Exam 3

prevention of osteoporosis that includes maintaining optimal calcium intake and using estrogen replacement therapy is what kind of prevention?

Primary prevention

break in the continuity of the bone. is called?

fracture

what happen to tremors to pt wit PD during active movement?

tremors disappear with active movement in PD

separation of joint surfaces called?

dislocation

Which nursing action would help prevent deep vein thrombosis in a client who has had an orthopedic surgery? use cold packs Apply antiembolism stockings

-Apply antiembolism stockings Explanation: Applying antiembolism stockings helps prevent deep vein thrombosis (DVT) in a client who is immobilized due to orthopedic surgery. Regular administration of analgesics controls and prevents escalation of pain, while ROM exercises help maintain muscle strength and tone and prevent contractions. On the other hand, cold packs are applied to help reduce swelling; cold does not prevent deep vein thrombosis.

A client has just been diagnosed with Parkinson's disease. The nurse is teaching the client and family about dietary issues related to this diagnosis. Which of the following are risks for this client? Select all that apply. - Dysphagia - Anorexia - Choking -Constipation - fluid overload

Correct response: -Dysphagia -Choking -Constipation Explanation: Eating problems associated with Parkinson's disease include aspiration, choking, constipation, and dysphagia. Fluid overload and anorexia are not specifically related to Parkinson's disease.

Which nursing assessment finding indicates the client with traction has not met expected outcomes? and is a complication of traction?

calf warm and swollen Explanation: Deep vein thrombosis is a potential complication of the client immobilized by traction. calf tenderness, warmth, redness, and swelling of the affected extremity. deep vein thrombosis include calf tenderness, warmth, redness, and swelling of the affected extremity.

Assessment of cardiac and renal status would be priorities if the client experienced?

multiple fractures or had an open reduction.

Which term refers to the failure of fragments of a fractured bone to heal together? Malunion Nonunion

Correct response: Nonunion Explanation: When nonunion occurs, the client reports persistent discomfort and movement at the fracture site. Dislocation refers to the separation of joint surfaces. Subluxation refers to partial separation or dislocation of joint surfaces. Malunion refers to growth of the fragments of a fractured bone in a faulty position, forming an imperfect union.

Nausea and vomiting occurs in: open-angle glaucoma acute angle-closure glaucoma

acute angle-closure glaucoma

A fracture that occurs at an angle across the bone? An impacted fracture A transverse fracture An oblique fracture A spiral fracture

An oblique fracture

musculotendinous injury. is called?

strain

a fracture that is straight across the bone shaft. A transverse fracture A spiral fracture An oblique fracture An impacted fracture

A transverse fracture

Which nursing intervention is appropriate for minimizing muscle spasms in the client with a hip fracture?

Maintain Buck's traction. Explanation: Buck's traction decreases pain, muscle spasm, and external rotation by immobilizing the hip fracture.

Nursing assessment after a closed reduction would include checking for a sign of neurovascular complications. What is the indicator? Pain during movement Numbness or tingling

Numbness or tingling Neurovascular assessments are initially done every 15 minutes to make certain that blood supply has not been compromised and nerves are intact. Numbness and tingling may indicate nerve damage.

The nurse is educating a group of women on the prevention of osteoporosis. The nurse recognizes the education as being effective when the group members make which statement? "We need to increase aerobic exercise." "We need an adequate amount of exposure to sunshine."

"We need an adequate amount of exposure to sunshine." Explanation: The only accurate statement is related to getting an adequate amount of exposure to sunshine. Aerobic exercise, such as swimming, does not prevent osteoporosis. The exercise needs to be weight bearing. A diet low in calcium and high in phosphorus will increase the risk forosteoporosis. Estrogen deficiency is linked to decreased bone mass.

nurse is caring for a client who has a leg cast. The nurse observes that the client uses a pencil to scratch the skin under the edge of the cast. How should the nurse respond to this observation? -adm diphenhydramine -adm Benzodiazepines

-adm diphenhydramine Scratching should be discouraged because of the risk for skin breakdown or damage to the cast. Most clients can be discouraged from scratching if given a mild antihistamine, such as diphenhydramine, to relieve itching. Benzodiazepines would not be given for this purpose.

the nurse should initially perform neurovascular assessments a minimum of every------- minutes until stable in a client with a dislocation to assess for ------------------.

