Exam 6: Ch. 38 & 40 Musculoskeletal

During medication teaching, the patient asks the nurse, "Why are nonsteroidal anti-inflammatory agents used to treat rheumatoid arthritis?" Which response by the nurse is accurate? -To reduce inflammation -To reduce joint destruction -To alter the course of the disease -To slow the progression of bone erosion

To reduce inflammation

A patient with gout asks, "Why is my blood being examined for uric acid?" What should the nurse respond to this patient? -"We are testing to see why you have that big bruise on your hip." -"A uric acid test is done to diagnose rheumatoid arthritis." -"It will help us determine if you have inherited a familial muscle disease." -"A uric acid test is done to see if your gout medication is effective."

"A uric acid test is done to see if your gout medication is effective."

A patient with backpain is prescribed an MRI. In which way should the nurse explain this diagnostic test? -"An MRI uses radio waves and magnetic fields to see the bone and muscle structures of the spine." -"An MRI is an x-ray of the neck to find out what is causing your pain." -"An MRI is a test of the muscles in the back." -"An MRI is a test of the blood flow to the back."

"An MRI uses radio waves and magnetic fields to see the bone and muscle structures of the spine."

The nurse is assessing muscle strength. What should the nurse ask the patient to do to assess jaw muscle strength? (Select all that apply.) "Clench your teeth." "Stick out your tongue." "Close your eyes tightly." "Bend your head forward." "Blow out your cheeks."

"Clench your teeth." "Stick out your tongue."

A patient has a serum calcium level of 8.0 mg/dL. Which question should the nurse include in the assessment? -"How many servings of dairy products do you consume per day?" -"What activities do you perform during a typical work day?" -"Are you currently experiencing any pain and, if so, what is your pain level?" -"Have you ever been diagnosed with an infection in your bones?"

"How many servings of dairy products do you consume per day?"

The family of a patient with an alteration in mobility asks what can be done to prevent injuries. Which should the nurse respond? "Pick up all the throw rugs." "Keep the lights turned down low." "Encourage the patient to stay active." "Encourage the patient to learn something new."

"Pick up all the throw rugs."

A patient is scheduled for an arthrocentesis. Which information should the nurse provide the patient about this procedure? -"This test is done to determine if you possibly have an infection." -"This test is done to determine the electrical activity of the muscle." -"This test is done to analyze the electrical activity of the joint." -"This test is done to see if you have carpal tunnel syndrome."

"This test is done to determine if you possibly have an infection."

The nurse is teaching the family of a patient with an alteration of mobility how to protect the patient from injury. Which instruction about the patient's environment is appropriate for the nurse to include? -"Watch for slip hazards like loose carpets on the floor." -"Keep the lights turned down low." -"Avoid helping the patient do things they can do for themselves." -"Encourage the patient to learn something new."

"Watch for slip hazards like loose carpets on the floor."

A patient taking a nonsteroidal anti-inflammatory drug (NSAID) for osteoarthritis reports stomach upset when taking the medication. Which information should the nurse provide? -"Take the medication with food or milk." -"Discontinue the medication immediately." -"Decrease the dose of the NSAID." -"Take the medication first thing in the morning."

-"Take the medication with food or milk."

The nurse is caring for a patient with systemic lupus erythematosus (SLE) who is hospitalized during an exacerbation. The patient is receiving cytotoxic and antineoplastic medications. Which is the nurse's priority goal for this patient? -Preventing infections -Maximizing mobility -Providing psychological support -Assisting with pain management

-Preventing infections

The nurse is reviewing laboratory values for a patient with an acute attack of gout. Which laboratory value should the nurse expect to be increased? (Select all that apply.) -WBC -Creatinine -Hematocrit -Alkaline phosphatase -Sed rate

-WBC -Creatinine -Sed rate

A client is being discharged to home after application of a plaster leg cast. Which statement indicates that the client understands proper care of the cast? 1. "I need to avoid getting the cast wet." 2. "I need to cover the casted leg with warm blankets." 3. "I need to use my fingertips to lift and move my leg." 4. "I need to use something like a padded coat hanger end to scratch under the cast if it itches."

