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Chapter 41 - Med Surg Questions & answers latest update 2024/2025 with complete solution
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Chapter 41 - Med Surg Questions & answers latest update 2024/2025 with complete solution
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STUVIA 2024/2025Chapter 41 - Med Surg
Ans: D Feedback: A cast requires approximately 24 to 72 hours to dry, and until dry, it does not have
full strength. While drying, the cast should not be placed on a hard surface. The cast will exude heat
while it dries and should not be wrapped. - ✔✔A nurse is caring for a patient who has had a plaster
arm cast applied. Immediately postapplication, the nurse should provide what teaching to the patient?
A) The cast will feel cool to touch for the first 30 minutes.
B) The cast should be wrapped snuggly with a towel until the patient gets home.
C) The cast should be supported on a board while drying.
D) The cast will only have full strength when dry.
Ans: A Feedback: Volkmann contracture occurs when arterial blood flow is restricted to the forearm
and hand and results in contractures of the fingers and wrist. It does not result from nerve pressure,
skin irritation, or spasms. - ✔✔A patient broke his arm in a sports accident and required the
application of a cast. Shortly following application, the patient complained of an inability to straighten
his fingers and was subsequently diagnosed with Volkmann contracture. What pathophysiologic
process caused this complication? A) Obstructed arterial blood flow to the forearm and hand B)
Simultaneous pressure on the ulnar and radial nerves C) Irritation of Merkel cells in the patient's skin
surfaces D) Uncontrolled muscle spasms in the patient's forearm
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Ans: C Feedback: Buck's extension is used for fractures of the proximal femur. Russell's traction is
used for lower leg fractures. Dunlop's traction is applied to the upper extremity for supracondylar
fractures of the elbow and humerus. Cervical head halters are used to stabilize the neck. - ✔✔A
patient is admitted to the unit in traction for a fractured proximal femur and requires traction prior to
surgery. What is the most appropriate type of traction to apply to a fractured proximal femur?
A) Russell's traction
B) Dunlop's traction
C) Buck's extension traction
D) Cervical head halter
Ans: D Feedback: The pin insertion site should be assessed every 8 hours for inflammation and
infection. Loose cover dressings should be applied to pin sites. The patient should be encouraged to
use the overhead trapeze to shift weight for repositioning. Isometric exercises should be done 10
times an hour while awake. - ✔✔A nurse is caring for a patient who is in skeletal traction. To prevent
the complication of skin breakdown in a patient with skeletal traction, what action should be included
in the plan of care?
A) Apply occlusive dressings to the pin sites.
B) Encourage the patient to push up with the elbows when repositioning.
C) Encourage the patient to perform isometric exercises once a shift.
D) Assess the pin insertion site every 8 hours.
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Ans: A Feedback: The hips should be kept in abduction by an abductor pillow. Hips should not be
flexed more than 90 degrees, and the head of bed should not be elevated more than 60 degrees. The
patient's hips should be higher than the knees; as such, high seat chairs should be used. - ✔✔A
nurse is caring for a patient who is postoperative day 1 right hip replacement. How should the nurse
position the patient?
A) Keep the patient's hips in abduction at all times.
B) Keep hips flexed at no less than 90 degrees.
C) Elevate the head of the bed to high Fowler's.
D) Seat the patient in a low chair as soon as possible.
Ans: B Feedback: The hematoma may cause an interruption of tissue perfusion, so the most
appropriate nursing diagnosis is Risk of Peripheral Neurovascular Dysfunction. There is also an
associated risk for infection because of the hematoma, but impaired neurovascular function is a more
acute threat. Unilateral neglect and impaired sensation are lower priorities than neurovascular status.
- ✔✔While assessing a patient who has had knee replacement surgery, the nurse notes that the
patient has developed a hematoma at the surgical site. The affected leg has a decreased pedal
pulse. What would be the priority nursing diagnosis for this patient?
A) Risk for Infection
B) Risk for Peripheral Neurovascular Dysfunction
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C) Unilateral Neglect
D) Disturbed Kinesthetic Sensory Perception
Ans: A Feedback: After receiving a hip prosthesis, the affected leg should be kept abducted. Mobility
should be encouraged within safe limits. There is no need to avoid knee flexion and the patient's legs
do not need to be higher than the level of the chest. - ✔✔A patient was brought to the emergency
department after a fall. The patient is taken to the operating room to receive a right hip prosthesis. In
the immediate postoperative period, what health education should the nurse emphasize?
A) "Make sure you don't bring your knees close together."
B) "Try to lie as still as possible for the first few days."
C) "Try to avoid bending your knees until next week."
D) "Keep your legs higher than your chest whenever you can."
Ans: D Feedback: Traction is used to reduce the fracture and must be maintained at all times,
including during repositioning. It would be inappropriate to add tension or release the weights. Moving
the bed instead of the patient is not feasible. - ✔✔A patient with a fractured femur is in balanced
suspension traction. The patient needs to be repositioned toward the head of the bed. During
repositioning, what should the nurse do?
A) Place slight additional tension on the traction cords.
B) Release the weights and replace them immediately after positioning.
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