class nclex & prep U (MS) Med Surg

A client presents to the emergency department gently holding the left arm, which is slightly swollen and painful to the touch. Based on these findings, the nurse: a) Elevates the arm and applies an ice pack b) Has the client perform active range of motion c) Elevates the arm and applies a heating pad d) Positions the arm below the level of the heart

a) Elevates the arm and applies an ice pack

A client with arterial insufficiency undergoes below-knee amputation of the right leg. Which action should the nurse include in the postoperative care plan? a) Elevating the stump for the first 24 hours b) Applying heat to the stump as the client desires c) Maintaining the client on complete bed rest d) Removing the pressure dressing after the first 8 hours

a) Elevating the stump for the first 24 hours

Elderly clients who fall are most at risk for which injuries? a) Pelvic fractures b) Humerus fractures c) Cervical spine fractures d) Wrist fractures

a) Pelvic fractures

Which nursing intervention is essential in caring for a client with compartment syndrome? a) Removing all external sources of pressure, such as clothing and jewelry b) Wrapping the affected extremity with a compression dressing to help decrease the swelling c) Keeping the affected extremity below the level of the heart d) Starting an I.V. line in the affected extremity in anticipation of venogram studies

a) Removing all external sources of pressure, such as clothing and jewelry

A client is diagnosed with osteomyelitis. This is most commonly caused by which of the following? a) Staphylococcus aureus b) Psuedomonas aeruginosa c) Proteus vulgaris d) Escherichia coli

a) Staphylococcus aureus

Instructions for the patient with low back pain include that when lifting the patient should a) avoid overreaching. b) bend the knees and loosen the abdominal muscles. c) use a narrow base of support. d) place the load away from the body.

a) avoid overreaching.

A physician diagnoses primary osteoporosis in a client who has lost bone mass. In this metabolic disorder, the rate of bone resorption accelerates while bone formation slows. Primary osteoporosis is most common in: a) elderly postmenopausal women. b) young children. c) elderly men. d) young menstruating women.

a) elderly postmenopausal women.

or a client with osteoporosis, the nurse should provide which dietary instruction? a) "Decrease your intake of popcorn, nuts, and seeds." b) "Eat more dairy products to increase your calcium intake." c) "Decrease your intake of red meat." d) "Eat more fruits to increase your potassium intake."

b) "Eat more dairy products to increase your calcium intake."

safety should the nurse include? a) "Most falls among the elderly occur outside the home. Clients should confine themselves to their homes as much as practical." b) "Most falls among the elderly occur in the home. These clients should remove throw rugs and install bathroom grab bars." c) "Because of the increase in home burglaries involving the elderly, these clients should have burglar bars on every window in the home." d) "Most accidental injuries among the elderly are automobile-related. Elderly clients should have vision testing every 6 months while they're still driving."

b) "Most falls among the elderly occur in the home. These clients should remove throw rugs and install bathroom grab bars."

Which assessment findings would cause the nurse to suspect compartment syndrome after casting of the leg? a) Warm, pink foot and ability to move toes of affected leg b) Complaints of numbness and tingling in toes of affected leg c) Low-grade fever, dyspnea, tachycardia, and crackles d) Increased capillary refill and bounding pulses in affected leg

b) Complaints of numbness and tingling in toes of affected leg

Which of the following clinical manifestations would the nurse expect to find in a client who has had osteoporosis for several years? a) Increased heel pain b) Decreased height c) Diarrhea d) Bone spurs

b) Decreased height

Which of the following are general nursing measures for a patient with a fracture reduction? a) Examining the abdomen for enlarged liver or spleen b) Encourage participation in ADLs c) Assisting with intake of immune-enhancing tube feeding formulas d) Promoting intake of omega-3 fatty acids

b) Encourage participation in ADLs

A client with a fracture develops compartment syndrome that requires surgical intervention. The nurse would most likely prepare the client for which of the following? a) Bone graft b) Fasciotomy c) Joint replacement d) Amputation

