MED SURG Nursing Assessment and Care Examination: Hip Fracture
Management, Buck’s Traction, Skeletal Traction, Postoperative Positioning,
Neurovascular Assessment, Pain Management, Thrombophlebitis Prevention,
Cardiac Catheterization Preparation, Vital Signs Monitoring, Respiratory
Assessment, COPD Management, Packed RBC Transfusion Safety,
Anticoagulation Therapy, Immobility Complications, Orthostatic Hypotension
Prevention, Tuberculosis Screening, Mantoux Test Interpretation, Airborne
Precautions, Latent TB Treatment, Directly Observed Therapy, HIV-TB Co-
infection Care, Infection Control, Patient Education, Ethical Practice, Legal
Standards, Nursing Process Implementation, Clinical Decision-Making, Patient
Safety, Evidence-Based Interventions, Communication Skills, Critical Thinking,
Clinical Documentation, Patient Rights Exam Questions Verified and Provided
with Complete A+ Graded Rationales Latest Updated 2026
A nurse is caring for a client who has a fractured hip and was placed in Buck's traction 4 hr ago. Which of
the following actions should the nurse take?
a. Inspect the client's skin underneath the boot every 12 hr
b. Encourage the client to perform dorsiflexion of the affected extremity every 2 hr
c. Remove the weights from the traction while repositioning the client in bed
d. Loosen the ropes if the client reports muscle spasms in the affected extremity
B. Encourage the client to perform dorsiflexion of the affected extremity every 2 hr ---The nurse should
encourage the client to perform dorsiflexion of the affected extremity every 2 hours to assess if the
client is experiencing nerve damage. Weakness of dorsiflexion can indicate peroneal nerve damage. If
this occurs, the nurse should notify the provider immediately.
Incorrect Answers:
A. The nurse should inspect the client's skin underneath the boot for irritation, increased swelling, and
skin breakdown every 8 hours.
C. The weights should never be removed without a prescription from the provider. The purpose of the
weights is to decrease muscle spasms as a result of the hip fracture.
,D. The ropes of the traction should never be loosened. This can affect the traction and increase the
client's muscle spasms.
A nurse is caring for a client who has a fractured right hip. Which of the following types of traction
should the nurse expect the client to have prior to hip arthroplasty surgery?
a. Balanced skeletal traction
b. Pelvic belt
c. Pelvic sling
d. Buck's traction
D. Buck's traction---Buck's traction is used prior to hip arthroplasty to maintain alignment and prevent
muscle spasms prior to surgery.
Incorrect Answers:
A. Balanced skeletal traction is used to stabilize fractures of the femur or pelvis, not the hip. Skeletal
traction involves the surgical insertion of pins, tongs, wires, or screws; this is sometimes used to stabilize
long bone and vertebral fractures. B. A pelvic belt is used to treat back pain and does not provide
traction prior to hip arthroplasty.
C. A pelvic sling is used to stabilize pelvic fractures, not hip fractures.
A nurse is caring for a client with a hip fracture who has Buck's extension traction in place. Which of the
following pieces of information should the nurse give the client about this type of traction? (Select all
that apply.)
a. "You'll have considerably less pain with the traction in place."
b. "You'll have the traction in place for a week or so."
c. "The traction will help decrease muscle spasms."
d. "The weights act as a pulling force to keep your leg and hip still."
e. "We have to make sure the weights are just barely touching the floor."
A. "You'll have considerably less pain with the traction in place."
,C. "The traction will help decrease muscle spasms."
D. "The weights act as a pulling force to keep your leg and hip still."
Pain is usually more severe without the traction. Buck's extension traction uses weights to help decrease
muscle spasms. Typically, 2.3 to 5.5 kg (5 to 10 lb) of force helps stabilize the hip and leg preoperatively.
A nurse is caring for a client who is scheduled to undergo surgery to repair an open hip fracture. In
which of the following positions should the nurse plan to place the client postoperatively?
a. With the leg on the affected side adducted
b. With the hip externally rotated on the affected side
c. With the leg on the affected side abducted
d. With the hip flexed to 90° on the affected side
C. With the leg on the affected side abducted---The nurse should plan to place the client with the leg
abducted on the affected side postoperatively. Adduction or external rotation of the leg will cause the
hip to dislocate.
