Question

A client was brought to the emergency department after a fall and is now being taken to the operating room for a right hip prosthesis. In the immediate postoperative period, what health education should the nurse emphasize

Answer 1

Correct Answers:

Make sure you don't bring your knees close together or cross your legs."

Rationale :

🔵 After a hip prosthesis surgery, the priority is preventing hip dislocation, which is a major postoperative complication.

🔵 Crossing the legs or bringing the knees close together places stress on the hip joint and increases the risk of prosthetic dislocation.

🔵 The client should also avoid hip flexion greater than 90 degrees, twisting movements, and should use abduction pillows if prescribed.

🔵 Early education on positioning and movement is crucial for protecting the surgical site and ensuring proper healing.

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Answer 2

Correct Answers:

Clear, serous drainage

Rationale :

🟡 Clear, serous drainage is an expected finding in the early stages after pin insertion for skeletal traction and does not indicate infection.

🟡 Mild inflammation and minimal serous drainage are normal as the tissue adjusts to the pin.

🟡 Purulent drainage, increasing pain, or redness are abnormal and suggest possible infection, requiring immediate intervention.

🟡 Ongoing assessment is essential to prevent osteomyelitis or other severe complications.

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Answer 3

Correct Answers:

Fat embolism syndrome

Rationale :

🔴 Fat embolism syndrome (FES) is a serious complication following long bone fractures (such as the femur).

🔴 Classic signs include respiratory distress (hypoxia, tachypnea), tachycardia, fever, and mental status changes, often occurring within 24–72 hours post-injury or surgery.

🔴 The thick, white sputum and hypoxia indicate pulmonary involvement due to fat globules obstructing pulmonary capillaries, causing an inflammatory response.

🔴 Immediate intervention with oxygen therapy, respiratory support, and stabilization is crucial to prevent further deterioration.

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Answer 4

Correct Answers:

"Keep your right leg elevated above heart level."

Rationale :

🟢 Elevating the leg above heart level helps reduce swelling, which is common after a fracture and cast application.

🟢 Proper elevation also promotes venous return, decreasing the risk of compartment syndrome and improving comfort.

🟢 Clients should be taught to report foul smells, increased pain, or numbness, as these indicate possible infection or impaired circulation.

🟢 Scratching inside the cast or covering it while drying is contraindicated, as it can cause skin injury or delayed drying, leading to infection.

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Answer 5

Correct Answers:

"l will need my husband to assist me in getting off the low toilet seat at home."

Rationale :

🔴 After a total hip replacement, using low toilet seats is contraindicated because it forces excessive hip flexion (>90°), increasing the risk of hip dislocation.

🔴 Clients should use a raised toilet seat or other adaptive devices to maintain proper hip alignment.

🔴 Keeping a pillow between the legs, avoiding crossing legs, and using assistive devices like a sock puller are correct practices to maintain hip precautions.

🔴 Further teaching is required to ensure the client understands the need for appropriate assistive devices rather than manual assistance from a caregiver for unsafe furniture.

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Answer 6

Correct Answers:

Restrict intake of alcohol

Rationale :

🟢 Alcohol, especially beer and liquor, increases uric acid production and decreases its renal excretion, triggering gout attacks.

🟢 Clients with gout should also avoid purine-rich foods (organ meats, sardines) and maintain proper hydration to help eliminate uric acid.

🟢 While smoking cessation and rest are beneficial for overall health, they do not directly reduce hyperuricemia or prevent gout flare-ups.

🟢 Lifestyle modifications are key to preventing recurrent painful joint inflammation associated with gout.

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Answer 7

Correct Answers:

Check circulation and movement of toes frequently

Rationale :

🔵 The priority nursing care for a client with a new long leg cast is neurovascular assessment—checking circulation, sensation, and movement (CSM) of the toes frequently.

🔵 Early detection of impaired perfusion, numbness, or tingling is crucial to prevent compartment syndrome or permanent nerve damage.

🔵 Elevation and applying ice are supportive measures to reduce swelling but are secondary to monitoring circulation.

🔵 Weight-bearing restrictions depend on the healthcare provider’s orders but are not the immediate priority assessment.

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Answer 8

Correct Answers:

This will prevent bloating."

Rationale :

🟢 Fiber should be added gradually to the diet to allow the gastrointestinal system to adjust.

🟢 Adding large amounts of fiber too quickly can lead to excessive gas production, bloating, and abdominal discomfort due to increased fermentation in the colon.

🟢 Gradual introduction with increased fluid intake helps improve stool bulk and consistency effectively for constipation relief.

🟢 The primary goal is to enhance bowel motility without causing uncomfortable gastrointestinal symptoms.

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Answer 9

Correct Answers:

"I'll apply ice to my ankle today and tomorrow."

