Orthopaedic Nurse Test Ultimate Orthopaedic Nurse 2 — Questions and Answers
Question 1: A patient returns from total hip arthroplasty. Which position is MOST important to maintain to prevent dislocation with a posterior approach?
- Hip flexion greater than 90 degrees
- Hip adduction past midline
- Hip abduction with neutral rotation (Correct answer)
- Internal rotation of the operative hip
Correct answer: Hip abduction with neutral rotation
After posterior approach THA, the hip must be kept abducted with neutral or slight external rotation to prevent posterior dislocation.
Question 2: Which laboratory value is MOST critical to monitor in a patient receiving anticoagulation therapy after orthopaedic surgery?
- Serum creatinine
- Hemoglobin A1c
- International Normalized Ratio (INR) (Correct answer)
- Serum albumin
Correct answer: International Normalized Ratio (INR)
INR reflects the degree of anticoagulation with warfarin and must be monitored closely to prevent bleeding or clot formation.
Question 3: A patient with a long leg cast reports intense pain, pallor, and pulselessness in the foot. The nurse's FIRST action should be:
- Administer prescribed analgesics and reassess in 30 minutes
- Elevate the limb above heart level
- Notify the surgeon immediately (Correct answer)
- Apply a warm compress to improve circulation
Correct answer: Notify the surgeon immediately
Signs of acute compartment syndrome or vascular compromise require immediate surgical notification as this is a limb-threatening emergency.
Question 4: Which of the following BEST describes the purpose of continuous passive motion (CPM) after total knee arthroplasty?
- Prevent deep vein thrombosis
- Reduce postoperative swelling only
- Promote joint mobility and prevent adhesions (Correct answer)
- Strengthen quadriceps muscles
Correct answer: Promote joint mobility and prevent adhesions
CPM maintains range of motion and prevents fibrous adhesions in the joint while the patient is recovering from TKA.
Question 5: A patient with a hip fracture is placed in Buck's traction preoperatively. The PRIMARY purpose is to:
- Achieve definitive fracture reduction
- Prevent foot drop
- Reduce muscle spasm and maintain alignment (Correct answer)
- Increase venous return
Correct answer: Reduce muscle spasm and maintain alignment
Buck's traction reduces painful muscle spasm and maintains limb alignment until surgical repair can be performed.
Question 6: When educating a patient discharged with a new below-knee cast, the nurse emphasizes contacting the provider if the patient notices:
- Mild itching under the cast
- Slight warmth over the cast for the first 24 hours
- Drainage that soaks through and expands on the cast (Correct answer)
- Minor swelling of the toes
Correct answer: Drainage that soaks through and expands on the cast
Expanding wound drainage (strike-through) indicates significant bleeding or infection requiring immediate evaluation.
Question 7: A nurse is caring for a patient with osteomyelitis. Which assessment finding MOST strongly suggests the infection is worsening?
- ESR trending down over three days
- White blood cell count of 9,500/mm³
- Increasing erythema and warmth at the site with fever spike (Correct answer)
- Patient reports pain as 4/10 stable for two days
Correct answer: Increasing erythema and warmth at the site with fever spike
Worsening local signs of inflammation combined with a new fever spike indicate failure of infection control and potential abscess formation.
Orthopaedic Nurse Test Ultimate Orthopaedic Nurse 2
A patient returns from total hip arthroplasty.
Which position is MOST important to maintain to prevent dislocation with a posterior approach?