1. "I need to avoid getting the cast wet."

The nurse has given the client instructions about crutch safety. Which statements indicate that the client understands the instructions? Select all that apply. 1. "I should not use someone else's crutches." 2. "I need to remove any scatter rugs at home." 3. "I can use crutch tips even when they are wet." 4. "I need to have spare crutches and tips available." 5. "When I'm using the crutches, my arms need to be completely straight."

1. "I should not use someone else's crutches." 2. "I need to remove any scatter rugs at home." 4. "I need to have spare crutches and tips available."

A client being measured for crutches asks the nurse why the crutches cannot rest up underneath the arm for extra support. The nurse responds knowing that which would most likely result from this improper crutch measurement? 1. A fall and further injury 2. Injury to the brachial plexus nerves 3. Skin breakdown in the area of the axilla 4. Impaired range of motion while the client ambulates

2. Injury to the brachial plexus nerves

The nurse is caring for a client with a diagnosis of gout. Which laboratory value would the nurse expect to note in the client? 1. Calcium level of 9.0 mg/dL (2.25 mmol/L) 2. Uric acid level of 9.0 mg/dL (540 mcmol/L) 3. Potassium level of 4.1 mEq/L (4.1 mmol/L) 4. Phosphorus level of 3.1 mg/dL (1.0 mmol/L)

2. Uric acid level of 9.0 mg/dL (540 mcmol/L)

A client is complaining of low back pain that radiates down the left posterior thigh. The nurse should ask the client if the pain is worsened or aggravated by which factor? 1. Bed rest 2. Ibuprofen 3. Bending or lifting 4. Application of heat

3. Bending or lifting

A client has sustained a closed fracture and has just had a cast applied to the affected arm. The client is complaining of intense pain. The nurse elevates the limb, applies an ice bag, and administers an analgesic, with little relief. Which problem may be causing this pain? 1. Infection under the cast 2. The anxiety of the client 3. Impaired tissue perfusion 4. The recent occurrence of the fracture

3. Impaired tissue perfusion

The nurse has given instructions to a client returning home after knee arthroscopy. Which statement by the client indicates that the instructions are understood? 1. "I can resume regular exercise tomorrow." 2. "I can't eat food for the remainder of the day." 3. "I need to stay off the leg entirely for the rest of the day." 4. "I need to report a fever or swelling to my health care provider."

4. "I need to report a fever or swelling to my health care provider."

The nurse is conducting health screening for osteoporosis. Which client is at greatest risk of developing this problem? 1. A 25-year-old woman who runs 2. A 36-year-old man who has asthma 3. A 70-year-old man who consumes excess alcohol 4. A sedentary 65-year-old woman who smokes cigarettes

4. A sedentary 65-year-old woman who smokes cigarettes

A client with a hip fracture asks the nurse about Buck's (extension) traction that is being applied before surgery and what is involved. The nurse should provide which information to the client? 1. Allows bony healing to begin before surgery and involves pins and screws 2. Provides rigid immobilization of the fracture site and involves pulleys and wheels 3.Lengthens the fractured leg to prevent severing of blood vessels and involves pins and screws 4. Provides comfort by reducing muscle spasms, provides fracture immobilization, and involves pulleys and wheels

4. Provides comfort by reducing muscle spasms, provides fracture immobilization, and involves pulleys and wheels

A client with diabetes mellitus has had a right below-knee amputation. Given the client's history of diabetes mellitus, which complication is the client at most risk for after surgery? 1. Hemorrhage 2. Edema of the residual limb 3. Slight redness of the incision 4. Separation of the wound edges