Rationale :

🔵 The appropriate initial management for a sprain follows the RICE method: Rest, Ice, Compression, and Elevation.

🔵 Ice application for the first 24–48 hours helps reduce swelling, inflammation, and pain by causing vasoconstriction.

🔵 Heat should be avoided in the acute phase as it increases swelling and bleeding.

🔵 Weight-bearing should be avoided until swelling decreases and is approved by a healthcare provider.

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Answer 10

Correct Answers:

Maintaining correct body alignment

Rationale :

🟠 Buck’s traction is a type of skin traction used to immobilize fractures, reduce muscle spasms, and maintain alignment before surgery.

🟠 Maintaining proper body alignment ensures the traction force is applied correctly, preventing pressure injuries and further displacement of the fracture.

🟠 The weights should never be removed unless prescribed, and the bed should remain flat or slightly elevated at the head, not in the knee gatch position, to avoid disrupting traction.

🟠 Proper alignment promotes effective healing and comfort while minimizing complications such as nerve compression.

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Chapter 42 Musculoskeletal Trauma N3661 EXAM 3 SPRING 2025

No.

1 :
A client was brought to the emergency department after a fall and is now being taken to the operating room for a right hip prosthesis. In the immediate postoperative period, what health education should the nurse emphasize

2 :
The nurse is evaluating the pin sites of a client in skeletal traction. The nurse would be least concerned with which finding?

4 :
A Client With a right tibial fracture is being discharged home after having a cast applied. What instruction should the nurse provide about the client's cast care?

5 :
A nurse is caring for a client with a total hip replacement. The nurse is reviewing health education before discharge. Which of the client's statements would indicate to the nurse that the client requires further teaching?

6 :
A nurse is educating a client with gout about lifestyle modifications that can help control the signs and symptoms of the disease. What recommendation should the nurse make?

7 :
What is the most important nursing care aspect for a client with a new long leg cast?

8 :
A client with constipation asks, "Why do I need to add fiber to my new slowly?" The nurse responds,

9 :
A nurse is discharging a Client Who came to the outpatient Clinic With an ankle sprain. Which Of the following statements should the nurse identify as an indication that the client understands the discharge instructions?

10 :
A Client is in Buck's traction after fracturing his right hip. Which action should the nurse include in the care plan?

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Chapter 42 Musculoskeletal Trauma N3661 EXAM 3 SPRING 2025

No.

1 : A client was brought to the emergency department after a fall and is now being taken to the operating room for a right hip prosthesis. In the immediate postoperative period, what health education should the nurse emphasize

2 : The nurse is evaluating the pin sites of a client in skeletal traction. The nurse would be least concerned with which finding?

4 : A Client With a right tibial fracture is being discharged home after having a cast applied. What instruction should the nurse provide about the client's cast care?

5 : A nurse is caring for a client with a total hip replacement. The nurse is reviewing health education before discharge. Which of the client's statements would indicate to the nurse that the client requires further teaching?

6 : A nurse is educating a client with gout about lifestyle modifications that can help control the signs and symptoms of the disease. What recommendation should the nurse make?

7 : What is the most important nursing care aspect for a client with a new long leg cast?

8 : A client with constipation asks, "Why do I need to add fiber to my new slowly?" The nurse responds,

9 : A nurse is discharging a Client Who came to the outpatient Clinic With an ankle sprain. Which Of the following statements should the nurse identify as an indication that the client understands the discharge instructions?

10 : A Client is in Buck's traction after fracturing his right hip. Which action should the nurse include in the care plan?

1 :
A client was brought to the emergency department after a fall and is now being taken to the operating room for a right hip prosthesis. In the immediate postoperative period, what health education should the nurse emphasize

2 :
The nurse is evaluating the pin sites of a client in skeletal traction. The nurse would be least concerned with which finding?

4 :
A Client With a right tibial fracture is being discharged home after having a cast applied. What instruction should the nurse provide about the client's cast care?

5 :
A nurse is caring for a client with a total hip replacement. The nurse is reviewing health education before discharge. Which of the client's statements would indicate to the nurse that the client requires further teaching?

6 :
A nurse is educating a client with gout about lifestyle modifications that can help control the signs and symptoms of the disease. What recommendation should the nurse make?

7 :
What is the most important nursing care aspect for a client with a new long leg cast?

8 :
A client with constipation asks, "Why do I need to add fiber to my new slowly?" The nurse responds,

9 :
A nurse is discharging a Client Who came to the outpatient Clinic With an ankle sprain. Which Of the following statements should the nurse identify as an indication that the client understands the discharge instructions?

10 :
A Client is in Buck's traction after fracturing his right hip. Which action should the nurse include in the care plan?