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

Hypotension from sympathetic blockade and motor weakness from local anesthetic spread are serious epidural complications requiring immediate cessation of the infusion and provider notification.

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

Calcium carbonate requires gastric acid for dissolution and absorption; taking it with food stimulates acid secretion, significantly enhancing bioavailability.

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

Vitamin K is a cofactor for clotting factor synthesis and directly antagonizes warfarin's mechanism, so large or inconsistent intake of vitamin K-rich foods destabilizes INR control.

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

Cryotherapy reduces local edema, slows nerve conduction, and decreases metabolic activity at the surgical site, providing effective non-opioid analgesic benefit.

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

Tramadol lowers the seizure threshold and inhibits serotonin reuptake; combining it with SSRIs, SNRIs, or other serotonergic agents raises the risk of seizures and serotonin syndrome.

Orthopaedic Nurse Test Practice Test

Orthopaedic Nurse Test Practice Test

Orthopaedic Nurse Test Pharmacology & Pain Management 3