b) Fasciotomy

A 78-year-old client is in the emergency department following involvement in a motor-vehicle collision. Radiographs indicate a fractured humerus; the client is awaiting the casting of her upper extremity and admission to the orthopedic unit. What is the primary treatment for musculoskeletal trauma? a) Surgical repair b) Immobilization c) Enhancing complications d) External rotation

b) Immobilization

When caring for a client with a fracture, assessment of which of the following would be the priority? a) Hormonal imbalances b) Neurovascular compromise c) Altered kidney function d) Cardiac problems

b) Neurovascular compromise

The nurse recognizes that goal of treatment for metastatic bone cancer is to: a) Diagnose the extent of bone damage b) Promote pain relief and quality of life c) Reconstruct the bone with a prosthesis d) Cure the diseased bone and cartilage

b) Promote pain relief and quality of life

A male client, an ace professional tennis player, sprains his right ankle during a tennis match. The client is immediately rushed to the nurse who provides him with first-aid care. Which of the following would the nurse immediately provide? a) Rest, heat, compression, and elevation b) Rest, ice, compression, and elevation c) Heat, compression, analgesics, and exercise d) Exercise, ice, compression, and elevation

b) Rest, ice, compression, and elevation

A male client is to have an amputation. He is acutely ill and diagnosed with a gangrenous limb and related fever, disorientation, and electrolyte imbalances. Which of the following would be most important for the nurse to monitor in this client? a) Reduced urine output b) Signs of sepsis c) Signs of nausea and vomiting d) Occurrence of allergic reactions

b) Signs of sepsis

The nurse teaches the patient with a high risk for osteoporosis about risk-lowering strategies including which of the following actions? a) Decrease the intake of vitamin A and D b) Walk or perform weight-bearing exercises outdoors c) Increase fiber in the diet d) Reduce stress

b) Walk or perform weight-bearing exercises outdoors

The client with a fractured left humerus reports dyspnea and chest pain. Pulse oximetry is 88%. Temperature is 100.2 degrees Fahrenheit (38.5 degrees Centigrade); heart rate is 110 beats per minute; respiratory rate is 32 breaths per minute. The nurse suspects the client is experiencing: a) Delayed union b) Complex regional pain sydrome c) Fat embolism syndrome d) Compartment syndrome

c) Fat embolism syndrome

Which assessment findings would the nurse expect in a client diagnosed with osteomyelitis? a) Pruritus and uremic frost b) Petechiae over the chest and abnormal ABGs c) Leukocytosis and localized bone pain d) Thrombocytopenia and ecchymosis

c) Leukocytosis and localized bone pain

When joint manipulation is unsuccessful for a client, he is taken to surgery for surgical repair of his hip injury. He is brought to the ICU where you practice nursing for postoperative recovery. In addition to the regular assessments prescribed by policy, what assessment is completed every 30 minutes for several hours? a) Orientation b) Neurological c) Neurovascular d) Head-to-toe

c) Neurovascular

A nurse is caring for a client who underwent a total hip replacement. What should the nurse and other caregivers do to prevent dislocation of the new prosthesis? a) Use measures other than turning to prevent pressure ulcers. b) Keep the hip flexed by placing pillows under the client's knee. c) Prevent internal rotation of the affected leg. d) Keep the affected leg in a position of adduction.

c) Prevent internal rotation of the affected leg.

Primary prevention of osteoporosis includes: a) installing grab bars in the bathroom to prevent falls. b) using a professional alert system in the home in case a client falls when she's alone. c) placing items within the client's reach. d) optimal calcium intake and estrogen replacement therapy.

d) optimal calcium intake and estrogen replacement therapy.

The nurse is caring for a client with skeletal traction. It is important that the nurse monitor which of the following? A. The pin site for unusual redness, swelling, purulent drainage, and foul odor. B. The distance between the client's hip and the traction. C. The number of times the client exercises the affected limb. D. How the client is coping with immobilization.

