Question

One week after total hip arthroplasty, a patient complains of sudden severe pain in the affected hip and inability to bear weight on that leg. Which of the following should be expected?

Answer 1

Correct Answers:

Prosthesis dislocation

Rationale :

🦴 Prosthesis dislocation is the expected finding because sudden severe pain and inability to bear weight one week after a total hip arthroplasty are classic signs of hip joint displacement.

🦴 A hip replacement creates a new joint that can become dislocated, especially during the early postoperative period before surrounding tissues fully heal.

🦴 Dislocation commonly occurs with movements such as hip flexion greater than 90°, adduction, or internal rotation.

🦴 The client may report sudden pain, inability to move the affected leg, shortening or abnormal positioning of the leg, and difficulty bearing weight.

🦴 The nurse should keep the client from moving the affected hip and notify the provider for evaluation and possible reduction of the prosthesis.

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Answer 2

Correct Answers:

Apply a warm moist pack

Rationale :

🦶 Applying a sterile gauze wrap to immobilize the ankle is appropriate 36 hours after an ankle sprain because stabilization helps support the injured ligaments and prevents further injury during healing.

🦶 An ankle sprain involves stretching or tearing of ligaments, and immobilization or compression can reduce swelling and provide support.

🦶 The nurse should continue measures such as RICE (Rest, Ice, Compression, Elevation) during the early phase of injury.

🦶 A supportive wrap helps limit excessive movement while allowing gradual recovery of the affected joint.

🦶 This answer is correct because compression and immobilization protect the injured ankle and promote healing.

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Answer 3

Correct Answers:

Cover the edges of the cast

Rationale :

🦴 Covering the edges of the cast is the correct nursing action because it protects the client’s skin from irritation and prevents injury from rough plaster edges.

🦴 Plaster casts can have sharp or rough edges that may rub against the skin, causing pressure areas, abrasions, or breakdown.

🦴 Padding or covering the cast edges improves comfort and reduces the risk of skin complications.

🦴 The nurse should also assess circulation, sensation, and movement of the fingers regularly to identify complications such as impaired neurovascular status or compartment syndrome.

🦴 This answer is correct because protecting the cast edges helps maintain skin integrity and client comfort.

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Answer 4

Correct Answers:

5

Rationale :

Ordered dose: 3 grams daily

Available dose: 600 mg/tablet

Convert grams to milligrams:

3 g×1000=3000 mg

Divide the total dose by the tablet strength:

3000 mg÷600 mg/tablet=5 tablets

Answer: 5 tablets per day.

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Answer 5

Correct Answers:

Isometric exercises of the unaffected leg

Rationale :

🦵 Isometric exercises of the unaffected leg are the priority activity immediately after a below-the-knee amputation because they help maintain muscle strength and prepare the client for future ambulation with crutches.

🦵 Early postoperative exercise focuses on maintaining strength, preventing muscle atrophy, and promoting circulation while the surgical site heals.

🦵 The unaffected leg will be essential for supporting body weight during transfers and ambulation with assistive devices.

🦵 Isometric exercises involve contracting muscles without moving the joint, making them safe soon after surgery.

🦵 These exercises also help prevent complications related to immobility, such as venous stasis and deconditioning.

🦵 This answer is correct because strengthening the remaining limb is an early step toward safe mobility after amputation.

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Answer 6

Correct Answers:

Weak pedal pulses

Rationale :

🦵 Weak pedal pulses indicate a possible complication of Buck’s traction because traction equipment can place pressure on surrounding tissues and impair circulation to the affected extremity.

🦵 Neurovascular assessment is essential for clients in traction, including checking pedal pulses, capillary refill, skin color, temperature, sensation, and movement.

🦵 A decrease in pedal pulse strength may indicate reduced arterial blood flow and requires immediate assessment and intervention.

🦵 Prolonged impaired circulation can lead to tissue ischemia and further complications.

🦵 This answer is correct because a weak pulse is an abnormal neurovascular finding indicating compromised circulation.

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Answer 7

Correct Answers:

Hematoma

Rationale :

🦴 Hematoma is the expected immediate complication to monitor for after a bone biopsy because the procedure involves inserting a needle or making an incision into bone tissue, which can cause bleeding.

🦴 Blood can collect under the skin or within surrounding tissues, forming a hematoma at the biopsy site.

🦴 The nurse should assess for swelling, bruising, increased pain, and bleeding after the procedure.

🦴 Applying pressure as ordered and monitoring the dressing help reduce the risk of excessive bleeding.

🦴 Infection is also a possible complication, but it typically develops later rather than immediately after the biopsy.

🦴 This answer is correct because bleeding-related complications such as hematoma are common immediate concerns after invasive procedures.

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Answer 8

Correct Answers:

Pathological fractures

Rationale :

🦴 Pathological fractures are the most significant sign of bone cancer because malignant tumors weaken the normal structure and strength of the bone.

🦴 Cancerous growth replaces healthy bone tissue, making the affected bone fragile and unable to withstand normal stress.

🦴 A fracture can occur with minimal trauma or normal activity because the bone has been compromised by the tumor.

🦴 Pathological fractures are a major concern because they can cause severe pain, loss of function, and mobility limitations.

🦴 Although pain and movement restrictions can occur with bone cancer, a fracture indicates significant structural damage.

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Answer 9

Correct Answers:

Abduction of the thighs

Rationale :

🦴 Abduction of the thighs is maintained after a hip arthroplasty to prevent dislocation of the artificial hip joint.

🦴 Placing a pillow between the client’s legs keeps the hips separated and prevents adduction, which is when the legs move toward the midline.

🦴 Hip adduction, especially combined with internal rotation and excessive flexion, can cause the prosthetic joint to dislocate during the postoperative healing period.

