope should not be resting against pulleys.
B. Weights should rest against the bed rails.
C. The end of the limb in traction should be braced by the footboard of the bed.
D. Skeletal traction may be removed for brief .eriods to facilitate the patient's
independence.
Ans: A. Knots in the rope should not rest against pulleys, because this interferes with traction. Weights
are used to apply the vector of force necessary to achieve effective traction and shisn't hang freely at all
times. To avoid interrupting traction, the limb in traction should not rest against anything. Skeletal
traction is never interrupted.
• The orthopedic surgeon has prescribed balanced skeletal traction for a patient.
What advantage is conferred by balanced traction?
A. Balanced traction can be applied at night and removed during the day.
B. Balanced traction allows for greater patient movement and independence
than other forms of traction.
C. Balanced traction is portable and may accompany the patient's movements.
D. Balanced traction facilitates bone remodeling in as little as 4 days.
Ans: B. Often, skeletal traction is balanced traction, which supports the affected extremity, allows for
some patient movement, and facilitates patient independence and nursing care while maintaining
effective traction. It is not portable, however, and it cannot be removed. Bone remodeling takes longer
than 4 days.
• The nursing care plan for a patient in traction specifies regular assessments for venous
thromboembolism (VTE). When assessing a patients lower limbs, what symptom is suggestive
of deep vein thrombosis (DVT)?
, A. Increased warmth of the calf
B. Decreased circumference of the calf
C. Loss of sensation in the calf
D. Pale-appearing calf
Ans: A. Signs of DVT include increased warmth, redness, swelling, and calf tenderness. These findings
are promptly reported to the physician for definitive evaluation and therapy. Signs and symptoms of a
DVT do not include a decreased circumference of the calf, a loss of sensation in the calf, or a pale-
appearing calf.
• An elderly patient's hip joint is immobilized before surgery to correct a femoral head
fracture. What is the nurses priority assessment?
A. The presence of leg shortening
B. The patients complaints of pain
C. Signs of neurovascular compromise
D. The presence of internal or external rotation
Ans: C. Because impaired circulation can cause permanent damage, neurovascular assessment of
the affected leg is always a priority assessment. Leg shortening and internal or external rotation are
common findings with a fractured hip. Pain, especially on movement, is also common after a hip
fracture.
• A nurse is caring for a patient who has had a total hip replacement. The nurse is reviewing
health education before discharge. Which of the patient's statements would indicate to the
nurse that the patient requires further teaching?
A. I'll need to keep several pillows between my legs at night.
B. I need to remember not to cross my legs. Its such a habit.
C. The occupational therapist is showing me how to use a sock puller to help
, me get dressed. D. I will need my husband to assist me in getting off the
low toilet seat at home.
Ans: D. To prevent hip dislocation after a total hip replacement, the patient must avoid bending the hips
beyond 90 degrees. Assistive devices, such as a raised toilet seat, should be used to prevent severe hip
flexion. Using an abduction pillow or placing several pillows between the legs reduces the risk of hip
dislocation by preventing adduction and internal rotation of the legs. Likewise, teaching the patient to
avoid crossing the legs also reduces the risk of hip dislocation. A sock puller helps a patient get dressed
without flexing the hips beyond 90 degrees.
• the nurse is admitting a patient to the unit who presented with a lower extremity
fracture. What signs and symptoms would suggest to the nurse that the patient may
have aperoneal nerve injury?
A. Numbness and burning of the foot
B. Pallor to the dorsal surface of the foot
C. Visible cyanosis in the toes
D. Inadequate capillary refill to the toes
Ans: A. Peroneal nerve injury may resupatient'smbness, tingling, and burning in the feet. Cyanosis,
pallor, and decreased capillary refill are signs of inadequate circulation.
• the patient has suffered a muscle strain and is complaining of pain that she rates at 6
on a 10-point scale. The nurse should recommend what action?
A. Taking an opioid
analgesic as ordered
Applying a cold pack to
the injured site
• Performing passive ROM exercises
A patient is suspected of having rheumatoid arthritis and her diagnostic regimen
The nurse is caring for a patient who underwent a total hip replacement yesterday.
What should the nurse do to prevent the dislocation of the new prosthesis?
A. Keep the affected leg in a position of adduction.
B. Have the patient reposition himself independently.
C. Protect the affected leg from internal rotation.
D. Keep the hip flexed by placing pillows under the patient's knee.
Ans: Abduction of the hip helps to prevent the dislocation of a new hip joint. Rotation and adduction
should be avoided. While the hip may be flexed slightly, it shouldnt exceed 90 degrees and
maintenance of flexion isn't necessary. The patient may not be capable of safe independent
repositioning at this early stage of recovery.