4. Separation of the wound edges

The nurse suspects that a patient who reports joint stiffness and swelling of the finger joints may have osteoarthritis. Which diagnostic test should the nurse anticipate will be ordered? X-ray of the joint Joint fluid analysis CT scan Sedimentation rate

X-ray of the joint

During an assessment the nurse asks the patient to move an extremity away from the body midline. The nurse would document the patient's ability to make which movement? Flexion Extension Abduction Adduction

Abduction

The nurse is presenting issues related to alterations in mobility with a group of community members. Which major risk factor should the nurse include? Aging Gender Genetics Fluid level

Aging

A patient is diagnosed with an exacerbation of gout of the left foot. Which medication should the nurse expect to be prescribed? Colchicine (Colcrys) Alendronate (Fosamax) Sulfasalazine (Azulfidine) Calcitriol (Rocaltrol)

Colchicine (Colcrys)

The nurse hears a grating sound while assessing range of motion of a patient's hip. How should the nurse document this finding? Crackles Arthritis Synovitis Crepitation

Crepitation

The nurse reviews the results of a patient's laboratory tests. Which result should indicate to the nurse that the patient requires vitamin D supplements? Decreased phosphorous Presence of human leukocyte antigen-B27 (HLA-B27) Decreased creatine kinase Increased uric acid

Decreased phosphorous

A patient is suspected of having a spinal cord injury. Which test should the nurse expect to be prescribed to determine electrical activity of the patient's muscles? Electromyogram (EMG) Spinal x-rays MRI of the spine CT of the spine

Electromyogram (EMG)

The nurse is preparing a teaching session for community members on osteoporosis and osteomalacia. What should the nurse include as a potential complication for both health problems? Infection Fractures Blood clots Contractures

Fractures

While conducting a health history for a patient with rheumatoid arthritis, the nurse learns that the patient takes aspirin for inflammation and pain. Which medication side effect should the nurse assess in the patient? GI bleeding Stomatitis Bone marrow depression Eye and vision problems

GI bleeding

A patient recently diagnosed with osteoarthritis participates in high-impact aerobics, cycling, swimming, and low-impact muscle-strengthening exercises. Which activity should the nurse encourage the patient to stop? -High-impact aerobic exercises -Cycling -Low-impact muscle strengthening -Swimming

High-impact aerobic exercises

The nurse is preparing a teaching tool about the types of joints in the body. Which area should the nurse identify as a synovial joint? Hip Vertebrae Sternum Skull

Hip

A patient has a fracture of a bone responsible for red bone marrow. For which bone fracture should the nurse plan care for this patient? Humerus Vertebrae Skull Wrist

Humerus

A patient has a history of temporomandibular joint (TMJ) syndrome. Which area should the nurse palpate for tenderness? -In front of the ear -At the sternoclavicular joint -Proximal to the acromioclavicular joint -Over the carotid pulses

In front of the ear

A patient seeks medical attention for an alteration in extension of the elbow joint. Which should the nurse expect to assess in this patient? Inability to straighten the arm Inability to bend the arm Inability move the arm towards the midline Inability to move the arm away from the midline

Inability to straighten the arm

A patient it diagnosed with bursitis. Which joint should the nurse expect to be affected? Knee Wrist Vertebrae Symphysis pubis

Knee

A patient reports fatigue after using the arms for routine activities. Which substance should the nurse explain is responsible for the fatigue? Lactic acid Calcium Sodium Acetylcholine

Lactic acid

The nurse is caring for a patient with an epiphyseal fracture. What bone classification should the nurse keep in mind when planning this patient's care? Flat Long Short Irregular

Long

A patient has a history of scoliosis. Which assessment technique should be used to confirm this health problem? Measure leg length Perform hip flexion Compress ulnar nerve Curl toes downward

Measure leg length

A patient with lordosis is experiencing back pain. Which should the nurse suspect is contributing to this patient's discomfort? Obesity Osteoporosis Osteoarthritis Autoimmune disorder

Obesity

The nurse prepares to assess a patient with altered mobility. Which assessment should the nurse complete first? -Observe as the patient walks across the room. -Observe the patient eat a meal. -Observe the patient interact with family. -Observe the patient get undressed.