🦴 Maintaining abduction helps keep the femoral head properly positioned within the acetabulum and promotes safe recovery.

🦴 The nurse should continue to follow hip precautions, including avoiding crossing the legs and avoiding hip flexion beyond 90°.

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Answer 10

Correct Answers:

Allopurinol

Rationale :

🦶 Allopurinol is the preferred medication for chronic gout because it lowers uric acid production by inhibiting the enzyme xanthine oxidase.

🦶 Chronic gout occurs due to persistent elevation of uric acid, leading to deposition of urate crystals in joints and recurrent gout attacks.

🦶 Allopurinol helps prevent future attacks by decreasing uric acid levels and reducing the formation of new urate crystals.

🦶 It is used as a long-term maintenance medication rather than for immediate relief of an acute gout flare.

🦶 The nurse should teach the client that adherence is important and that gout prevention requires maintaining therapeutic uric acid levels over time.

🦶 This answer is correct because allopurinol is the primary urate-lowering therapy used for chronic gout management.

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Ati Custom Med Surg II Exam 1B

No.

1 :
One week after total hip arthroplasty, a patient complains of sudden severe pain in the affected hip and inability to bear weight on that leg. Which of the following should be expected?

2 :
A nurse is caring for a 20-year-old athlete with a sprained left ankle. What nursing measures should the nurse employ 36 hours later?

3 :
A nurse is caring for a 30-year-old patient with a simple fracture of the right hand supported with plaster cast. What measures must the nurse employ when caring for this patient?

4 :
The health care provider has ordered 3 grams of Equanil daily. What is available is 600 mg/tablets. Administer how many tablets?

5 :
A patient has undergone a right below-the-knee amputation. The nurse and physical therapist develop a plan of care for muscle strengthening to prepare for ambulating with crutches. What nursing activity is priority to begin implementing immediately after the patient's surgery?

6 :
The nurse caring for a patient with Buck's traction of the right leg is monitoring the patient for associated complications. Which finding indicates a complication of this form of traction?

7 :
Following a bone biopsy, the nurse inspects the biopsy site. The nurse is monitoring the site for which complication that may occur immediately post-biopsy?

8 :
The nurse is caring for a patient newly diagnosed with bone cancer. The nurse understands that the most significant sign of cancer of the bone is:

9 :
When a patient who has a right hip arthroplasty is turned, the nurse places a pillow between the patient's legs to maintain which position?

10 :
A patient presents to the emergency department with swelling of the right big toe, redness, and pain. The patient has a history of gout. Upon discharge from the emergency department, the nurse understands that the preferred drug of choice for chronic gout would be which of the following?

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Ati Custom Med Surg II Exam 1B

No.

1 : One week after total hip arthroplasty, a patient complains of sudden severe pain in the affected hip and inability to bear weight on that leg. Which of the following should be expected?

2 : A nurse is caring for a 20-year-old athlete with a sprained left ankle. What nursing measures should the nurse employ 36 hours later?

3 : A nurse is caring for a 30-year-old patient with a simple fracture of the right hand supported with plaster cast. What measures must the nurse employ when caring for this patient?

4 : The health care provider has ordered 3 grams of Equanil daily. What is available is 600 mg/tablets. Administer how many tablets?

5 : A patient has undergone a right below-the-knee amputation. The nurse and physical therapist develop a plan of care for muscle strengthening to prepare for ambulating with crutches. What nursing activity is priority to begin implementing immediately after the patient's surgery?

6 : The nurse caring for a patient with Buck's traction of the right leg is monitoring the patient for associated complications. Which finding indicates a complication of this form of traction?

7 : Following a bone biopsy, the nurse inspects the biopsy site. The nurse is monitoring the site for which complication that may occur immediately post-biopsy?

8 : The nurse is caring for a patient newly diagnosed with bone cancer. The nurse understands that the most significant sign of cancer of the bone is:

9 : When a patient who has a right hip arthroplasty is turned, the nurse places a pillow between the patient's legs to maintain which position?

10 : A patient presents to the emergency department with swelling of the right big toe, redness, and pain. The patient has a history of gout. Upon discharge from the emergency department, the nurse understands that the preferred drug of choice for chronic gout would be which of the following?

1 :
One week after total hip arthroplasty, a patient complains of sudden severe pain in the affected hip and inability to bear weight on that leg. Which of the following should be expected?

2 :
A nurse is caring for a 20-year-old athlete with a sprained left ankle. What nursing measures should the nurse employ 36 hours later?

3 :
A nurse is caring for a 30-year-old patient with a simple fracture of the right hand supported with plaster cast. What measures must the nurse employ when caring for this patient?

4 :
The health care provider has ordered 3 grams of Equanil daily. What is available is 600 mg/tablets. Administer how many tablets?

5 :
A patient has undergone a right below-the-knee amputation. The nurse and physical therapist develop a plan of care for muscle strengthening to prepare for ambulating with crutches. What nursing activity is priority to begin implementing immediately after the patient's surgery?

6 :
The nurse caring for a patient with Buck's traction of the right leg is monitoring the patient for associated complications. Which finding indicates a complication of this form of traction?

7 :
Following a bone biopsy, the nurse inspects the biopsy site. The nurse is monitoring the site for which complication that may occur immediately post-biopsy?

8 :
The nurse is caring for a patient newly diagnosed with bone cancer. The nurse understands that the most significant sign of cancer of the bone is:

9 :
When a patient who has a right hip arthroplasty is turned, the nurse places a pillow between the patient's legs to maintain which position?

10 :
A patient presents to the emergency department with swelling of the right big toe, redness, and pain. The patient has a history of gout. Upon discharge from the emergency department, the nurse understands that the preferred drug of choice for chronic gout would be which of the following?