A nurse is assessing a client who has a fractured left femur and is in skeletal traction. Which of the
following findings should the nurse report to the provider?
a. Ecchymosis of the thigh
b. Serous drainage at the pin site
c. Chest petechiae
d. Muscle spasms in the left leg
C. Chest petechiae--- The nurse should identify chest petechiae as an indication of fat embolism
syndrome. Clients who have fractures of the long bones such as the femur are at increased risk of fat
emboli. Fat emboli typically occur 12 to 48 hours after the injury when fat droplets from the marrow
enter into the systemic circulation and are deposited in the lungs. The nurse should immediately notify
the provider because the client could progress to acute respiratory failure.
, A nurse is preparing to care for a client who is in balanced skeletal traction to stabilize a femur fracture.
Which of the following actions should the nurse include in the client's plan of care?
a. Offering the client a diet high in fluid and fiber
b. Encouraging active range of motion of the affected leg
c. Removing the weights prior to repositioning the client
d. Inspecting pin sites every 24 hr for drainage
A. Offering the client a diet high in fluid and fiber---- A client who is immobile is at risk of constipation.
The nurse should encourage a diet high in fluid and fiber to promote gastrointestinal function.
Incorrect Answers:
B. Active range of motion of the unaffected limbs is encouraged to prevent muscle wasting; however,
active range of motion of a limb in traction is not feasible, as the traction apparatus limits mobility.
C. Once the weights are in place, the nurse should not remove them.
D. The nurse should plan to inspect the client's pin sites at least every 8 to 12 hours due to the risk of
infection.
A nurse is caring for a client who is in skeletal traction following a femur fracture. On entering, the nurse
finds that the client has slid toward the foot of the bed, and the traction weight is resting on the floor.
Which of the following actions should the nurse take?
a. Remove the weight temporarily to reposition the client to the correct alignment in bed
b. Have the client use a trapeze to pull himself up while ensuring the weight hangs freely
c. Lift the rope off the pulley while the client rocks back and forth to reposition himself
d. Lift the weight manually while another staff member moves the client up in bed
B. Have the client use a trapeze to pull himself up while ensuring the weight hangs freely---The nurse
should ensure that traction weight is hanging freely. The client can use an overhead trapeze bar to move
up in bed, or the nurse can assist the client while making sure to maintain proper alignment of the
extremity.
Management, Buck’s Traction, Skeletal Traction, Postoperative Positioning,
Neurovascular Assessment, Pain Management, Thrombophlebitis Prevention,
Cardiac Catheterization Preparation, Vital Signs Monitoring, Respiratory
Assessment, COPD Management, Packed RBC Transfusion Safety,
Anticoagulation Therapy, Immobility Complications, Orthostatic Hypotension
Prevention, Tuberculosis Screening, Mantoux Test Interpretation, Airborne
Precautions, Latent TB Treatment, Directly Observed Therapy, HIV-TB Co-
infection Care, Infection Control, Patient Education, Ethical Practice, Legal
Standards, Nursing Process Implementation, Clinical Decision-Making, Patient
Safety, Evidence-Based Interventions, Communication Skills, Critical Thinking,
Clinical Documentation, Patient Rights Exam Questions Verified and Provided
with Complete A+ Graded Rationales Latest Updated 2026
A nurse is caring for a client who has a fractured hip and was placed in Buck's traction 4 hr ago. Which of
the following actions should the nurse take?
a. Inspect the client's skin underneath the boot every 12 hr
b. Encourage the client to perform dorsiflexion of the affected extremity every 2 hr
c. Remove the weights from the traction while repositioning the client in bed
d. Loosen the ropes if the client reports muscle spasms in the affected extremity
B. Encourage the client to perform dorsiflexion of the affected extremity every 2 hr ---The nurse should
encourage the client to perform dorsiflexion of the affected extremity every 2 hours to assess if the
client is experiencing nerve damage. Weakness of dorsiflexion can indicate peroneal nerve damage. If
this occurs, the nurse should notify the provider immediately.
Incorrect Answers:
A. The nurse should inspect the client's skin underneath the boot for irritation, increased swelling, and
skin breakdown every 8 hours.
C. The weights should never be removed without a prescription from the provider. The purpose of the
weights is to decrease muscle spasms as a result of the hip fracture.
,D. The ropes of the traction should never be loosened. This can affect the traction and increase the
client's muscle spasms.
