Deck 17: Traction, cast Care, and Immobilization Devices

Question 1

The patient receives a plaster cast for an ulnar fracture.What would the nurse expect to see on the first day after cast application?

A) The fingers are slightly edematous.
B) The fingers are cool, pale, and dry.
C) The fingertips blanch slowly.
D) Skin is bulging over the cast edge.

Answer 1

The fingers are slightly edematous.

Question 2

The nurse is assisting with the application of a long arm plaster cast.Which action should the nurse take for this patient?

A) Apply an ice pack along the top of the cast.
B) Handle the wet cast with the fingertips.
C) Maintain the extremity below the heart level.
D) Fold the stockinette over the outer edge of the cast.

Answer 2

Fold the stockinette over the outer edge of the cast.

Question 3

The nurse provides teaching for the family of a 5-year-old patient who has a one-and-a-half hip spica cast.Which of the following recommendations should the nurse include in patient teaching?

A) The patient can sit in a chair with a dry cast if propped carefully.
B) Large casts dry from the outside to the inside.
C) Several people are needed to safely turn and move the patient.
D) Turn and position the patient with the abduction bar.

Answer 3

Several people are needed to safely turn and move the patient.

Question 4

A patient with fractures of the femur and pelvis is restless and has a heart rate of 112 and a respiratory rate of 28.What actions should the nurse take?

A) Notify the healthcare provider and check vital signs.
B) Restrict physical activity and elevate the head of the bed.
C) Reposition the patient and administer pain medication.
D) Listen to the lung sounds and give a muscle relaxant.

Question 5

The nurse completes patient teaching about synthetic cast care at home.What does the nurse instruct the patient to report about the cast?

A) If it becomes dry and stiff
B) Any softening of the cast
C) If the exterior becomes soiled
D) If the exterior feels rough

Question 6

The nurse is preparing an 11-year-old patient to have a synthetic cast placed on the arm after a fracture.What question should the nurse include to promote the child's acceptance of the cast?

A) "Are you right or left handed?"
B) "Would you like a green or a blue cast?"
C) "How do you usually do in school?"
D) "Do you like to play sports after school?"

Question 7

The nurse is caring for a patient who is in skeletal traction for a femoral fracture and notes that patient assessment data include dyspnea,hypoxia,petechial rash on chest,and hypotension.Which should the nurse implement?

A) Initiate emergency treatment measures and call the healthcare provider at once.
B) Medicate the patient for severe pain and reevaluate in 30 minutes.
C) Place the patient in semi-Fowler's position and listen to bowel sounds.
D) Review the list of patient medications and ask about any coughing.

Question 8

The nurse assesses a patient 22 hours after skeletal traction was applied to the femur.Which clinical finding is inconsistent with the patient's baseline data but acceptable to the nurse?

A) A decreased sensation in the affected foot
B) An increase in patient anxiety after procedure
C) Lower leg pallor with a weaker pedal pulse
D) A small amount of clear drainage from the pin sites

Question 9

The nurse assesses the traction boot for a proper fit.Which observation by the nurse verifies that the patient has a properly fitting Buck's traction boot?

A) The heel rests firmly on the inner heel padding of the boot.
B) The leg slips out of the boot after applying weight.
C) The pain level increases from a level of 6 to 7 on a scale of 10.
D) The traction boot fits snugly without pressure points.

Question 10

The nurse provides discharge patient teaching for a patient with an external skeletal fixation device on a leg fracture.What does the nurse include in patient teaching?

A) Increase your intake of vitamins and red meat to heal the bone more quickly.
B) Notify the healthcare provider if there is a change in the color of the pin site drainage.
C) Cleanse the pin site once in the morning and before bed with mild soap and water.
D) Increase the speed at which you ambulate around the house to prepare for increased physical activity.

Question 11

The patient asks what to expect immediately after removal of a long leg cast.What is the most accurate response by the nurse?

A) "The skin will look smooth and moist."
B) "You will be able to stand on both legs easily."
C) "Your joints will have full range of motion."
D) "The skin will be dry and scaly but intact."

Question 12

The patient tells the nurse that the top of the plaster cast feels rough and is scratching the skin.Which intervention should the nurse implement?

A) Explain that this is an expected outcome.
B) Trim away sharp areas and edge with tape.
C) Medicate the patient with a prescribed analgesic.
D) Speak with the healthcare provider about a cast change.

Question 13

The nurse plans care for a patient who has just received a prescription for a leg brace and crutches.Which of the following is the nurse's priority in the patient's plan of care?

A) Assisting the patient to a supine position to apply the leg brace
B) Asking which device the patient prefers and uses most often
C) Determining patient experience with a leg brace and crutches
D) Assessing how the leg brace affects ambulation with crutches

Question 14

The nurse is teaching a patient about pin site care.Which of the following should the nurse include in patient teaching for self-care at home?

A) Use a new sterile applicator for each pin.
B) Wrap the pins with sterile gauze saturated in an antibiotic.
C) Use a new clean swab for each pin site.
D) Use cotton swabs with hydrogen peroxide to clean the pins.

Question 15

The parent of a 4-year-old patient with bilateral leg splints calls the office nurse and reports that the child is "more restless than usual,and I've found the splint straps partially loosened." Which response by the nurse is most appropriate?