15 compartment syndrome

A fracture that twists around the shaft of the bone? An impacted fracture A transverse fracture A spiral fracture An oblique fracture

A spiral fracture

A nurse is caring for an elderly female client with osteoporosis. When teaching the client, the nurse should include information about which major complication? Loss of estrogen Bone fracture

Bone fracture Explanation: Bone fracture is a major complication of osteoporosis; it results when loss of calcium and phosphate increases the fragility of bones. Estrogen deficiencies result from menopause — not osteoporosis. Calcium and vitamin D supplements may be used to support normal bone metabolism, but a negative calcium balance isn't a complication of osteoporosis. Dowager's hump results from bone fractures. It develops when repeated vertebral fractures increase spinal curvature.

Which assessment findings would cause the nurse to suspect compartment syndrome after casting of the leg?

Complaints of numbness and tingling in toes of affected leg Explanation: Numbness and tingling indicate nerve ischemia and edema, suggesting development of compartment syndrome.

Following cataract removal, discharge instructions will be provided to the client. Which of the following instructions is most important? You Selected: Apply protective patch to both eyes at bedtime. Avoid any activity that can increase intraocular pressure.

Correct response: Avoid any activity that can increase intraocular pressure. Explanation: For approximately 1 week, the client should avoid any activity that can cause an increase in intraocular pressure. Clients may sleep on back or unaffected side. Clients may use a clean damp cloth to remove eye discharge and wash face. An eye shield is often ordered for the first 24 hours and during the night to prevent rubbing or trauma to the operative eye.

A nurse is providing care to a client with Parkinson's disease. The nurse understands the the client's signs and symptoms are related to a depletion of which of the following?

Dopamine Explanation: Parkinson's disease is associated with decreased levels of dopamine resulting from destruction of pigmented neuronal cells in the substantia nigra in the basal ganglion region. The loss of dopamine stores results in more excitatory neurotransmitters (acetylcholine) than inhibitory transmitters (dopamine). Serotonin and norepinephrine are not involved.

The nurse identifies the nursing diagnosis of deficient knowledge related to a new hearing aid for a client. After teaching a client about caring for his new hearing aid, the nurse determines that the outcome has been achieved when the client states which of the following? "I need to wipe the ear mold daily with a moist washcloth." "I need to keep my ear canal clean and dry."

I need to keep my ear canal clean and dry." Explanation: The client demonstrates understanding of the care of a hearing aid when stating the need to keep the ear canal clean and dry. The ear mold is the only part of the hearing aid that can be washed frequently, that is daily with soap and water. It should be allowed to dry completely before it is snapped into the receiver or inserted into the ear.

what can delay or prevent union? A short-term vitamin D deficiency VTE bleeding Inadequate fracture immobilization

Inadequate immobilization Explanation: Inadequate fracture immobilization can delay or prevent union. A short-term vitamin D deficiency would not likely prevent bone union. VTE is a serious complication but would not be a cause of nonunion. Similarly, bleeding would not likely delay union.

Which nursing diagnosis takes the highest priority for a client with parkinsonian crisis? Risk for injury Ineffective airway clearance Imbalanced nutrition: Less than body requirements mpaired urinary elimination

Ineffective airway clearance Explanation: In parkinsonian crisis, dopamine-related symptoms are severely exacerbated, virtually immobilizing the client. A client confined to bed during such a crisis is at risk for aspiration and pneumonia. Also, excessive drooling increases the risk of airway obstruction. Because of these concerns, the nursing diagnosis of Ineffective airway clearance takes the highest priority. Although Imbalanced nutrition: Less than body requirements, Impaired urinary elimination, and Risk for injury are also appropriate nursing diagnoses, they aren't immediately life-threatening. Reference:

Which medication is the most effective agent in the treatment of Parkinson disease?

Levodopa Explanation: Levodopa is the most effective agent and is the mainstay of treatment for Parkinson disease (PD). Benztropine, amantadine, and bromocriptine mesylate are utilized in the treatment of PD but are not the most effective.

A patient is participating in aural rehabilitation. The nurse understands that this type of training emphasizes which of the following? Functional skills Listening skills

Listening skills Explanation: Auditory training emphasizes listening skills, so the person who is hearing-impaired concentrates on the speaker.

Hearing aids help with which of the following problems? Improves understanding of speech Makes sounds louder eliminating background noise

Makes sounds louder Explanation: A hearing aid makes sounds louder, but it does not improve a patient's ability to discriminate words or understand speech. Hearing aids amplify all sounds, including background noise, which may be disturbing to the wearer. It does not improve communication skills.