Observe as the patient walks across the room.

The nurse is assessing the musculoskeletal system of an older female patient. Which disorder should the nurse consider? Osteoporosis Synovitis Carpal tunnel syndrome Lumbar back pain

Osteoporosis

The nurse is preparing to assess a patient's musculoskeletal system. What should the nurse keep in mind as being the most common manifestations of musculoskeletal disorders? (Select all that apply.) Pain Cyanosis Decreased pulses Exaggerated reflexes Limited mobility

Pain Limited mobility

The nurse is teaching a patient about rheumatoid arthritis (RA). Which clinical term that is defined as abnormal tissue leading to joint damage and immobilization should the nurse include? Pannus Uveitis Pleurodesis Synovial membrane

Pannus

The nurse palpates boggy, spongelike areas over a patient's both wrists. Which condition should the nurse suspect in the patient? Rheumatoid arthritis Psoriatic arthritis Osteoarthritis Paget disease

Rheumatoid arthritis

A patient is being treated for injuries after a motor vehicle crash. Which bone should the nurse identify as irregular? Scapula Rib Femur Tibia

Scapula

During the physical assessment of a young adult, the nurse notes a lateral, S-shaped curve of the spine. What should the nurse suspect is occurring with this patient? Lordosis Scoliosis Kyphosis Musculosis

Scoliosis

Which term should be used to describe this spinal deformity? Scoliosis Herniated disc Lordosis Kyphosis

Scoliosis

The nurse finds discoid lesions and a butterfly rash on the patient's skin during an assessment and suspects that the patient has systemic lupus erythematosus (SLE). Which additional finding should the nurse inspect in the patient? Splinter hemorrhages Diffuse vesicles Seborrheic dermatitis Tinea corporis

Splinter hemorrhages

A patient reports tenderness when the area in front of the ear is palpated. Which health problem should the nurse suspect? Temporomandibular joint (TMJ) syndrome Degenerative joint disease Lateral epicondylitis Carpal tunnel syndrome

Temporomandibular joint (TMJ) syndrome

The community nurse is preparing a presentation on Lyme disease for community members. What should the nurse explain about the spread of the organism for this disease? -The bite of an infected mosquito -Brief contact with an infected tick -An infected tick embedded for over 24 hours -Primarily by droplets from infected people

-An infected tick embedded for over 24 hours

A patient diagnosed with rheumatoid arthritis (RA) tells the nurse, "I am sick of taking medications, and they don't always work well anyway. Are there any other treatments that I can use to treat my RA?" Which nonpharmacologic treatment should the nurse recommend? -Application of heat or cold packs -Jogging to relieve pain and maintain mobility -Wearing a copper bracelet to reduce pain and swelling -Weightlifting to improve joint strength

-Application of heat or cold packs

During an assessment the nurse determines that a patient with knee pain is at risk for osteoarthritis. What did the nurse assess in this patient? -Having a history of falls -Eating a diet high in calcium -Walking 30 minutes each day -Being overweight by 30 pounds

-Being overweight by 30 pounds

Which health problem is least likely to be linked to the development of osteoporosis? -Bone injuries from sports in youth -Chronic kidney disease -Family history of osteoporosis -Use of anticonvulsants

-Bone injuries from sports in youth

A patient is scheduled for an electromyogram. What should the nurse instruct the patient to do in preparation for this diagnostic test? (Select all that apply.) -Do not smoke for 3 hours before the test. -Avoid taking muscle relaxants before the test. -Avoid taking oral hypoglycemic agents before the test. -Alert the healthcare provider about an allergy to shellfish. -Avoid fluids containing caffeine for 3 hours before the test.

