Orthopaedic Nurse Test Risk Assessment & Management 2 — Questions and Answers
Question 1: A patient with a hip fracture has a Braden Scale score of 14. What does this indicate?
- No risk for pressure injury
- Mild risk for pressure injury (Correct answer)
- Moderate risk for pressure injury
- Severe risk for pressure injury
Correct answer: Mild risk for pressure injury
A Braden Scale score of 13–14 indicates mild risk for pressure injury development.
Question 2: Which lab value is MOST important to monitor when assessing DVT prophylaxis effectiveness in a patient receiving low-molecular-weight heparin?
- PT/INR
- Anti-Xa level (Correct answer)
- PTT
- Platelet count
Correct answer: Anti-Xa level
Anti-Xa levels are used to monitor the therapeutic effect of low-molecular-weight heparin.
Question 3: A post-operative total knee replacement patient suddenly develops tachycardia, hypoxia, and hypotension. What is the priority nursing action?
- Administer IV fluid bolus
- Notify the physician immediately
- Apply supplemental oxygen and call a rapid response (Correct answer)
- Reposition the patient to improve venous return
Correct answer: Apply supplemental oxygen and call a rapid response
These signs suggest pulmonary embolism; applying oxygen and activating rapid response is the priority action.
Question 4: Which patient is at HIGHEST risk for intraoperative and postoperative hemorrhage during orthopaedic surgery?
- A patient taking aspirin stopped 5 days ago
- A patient with a history of von Willebrand disease (Correct answer)
- A patient on metformin for type 2 diabetes
- A patient with controlled hypertension
Correct answer: A patient with a history of von Willebrand disease
Von Willebrand disease impairs platelet adhesion and clotting factor VIII activity, significantly increasing bleeding risk.
Question 5: The STOP-BANG tool is used preoperatively in orthopaedic patients to screen for which condition?
- Venous thromboembolism
- Obstructive sleep apnea (Correct answer)
- Chronic pain syndrome
- Postoperative delirium
Correct answer: Obstructive sleep apnea
The STOP-BANG questionnaire screens for obstructive sleep apnea, which increases anesthesia and airway risk.
Question 6: An orthopaedic patient develops acute confusion on postoperative day 2. Which assessment tool is MOST appropriate to use first?
- Glasgow Coma Scale
- Mini-Mental State Examination
- Confusion Assessment Method (CAM) (Correct answer)
- Montreal Cognitive Assessment
Correct answer: Confusion Assessment Method (CAM)
The CAM is a validated tool specifically designed to identify delirium in hospitalized patients.
Question 7: A patient undergoing revision total hip arthroplasty has a body mass index of 42. Which risk is MOST directly associated with obesity in this context?
- Increased risk of intraoperative hypothermia
- Increased risk of wound dehiscence and infection (Correct answer)
- Decreased risk of DVT due to immobility
- Reduced need for thromboprophylaxis
Correct answer: Increased risk of wound dehiscence and infection
Obesity increases surgical site infection risk and impairs wound healing due to poor tissue perfusion in adipose layers.
Orthopaedic Nurse Test Risk Assessment & Management 2
A patient with a hip fracture has a Braden Scale score of 14.
What does this indicate?