The nurse is performing an assessment of the visual fields for a patient with glaucoma. When assessing the visual fields in acute glaucoma, what would the nurse expect to find?

Marked blurring of vision

Which condition is the leading cause of disability and pain in the elderly? RA SLE OA scleroderma

Osteoarthritis (OA) Explanation: OA is the leading cause of disability and pain in the elderly. RA, SLE, and scleroderma are not leading causes of disability and pain in the elderly.

Which nursing diagnosis is most appropriate for an elderly client with osteoarthritis?

Risk for injury related to altered mobility Explanation: Typically, a client with osteoarthritis has stiffness in large, weight-bearing joints, such as the hips. This joint stiffness alters functional ability and range of movement, placing the client at risk for falling and injury. Therefore, Risk for injury is the most appropriate nursing diagnosis. Impaired urinary elimination, Ineffective breathing patterns, and Imbalanced nutrition: Less than body requirements are incorrect because osteoarthritis doesn't affect urinary elimination, breathing, or nutrition.

You are admitting a 30-year-old who has a hearing impairment. The client is accompanied by family members. What information would be important to ask the family members to help you care for your client? The client's preferred method of communication when the client lost their hearing what allergies the client has how much the client weighs

The client's preferred method of communication Explanation: Some clients with hearing deficits learn sign language, a method for communication that uses a hand-spelled alphabet and word symbols. Clients also learn speech reading, also called lip reading. Knowing when the client lost their hearing, or what allergies the client has or how much the client weighs will not help you communicate, thereby, care for the client better.

A client diagnosed with Parkinson's disease has developed slurred speech and drooling. The nurse knows that these symptoms indicate which of the following? -The client is having an exacerbation. -The disease has entered the late stages.

The disease has entered the late stages. Explanation: In late stages, the disease affects the jaw, tongue, and larynx; speech is slurred; and chewing and swallowing become difficult. Rigidity can lead to contractures. Salivation increases, accompanied by drooling. In a small percentage of clients, the eyes roll upward or downward and stay there involuntarily (oculogyric crises) for several hours or even a few days. Options A, B, and C are therefore incorrect.

Tremors should decrease, or increase, with purposeful movement and sleep.

Tremors should decrease, not increase, with purposeful movement and sleep.

nursing diagnosis of self-care deficit with PD what's nursing intervention?

Using specialized utensils, feeding to foster a sense of greater independence and control with eating.

A client with a musculoskeletal injury is instructed to alter the diet. The objective of altering the diet is to facilitate the absorption of calcium from food and supplements. Considering the food intake objective, which food item should the nurse encourage the client to include in the diet? -Green vegetables -Vitamin D-fortified milk

Vitamin D-fortified milk Explanation: The nurse should advise the client to include dietary sources of vitamin D, such as fatty fish, vitamin D-fortified milk, and cereals. These foods protect against bone loss and decrease the risk of fracture by facilitating the absorption of calcium from food and supplements. Red meat, bananas, and green vegetables do not facilitate calcium absorption from food and supplements.

A client sustains an injury to the left ankle when he fell down three steps. There was immediate swelling and pain from the injury, and the client was taken to the local emergency department. What initial test does the nurse anticipate the physician will order to rule out a fracture? Arthrography X-ray CT scan arthroscopy

X-ray Explanation: X-rays may show a larger-than-usual joint space and rule out or confirm an accompanying fracture. Arthrography demonstrates asymmetry in the joint as a result of the damaged ligaments, or arthroscopy may disclose trauma in the joint capsule. A CT scan is costly and not used as a first-line diagnostic tool in the initial stage of an ankle injury.

There are a variety of problems that can become complications after a fracture. Which is described as a condition that occurs from interruption of the blood supply to the fracture fragments after which the bone tissue dies, most commonly in the femoral head?

avascular necrosis Explanation: Avascular necrosis is described as a condition that occurs from interruption of the blood supply to the fracture fragments after which the bone tissue dies, most commonly in the femoral head.

fracture involves a break through only part of the cross-section of the bone -comminuted -open fracture -oblique fracture -incomplete fracture

incomplete fracture

Osteoarthritis is known as a disease that: affects the cartilaginous joints is the most common and frequently disabling of joint disorders.

is the most common and frequently disabling of joint disorders. Explanation: The functional impact of osteoarthritis on quality of life, especially for elderly clients, is often ignored. Reiter syndrome is a spondyloarthropathy that affects young adult males and is characterized primarily by urethritis, arthritis, and conjunctivitis. Psoriatic arthritis, characterized by synovitis, polyarthritis, and spondylitis, requires early treatment because of early damage caused by disease. Ankylosing spondylitis affects the cartilaginous joints of the spine and surrounding tissues, making them rigid and decreasing mobility; it is usually diagnosed in the second or third decade of life.

