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This article has been approved by the Orthopaedic Nurses Certification Board for Category A credit toward recertification as an ONC.


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GENERAL PURPOSE: To present health care providers with essential information about discharge readiness following total knee replacement surgery (TKR).


LEARNING OBJECTIVES/OUTCOMES: After completing this continuing education activity, you should be able to:


1. Discuss components of discharge readiness following TKR.


2. Summarize potential complications after TKR that may lead to hospital readmission and further functional declines.



1. Patients at high risk for in-hospital falls are those who


a. have surgery at large urban hospitals.


b. are female.


c. are older.


2. Hamel and colleagues reported that patients undergoing total hip and total knee replacement need about how many days to return to independence with housework?


a. 38


b. 49


c. 60


3. Stockwell and colleagues found that, at 12 months after knee replacement, 28% of patients still perceived that they were not able to complete which of the following?


a. kneeling on their surgical lower extremity


b. fully flexing their surgical lower extremity


c. fully extending their surgical lower extremity


4. Multiple sources report that the main causes of readmission after TKR are infection, deep vein thrombosis, and


a. falls.


b. arthrofibrosis.


c. unrelieved pain.


5. The risk for readmission after TKR is increased for patients who


a. are male.


b. had a shorter hospital stay.


c. have a history of transient ischemic attacks.


6. Clarke and colleagues have linked preoperative education to reducing the incidence of which of the following occurrences in-hospital after TKR?


a. falls


b. infection


c. deep vein thrombosis


7. When Ingadottir and colleagues compared patients' knowledge expectations prior to TKR with what they received in preoperative education, they found that their expectations


a. were lower than the education they received.


b. matched the education they received.


c. exceeded the education they received.


8. According to Matassi and colleagues, the strongest predictor of range of motion (ROM) after surgery is


a. ROM before surgery.


b. analgesia prior to postoperative ROM.


c. education about the importance of ROM.


9. Dorsey and Bradshaw reported that including which of the following in perioperative care for TKR resulted in reduced length of stay (LOS) and increased health-related quality of life scores?


a. physical therapy


b. occupational therapy


c. strong social support


10. Johnson and colleagues and others reported that family members and patients have expressed feeling which of the following about changes in their social roles following total joint replacement?


a. motivated


b. challenged


c. overwhelmed


11. Compared with the readmission rates among patients who are discharged to home from the acute care setting, those who require inpatient rehabilitation after TKR have rates that are


a. higher.


b. about the same.


c. lower.


12. When Chan and colleagues compared continuous femoral nerve blocks (cFNB) to a single-dose femoral nerve block (FNB), they found no statistically significant differences in which of the following outcomes?


a. degrees of flexion


b. pain relief


c. LOS


13. According to Chan and colleagues, patients who received which of the following had the lowest odds of achieving 90 degrees of knee flexion on their surgical lower extremity?


a. patient-controlled analgesia (PCA) alone


b. cFNB plus PCA


c. FNB plus PCA


14. When Kirkness and colleagues compared local infiltration analgesia (LIA) to cFNB, they found a statistically significant improvement in which of the following outcomes with LIA?


a. pain management


b. average walking distance


c. rehabilitation requirement


15. Otten and Dunn reported the best pain control with which of the following therapies?


a. adductor canal block (ACB)


b. FNB


c. LIA plus ACB


16. Schwarzkopf and colleagues and others reported that which of the following groups is most likely to be discharged to home after TKR rather than to a non-home setting after surgery?


a. females


b. younger patients


c. African-Americans


17. According to Gong and Dong, which of the following personality traits predisposes patients to responding negatively to setbacks such as pain or weakness during exercise after surgery?


a. anxious


b. cautious


c. analytical


18. An increased LOS and a slower functional recovery following TKR are common among patients who are


a. male.


b. obese.


c. extroverted.