-Do not smoke for 3 hours before the test. -Avoid taking muscle relaxants before the test. -Avoid fluids containing caffeine for 3 hours before the test.

While assessing posture and gait, the nurse notes the patient has a flattened lumbar spine. Which should the nurse suspect is occuring with this patient? -Herniated lumbar disc -Bulging cervical disc -Displaced thoracic disc -Lordosis

-Herniated lumbar disc

The nurse is assessing the wrist mobility of a patient. For which finding should the nurse be concerned? -Maximum flexion of 45 degrees -Maximum extension of 70 degrees -Maximum radial deviation of 20 degrees -Maximum ulnar deviation of 55 degrees

-Maximum flexion of 45 degrees

The nurse is preparing teaching for a patient with mild osteoarthritis of the knees. Which medication treatments should the nurse include in these instructions? (Select all that apply.) -Opioids -NSAIDs -Hormones -Antibiotics -Hyaluronic acid

-NSAIDs -Hyaluronic acid

The nurse identifies that a patient with systemic lupus erythematosus has ineffective protection. Which intervention is priority when caring for this patient? -Monitor laboratory findings. -Provide appropriate skin care. -Practice careful hand hygiene. -Administer prescribed medications.

-Practice careful hand hygiene.

The nurse assesses a patient with a history of rheumatoid arthritis (RA). Which finding should the nurse expect to observe? -Progressive joint stiffness and deformation -Cool, hard, bony joints -Intermittent joint pain, mostly in the great toe -Multiple joints and organs being affected and having high fever and rheumatoid rash

-Progressive joint stiffness and deformation

A patient tells the nurse, "My osteoarthritis is beginning to interfere with my ability to work despite adhering to my current treatment plan." Which collaborative or independent action should the nurse perform? -Refer the patient to occupational therapy -Ask the provider to prescribe an MRI -Refer the patient for a surgical consult -Encourage the patient to increase the use of over-the-counter analgesics

-Refer the patient to occupational therapy

The nurse prepares to assess a patient experiencing manifestations of fibromyalgia. What manifestation should the nurse expect the patient to exhibit? -Stabbing or burning pain in the neck, spine, and shoulders -Crushing pain located in the chest and left arm -Pain and stiffness that are worse in the evening -Inflamed, reddened joints

-Stabbing or burning pain in the neck, spine, and shoulders

An older female patient takes calcium supplements to prevent the development of osteoporosis. Which additional recommendation should the nurse make to this patient? -Engage in weight-bearing exercise -Avoid extreme activities -Rest between activities -Limit the intake of dairy products

Engage in weight-bearing exercise

The nurse prepares an educational program on bone health for a community health fair. Which information should the nurse include? Exercise regularly Consume a low-fat diet Sleep 8 hours each night Avoid stressful situations

Exercise regularly

A patient is unable to straighten the right arm at the elbow joint. Which should the nurse document about this finding? -Extension of the right elbow limited -Flexion of the right elbow limited -Adduction of the right elbow limited -Abduction of the right elbow limited

Extension of the right elbow limited

A patient is scheduled for an electromyogram (EMG). Which should the nurse explain about this test? -"It measures the electrical activity of the muscles at rest and during contraction. " -"It is used to determine the level of the spinal cord that is damaged." -"It is used to examine diseased structures in the spinal cord." -"It identifies fractured vertebrae."

"It measures the electrical activity of the muscles at rest and during contraction. "

A patient with newly diagnosed rheumatoid arthritis asks how the disease is treated. Which response should the nurse make to this patient? -"Disease-modifying antirheumatic drugs are used to relieve disease-related symptoms." -"There are medications to help with the pain, but there are no medications to slow disease progression." -"It is best to focus on rest and therapy to help stop disease progression." -"Heat therapy will help to relieve the pain and will help improve mobility."

-"Disease-modifying antirheumatic drugs are used to relieve disease-related symptoms."

