Orthopaedic Nurse Test Pharmacology & Pain Management 2

Question 1

A patient undergoing total knee replacement receives a femoral nerve block pre-operatively. The primary purpose of this regional anesthetic technique is to:

Accepted Answer

Provide postoperative analgesia and reduce opioid consumption

Answer

Prevent surgical site infection

Answer

Ensure complete intraoperative anesthesia without general anesthesia

Answer

Reduce intraoperative blood loss

Question 2

A physician orders a corticosteroid injection (triamcinolone) into an arthritic knee joint. Which post-injection instruction should the nurse provide?

Accepted Answer

Avoid weight-bearing on the joint for 24–48 hours

Answer

Ambulate vigorously to distribute the medication

Answer

Apply heat immediately to reduce local swelling

Answer

Take an antibiotic prophylactically for one week

Question 3

An orthopaedic patient is receiving warfarin for DVT treatment. Which laboratory value is the primary parameter used to monitor therapeutic anticoagulation?

Accepted Answer

International normalized ratio (INR)

Answer

Activated partial thromboplastin time (aPTT)

Answer

Platelet count

Answer

Anti-Xa level

Question 4

Gabapentin (Neurontin) is sometimes used as part of multimodal analgesia in orthopaedic surgery. Its primary mechanism of action is:

Accepted Answer

Binding to alpha-2-delta subunits of voltage-gated calcium channels

Answer

Inhibition of COX-1 and COX-2 enzymes

Answer

Antagonism of NMDA glutamate receptors

Answer

Mu-opioid receptor agonism

Question 5

Which condition is an absolute contraindication to the use of NSAIDs in an orthopaedic patient?

Accepted Answer

Severe renal impairment (CrCl < 30 mL/min)

Answer

Mild osteoarthritis

Answer

Chronic low back pain

Answer

Post-operative day 3 after hip replacement

Question 6

A patient on patient-controlled analgesia (PCA) asks why family members are not allowed to press the PCA button. The best nursing explanation is:

Accepted Answer

Only the patient can assess their own pain level, preventing overdose

Answer

The pump requires a special PIN that only the nurse knows

Answer

Family members may administer medication too slowly

Answer

Hospital policy prohibits it to reduce medication waste

Question 7

A surgeon orders prophylactic cefazolin 2 g IV for a patient undergoing spinal fusion. When should this antibiotic be administered to achieve optimal tissue levels?

Accepted Answer

Within 60 minutes before surgical incision

Answer

24 hours before the scheduled procedure

Answer

Immediately after the surgical incision is made

Answer

At the conclusion of the surgical procedure