Care of Patients with Hip Arthroplasty, Knee
Arthroplasty, and Amputations
When educating a patient about total joint arthroplasty (TJA), what does the nurse do first?
A. Ensure that the patient wants the procedure
B. Review instructions and ask the patient to repeat back
C. Assess the patient's knowledge about TJA
D. Ask if the provider has explained the procedure - Answer- C. Assess the patient's knowledge
about TJA
For preoperative care of a patient scheduled for total joint arthroplasty, what does the nurse plan
to do? SATA
A. Provide written or videotaped information about the procedure
B. Assess the patient's understanding of the procedure
C. Assess and include the patient's support people or family
D. Obtain the patient's signature on the consent form
E. Assist in scheduling needed dental procedures after the surgery
F. Include interdisciplinary team members, if possible - Answer- A. Provide written or videotaped
information about the procedure
B. Assess the patient's understanding of the procedure
C. Assess and include the patient's support people or family
F. Include interdisciplinary team members, if possible
Which patient circumstance would be considered a contraindication for total joint arthroplasty?
A. Patient is currently being treated for a persistent urinary tract infection
B. Patient reports pain and loss of mobility related to joint dysfunction
C. Patient reports her osteopenia is now considered to be osteoporosis
D. Patient is elderly and has no one to provide postoperative care - Answer- A. Patient is currently
being treated for a persistent urinary tract infection
A patient with rheumatoid arthritis (RA) may need to undergo general anesthesia for a hip
replacement. Which information needs to be brought to the immediate attention of the surgeon
before the procedure is scheduled?
A. Patient has a previous history of joint surgery on the affected side
B. Patient has been taking vitamin C and non-steroidal anti-inflammatory drugs for years
C. Patient has cervical spine disease and has not had any recent spinal x-rays
D. Patient fears that the procedure will cause complications because of RA - Answer- C. Patient
has cervical spine disease and has not had any recent spinal x-rays
The nurse is caring for a patient who had a total hip replacement. On assessment, the nurse
observes shortening of the affected leg and internal rotation. The patient reports increased pain
that is not relieved with medication. What should the nurse do?
A. Conduct additional pain assessment and obtain new medication orders
B. Position the leg in an anatomical position and place pillows for support
C. Compare the length of the affected leg to unaffected leg
D. Keep the patient in bed and immediately notify the surgeon - Answer- D. Keep the patient in
bed and immediately notify the surgeon
, Which interventions can the nurse use to prevent or manage infections in patients who have
undergone total joint replacement? SATA
A. Use aseptic technique for wound care and emptying of drains
B. Wash hands thoroughly when caring for patient
C. Culture drainage fluid if a change is observed
D. Encourage early ambulation along with leg exercises
E. Monitor the incision every 4 hours for the first 24 hours and every 8 to 12 hours thereafter
F. Advocate that the patient be placed in a private isolation room - Answer- A. Use aseptic
technique for wound care and emptying of drains
B. Wash hands thoroughly when caring for patient
C. Culture drainage fluid if a change is observed
E. Monitor the incision every 4 hours for the first 24 hours and every 8 to 12 hours thereafter
The nurse is caring for a patient who had a total joint replacement and administers subcutaneous
enoxaparin as ordered. Which outcome statement indicates that the intended goal of the
enoxaparin therapy is being met?
A. Patient does not show signs or symptoms of venous thromboembolism
B. Prothrombin time and International Normalized Ration are within normal range
C. Pain is rated at 3/10 within 30 minutes after receiving the medication
D. Wound site is free of infection signs and oral temperature is 98.8 - Answer- A. Patient does not
show signs or symptoms of venous thromboembolism
A patient is reluctant to consider hip surgery because of a fear of blood transfusion reaction. What
is the nurse's best response?
A. "No one will force you to receive blood if you don't want it"
B. "A cell saver can be used to collect your own red blood cells during surgery."
C. "It's unlikely that you will need a blood transfusion, please don't worry."
D. "Blood products are very safe these days and there are numerous safety protocols." - Answer-
B. "A cell saver can be used to collect your own red blood cells during surgery."
Which routine interventions would the nurse perform to prevent the life-threatening complication of
venous thromboembolism? SATA
A. Ensure that sequential compression device is in place and functional
B. Administer anticoagulant therapy as ordered
C. Roll and secure top of anti-embolic stockings to mid-calf area
D. Encourage early ambulation
E. Teach patient about leg exercises
F. Encourage foods that are rich in iron and protein - Answer- A. Ensure that sequential
compression device is in place and functional
B. Administer anticoagulant therapy as ordered
D. Encourage early ambulation
E. Teach patient about leg exercises
The nurse is providing care for a patient scheduled for a total hip arthroplasty. Which medication
should the patient receive one hour before the surgical incision in accordance with the Surgical
Care Improvement Project Core Measures?
A. Low-molecular-weight heparin, such as subcutaneous enoxaparin
B. Fast-acting opioid, such as IV morphine
C. Broad-spectrum antibiotic, such as IV cefazolin
Arthroplasty, and Amputations
When educating a patient about total joint arthroplasty (TJA), what does the nurse do first?