The nurse is performing an assessment on a patient diagnosed with rheumatoid arthritis (RA) who complains of joint pain and stiffness. Which symptoms reported by the patient should the nurse consider to be inconsistent with the clinical manifestations of RA? -"I have trouble with walking because of pain. When I am finally done with my morning chores and sit down, my knees get so stiff I can hardly get up after I rested." -"I am in so much pain in the morning! It is very hard for me to get out of bed and start my day. I can hardly move my legs; my knees feel like they are frozen." -"Whenever my disease gets worse, my joints get red, hot, and swollen." -"I am just tired all the time and feel very weak."

-"I have trouble with walking because of pain. When I am finally done with my morning chores and sit down, my knees get so stiff I can hardly get up after I rested."

The nurse is providing care for a patient diagnosed with rheumatoid arthritis (RA). Which patient statement about methods to relieve pain would require intervention by the nurse? -"I take my NSAID 1 hour before breakfast." -"I have a plan to balance rest with activity." -"I find that sometimes cold packs work and sometimes warm packs work to ease the pain." -"I found a great splint for my wrists that eases the pain."

-"I take my NSAID 1 hour before breakfast."

A patient is receiving antineoplastic medication to treat active systemic lupus erythematosus (SLE). Which statement by the nurse supports the priority goal for this patient? -"I will review hand hygiene techniques with the patient." -"I will encourage the patient to increase the oral fluid intake." -"I will provide the patient instructions on oral care." -"I will use bedside lighting in the room and avoid fluorescent lighting."

-"I will review hand hygiene techniques with the patient."

The nurse is evaluating a patient's response to treatment for back pain. Which patient statement reflects a successful outcome of the treatment regimen? -"My pain is decreasing, and I am able to walk for 30 minutes each day." -"I am in less pain but am not able to stand for long periods of time." -"I am unable to bend down to feed my cat." -"I am having tingling in my left leg."

-"My pain is decreasing, and I am able to walk for 30 minutes each day."

The nurse suspects that a patient experiencing neck, back, and hip pain, despite having an active lifestyle, has fibromyalgia. How should the nurse expect the patient to describe the pain and fatigue? -"Pain is exacerbated by disrupted sleep." -"Pain and fatigue are greatest in the early evening." -"There is no identifiable pattern with the pain and fatigue." -"Tiredness and pain ease after light activity."

-"Pain is exacerbated by disrupted sleep."

A patient diagnosed with osteoarthritis asks the nurse why there is so much joint pain. Which response by the nurse is accurate? -"The bones are rubbing against each other and irritating the synovial tissue." -"Ligaments that stabilize the joint degenerate, leading to instability and pain." -"The skeletal muscles traveling across the joint are stretched too far by inflammation." -"Inflammation of the connective tissue decreases flexibility of the joint."

-"The bones are rubbing against each other and irritating the synovial tissue."

A patient diagnosed with osteoporosis asks, "How can I prevent this disease from progressing?" Which response by the nurse provides the patient with important dietary information to prevent the osteoporosis from progressing? -"To help prevent further progression of the disease, it is important for you to increase your calcium intake." -"An increase in dietary intake of foods rich in vitamins A and E will help slow down the disease progression." -"Increasing your dietary intake of animal protein will help slow the progression of your osteoporosis." -"Foods high in dietary zinc and iron are a key factor in the prevention of disease progression."

-"To help prevent further progression of the disease, it is important for you to increase your calcium intake."

A patient is instructed to take a nonsteroidal anti-inflammatory drug for osteoarthritic pain with food or milk. Which should the nurse explain as the rationale for this instruction? -"To prevent gastrointestinal upset" -"To promote gastrointestinal absorption" -"To prevent drug-to-drug interactions" -"To promote renal excretion"

-"To prevent gastrointestinal upset"

A patient with ankylosing spondylitis is experiencing increased spinal stiffness and asks why this is occurring. Which response should the nurse make to this patient? -"With ankylosing spondylitis, the vertebrae fuse and decrease your mobility." -"With ankylosing spondylitis, the bones degenerate and you lose function." -"With ankylosing spondylitis, the vertebrae collapse and cause nerve compression." -"With ankylosing spondylitis, the bones narrow the spinal column and impede blood flow."