The impaired balance and uncontrolled tremors of Parkinson's disease have been linked with ? low levels of Serotonin low levels of dopamine. low levels of norepinephrine

low levels of dopamine. Parkinson's disease is associated with decreased levels of dopamine resulting from destruction of pigmented neuronal cells in the substantia nigra in the basal ganglion region. The loss of dopamine stores results in more excitatory neurotransmitters (acetylcholine) than inhibitory transmitters (dopamine). Serotonin and norepinephrine are not involved.

fracture that runs across the bone at a diagonal angle of 45 to 60 degrees. -comminuted -open fracture -oblique fracture -incomplete fracture

oblique fracture

fracture that the skin or mucous membrane wound extends to the fractured bone. -comminuted -open fracture -oblique fracture -incomplete fracture

open fracture

Reduced peripheral vision, halos around lights, and blurred vision occur in: open-angle glaucoma acute angle-closure glaucoma

open-angle glaucoma

prevention of osteoporosis that includes ensuring adequate calcium and vitamin D intake is what kind of prevention?

primary prevention of osteoporosis

prevention of osteoporosis that includes placing items within a client's reach, using a professional alert system in the home, and installing grab bars in bathrooms to prevent fall is what kind of prevention?

secondary and tertiary prevention methods of prevention of osteoporosis

A client has had surgical repair of a hip injury after joint manipulation was unsuccessful. After surgery, the nurse implements measures to prevent complications. Which complications is the nurse seeking to prevent? Select all that apply.

skin breakdown wound infection pneumonia Explanation: After surgery, the nurse implements measures to prevent skin breakdown, wound infection, pneumonia, constipation, urinary retention, muscle atrophy, and contractures.

An older adult female has a bone density test that reveals severe osteoporosis. What does the nurse understand can be a problem for this client due to the decrease in bone mass and density? - Diabetes - Compression fractures

Compression fractures Explanation: In osteoporosis, loss of bone substance exceeds bone formation. The total bone mass and density is reduced, resulting in bones that become progressively porous, brittle, and fragile. Compression fractures of the vertebrae are common. Diabetes, hypertension, and cardiac disease may occur in response to the aging process but are not the result of osteoporosis.

A nurse is caring for a client who has a leg cast. The nurse observes that the client uses a pencil to scratch the skin under the edge of the cast. How should the nurse respond to this observation? -Obtain a prescription for a sedative, such as lorazepam, to prevent the client from scratching. - Encourage the client to avoid scratching, and obtain a prescription for an antihistamine if severe itching persists.

-Encourage the client to avoid scratching, and obtain a prescription for an antihistamine if severe itching persists. Explanation: Scratching should be discouraged because of the risk for skin breakdown or damage to the cast. Most clients can be discouraged from scratching if given a mild antihistamine, such as diphenhydramine, to relieve itching. Benzodiazepines would not be given for this purpose.

The nurse is caring for a client hospitalized after a motor vehicle accident. The client has a comorbidity of Parkinson's disease. Why should the nurse closely monitor the condition and the drug regimen of a client with Parkinson's disease? -drugs may not cause the requisite therapeutic effect -drugs may not cause the requisite therapeutic effect -drugs administered for Parkinsonism may cause a wide variety of adverse effects, which requires careful observation of the client.

Drugs administered for Parkinsonism may cause a wide variety of adverse effects, which requires careful observation of the client. Over time, clients may respond less and less to their standard drug therapy and have more frequent "off episodes" of hypomobility. As a result, the nurse should administer the drugs closely to the schedule. Generally, a single drug called levodopa is administered to clients with Parkinson's disease. It is also not true that drugs may not cause the requisite therapeutic effect or suchdrugs may not cause the requisite therapeutic effect

A client with Parkinson's disease has been receiving levodopa as treatment for the past 7 years. The client comes to the facility for an evaluation and the nurse observes facial grimacing, head bobbing, and smacking movements. The nurse interprets these findings as which of the following?

Dyskinesia Explanation: Most clients within 5 to 10 years of taking levodopa develop a response to the medication called dyskinesia, manifested as facial grimacing, rhythmic jerking movements of the hands, head bobbing, chewing and smacking movements, and involuntary movements of the trunk and extremities. Bradykinesia refers to an overall slowing of active movement and is a manifestation of the disorder. Micrographia refers to the development of small handwriting as dexterity declines with Parkinson's disease. Dysphonia refers to soft, slurred, low-pitched, and less audible speech that occurs as the disorder progresses.