A nurse is caring for a client who has a fractured right hip. Which of the following types of traction
should the nurse expect the client to have prior to hip arthroplasty surgery?
a. Balanced skeletal traction
b. Pelvic belt
c. Pelvic sling
d. Buck's traction
D. Buck's traction---Buck's traction is used prior to hip arthroplasty to maintain alignment and prevent
muscle spasms prior to surgery.
Incorrect Answers:
A. Balanced skeletal traction is used to stabilize fractures of the femur or pelvis, not the hip. Skeletal
traction involves the surgical insertion of pins, tongs, wires, or screws; this is sometimes used to stabilize
long bone and vertebral fractures. B. A pelvic belt is used to treat back pain and does not provide
traction prior to hip arthroplasty.
C. A pelvic sling is used to stabilize pelvic fractures, not hip fractures.
A nurse is caring for a client with a hip fracture who has Buck's extension traction in place. Which of the
following pieces of information should the nurse give the client about this type of traction? (Select all
that apply.)
a. "You'll have considerably less pain with the traction in place."
b. "You'll have the traction in place for a week or so."
c. "The traction will help decrease muscle spasms."
d. "The weights act as a pulling force to keep your leg and hip still."
e. "We have to make sure the weights are just barely touching the floor."
A. "You'll have considerably less pain with the traction in place."
,C. "The traction will help decrease muscle spasms."
D. "The weights act as a pulling force to keep your leg and hip still."
Pain is usually more severe without the traction. Buck's extension traction uses weights to help decrease
muscle spasms. Typically, 2.3 to 5.5 kg (5 to 10 lb) of force helps stabilize the hip and leg preoperatively.
A nurse is caring for a client who is scheduled to undergo surgery to repair an open hip fracture. In
which of the following positions should the nurse plan to place the client postoperatively?
a. With the leg on the affected side adducted
b. With the hip externally rotated on the affected side
c. With the leg on the affected side abducted
d. With the hip flexed to 90° on the affected side
C. With the leg on the affected side abducted---The nurse should plan to place the client with the leg
abducted on the affected side postoperatively. Adduction or external rotation of the leg will cause the
hip to dislocate.
A nurse is assessing a client who has a fractured left femur and is in skeletal traction. Which of the
following findings should the nurse report to the provider?
a. Ecchymosis of the thigh
b. Serous drainage at the pin site
c. Chest petechiae
d. Muscle spasms in the left leg
C. Chest petechiae--- The nurse should identify chest petechiae as an indication of fat embolism
syndrome. Clients who have fractures of the long bones such as the femur are at increased risk of fat
emboli. Fat emboli typically occur 12 to 48 hours after the injury when fat droplets from the marrow
enter into the systemic circulation and are deposited in the lungs. The nurse should immediately notify
the provider because the client could progress to acute respiratory failure.
, A nurse is preparing to care for a client who is in balanced skeletal traction to stabilize a femur fracture.
Which of the following actions should the nurse include in the client's plan of care?
a. Offering the client a diet high in fluid and fiber
b. Encouraging active range of motion of the affected leg
c. Removing the weights prior to repositioning the client
d. Inspecting pin sites every 24 hr for drainage
A. Offering the client a diet high in fluid and fiber---- A client who is immobile is at risk of constipation.
The nurse should encourage a diet high in fluid and fiber to promote gastrointestinal function.
Incorrect Answers:
B. Active range of motion of the unaffected limbs is encouraged to prevent muscle wasting; however,
active range of motion of a limb in traction is not feasible, as the traction apparatus limits mobility.
C. Once the weights are in place, the nurse should not remove them.
D. The nurse should plan to inspect the client's pin sites at least every 8 to 12 hours due to the risk of
infection.
A nurse is caring for a client who is in skeletal traction following a femur fracture. On entering, the nurse
finds that the client has slid toward the foot of the bed, and the traction weight is resting on the floor.
Which of the following actions should the nurse take?
a. Remove the weight temporarily to reposition the client to the correct alignment in bed
b. Have the client use a trapeze to pull himself up while ensuring the weight hangs freely
c. Lift the rope off the pulley while the client rocks back and forth to reposition himself
d. Lift the weight manually while another staff member moves the client up in bed
B. Have the client use a trapeze to pull himself up while ensuring the weight hangs freely---The nurse
should ensure that traction weight is hanging freely. The client can use an overhead trapeze bar to move
up in bed, or the nurse can assist the client while making sure to maintain proper alignment of the
extremity.