A. Ensure that the patient wants the procedure
B. Review instructions and ask the patient to repeat back
C. Assess the patient's knowledge about TJA
D. Ask if the provider has explained the procedure - Answer- C. Assess the patient's knowledge
about TJA
For preoperative care of a patient scheduled for total joint arthroplasty, what does the nurse plan
to do? SATA
A. Provide written or videotaped information about the procedure
B. Assess the patient's understanding of the procedure
C. Assess and include the patient's support people or family
D. Obtain the patient's signature on the consent form
E. Assist in scheduling needed dental procedures after the surgery
F. Include interdisciplinary team members, if possible - Answer- A. Provide written or videotaped
information about the procedure
B. Assess the patient's understanding of the procedure
C. Assess and include the patient's support people or family
F. Include interdisciplinary team members, if possible
Which patient circumstance would be considered a contraindication for total joint arthroplasty?
A. Patient is currently being treated for a persistent urinary tract infection
B. Patient reports pain and loss of mobility related to joint dysfunction
C. Patient reports her osteopenia is now considered to be osteoporosis
D. Patient is elderly and has no one to provide postoperative care - Answer- A. Patient is currently
being treated for a persistent urinary tract infection
A patient with rheumatoid arthritis (RA) may need to undergo general anesthesia for a hip
replacement. Which information needs to be brought to the immediate attention of the surgeon
before the procedure is scheduled?
A. Patient has a previous history of joint surgery on the affected side
B. Patient has been taking vitamin C and non-steroidal anti-inflammatory drugs for years
C. Patient has cervical spine disease and has not had any recent spinal x-rays
D. Patient fears that the procedure will cause complications because of RA - Answer- C. Patient
has cervical spine disease and has not had any recent spinal x-rays
The nurse is caring for a patient who had a total hip replacement. On assessment, the nurse
observes shortening of the affected leg and internal rotation. The patient reports increased pain
that is not relieved with medication. What should the nurse do?
A. Conduct additional pain assessment and obtain new medication orders
B. Position the leg in an anatomical position and place pillows for support
C. Compare the length of the affected leg to unaffected leg
D. Keep the patient in bed and immediately notify the surgeon - Answer- D. Keep the patient in
bed and immediately notify the surgeon
, Which interventions can the nurse use to prevent or manage infections in patients who have
undergone total joint replacement? SATA
A. Use aseptic technique for wound care and emptying of drains
B. Wash hands thoroughly when caring for patient
C. Culture drainage fluid if a change is observed
D. Encourage early ambulation along with leg exercises
E. Monitor the incision every 4 hours for the first 24 hours and every 8 to 12 hours thereafter
F. Advocate that the patient be placed in a private isolation room - Answer- A. Use aseptic
technique for wound care and emptying of drains
B. Wash hands thoroughly when caring for patient
C. Culture drainage fluid if a change is observed
E. Monitor the incision every 4 hours for the first 24 hours and every 8 to 12 hours thereafter
The nurse is caring for a patient who had a total joint replacement and administers subcutaneous
enoxaparin as ordered. Which outcome statement indicates that the intended goal of the
enoxaparin therapy is being met?
A. Patient does not show signs or symptoms of venous thromboembolism
B. Prothrombin time and International Normalized Ration are within normal range
C. Pain is rated at 3/10 within 30 minutes after receiving the medication
D. Wound site is free of infection signs and oral temperature is 98.8 - Answer- A. Patient does not
show signs or symptoms of venous thromboembolism
A patient is reluctant to consider hip surgery because of a fear of blood transfusion reaction. What
is the nurse's best response?
A. "No one will force you to receive blood if you don't want it"
B. "A cell saver can be used to collect your own red blood cells during surgery."
C. "It's unlikely that you will need a blood transfusion, please don't worry."
D. "Blood products are very safe these days and there are numerous safety protocols." - Answer-
B. "A cell saver can be used to collect your own red blood cells during surgery."
Which routine interventions would the nurse perform to prevent the life-threatening complication of
venous thromboembolism? SATA
A. Ensure that sequential compression device is in place and functional
B. Administer anticoagulant therapy as ordered
C. Roll and secure top of anti-embolic stockings to mid-calf area
D. Encourage early ambulation
E. Teach patient about leg exercises
F. Encourage foods that are rich in iron and protein - Answer- A. Ensure that sequential
compression device is in place and functional
B. Administer anticoagulant therapy as ordered
D. Encourage early ambulation
E. Teach patient about leg exercises
The nurse is providing care for a patient scheduled for a total hip arthroplasty. Which medication
should the patient receive one hour before the surgical incision in accordance with the Surgical
Care Improvement Project Core Measures?
A. Low-molecular-weight heparin, such as subcutaneous enoxaparin
B. Fast-acting opioid, such as IV morphine
C. Broad-spectrum antibiotic, such as IV cefazolin