A nurse is managing the care of a client with osteoarthritis. What is the appropriate treatment strategy the nurse will teach the about for osteoarthritis? Intra-articular injection Opioids administration of nonsteroidal anti-inflammatory drugs (NSAIDs) vigorous physical therapy

administration of nonsteroidal anti-inflammatory drugs (NSAIDs) Explanation: NSAIDs are routinely used for anti-inflammatory and analgesic effects. NSAIDs reduce inflammation, which causes pain. Opioids aren't used for pain control in osteoarthritis. Intra-articular injection of corticosteroids is used cautiously for an immediate, short-term effect when a joint is acutely inflamed. Normal joint range of motion and exercise (not vigorous physical therapy) are encouraged to maintain mobility and reduce joint stiffness.

Which nursing intervention is appropriate for a client with a closed-reduction extremity fracture? Promote intake of omega-3 fatty acids Encourage participation in ADLs

Encourage participation in ADLs Explanation: General nursing measures for a client with a fracture reduction include administering analgesics, providing comfort measures, encouraging participation with ADLs, promoting physical mobility, preventing infection, maintaining skin integrity, and preparing the client for self-care. Omega-3 fatty acids have no implications on the diet of a client with a fracture reduction. Dependent positioning may increase edema because the extremity is below the level of the heart. While some pain medications may contribute to constipation, this intervention would be reserved for a client experiencing constipation and not as a preventative measure.

An older female client who had a total hip replacement is to be discharged because her healing is almost complete. What would be most important for this client? educating her about the effects of menopause keep the affected limb elevated Exploring factors related to the client's home environment.

Exploring factors related to the client's home environment. Explanation: Exploring factors related to the older adult client's home environment and determining a plan for continued rehabilitation before discharge is most important. The client should be encouraged to eat foods rich in protein, calcium, and vitamin D. Since the healing is almost complete, the client need not always keep the affected limb elevated unless prescribed to do so. Since the client is in her late 60s, she is most likely to have already undergone menopause. Therefore, educating her about the effects of menopause is not as important.

A home care nurse makes a visit to a client with Parkinson's disease who is being cared for by his spouse. During the visit, the spouse says, "I'm just so tired. I have to do just about everything for him." Which response by the nurse would be most appropriate?

"You sound a bit overwhelmed. Tell me more about what's happening." Explanation: The spouse appears to be under considerable stress from living with and caring for the husband. Therefore, the nurse's response about being overwhelmed addresses the spouse's concerns and feelings. Telling the nurse about what is happening provides the spouse with an opportunity to verbalize her concerns and provides the nurse with additional information from which to identify areas where additional assistance may be needed. Telling the spouse that she is doing a great job ignores the spouse's feelings. Although the statement about it being difficult for the spouse may be true, it does not address the underlying issues related to the spouse's original statement. Asking the spouse if she is upset about her husband's condition may be appropriate, but it is a closed-ended question that would not allow the spouse to verbalize what she is feeling.

After undergoing surgery the previous day for a total knee replacement, a client states, "I am not ready to ambulate yet." What should the nurse do? - Document the client's refusal to ambulate. - Discuss the complications that the client may experience if there is lack of cooperation with the care plan.

-Discuss the complications that the client may experience if there is lack of cooperation with the care plan. Explanation: The nurse should discuss the care plan and its rationale with the client. Calling the health care provider to report the client's noncompliance won't alter the client's degree of participation and shouldn't be used to force the client to comply. Doing nothing isn't acceptable. Although the client does have the right to make choices, it's the nurse's responsibility to provide education to help the client make informed decisions. Although the nurse should ultimately document the client's refusal, the nurse should first discuss the care plan with the client.

A client sustains a fractured right humerus in an automobile accident. The arm is edematous, the client states that he cannot feel or move his fingers, and the nurse does not feel a pulse. What condition should the nurse be concerned about that requires emergency measures? Muscle spasms Compartment syndrome Subluxation The fractured humerus may also be dislocated

Compartment syndrome Explanation: Separation of adjacent bones from their articulating joint interferes with normal use and produces a distorted appearance. The injury may disrupt local blood supply to structures such as the joint cartilage, causing degeneration, chronic pain, and restricted movement. Compartment syndrome is a condition in which a structure such as a tendon or nerve is constricted in a confined space. The fractured humerus may also be dislocated but is not the result of the impaired circulatory status. Muscle spasms may occur around the fracture site but are not the cause of circulatory impairment. Subluxation is a partial dislocation.