A) "Orthotic devices provide needed support."
B) "Manufacturers use flexible materials for comfort of the splints."
C) "Check the skin around the splints."
D) "Bring the child in for us to see either today or tomorrow."

Question 16

The nurse prepares to place the patient in skin traction.Which is the nurse's main concern before applying the skin traction?

A) Obtain informed consent from patient.
B) Verify that the patient assessment is complete.
C) Prepare a sterile field for pin insertion.
D) Assemble the overhead frame and pulleys.

Question 17

During the removal of a synthetic cast to the lower leg,the patient complains of heat inside the cast.Which response by the nurse is most appropriate to the patient?

A) "Do you feel some heat inside the cast?"
B) "The heat that you feel inside the cast is expected."
C) "What is your pain level on a scale of 0 to 10?"
D) "The heat that you feel will dissipate by tomorrow."

Question 18

A patient complains of a slight tingling in the toes of the affected leg 2 hours after the application of Buck's traction with a foam boot with Velcro straps.Which nursing intervention will prevent potential complications related to the patient complaint?

A) Apply warm blankets to the feet and reassess.
B) Check the fit of the traction device near the knee.
C) Medicate the patient for pain with an opioid analgesic.
D) Reassure the patient that this is a common complaint.

Question 19

A 5-year-old child comes to the healthcare provider for cast removal.Which of the following should the nurse implement to minimize the child's fears of the cast saw?

A) Premedicate with an opioid analgesic.
B) Encourage the caregiver to leave the room.
C) Instruct the caregiver to avoid restraint.
D) Show that the saw does not cut into skin.

Question 20

The patient is in Buck's traction for a fractured femur.What should the nurse do to minimize any muscle spasms of the affected leg?

A) Apply traction gradually, gently, and completely.
B) Assess the affected leg with the "four Ps" criterion.
C) Eliminate potential pressure points from the traction.
D) Ensure unobstructed countertraction to the patient's pelvis.

Question 21

The nurse is preparing for the initial placement of an orthotic device onto the patient's lower leg.Which of the following is the priority nursing intervention?

A) Instruct the patient how to care for the orthotic device.
B) Provide patient teaching before ending the visit.
C) Ensure that the orthotic device is free of patient clothing.
D) Obtain a baseline observation of the affected skin area.

Question 22

During assessment of an African-American patient,the nurse notes that the fingernails on the hand casted in plaster are an ashen-gray color.What information should the nurse collect next?

A) Whether the patient is experiencing numbness or tingling in the affected hand
B) How pink the fingernails were before the application of the cast
C) Whether the patient has an allergy to latex or medications
D) The color of the toenail beds for a comparison

Question 23

The nurse is preparing to help with removal of a long arm plaster cast.What information should the nurse include in patient preparation for plaster cast removal?

A) "Stretch your arm and wrist as soon as the cast is removed."
B) "I'll get a nail brush to help remove dead cells from your skin."
C) "This is the enzyme wash we'll use to remove dead skin cells."
D) "The cast saw causes a little discomfort and a burning sensation."

Question 24

1. The first sign that a neurovascular deficit is developing in a patient who is immobilized in a traction device after a fracture is ___________on passive range of motion.

Question 25

The nurse is instructing nursing assistant personnel (NAP)about caring for a patient with bilateral plaster long leg casts.Which activity can the nurse delegate to NAP?

A) Use a warm blow dryer to assist in drying the cast faster.
B) Hold the bed linens away from the patient's cast until it is dry.
C) Position the patient's legs above his or her heart level.
D) Teach the patient how to identify potential indicators of infection.

Question 26

The patient is complaining of increasing pain several hours after a cast was applied for a severe lower leg injury.What actions should the nurse implement after giving additional pain medication with no relief?

A) Call the physician and order a cast saw to the bedside.
B) Elevate the leg as high as possible and put ice on the cast.
C) Administer half of a dose of additional pain medication and check vital signs.
D) Try to distract the patient and have nursing assistive personnel (NAP) stay with him or her.

Question 27

2. The nurse is performing pin site care using evidence-based guidelines.Those guidelines recommend using __________ solution to clean the pin sites.

Question 28

The nurse is preparing a patient for discharge after application of a plaster cast.What information does the nurse include in the patient teaching?

A) Report any changes in sensation or mobility.
B) Use a cool blow dryer to dry a wet cast.
C) Use only soft objects to scratch inside the cast.
D) Trim the cast if the skin becomes irritated.

Question 29

The nurse is assisting an adolescent female with a Milwaukee back brace for treatment of scoliosis.Nursing care is correct if the nurse takes which action?

A) Has the patient take a Betadine shower before the brace is placed
B) Removes any wrinkles from the patient's thin cotton shirt under the brace
C) Asks the patient when her menstrual period is next due
D) Instructs the patient on how to loosen the brace for comfort

Question 30

A patient with Buck's traction complains of increased pain after the traction is applied and pain medication is given.After loosening the traction slightly,the nurse assesses the extremity and can find nothing wrong,although the patient is still complaining of pain at a level of 4 on a scale of 0 to 10.What action should the nurse initiate next?

A) Notify the healthcare provider.
B) Administer additional pain medication.
C) Explain that an x-ray film of the leg might be taken.
D) Have the patient describe the pain in detail.