Orthopaedic Nurse Test Pharmacology & Pain Management 3

Question 1

A patient with a hip fracture has an epidural catheter for pain management. The nurse notes hypotension and lower extremity weakness. What is the most appropriate initial nursing action?

Accepted Answer

Stop the epidural infusion and notify the provider

Answer

Increase the epidural infusion rate

Answer

Administer a bolus of the epidural medication

Answer

Reposition the patient to the prone position

Question 2

Calcium carbonate and vitamin D3 supplements are prescribed for an orthopaedic patient post-vertebral fracture. For optimal calcium absorption, calcium carbonate should be taken:

Accepted Answer

With meals or immediately after eating

Answer

On an empty stomach one hour before meals

Answer

At bedtime with a large glass of water

Answer

Two hours after taking any other medication

Question 3

Which food or drug interaction is most clinically significant for a patient taking warfarin after orthopaedic surgery?

Accepted Answer

Vitamin K-rich foods (e.g., leafy greens) can reduce warfarin's effect

Answer

Grapefruit juice increases warfarin clearance, reducing anticoagulation

Answer

High-protein diets increase warfarin absorption and risk of bleeding

Answer

Calcium supplements potentiate warfarin and increase bleeding risk

Question 4

Which non-pharmacological pain management strategy is considered first-line complementary care for acute post-operative orthopaedic pain?

Accepted Answer

Cryotherapy (ice application) to reduce swelling and pain

Answer

Therapeutic massage over the surgical incision site

Answer

Transcutaneous electrical nerve stimulation (TENS) at the incision

Answer

Guided imagery and progressive muscle relaxation alone

Question 5

Tramadol (Ultram) is prescribed for a patient with moderate orthopaedic pain. The nurse should be aware that tramadol carries a risk of:

Accepted Answer

Seizures, especially when combined with serotonergic drugs

Answer

Severe hepatotoxicity at standard doses

Answer

Irreversible bone marrow suppression

Answer

Acute angle-closure glaucoma

Question 6

Colchicine is ordered for a patient admitted with acute gout affecting the first metatarsophalangeal joint. The nurse should monitor for which common adverse effect?

Accepted Answer

Diarrhea, nausea, and vomiting

Answer

Hyperkalemia and bradycardia

Answer

Urinary retention and dry mouth

Answer

Hypertension and peripheral edema

Question 7

A patient with rheumatoid arthritis and a recent orthopaedic procedure is on long-term methotrexate therapy. Which laboratory monitoring is essential before continuing methotrexate?

Accepted Answer

Complete blood count (CBC) and liver function tests (LFTs)

Answer

Serum creatinine and blood urea nitrogen only

Answer

Serum calcium and phosphorus levels

Answer

Thyroid-stimulating hormone (TSH) and free T4