🦴 Maintaining a healthy weight is one of the most important lifestyle measures for slowing osteoarthritis progression.

🦴 Extra body weight increases pressure on weight-bearing joints, especially the knees, hips, and spine.

🦴 This repeated pressure worsens cartilage breakdown, which is the main degenerative change in osteoarthritis.

🦴 Weight management helps reduce joint pain, stiffness, and inflammation during movement.

🦴 It also improves mobility and supports better tolerance of low-impact exercise.

🦴 For clients with osteoarthritis, weight control is a long-term joint-protection strategy.

❌ Incorrect Options:

❌ Propping the head with multiple pillows may help comfort in some situations, but it does not address the joint degeneration caused by osteoarthritis. It also does not reduce mechanical stress on affected joints.

❌ Taking 5000 mg of acetaminophen daily is unsafe because it exceeds the recommended maximum daily dose and increases the risk for severe liver injury.

❌ A 26-mile marathon is a high-impact activity that can worsen joint stress and increase pain. Clients with osteoarthritis are encouraged to perform low-impact exercises instead.

🔨 A comminuted fracture occurs when a bone is broken or splintered into multiple fragments.

🔨 The x-ray description of the tibia being “splintered into several pieces around the shaft” is the classic finding of this fracture type.

🔨 Comminuted fractures commonly result from high-impact trauma, such as falls, motor vehicle accidents, or crushing injuries.

🔨 These fractures are often unstable because the bone has fragmented into several sections, making alignment and healing more difficult.

🔨 Clients with comminuted fractures may require traction, casting, or surgical procedures such as open reduction and internal fixation (ORIF).

🔨 Nurses should closely monitor for complications including pain, swelling, impaired circulation, and delayed bone healing.

❌ Oblique fracture

❌ An oblique fracture involves a diagonal or slanted break across the bone.

❌ The fracture line is usually angled rather than fragmented into many pieces.

❌ The stem specifically describes splintering, which is not characteristic of an oblique fracture.

❌ Impacted fracture

❌ An impacted fracture occurs when one end of the broken bone is driven into another portion of the bone.

❌ This type is commonly seen in falls where compressive force pushes the fragments together.

❌ The question does not describe bone ends being compressed into each other.

❌ Transverse fracture

❌ A transverse fracture is a straight horizontal break across the shaft of the bone.

❌ It usually results from a direct blow or bending force.

❌ This fracture type does not involve multiple splintered bone fragments.

🌬️ Using a cool hair dryer is a safe method to relieve itching inside a fiberglass cast.

🌬️ Children should never insert objects such as pencils, rulers, or hangers into the cast because this can injure the skin and increase the risk for infection.

🌬️ Fiberglass casts are lighter and dry faster than plaster casts, but proper cast care is still essential to prevent complications.

🌬️ The nurse should teach the child and parents to monitor for swelling, numbness, discoloration, foul odor, or increased pain because these may indicate impaired circulation or infection.

🌬️ Keeping the extremity elevated during the first 24–48 hours helps reduce swelling and discomfort.

🌬️ This statement demonstrates correct understanding of safe cast care management.

❌ “I should expect full range of motion in the first few days.”

❌ Full range of motion is not expected immediately after a fracture because swelling, pain, and immobilization limit movement.

❌ Recovery of motion usually occurs gradually as healing progresses.

❌ The cast is intended to stabilize the fracture and temporarily restrict movement for proper bone healing.

❌ “I should expect the cast to be dry in 2 days.”

❌ Fiberglass casts generally dry within a much shorter period, often within about 30 minutes to 1 hour.

❌ Waiting 2 days is more consistent with plaster cast drying times.

❌ Understanding drying times is important to prevent damage to the cast structure.

❌ “I can let my arm hang down for 1 hour at a time every 4 hours.”

❌ Allowing the arm to hang down for long periods increases swelling and pain.

❌ The affected extremity should be elevated above heart level during the first days after cast application.

❌ Elevation promotes venous return and helps reduce edema around the fracture site.

🩸 Decreased or absent pulses following an open reduction and internal fixation (ORIF) of a fractured femur indicate impaired circulation and possible vascular compromise.

🩸 This finding may suggest a serious complication such as compartment syndrome, arterial obstruction, or severe swelling that is reducing blood flow to the extremity.

🩸 Neurovascular assessments are a priority after orthopedic surgery and include checking pulses, skin color, temperature, capillary refill, movement, and sensation.

🩸 Inadequate blood supply can quickly lead to tissue ischemia, nerve damage, and permanent loss of limb function if not treated immediately.

🩸 The nurse should notify the healthcare provider immediately because absent or weak pulses are considered an emergency finding.

