Chapter 67 Musculoskeletal Care Modalities

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Chapter 67  Musculoskeletal Care Modalities

 

 

Complete Chapter Questions And Answers
 

Sample Questions

 

Multiple Choice

1. The nurse is caring for a patient who has had a plaster leg cast applied. Immediately post- application, the nurse should inform the patient that:
A) The cast will cool in 5 minutes.
B) The cast should be covered with a towel.

C) The cast should be supported on a board while drying. D) The cast will only have full strength when dry.

Ans: D
Chapter: 67
Client Needs: B
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Teaching/Learning
Objective: 1
Page and Header: 2025, The Patient in a Cast, Splint, or Brace

Feedback: A cast requires approximately 24 to 72 hours to dry, and until dry, it does not have full strength. While drying, the cast should not be placed on a hard surface. The initial cooling occurs in about 15 minutes after application of the cast.

2. An 18-year-old male patient broke his arm in a skateboarding accident. The arm was put in an arm cast. The patient states that he is unable to straighten his fingers. The nurse notes that the patient is experiencing Volkmann’s contracture, which is due to what?
A) Obstructed arterial blood flow to the forearm and hand

B) Obstructed venous blood flow from the forearm and hand C) The cast being applied too loosely
D) Muscle spasm of the forearm

Ans: A
Chapter: 67
Client Needs: D-4
Cognitive Level: Analysis
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 2
Page and Header: 2029, The Patient in a Cast, Splint, or Brace

Feedback: Volkmann’s contracture occurs when arterial blood flow is restricted to the forearm and hand and results in contractures of the fingers and wrist. Therefore options B, C, and D are incorrect.

3. A patient is admitted to the unit in traction for a fractured proximal femur. What is the most appropriate type of traction to apply to a fractured proximal femur?
A) Russell’s traction
B) Dunlop’s traction

C) Buck’s extension traction D) Cervical head halter

Ans: C
Chapter: 67
Client Needs: D-1
Cognitive Level: Knowledge
Difficulty: Difficult
Integrated Process: Nursing Process Objective: 3
Page and Header: 2033, The Patient in Traction

Feedback: Buck’s extension is used for fractures of the proximal femur. Dunlop’s traction is applied to the upper extremity for supracondylar fractures of the elbow and humerus. Russell’s is used for lower leg fractures. Cervical head halters are used to treat back pain.

4. The nurse is caring for a patient who is in skeletal traction. To prevent the complication of skin breakdown in a patient with skeletal traction, what preventive measures would the nurse implement?
A) Do not remove the crusting around the pin insertion site.

B) Encourage the patient to push up with the elbows when repositioning.
C) Encourage the patient to perform ankle and calf muscle exercises once a shift. D) Assess the pin insertion site every 8 hours.

Ans: D
Chapter: 67
Client Needs: D-3
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Nursing Process Objective: 4
Page and Header: 2035, The Patient in Traction

Feedback: The pin insertion site should be assessed every 8 hours for inflammation and infection. The patient should be encouraged to use the overhead trapeze to shift weight for repositioning. Ankle and calf exercises should be done 10 times an hour while awake.

5. You are caring for a patient who has had a right hip replacement. What should the nurse follow when caring for a patient who has just had hip replacement surgery?
A) Keep the hips in abduction.
B) Keep hips flexed at 95 degrees.

C) Elevate the head of the bed to a high Fowler’s position. D) Seat the patient in a low chair.

Ans: A
Chapter: 67
Client Needs: D-3
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 6
Page and Header: 2038, The Patient Undergoing Orthopedic Surgery

Feedback: The hips should be kept in abduction by an abductor pillow. Hips should not be flexed more than 90 degrees, and the head of bed should not be elevated more than 60 degrees.

The patient’s hips should be higher than the knees; as such, high seat chairs should be used.

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