NCLEX CRUSADE ACADEMY TEST - 2 USE OF CASTS, SPLINTS, BRACES AND TRACTIONS

1. A patient with a newly applied forearm cast reports severe pain not relieved by analgesics. What is the nurses priority action?. Elevate the limb and reassess in 2 hours. Administer additional pain medication. Immediately notify the provider for possible compartment syndrome. Apply ice directly over the cast.

2. Which assessment finding represents an early sign of neurovascular compromise in a casted extremity?. Paralysis. Paresthesia. Pulselessness. Cool skin.

3. The nurse evaluates a patient using the '6 Ps' of neurovascular assessment. Which finding indicates a late and severe sign?. Pain. Pallor. Paralysis. Paresthesia.

4. Which immobilization device is most appropriate during the acute phase of injury when swelling is expected?. Cast. Brace. Splint. External fixation.

5. What is the primary purpose of braces during orthopedic rehabilitation?. Allow swelling. Provide structural support with controlled movement. Completely immobilize the joint. Replace surgical fixation.

6. A nurse is caring for a patient in skeletal traction. Which action is appropriate?. Adjust the weights when the patient complains of pain. Ensure weights hang freely at all times. Remove traction weights during repositioning. Place weights on the floor during patient transfer.

7. Which statement about skin traction is correct?. It involves surgical insertion of pins. It is used primarily for long term fracture management. It is non invasive and typically short term. It requires anesthesia for application.

8. Which complication is most associated with prolonged immobilization?. Hyperglycemia. Deep vein thrombosis. Hyperthyroidism. Pneumonia caused by bacteria.

9. A patient in traction should not have which intervention performed by the nurse?. Neurovascular assessment. Pin site care. Adjustment of traction weights. Skin assessment.

10. A patient with a forearm cast reports numbness and tingling in the fingers. What is the nurses priority action?. Encourage finger movement. Document the finding. Assess circulation and notify provider. Apply warm compress.

11. The R.I.C.E protocol for soft tissue injury includes which components?. Rest, Immobilization, Compression, Elevation. Rest, Ice, Compression, Elevation. Rest, Ice, Circulation, Exercise. Rest, Ice, Cast, Elevation.

12. A patient reports calf pain while immobilized in traction. Which complication should the nurse suspect?. Osteomyelitis. Deep vein thrombosis. Hypokalemia. Pneumonia.

13. What is the most appropriate nursing intervention to prevent atelectasis in immobilized patients?. Fluid restriction. Incentive spirometry and deep breathing. Strict bed rest. Oxygen therapy continuously.

14. Which sign suggests compartment syndrome?. Increased appetite. Severe unrelieved pain. Bradycardia. Increased urine output.

15. Which condition is considered a spinal emergency requiring immediate surgical decompression?. Herniated disc. Spinal stenosis. Cauda equina syndrome. Scoliosis.

16. A patient with suspected cauda equina syndrome may present with which symptom?. Bladder or bowel incontinence. Mild localized back pain. Fever and cough. Increased appetite.

17. Which is a priority nursing assessment for patients in traction?. Dietary intake. Neurovascular status. Sleep patterns. Emotional coping.

18. A halo sign observed on a surgical dressing indicates what complication?. Infection. Hemorrhage. Cerebrospinal fluid leak. Allergic reaction.

19. What is the purpose of pin care in skeletal traction?. Prevent infection. Increase bone density. Promote circulation. Reduce swelling.

20. Which patient symptom most strongly indicates osteomyelitis?. Fever and elevated WBC with bone pain. Mild swelling after exercise. Shortness of breath. Chest pain.