Orthopaedic Nurse Test Surgical Procedures & Perioperative Care Flashcards

Prior to total hip arthroplasty, which positioning precaution is most critical for the nurse to reinforce with the patient?

Answer: Avoid hip flexion beyond 90 degrees

After total hip arthroplasty, patients must avoid hip flexion greater than 90° to prevent prosthesis dislocation, especially in the early postoperative period.

Which classification system is most commonly used to assess the severity of open fractures?

Answer: Gustilo-Anderson classification

The Gustilo-Anderson classification grades open fractures I–III based on wound size, contamination, and soft tissue damage to guide management.

A patient returning from spinal fusion surgery develops sudden weakness and loss of bladder control. What is the priority nursing action?

Answer: Notify the surgeon immediately

New-onset neurological deficits (weakness, bladder/bowel dysfunction) post-spinal surgery suggest epidural hematoma or cord compression — an emergency requiring immediate surgical notification.

Which anticoagulation agent is most commonly used for DVT prophylaxis following total knee replacement in the US?

Answer: Warfarin or a direct oral anticoagulant (DOAC)

AAOS and ACCP guidelines recommend warfarin or DOACs (e.g., rivaroxaban, apixaban) as standard DVT prophylaxis after total knee arthroplasty.

Compartment syndrome is best confirmed by which assessment finding?

Answer: Pain out of proportion to injury with pain on passive stretch

The hallmark signs of acute compartment syndrome are pain disproportionate to the injury and pain elicited by passive stretch of muscles in the affected compartment.

What is the immediate treatment for confirmed acute compartment syndrome?

Answer: Emergency fasciotomy

Emergency fasciotomy, the surgical release of the fascia, is the definitive treatment for acute compartment syndrome to relieve pressure and restore perfusion.