Orthopaedic Nurse Test Risk Assessment & Management 3 — Questions and Answers
Question 1: Which complication is MOST closely associated with tourniquet use during orthopaedic limb surgery?
- Compartment syndrome and nerve injury (Correct answer)
- Arterial thrombosis only
- Venous air embolism
- Fat embolism syndrome
Correct answer: Compartment syndrome and nerve injury
Prolonged tourniquet use can cause compartment syndrome and pressure-related nerve injury distal to the cuff.
Question 2: A nurse notes that a patient's cast on their forearm feels tight and the patient reports numbness. What is the FIRST priority action?
- Elevate the extremity and reassess in one hour
- Administer prescribed analgesics and document
- Notify the provider immediately for cast bivalving or removal (Correct answer)
- Apply ice over the cast to reduce swelling
Correct answer: Notify the provider immediately for cast bivalving or removal
Numbness and tightness in a casted extremity suggest impending compartment syndrome requiring immediate intervention.
Question 3: Which scoring tool is commonly used in orthopaedic settings to assess a patient's fall risk?
- Morse Fall Scale (Correct answer)
- Ottawa Ankle Rules
- Harris Hip Score
- FRAX Tool
Correct answer: Morse Fall Scale
The Morse Fall Scale is a widely used, validated tool to assess fall risk in hospitalized patients.
Question 4: A patient with a femur fracture develops sudden onset of petechiae, respiratory distress, and confusion 48 hours post-injury. The nurse should suspect:
- Pulmonary embolism
- Fat embolism syndrome (Correct answer)
- Hypovolemic shock
- Anaphylactic reaction to contrast dye
Correct answer: Fat embolism syndrome
The classic triad of petechiae, respiratory distress, and neurological changes within 72 hours of long bone fracture indicates fat embolism syndrome.
Question 5: When using the Wells Score for DVT in an orthopaedic patient, which finding INCREASES the pretest probability?
- Bilateral calf tenderness
- Alternative diagnosis equally likely
- Pitting edema confined to the symptomatic leg (Correct answer)
- Normal CBC results
Correct answer: Pitting edema confined to the symptomatic leg
Pitting edema localized to the symptomatic leg is a positive criterion on the Wells DVT score.
Question 6: What is the primary purpose of sequential compression devices (SCDs) in post-operative orthopaedic patients?
- Reduce post-operative pain
- Prevent deep vein thrombosis by improving venous return (Correct answer)
- Decrease peripheral edema from fluid resuscitation
- Maintain limb temperature and perfusion
Correct answer: Prevent deep vein thrombosis by improving venous return
SCDs apply intermittent pneumatic compression to the legs to simulate muscle pump action and prevent venous stasis.
Question 7: A nurse assessing a post-operative spinal fusion patient notices the patient cannot dorsiflex their right foot. This finding MOST likely indicates:
- Normal post-anesthesia motor block
- Damage to the common peroneal nerve (Correct answer)
- Inadequate pain control causing guarding
- Compartment syndrome of the thigh
Correct answer: Damage to the common peroneal nerve
Inability to dorsiflex the foot (foot drop) indicates common peroneal nerve injury or compression.
Orthopaedic Nurse Test Risk Assessment & Management 3
Which complication is MOST closely associated with tourniquet use during orthopaedic limb surgery?