Online Nursing Practice Test about Musculoskeletal Diseases (41-45)

41. A nurse is working with a nursing assistant on an orthopedic unit. The nurse observes the nursing assistant caring for a client after a left total hip replacement. The nurse will intervene if which of the following is observed?

a) the nursing assistant stoops by bending at the hips and knees to pick up an object that the client dropped on the floor
b) the nursing assistant keeps the client's bed in the low position when administering the bath
c) the client is positioned with leg abducted slightly
d) the head of the bed is elevated 30 degrees 

42. A nurse has conducted preoperative teaching for a client scheduled for surgery in 1 week. The client has a history of arthritis and has been taking acetylsalicylic acid (aspirin). The nurse determines that the client needs additional teaching if the client states:

a) aspirin can cause bleeding after surgery
b) aspirin can cause my ability to clot blood to abnormal
c) I need to discontinue the aspirin 48 hours before the scheduled surgery
d) I need to continue to take aspirin until the day of surgery

43. A 4-year old sustains a fall at home and is brought to the emergency room by the mother. After an x-ray examination, the child is determined to have a fractured arm and plaster cast is applied. The nurse provides instructions to the mother regarding care for the child's cast. Which statement by the mother indicates a need for further instructions?

a) the cast may feel warm as the cast dries
b) I can use lotion or powder around the cast edges to relieve itching
c) a small amount of white shoe polish can touch up a soiled white cast
d) if the cast becomes wet, a blow drier set on the cool setting may be used to dry the cast

44. A nurse is providing instructions to the parents of a child with scoliosis regarding the use of a brace. Which statement by the parents indicates a need for further instruction?

a) I will encourage my child to perform prescribed exercises
b) I will have my child wear soft fabric clothing under the brace
c) I should apply lotion under the brace to prevent skin breakdown
d) I should avoid the use of powder because it will cake under the brace

45. A 1-month old infant is seen in a clinic and is diagnosed with developmental dysplasia of the hip (DDH). The nurse assesses the infant, knowing that which of the following findings would be noted in this condition?

a) limited range of motion in the affected hip 
b) an apparent lengthened femur on the affected side
c) asymmetrical adduction of hte affected hip when the infant is placed supine with the knees and hips flexed
d) symmetry of the gluteal skinfolds when the infant is placed prone and the legs are extended against the examining table



ANSWERS AND RATIONALE

41) B
- during administration of bath, the nursing assistant should raise the bed to waist level to prevent bending and stooping. This prevents muscle strain and back injury.

42) D
- anticoagulants alter normal clotting factors and increase the risk of bleeding after surgery. Aspirin has properties that can alter the clotting mechanism and should be discontinued at least 48 hours before surgery. Options A, B, and C are accurate client statements.

43) B
- The mother needs to be instructed not to use lotion or powders on the skin around the cast edges or inside the cast. Lotions or powders can become sticky or caked and cause skin irritation. Options A, C, and D are appropriate instructions.

44) C
- The use of lotions or powders under a brace should be avoided because they can become sticky and cake under the brace, causing irritation. Options A, B, and D are appropriate interventions in the care of a child with a brace.

45) A
- In DDH, the head of the femur is seated improperly in the acetabulum or hip socket of the pelvis. Asymmetrical abduction of the affected hip, when the child is placed supine with the knees and hips flexed, would be an assessment finding in DDH in infants beyond the newborn period. Other findings include an apparent short femur on the affected side, asymmetry of the gluteal skinfolds, and limited range of motion in the affected extremity.




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Related Topics:

• Online Nursing Practice Test about Musculo-Skeletal Diseases (46-50)
• Go back to Online Nursing Practice Test about Musculo-Skeletal Diseases (1-8) to start the test from the beginning.