Which of the following statements is accurate regarding osteoarthritis? It is the most common inflammatory arthritic disorder. It is a noninflammatory disorder and the most common and frequently disabling of joint disorders. overproduction of uric acid

Correct response: It is a noninflammatory disorder and the most common and frequently disabling of joint disorders. Explanation: Osteoarthritis (OA), also known as degenerative joint disease, is a chronic, noninflammatory (even though inflammation may be present), progressive disorder that causes cartilage deterioration in synovial joints and vertebrae. OA is the most common and most frequently disabling of the joint disorders that is overdiagnosed and trivialized and frequently over or undertreated. Aging is the risk factor most strongly correlated with OA. Gout is caused by an overproduction of uric acid. Rheumatoid arthritis is the most common inflammatory arthritic disorder.

The nurse identifies a nursing diagnosis of imbalanced nutrition, less than body requirements related to difficulty in chewing and swallowing for a client with Parkinson's disease. Which of the following would be most appropriate for the nurse to integrate into the client's plan of care? -Arrange for specialized utensils for the client to use when eating. -Encourage the client to massage the facial and neck muscles before eating.

Encourage the client to massage the facial and neck muscles before eating. Explanation: The client is having difficulty swallowing, which is interfering with nutritional intake. Therefore, the nurse should encourage the client to massage the facial and neck muscles before meals, sit in an upright position during meals, consume a semisolid diet with thick rather than thin liquids (which are easier to swallow), and think through the swallowing sequence. Raising the head of the bed 30 degrees is not high enough. Using specialized utensils would be more appropriate for a nursing diagnosis of self-care deficit, feeding to foster a sense of greater independence and control with eating.

A client with osteoarthritis expresses concerns that the disease will prevent the ability to complete daily chores. Which suggestion should the nurse offer? do chores in the morning "Pace yourself and rest frequently, especially after activities." do chores in the evening

"Pace yourself and rest frequently, especially after activities." Explanation: A client with osteoarthritis must adapt to this chronic and disabling disease, which causes deterioration of the joint cartilage. The most common symptom of the disease is deep, aching joint pain, particularly in the morning and after exercise and weight-bearing activities. Because rest usually relieves the pain, the nurse should instruct the client to rest frequently, especially after activities, and to pace oneself during daily activities. Telling the client to do chores in the morning is incorrect because the pain and stiffness of osteoarthritis are most pronounced in the morning. Telling the client to do all chores after performing morning exercises or in the evening is incorrect because the client should pace oneself and take frequent rests rather than doing all chores at once

Eating problems associated with Parkinson's disease include : -aspiration -choking -constipation -dysphagia -Fluid overload -anorexia

-aspiration -choking -constipation -dysphagia Eating problems associated with Parkinson's disease include aspiration, choking, constipation, and dysphagia. Fluid overload and anorexia are not specifically related to Parkinson's disease.

rapidly progressive and accompanied by pain, elevated IOP, corneal edema, and a pupil that is fixed in a semi-dilated position. The nurse knows that these clinical signs are diagnostic of the type of glaucoma known as:

Acute angle-closure. Explanation: Acute angle-closure glaucoma is characterized by the symptoms listed, as well as by being rapidly progressive and accompanied by pain.

An older adult client slipped on an area rug at home and fractured the left hip. The client is unable to have surgery immediately and is having severe pain. What interventions should the nurse provide for the patient to minimize energy loss in response to pain?

Administer prescribed analgesics around-the-clock. Explanation: Pain associated with hip fracture is severe and must be carefully managed with around-the-clock dosing of pain medication to minimize energy loss in response to pain. The client may not request the medication even if they are in pain, and it should be offered at the prescribed time. Give pain medication prior to providing any type of care involved in moving the client.

A client is transported to the emergency department for a femur fracture following a motor vehicle crash. What action by the nurse is the highest priority? Assess pedal pulses. Assess vital signs and level of consciousness.

Assess vital signs and level of consciousness. Explanation: Femur fractures can lead to hypovolemic shock due to blood loss in the tissue. By assessing the vital signs and level of consciousness, the nurse can assess for shock. Assessing the pedal pulses and measuring the diameter of the thigh are appropriate interventions for someone with a femur fracture, but assessing for hypovolemic shock would be a priority. Pain medication should be safely administered per orders to help control pain. Many pain medications lower blood pressure (BP). If the client is in shock, BP may be too low to administer the pain medication safely.