-"With ankylosing spondylitis, the vertebrae fuse and decrease your mobility."

The nurse is performing a yearly health screening on a patient at risk for osteoporosis. Which clinical assessment finding should the nurse associate with osteoporosis? -A decrease in height over time -An increase in weight over time -Chronic episodes of vertebral pain -Vertebral pain with substantial movement

-A decrease in height over time

The nurse is caring for an older female patient with osteoporosis. Which complication should the nurse identify as being related to the patient's health problem? -A hip fracture of unknown etiology -Wrist tenderness upon palpation -Unintentional 10-lb weight loss -Joint stiffness of the arms and legs

-A hip fracture of unknown etiology

A patient diagnosed with osteoporosis states to the nurse, "I don't understand how my bones can be so brittle and break easily." Before responding to the patient, the nurse should understand that which process is involved in the pathophysiology of osteoporosis? -An imbalance between osteoblasts and osteoclasts has occurred. -Osteoclasts are unable to produce new bone. -Osteoblasts are not able to reabsorb bone. -Excessive bone reabsorption has occurred.

-An imbalance between osteoblasts and osteoclasts has occurred.

A patient with osteoporosis is prescribed the bisphosphonate alendronate (Fosamax). What should the nurse include when teaching the patient about this medication? (Select all that apply.) -Take the medication as directed with clear water only. -Avoid lying down for 30 to 60 minutes after taking the drug. -Consume no food or fluids for 30 minutes after taking the drug. -Take calcium and vitamin D supplements as instructed by your healthcare provider. -For ease in swallowing, you may chew the tablet thoroughly.

-Take the medication as directed with clear water only. -Avoid lying down for 30 to 60 minutes after taking the drug. -Consume no food or fluids for 30 minutes after taking the drug. -Take calcium and vitamin D supplements as instructed by your healthcare provider.

The nurse is assessing the musculoskeletal status of a 70-year-old patient. What findings should the nurse consider as expected age-related changes in this body system? (Select all that apply.) -The patient's upper arm and thigh circumference has decreased. -The patient says, "I don't think I am as strong in my muscles as I was a few years ago." -There is significant edema in the patient's ankles, hips, and knees. -The patient has difficulty raising arms up above the head. -There has been a loss of 1/2 inch in height from previous assessment one year ago.

-The patient's upper arm and thigh circumference has decreased. -The patient says, "I don't think I am as strong in my muscles as I was a few years ago." -The patient has difficulty raising arms up above the head. -There has been a loss of 1/2 inch in height from previous assessment one year ago.

The nurse is caring for a client being treated for fat embolus after multiple fractures. Which data would the nurse evaluate as the most favorable indication of resolution of the fat embolus? 1. Clear mentation 2. Minimal dyspnea 3. Oxygen saturation of 85% 4. Arterial oxygen level of 78 mm Hg

1. Clear mentation

Which cast care instructions should the nurse provide to a client who just had a plaster cast applied to the right forearm? Select all that apply. 1. Keep the cast clean and dry. 2. Allow the cast 24 to 72 hours to dry. 3. Keep the cast and extremity elevated. 4. Expect tingling and numbness in the extremity. 5. Use a hair dryer set on a warm to hot setting to dry the cast. 6. Use a soft, padded object that will fit under the cast to scratch the skin under the cast

1. Keep the cast clean and dry. 2. Allow the cast 24 to 72 hours to dry. 3. Keep the cast and extremity elevated.

The nurse is caring for a client who has had spinal fusion, with insertion of hardware. The nurse would be most concerned with which assessment finding? 1. Temperature of 101.6° F (38.7° C) orally 2. Complaints of discomfort during repositioning 3. Old bloody drainage outlined on the surgical dressing 4. Discomfort during coughing and deep-breathing exercises