🩸 Early recognition and intervention are essential to prevent irreversible complications.

❌ Pain 3/10 scale

❌ Mild postoperative pain is expected after orthopedic surgery and does not usually indicate a complication.

❌ Pain becomes more concerning when it is severe, sudden, increasing, or not relieved by prescribed medication.

❌ A pain score of 3/10 is considered relatively controlled postoperative discomfort.

❌ Dry, clean wound dressing

❌ A dry and clean dressing is an expected postoperative finding and suggests proper wound management.

❌ It indicates there is no excessive bleeding or drainage at the surgical site.

❌ This assessment finding supports normal postoperative recovery.

❌ Oral temperature of 100°F

❌ A slight temperature elevation can occur after surgery due to the inflammatory response associated with tissue trauma.

❌ Temperatures become more concerning when significantly elevated or accompanied by redness, drainage, or other infection signs.

❌ A temperature of 100°F alone is not the priority complication in this situation.

🔴 Warmth and redness around skeletal traction pin sites can indicate local inflammation and possible pin-site infection.

🔴 Skeletal traction uses pins or wires inserted through the bone, creating an opening where microorganisms can enter.

🔴 The nurse should also assess for purulent drainage, swelling, tenderness, foul odor, fever, or increased pain around the pin site.

🔴 Pin-site infection is important to identify early because it can spread deeper into the bone and lead to osteomyelitis.

🔴 Proper pin care, sterile technique, and frequent assessment help reduce infection risk.

🔴 This finding should be reported and managed promptly to prevent worsening complications.

❌ A negative wound culture

❌ A negative wound culture means no infectious organism was identified in the sample.

❌ This finding does not support the presence of infection.

❌ The nurse would continue routine monitoring, but this is not an abnormal infection finding.

❌ Cap refill less than 3 seconds

❌ Capillary refill less than 3 seconds is a normal neurovascular finding.

❌ It indicates adequate peripheral perfusion to the affected extremity.

❌ This finding is important in traction care, but it does not indicate infection.

❌ Positive pedal pulses

❌ Positive pedal pulses indicate blood flow is present in the lower extremity.

❌ This is an expected circulation finding during neurovascular assessment.

❌ It does not suggest infection at the pin sites.

💊 Alendronate is a bisphosphonate used to treat or prevent osteoporosis by slowing bone resorption.

💊 It should be taken first thing in the morning on an empty stomach with a full glass of plain water.

💊 Food, calcium, antacids, coffee, juice, and other medications can greatly reduce absorption of alendronate.

💊 The client should remain upright for at least 30 minutes after taking it to reduce the risk of esophageal irritation.

💊 Taking the medication correctly improves absorption and helps reduce the risk of esophagitis or esophageal ulcers.

💊 This statement shows the client understands the most important administration instruction.

❌ “I will lie down for 30 minutes after taking this.”

❌ The client should not lie down after taking alendronate because it can irritate the esophagus.

❌ The client should sit or stand upright for at least 30 minutes.

❌ Remaining upright helps the medication pass into the stomach and lowers the risk of esophageal injury.

❌ “I will take calcium at the same time with this medication.”

❌ Calcium should not be taken at the same time because it decreases alendronate absorption.

❌ Calcium supplements may be prescribed, but they should be taken later in the day.

❌ Separating calcium from alendronate helps the medication work effectively.

❌ “I will take this medication after a full meal.”

❌ Alendronate should not be taken after a full meal because food reduces absorption.

❌ It is best taken before any food or drink other than plain water.

❌ Taking it with meals can make the medication much less effective.

🦵 A patient with a hip fracture often presents with the affected leg shortened and externally rotated.

🦵 External rotation occurs because the fractured femoral head or neck disrupts normal alignment of the hip joint.

🦵 The client may also have severe hip or groin pain, inability to move the leg, and difficulty bearing weight.

🦵 The nurse should avoid unnecessary movement of the affected extremity to prevent further injury.

🦵 Neurovascular status should be assessed because swelling or trauma can affect circulation and sensation.

🦵 External rotation is a classic assessment finding associated with hip fracture.

❌ Able to bear weight

❌ Clients with a hip fracture are usually unable or unwilling to bear weight on the affected leg.

❌ Weight bearing can worsen pain and may increase displacement of the fracture.

❌ The affected extremity should be protected until evaluated and treated.

❌ Calf atrophy

❌ Calf atrophy develops over time from prolonged immobility or disuse.

❌ It is not an expected immediate finding of an acute hip fracture.

❌ The question asks for an expected assessment finding at the time of injury.

❌ Leg lengthening

❌ Hip fractures commonly cause shortening, not lengthening, of the affected leg.

❌ Muscle spasms and displacement can pull the fractured limb upward.

