Orthopaedic Nurse Test Orthopaedic Nurse Test Rehabilitation & Patient Recovery 2 — Questions and Answers
Question 1: Which exercise is recommended during the early rehabilitation phase following anterior cruciate ligament (ACL) reconstruction?
- Full squats to 90 degrees
- Closed kinetic chain exercises such as mini-squats (Correct answer)
- Open kinetic chain leg extensions through full range
- Plyometric jumping drills
Correct answer: Closed kinetic chain exercises such as mini-squats
Closed kinetic chain exercises (e.g., mini-squats, step-ups) are preferred in early ACL rehab as they promote co-contraction of stabilizing muscles with less graft stress.
Question 2: A patient with a long leg cast reports increasing pain, tingling, and inability to dorsifllex the foot. What does the orthopaedic nurse do first?
- Administer IV pain medication
- Bivalve or remove the cast and notify the physician (Correct answer)
- Elevate the extremity above heart level
- Apply ice over the cast
Correct answer: Bivalve or remove the cast and notify the physician
Signs of compartment syndrome (worsening pain, paresthesia, motor weakness) in a casted limb require immediate cast splitting (bivalving) or removal and urgent physician notification.
Question 3: When instructing a patient in stair climbing with crutches after a lower extremity injury, the nurse teaches which sequence for ascending stairs?
- Crutches first, then unaffected leg, then affected leg
- Unaffected leg first, then crutches and affected leg together (Correct answer)
- Affected leg first, then crutches and unaffected leg
- Crutches and both legs simultaneously
Correct answer: Unaffected leg first, then crutches and affected leg together
When ascending stairs with crutches, the unaffected (good) leg leads, followed by the crutches and affected leg — 'good goes up to heaven.'
Question 4: Which outcome is the primary indicator that a patient is ready for discharge to home after total knee arthroplasty?
- Complete pain resolution
- Ability to perform self-care and ambulate safely with assistive device (Correct answer)
- Full return to pre-surgery range of motion
- Radiographic confirmation of bone healing
Correct answer: Ability to perform self-care and ambulate safely with assistive device
Discharge readiness after TKA is determined by the patient's ability to safely ambulate with an assistive device, manage pain, and perform basic activities of daily living.
Question 5: In managing a patient with rheumatoid arthritis who develops a painful flare during inpatient orthopaedic rehabilitation, the nurse's first action is to:
- Encourage the patient to push through the pain with exercises
- Assess the joints for signs of acute inflammation and withhold aggressive exercise (Correct answer)
- Apply heat packs to all affected joints
- Increase the intensity of physical therapy
Correct answer: Assess the joints for signs of acute inflammation and withhold aggressive exercise
During an RA flare, active inflammation contraindicates aggressive exercise; joint rest, gentle ROM, and anti-inflammatory management are prioritized to prevent further damage.
Question 6: What is the purpose of using a abductor pillow following total hip arthroplasty?
- Reduce postoperative swelling by elevating the leg
- Keep the hip in abduction to prevent dislocation (Correct answer)
- Provide traction to the hip joint
- Prevent deep vein thrombosis
Correct answer: Keep the hip in abduction to prevent dislocation
An abductor wedge pillow maintains the operative hip in abduction, preventing adduction and internal rotation that could dislocate the posterior hip prosthesis.
Orthopaedic Nurse Test Orthopaedic Nurse Test Rehabilitation & Patient Recovery 2
Which exercise is recommended during the early rehabilitation phase following anterior cruciate ligament (ACL) reconstruction?