A. The pin site for unusual redness, swelling, purulent drainage, and foul odor.

To assess the neurologic status in a patient with a fractured humerus, the nurse asks the patient to A. Evert, invert, dorsiflex, and plantar flex the foot B. Abduct, adduct, and oppose the fingers, and pronate and supinate the hand C. Assess the location, quality, and intensity of pain below the site of the injury D. Assess the color, temperature, capillary refill, peripheral pulses, and presence of edema in the extremity

B. Abduct, adduct, and oppose the fingers, and pronate and supinate the hand

Following laminectomy (back) surgery, the nurse should turn and reposition the client by doing which of the following? A. Having the client use the side rails of the bed. B. Elevating the head of the bed 45 degrees, then turning the legs together toward the floor, bending at the waist. C. Logrolling the client as a unit, keeping the body in proper alignment. D. Turning the client's head and shoulders then hips.

C. Logrolling the client as a unit, keeping the body in proper alignment.

A patient with a fractured tibia accompanied by extensive soft tissue damage initially has a splint applied and held in place with an elastic bandage. An early sign that would alert the nurse that the patient is developing compartment syndrome is A. Paralysis of the toes B. Absence of peripheral pulses C. Progressive pain unrelieved by usual analgesics D. The skin over the injury site is blanched when the bandage is removed

C. Progressive pain unrelieved by usual analgesics

The nurse receives a client with a hip spica cast that is not completely dry. When turning the client, the nurse uses the palms and not the fingertips. The nurse chooses this technique for which of the following purposes? A. To speed-dry the cast B. To decrease pain from moving C. To prevent damage to the cast D. To prevent swelling

C. To prevent damage to the cast

A 78 year old woman has a physiologic change related to aging in her joints. An appropriate nursing diagnosis related to common changes of aging in the musculoskeletal system is Fatigue Risk for falls Self-care deficit Risk for impaired skin integrity

Risk for falls

A client undergoes a total hip replacement. Which statement made by the client indicates to the nurse that the client requires further teaching? a) "I don't know if I'll be able to get off that low toilet seat at home by myself." b) "I'll need to keep several pillows between my legs at night." c) "I need to remember not to cross my legs. It's such a habit." d) "The occupational therapist is showing me how to use a sock puller to help me get dressed."

a) "I don't know if I'll be able to get off that low toilet seat at home by myself."

Two days after surgery to amputate his left lower leg, a client states that he has pain in the missing extremity. Which action by the nurse is most appropriate? a) Administer medication, as ordered, for the reported discomfort. b) Initiate a consult with a psychologist. c) Do nothing because it isn't possible to have pain in a missing limb. d) Contact the physician.

a) Administer medication, as ordered, for the reported discomfort.

A client is admitted with acute osteomyelitis that developed after an open fracture of the right femur. When planning this client's care, the nurse should anticipate which measure? a) Withholding all oral intake b) Administering large doses of oral antibiotics as ordered c) Administering large doses of I.V. antibiotics as ordered d) Instructing the client to ambulate twice daily

c) Administering large doses of I.V. antibiotics as ordered

A nurse is inspecting the area of contusion and notes numerous areas of bruising. The nurse would document this finding as which of the following? a) Whiplash injury b) Callus c) Ecchymosis d) Palsy

c) Ecchymosis

A client has sustained a right tibial fracture and has just had a cast applied. Which instruction should the nurse provide in his cast care? a) "Cover the cast with a blanket until the cast dries." b) "A foul smell from the cast is normal." c) "Use a knitting needle to scratch itches inside the cast." d) "Keep your right leg elevated above heart level."

d) "Keep your right leg elevated above heart level."

Which nursing intervention is appropriate for minimizing muscle spasms in the client with a hip fracture? a) Assist the client with use of a trapeze. b) Maintain the internal fixator. c) Apply a soft compression dressing. d) Maintain Buck's traction.

d) Maintain Buck's traction.

Which of the following is a hallmark sign of compartment syndrome? a) Edema b) Motor weakness c) Weeping skin surfaces d) Pain

d) Pain

A client with low back pain is being seen in the clinic. In planning care, which teaching point should the nurse include? a) Sleep on the stomach to alleviate pressure on the back. b) Avoid twisting and flexion activities. c) A soft mattress is most supportive by conforming to the body. d) Use the large muscles of the leg when lifting items.

d) Use the large muscles of the leg when lifting items.