• the patient is complaining of pain in her casted leg. The nurse has administered analgesics
and elevated the limb. Thirty minutes after administering the analgesics, the patient states
the pain is unrelieved. The nurse should identify the warning signs of what complication?
A. Subcutaneous emphysema
B. Skin breakdown
C. Compartment syndrome
D. Disuse syndrome
Ans: C. Compartment syndrome may manifest as unrelenting, uncontrollablthe e pain. This
presentation of pain is not suggestive of disuse syndrome or skin breakdown. Subcutaneous
emphysema is not a complication of cas,ting.
• The nurse educator on an orthopedic trauma unit is reviewing the safe and effective use
of traction with some recent nursing graduates. What principle should the educator
, promote?
A. Knots in the rope should not be resting against pulleys.
B. Weights should rest against the bed rails.
C. The end of the limb in traction should be braced by the footboard of the bed.
D. Skeletal traction may be removed for brief .eriods to facilitate the patient's
independence.
Ans: A. Knots in the rope should not rest against pulleys, because this interferes with traction. Weights
are used to apply the vector of force necessary to achieve effective traction and shisn't hang freely at all
times. To avoid interrupting traction, the limb in traction should not rest against anything. Skeletal
traction is never interrupted.
• The orthopedic surgeon has prescribed balanced skeletal traction for a patient.
What advantage is conferred by balanced traction?
A. Balanced traction can be applied at night and removed during the day.
B. Balanced traction allows for greater patient movement and independence
than other forms of traction.
C. Balanced traction is portable and may accompany the patient's movements.
D. Balanced traction facilitates bone remodeling in as little as 4 days.
Ans: B. Often, skeletal traction is balanced traction, which supports the affected extremity, allows for
some patient movement, and facilitates patient independence and nursing care while maintaining
effective traction. It is not portable, however, and it cannot be removed. Bone remodeling takes longer
than 4 days.
• The nursing care plan for a patient in traction specifies regular assessments for venous
thromboembolism (VTE). When assessing a patients lower limbs, what symptom is suggestive
of deep vein thrombosis (DVT)?
, A. Increased warmth of the calf
B. Decreased circumference of the calf
C. Loss of sensation in the calf
D. Pale-appearing calf
Ans: A. Signs of DVT include increased warmth, redness, swelling, and calf tenderness. These findings
are promptly reported to the physician for definitive evaluation and therapy. Signs and symptoms of a
DVT do not include a decreased circumference of the calf, a loss of sensation in the calf, or a pale-
appearing calf.
• An elderly patient's hip joint is immobilized before surgery to correct a femoral head
fracture. What is the nurses priority assessment?
A. The presence of leg shortening
B. The patients complaints of pain
C. Signs of neurovascular compromise
D. The presence of internal or external rotation
Ans: C. Because impaired circulation can cause permanent damage, neurovascular assessment of
the affected leg is always a priority assessment. Leg shortening and internal or external rotation are
common findings with a fractured hip. Pain, especially on movement, is also common after a hip
fracture.
• A nurse is caring for a patient who has had a total hip replacement. The nurse is reviewing
health education before discharge. Which of the patient's statements would indicate to the
nurse that the patient requires further teaching?
A. I'll need to keep several pillows between my legs at night.
B. I need to remember not to cross my legs. Its such a habit.
C. The occupational therapist is showing me how to use a sock puller to help
, me get dressed. D. I will need my husband to assist me in getting off the
low toilet seat at home.
Ans: D. To prevent hip dislocation after a total hip replacement, the patient must avoid bending the hips
beyond 90 degrees. Assistive devices, such as a raised toilet seat, should be used to prevent severe hip
flexion. Using an abduction pillow or placing several pillows between the legs reduces the risk of hip
dislocation by preventing adduction and internal rotation of the legs. Likewise, teaching the patient to
avoid crossing the legs also reduces the risk of hip dislocation. A sock puller helps a patient get dressed
without flexing the hips beyond 90 degrees.
• the nurse is admitting a patient to the unit who presented with a lower extremity
fracture. What signs and symptoms would suggest to the nurse that the patient may
have aperoneal nerve injury?
A. Numbness and burning of the foot
B. Pallor to the dorsal surface of the foot
C. Visible cyanosis in the toes
D. Inadequate capillary refill to the toes
Ans: A. Peroneal nerve injury may resupatient'smbness, tingling, and burning in the feet. Cyanosis,
pallor, and decreased capillary refill are signs of inadequate circulation.
• the patient has suffered a muscle strain and is complaining of pain that she rates at 6
on a 10-point scale. The nurse should recommend what action?
A. Taking an opioid
analgesic as ordered
Applying a cold pack to
the injured site
• Performing passive ROM exercises
