1. A nurse at outpatient clinic is returning phone calls that have been made to the clinic.

Which of the following calls should have the highest priority for medical intervention? A. A home health patient reports, I am starting to have breakdown of my heels. B. A patient that received an upper extremity cast yesterday reports, I cant feel my fingers in my right hand today. C. A young female reports, I think I sprained my ankle about 2 weeks ago. D. A middle-aged patient reports, My knee is still hurting from the TKR. (B) The patient experiencing neurovascular changes should have the highest priority. Pain following a TKR is normal, and breakdown over the heels is a gradual process. Moreover, a subacute ankle sprain is almost never a medical emergency. 2. A nurse working a surgical unit, notices a patient is experiencing SOB, calf pain, and warmth over the posterior calf. All of these may indicate which of the following medical conditions? A: Patient may have a DVT. B: Patient may be exhibiting signs of dermatitis. C: Patient may be in the late phases of CHF. D: Patient may be experiencing anxiety after surgery. 3. A nurse is performing a screening on a patient that has been casted recently on the left lower extremity. Which of the following statements should the nurse be most concerned about? A: The patient reports, I didnt keep my extremity elevated like the doctor asked me to. B: The patient reports, I have been having pain in my left calf. C: The patient reports, My left leg has really been itching. D: The patient reports, The arthritis in my wrists is flaring up, when I put weight on my crutches. (B) Pain may be indicating neurovascular complication. 4. A nurse is instructing a person who had a left CVA and right lower extremity hemiparesis to use a quad cane. Which of the following is the most appropriate gait sequence? A: Place the cane in the patients left upper extremity, encourage cane, then right lower extremity, then left upper extremity gait sequence. B: Place the cane in the patients left upper extremity, encourage cane, then left lower extremity, then right upper extremity gait sequence. C: Place the cane in the patients right upper extremity, encourage cane, then right lower extremity, then left upper extremity gait sequence. D: Place the cane in the patients right upper extremity, encourage cane, then left lower extremity, then right upper extremity gait sequence. (A) The cane should be placed in the patients strong upper extremity, and left

arm/right foot go together, for normal gait. 5. A nurse has just started on the 7PM surgical unit shift. Which of the following patients should the nurse check on first? A: A 75 year-old female who is scheduled for an EGD in 10 hours. B: A 34 year-old male who is complaining of low back pain following back surgery and has an onset of urinary incontinence in the last hour. C: A 21 year-old male who had a lower extremity BKA yesterday, following a MVA and has phantom pain. D: A 27 year-old female who has received 1.5 units of RBCs. via transfusion the previous day. (B) The new onset of urinary incontinence may require additional medical assessment, and the physician needs to be notified.
6. A nurse from medical-surgical unit is asked to work on the orthopedic unit. The medical-

surgical nurse has no orthopedic nursing experience. Which client should be assigned to the medical-surgical nurse? a) a client with a cast for a fractured femur and who has numbness and discoloration of the toes b) a client with balanced skeletal traction and who needs assistance with morning care c) a client who had an above-the-knee amputation yesterday and has a temperature of 101.4F d) a client who had a total hip replacement 2 days ago and needs blood glucose monitoring 1) D - a nurse from medical-surgical unit floated to the orthopedic unit should be given clients with stable condition, and those whose care are similar to her training and experience. A client who is 2-day postop is more likely to be on stable condition. And the medical-surgical unit nurse is competent in monitoring blood glucose. 7. The elderly client is admitted to the emergency room. Which symptom is the client with a fractured hip most likely to exhibit? A. Pain B. Disalignment C. Cool extremity D. Absence of pedal pulses 8. The nurse knows that a 60-year-old female client's susceptibility to osteoporosis is most likely related to: A. Lack of exercise B. Hormonal disturbances C. Lack of calcium D. Genetic predisposition

9. A 2-year-old is admitted for repair of a fractured femur and is placed in Bryant's traction. Which finding by the nurse indicates that the traction is working properly? A. The infant no longer complains of pain. B. The buttocks are 15 off the bed. C. The legs are suspended in the traction. D. The pins are secured within the pulley. 10. The nurse is assessing the client with a total knee replacement 2 hours post-operative. Which information requires notification of the doctor? E. Bleeding on the dressing is 3cm in diameter. F. The client has a temperature of 6F. G. The client's hematocrit is 26%. H. The urinary output has been 60 during the last 2 hours. 11. Which roommate would be most suitable for the 6-year-old male with a fractured femur in Russell's traction? I. 16-year-old female with scoliosis J. 12-year-old male with a fractured femur K. 10-year-old male with sarcoma L. 6-year-old male with osteomylitis 12. The teenager with a fiberglass cast asks the nurse if it will be okay to allow his friends to autograph his cast. Which response would be best? M. "It will be alright for your friends to autograph the cast." N. "Because the cast is made of plaster, autographing can weaken the cast." O. "If they don't use chalk to autograph, it is okay." P. "Autographing or writing on the cast in any form will harm the cast." 13. The nurse is assigned to care for the client with a Steinmen pin. During pin care, she notes that the LPN uses sterile gloves and Q-tips to clean the pin. Which action should the nurse take at this time? Q. Assisting the LPN with opening sterile packages and peroxide R. Telling the LPN that clean gloves are allowed S. Telling the LPN that the registered nurse should perform pin care T. Asking the LPN to clean the weights and pulleys with peroxide 14. A child with scoliosis has a spica cast applied. Which action specific to the spica cast should be taken? U. Check the bowel sounds V. Assess the blood pressure W. Offer pain medication X. Check for swelling 15. The client with a cervical fracture is placed in traction. Which type of traction will be utilized at the time of discharge?

Y. Russell's traction Z. Buck's traction AA. Halo traction BB. Crutchfield tong traction 16. A client with a fractured hip is being taught correct use of the walker. The nurse is aware that the correct use of the walker is achieved if the: CC. Palms rest lightly on the handles DD. Elbows are flexed 0 EE. Client walks to the front of the walker FF. Client carries the walker