Orthopaedic Nurse Test Communication & Stakeholder Relations 3 — Questions and Answers
Question 1: A patient with total hip replacement is being discharged and does not understand precaution instructions despite verbal teaching. What is the next best step?
- Discharge the patient with written materials only
- Use teach-back method, supplement with written instructions, and involve a family member if available (Correct answer)
- Request a social work consult to delay discharge
- Document that teaching was completed
Correct answer: Use teach-back method, supplement with written instructions, and involve a family member if available
The teach-back method confirms comprehension and multi-modal reinforcement improves retention, especially for complex orthopaedic precautions.
Question 2: An orthopaedic unit nurse disagrees with a physician's order for early weight-bearing in a patient with a tibial plateau fracture. What is the appropriate action?
- Follow the order without question since the physician is responsible
- Voice the concern directly to the physician using assertive communication, document the exchange (Correct answer)
- Refuse to carry out the order until it is reviewed
- Ask another nurse to implement the order
Correct answer: Voice the concern directly to the physician using assertive communication, document the exchange
Assertive, respectful communication of clinical concerns is a professional responsibility; documenting the exchange creates an accountability record.
Question 3: During a busy shift, a colleague appears overwhelmed after a difficult patient interaction. What communication approach best supports team cohesion?
- Report the colleague to the charge nurse for struggling
- Offer a brief check-in, validate feelings, and ask if help is needed with patient assignments (Correct answer)
- Ignore the situation to respect the colleague's autonomy
- Send an email to the manager about the colleague's performance
Correct answer: Offer a brief check-in, validate feelings, and ask if help is needed with patient assignments
Peer support through brief check-ins validates colleagues' experiences and strengthens unit cohesion while preventing burnout escalation.
Question 4: A patient asks the orthopaedic nurse about the risks of their upcoming spinal surgery. The nurse's best response is to:
- Fully describe all surgical risks in clinical detail
- Explain that only the surgeon can discuss surgical risks and facilitate a timely surgeon conversation (Correct answer)
- Tell the patient that the surgery is routine and low risk
- Provide a printed list of all possible surgical complications
Correct answer: Explain that only the surgeon can discuss surgical risks and facilitate a timely surgeon conversation
Informed consent regarding surgical risks is the surgeon's legal responsibility; the nurse's role is to facilitate access to that conversation promptly.
Question 5: Which documentation practice best supports continuity of care for an orthopaedic patient receiving physical therapy?
- Recording only physician orders related to therapy
- Documenting patient's pain response, functional progress, and barriers to therapy in the medical record (Correct answer)
- Noting therapy attendance without clinical outcomes
- Allowing the PT to document in the nursing section
Correct answer: Documenting patient's pain response, functional progress, and barriers to therapy in the medical record
Comprehensive nursing documentation of pain, progress, and barriers ensures all team members have the information needed for coordinated care.
Question 6: A patient with a shoulder arthroplasty reports that the night nurse 'never checked on them.' How should the day nurse respond?
- Defend the night nurse and explain that they were likely busy
- Acknowledge the patient's experience, assess current needs, and address the concern through appropriate channels (Correct answer)
- Tell the patient to file a formal complaint
- Dismiss the concern since the chart shows hourly rounding was documented
Correct answer: Acknowledge the patient's experience, assess current needs, and address the concern through appropriate channels
Validating the patient's experience and addressing their immediate needs while using proper channels for follow-up maintains trust and improves care quality.
Question 7: An orthopaedic nurse is caring for a patient who speaks limited English and is accompanied by a bilingual minor child. Consent for a procedure is needed. The nurse should:
- Allow the child to translate since the parent is present
- Contact the hospital's interpreter services or use a certified telephonic interpreter (Correct answer)
- Postpone the procedure until an adult interpreter is available in person
- Document that the patient consented using the child as interpreter
Correct answer: Contact the hospital's interpreter services or use a certified telephonic interpreter
Using a certified medical interpreter, including telephonic services, ensures accurate communication without placing the burden on a minor child.
Orthopaedic Nurse Test Communication & Stakeholder Relations 3
A patient with total hip replacement is being discharged and does not understand precaution instructions despite verbal teaching.
What is the next best step?