A client who has sustained a fracture reports an increase in pain and decreased function of the affected extremity. What will the nurse suspect? Pulmonary embolism Avascular necrosis

Avascular necrosis Avascular necrosis refers to the death of the bone from insufficient blood supply, typically manifested by complaints of increased pain and decreased function. Fever or redness, purulent drainage, and swelling of the site would suggest infection. Respiratory distress would suggest a pulmonary embolism. Changes in vital signs, level of consciousness, and signs and symptoms of fluid loss would suggest hypovolemic shock.

*Which topic is most important for the nurse to include in the teaching plan for a client newly diagnosed with Parkinson's disease? A) Involvement with diversion activities B) Maintaining a safe environment

B) Maintaining a safe environment The primary focus in caring for Parkinson's disease is on maintaining a safe environment. Parkinson's disease often has a propulsive gait, characterized by a tendency to take increasingly quicker steps while walking and an inability to stop abruptly without losing balance. Prevention of communicable diseases and establishing a balanced nutrition is encouraged with any chronic disorder. Diversional activities can be helpful in times of stress but not a priority.

Which term refers to a blunt force injury to soft tissue? dislocation strain Contusion fracture

Contusion Explanation: A contusion is blunt force injury to soft tissue. A dislocation is a separation of joint surfaces. A strain is a musculotendinous injury. A fracture is a break in the continuity of the bone.

calf is tender, warmth, red, and swelling of the affected extremity. in pt who's immobilized by traction. is a sign of?

Deep vein thrombosis is a potential complication of the client immobilized by traction.deep vein thrombosis include calf tenderness, warmth, redness, and swelling of the affected extremity.

Which type of fracture occurs when a bone fragment is driven into another bone fragment? A transverse fracture A spiral fracture An oblique fracture An impacted fracture

Impacted Explanation: An impacted fracture is one in which a bone fragment is driven into another bone fragment. An oblique fracture occurs at an angle across the bone. A spiral fracture is one that twists around the shaft of the bone. A transverse fracture is one that is straight across the bone shaft.

A client is admitted to the hospital with pneumonia. He has a history of Parkinson disease, which his family says is worsening. Which assessment should the nurse expect? -Tremors in the fingers that increase with purposeful movement -Impaired speech

Impaired speech Explanation: In Parkinson's disease, dysarthria, or impaired speech, results from a disturbance in muscle control. Muscle rigidity, not flaccidity, causes resistance to passive muscle stretching. The client may exhibit a masklike appearance rather than a pleasant and smiling demeanor. Tremors should decrease, not increase, with purposeful movement and sleep.

growth of the fragments of a fractured bone in a faulty position, forming an imperfect union.

Malunion

Which nursing diagnosis takes highest priority for a client with a compound fracture? Impaired physical mobility related to trauma Risk for infection related to effects of trauma

Risk for infection related to effects of trauma Explanation: A compound fracture involves an opening in the skin at the fracture site. Because the skin is the body's first line of defense against infection, any skin opening places the client at risk for infection. Imbalanced nutrition: Less than body requirements is rarely associated with fractures. Although Impaired physical mobility and Activity intolerance may be associated with any fracture, these nursing diagnoses don't take precedence because they aren't as life-threatening as infection.

Which of the following is the most important nursing diagnosis for an elderly patient diagnosed with osteoporosis? Acute pain related to fracture and muscle spasm Risk for injury related to fractures due to osteoporosis

Risk for injury related to fractures due to osteoporosis Explanation: The most important concern for an elderly patient with osteoporosis is prevention of falls and fractures. Pain and constipation can be managed, and knowledge can be reinforced, but fractures can cause significant morbidity and mortality.

A nurse advises a patient with a casted femur fracture to check for signs of a fat embolism. She tells the patient that the onset of symptoms for FES occur:

Within 12 to 48 hours. 1-2 days. Explanation: The onset of symptoms for a fat embolism is rapid, usually within 12 to 48 hours after injury, but may occur up to 10 days after injury.

A major role for nursing in the management of glaucoma is health education. Which of the following is the most important teaching point that the nurse should advise the patient of? a) Keep all follow-up appointments. b) Keep a record of eye pressure measurements. c) Adhere to the medication regimen. d) Participate in the decision-making process.

c) Adhere to the medication regimen. All of the teaching points are important but the most important is emphasizing the strict adherence to the medication regimen because glaucoma cannot be cured but its progression can be slowed.