❌ Lengthening does not match the typical presentation of a fractured hip.

🚶 Early ambulation after ORIF helps prevent postoperative complications such as venous thromboembolism, atelectasis, pneumonia, constipation, and muscle weakness.

🚶 Older adults are at high risk for complications from immobility, so movement should begin as soon as the provider allows and safety measures are in place.

🚶 Ambulation promotes circulation, improves lung expansion, supports bowel motility, and helps preserve functional independence.

🚶 After femur repair, the nurse should follow the prescribed weight-bearing status and assistive-device plan, such as walker use or physical therapy support.

🚶 The client should be assessed for pain, dizziness, orthostatic hypotension, and neurovascular status before and after activity.

🚶 This intervention supports safe recovery while reducing immobility-related complications.

❌ Maintain the client on bedrest for 72 hours after surgery

❌ Prolonged bedrest increases the risk for blood clots, pneumonia, pressure injuries, constipation, and deconditioning.

❌ Unless specifically prescribed due to instability, clients are usually encouraged to mobilize early after orthopedic surgery.

❌ Bedrest for 72 hours would delay recovery and increase complications in an older adult.

❌ Change dressings every other day to examine the site

❌ Dressings should be changed according to the provider’s prescription or facility policy, not automatically every other day.

❌ Unnecessary dressing changes can increase contamination risk and disrupt healing tissue.

❌ The nurse should monitor the dressing for drainage, bleeding, odor, and signs of infection without removing it unnecessarily.

❌ Limit fluids to 200 mL per day

❌ Limiting fluids to 200 mL/day is extremely restrictive and can cause dehydration, poor perfusion, constipation, and impaired healing.

❌ Postoperative clients usually need adequate hydration unless a specific condition requires fluid restriction.

❌ Fluids support circulation, kidney function, bowel function, and tissue repair.

🦵 Elevating a newly casted leg helps improve venous return by assisting blood and fluid movement back toward the heart.

🦵 After a fracture and cast application, swelling is common because of tissue injury and inflammation.

🦵 Elevation reduces dependent edema, which helps decrease pain and pressure inside the cast.

🦵 Less swelling also lowers the risk of impaired circulation, nerve compression, and complications such as compartment syndrome.

🦵 The extremity is usually elevated above the level of the heart during the early period after cast placement.

🦵 This is one of the most important instructions because circulation and swelling control are priority concerns after casting.

❌ Decrease odor

❌ Elevation does not directly decrease cast odor.

❌ Odor is more related to moisture, drainage, hygiene issues, or possible infection.

❌ The priority purpose of elevation is circulation and swelling control.

❌ Prevent infection

❌ Elevation does not directly prevent infection inside or around the cast.

❌ Infection prevention focuses on keeping the cast dry, avoiding skin injury, and reporting drainage or foul odor.

❌ While swelling reduction supports tissue health, the main reason for elevation is improved venous return.

❌ Reduce drying time of the cast

❌ Elevation does not make the cast dry faster.

❌ Drying time depends on the cast material, such as fiberglass or plaster, and air exposure.

❌ The question asks the most important reason, which is circulation support.

⚠️ Severe pain unrelieved by medication is a classic early sign of compartment syndrome.

⚠️ Compartment syndrome occurs when swelling or bleeding increases pressure inside a closed muscle compartment.

⚠️ This pressure reduces blood flow and oxygen delivery to nerves and muscles, creating a limb-threatening emergency.

⚠️ Pain is often disproportionate to the injury and may worsen with passive stretching of the affected extremity.

⚠️ The nurse should assess neurovascular status, keep the extremity at heart level, and notify the provider immediately.

⚠️ Untreated compartment syndrome can lead to tissue necrosis, nerve damage, and permanent loss of function.

❌ Capillary refill of 3 seconds

❌ Capillary refill of 3 seconds is borderline but may still be considered acceptable in some settings.

❌ It is not as specific or urgent as severe pain that is not relieved by medication.

❌ In compartment syndrome, worsening findings may include delayed capillary refill, pallor, paresthesia, paralysis, and pulselessness.

❌ Dyspnea and tachypnea

❌ Dyspnea and tachypnea are respiratory findings, not classic signs of compartment syndrome.

❌ These symptoms may suggest complications such as pulmonary embolism or respiratory distress.

❌ The question focuses on a casted fractured tibia and limb pressure complication.

❌ Decreased level of consciousness

❌ Decreased level of consciousness is a neurological or systemic concern, not the expected local finding of compartment syndrome.

❌ It may occur with hypoxia, shock, medication effects, or neurologic injury.

❌ Compartment syndrome is primarily identified through severe limb pain and neurovascular changes.