A client with Parkinson's disease asks the nurse what their treatment is supposed to do since the disease is progressive. What would be the nurse's best response?

"Treatment aims at keeping you independent as long as possible." Explanation: Treatment aims at prolonging independence. Treatment does matter, it is not palliative, and it is not aimed at keeping you emotionally healthy.

The nurse identifies a nursing diagnosis of imbalanced nutrition, less than body requirements for pt with PD what's nursing intervention? Raising the head of the bed 30 degrees encourage the client to massage the facial and neck muscles before meals

- encourage the client to massage the facial and neck muscles before meals The client is having difficulty swallowing, which is interfering with nutritional intake. Therefore, the nurse should encourage the client to massage the facial and neck muscles before meals, sit in an upright position during meals, consume a semisolid diet with thick rather than thin liquids (which are easier to swallow), and think through the swallowing sequence. Raising the head of the bed 30 degrees is not high enough.

What intervention is a priority for a client diagnosed with osteoarthritis? Colchicine allopurinol Physical therapy and exercise Hydrotherapy

Physical therapy and exercise Clients with osteoarthritis need to maintain joint mobility. To preserve joint function, individuals need to learn appropriate activities. Colchicine and allopurinol are used for gout, not osteoarthritis. Hydrotherapy is not a priority for care.

When the client who has experienced trauma to an extremity reports severe burning pain, vasomotor changes, and muscles spasms in the injured extremity, the nurse recognizes that the client is likely demonstrating signs of avascular necrosis of bone. complex regional pain syndrome.

complex regional pain syndrome. Explanation: Complex regional pain syndrome is frequently chronic and occurs most often in women. Avascular necrosis is manifested by pain and limited movement. Pain and decreased function are the prime indicators of reaction to an internal fixation device. Heterotrophic ossification causes muscular pain and limited muscular contraction and movement.

To help minimize calcium loss from a hospitalized client's bones, the nurse should: provide the client dairy products at frequent intervals. encourage the client to walk in the hall.

encourage the client to walk in the hall. Explanation: Calcium absorption diminishes with reduced physical activity because of decreased bone stimulation. Therefore, encouraging the client to increase physical activity, such as by walking in the hall, helps minimize calcium loss. Turning or repositioning the client every 2 hours wouldn't increase activity sufficiently to minimize bone loss. Providing dairy products and supplemental feedings wouldn't lessen calcium loss — even if the dairy products and feedings contained extra calcium — because the additional calcium doesn't increase bone stimulation or osteoblast activity.

A client has been in a motor vehicle collision. Radiographs indicate a fractured humerus; the client is awaiting the casting of the upper extremity and admission to the orthopedic unit. What is the primary treatment for musculoskeletal trauma?

immobilization Explanation: Treatment of musculoskeletal trauma involves immobilization of the injured area until it has healed.

The nurse is completing a health history with a client in a clinic. What assessment finding best correlates with a diagnosis of osteoarthritis? Erythema joint stiffness that decreases with activity edema over the affected joint

joint stiffness that decreases with activity Explanation: A characteristic feature of osteoarthritis (degenerative joint disease) is joint stiffness that decreases with activity and movement. Erythema and edema over the affected joint, anorexia, weight loss, and fever and malaise are associated with rheumatoid arthritis, a more severe and destructive form of arthritis.

Which is a hallmark sign of compartment syndrome intensifies with passive range of motion?

pain

The nurse is performing a health history with a new client in the clinic. What is the most common reason for a client to seek medical attention for arthritis? weakness pain joint swelling

pain Explanation: The symptom that most commonly causes a person to seek medical attention is pain. Other common symptoms include joint swelling, limited movement, stiffness, weakness, and fatigue.

A client has been diagnosed with a muscle strain. What does the physician mean with the term "strain"? injury resulting from a blow or blunt trauma stretched or pulled beyond its capacity

stretched or pulled beyond its capacity Explanation: A strain is an injury to a muscle when it is stretched or pulled beyond its capacity.

A client is experiencing pain, joint instability, and difficulty walking due to an injury to the knee ligaments. The injury was judged not to require surgery. Which intervention would not be included in this client's care? NSAIDs Immobilization weight-bearing traction

traction Explanation: Joint immobilization, limited weight bearing, ice, and NSAIDs would be included in the initial treatment. Traction is not required because there is no break, and surgery is not required