1. Temperature of 101.6° F (38.7° C) orally

The nurse has conducted teaching with a client in an arm cast about the signs and symptoms of compartment syndrome. The nurse determines that the client understands the information if the client states that he or she should report which early symptom of compartment syndrome? 1. Cold, bluish-colored fingers 2. Numbness and tingling in the fingers 3. Pain that increases when the arm is dependent 4. Pain that is out of proportion to the severity of the fracture

2. Numbness and tingling in the fingers

The nurse is assessing the casted extremity of a client. Which sign is indicative of infection? 1. Dependent edema 2. Diminished distal pulse 3. Presence of a "hot spot" on the cast 4. Coolness and pallor of the extremity

3. Presence of a "hot spot" on the cast

The nurse is caring for a client who had an above-knee amputation 2 days ago. The residual limb was wrapped with an elastic compression bandage, which has come off. Which immediate action should the nurse take? 1. Apply ice to the site. 2. Call the primary health care provider (PHCP). 3. Rewrap the residual limb with an elastic compression bandage. 4. Apply a dry, sterile dressing and elevate the residual limb on 1 pillow.

3. Rewrap the residual limb with an elastic compression bandage.

A patient is experiencing continuous back pain. Which diagnostic test should the nurse expect the healthcare provider to prescribe? MRI Cervical x-rays Myogram Arteriogram

MRI

The nurse is evaluating a client in skeletal traction. When evaluating the pin sites, the nurse would be most concerned with which finding? 1. Redness around the pin sites 2. Pain on palpation at the pin sites 3. Thick, yellow drainage from the pin sites 4. Clear, watery drainage from the pin sites

3. Thick, yellow drainage from the pin sites

The nurse is admitting a client with multiple trauma injuries to the nursing unit. The client has a leg fracture and had a plaster cast applied. Which position would be best for the casted leg? 1. Elevated for 3 hours, then flat for 1 hour 2. Flat for 3 hours, then elevated for 1 hour 3. Flat for 12 hours, then elevated for 12 hours 4. Elevated on pillows continuously for 24 to 48 hours

4. Elevated on pillows continuously for 24 to 48 hours

The nurse witnessed a vehicle hit a pedestrian. The victim is dazed and tries to get up. A leg appears fractured. Which intervention should the nurse take? 1. Try to reduce the fracture manually. 2. Assist the victim to get up and walk to the sidewalk. 3. Leave the victim for a few moments to call an ambulance. 4. Stay with the victim and encourage him or her to remain still.

4. Stay with the victim and encourage him or her to remain still.

The nurse suspects that the patient may have systemic lupus erythematosus when a butterfly rash and splinter hemorrhages are found during the assessment. Which other clinical finding supports the nurse's suspicion? Conjunctivitis Atopic dermatitis Neuropathy Varicosities

Conjunctivitis

A patient has a radioactive isotope injected for a bone scan. Which should the nurse instruct the patient to do before the scan is obtained? Drink three glasses of water Eat a low-fat meal Rest Walk

Drink three glasses of water

The nurse is assessing a patient's gait and posture. For which finding should the nurse suspect the patient has a herniated lumbar disk? Flattened lumbar curve Concave cervical spine Convex thoracic spine Presence of lordosis

Flattened lumbar curve

While assessing for ballottement, a nurse notes that the patella rebounds against the fingers. What does this finding indicate? Fluid in the knee joint Deformity of the elbow Crepitus in the hip joint Infection of the metatarsals

Fluid in the knee joint

The nurse is determining the type of arthritis a patient is experiencing. Which assessment finding would be present if the patient has rheumatoid arthritis? -Stiffness is relieved by activity. -Health history includes weight loss and fever. -Abnormal joint findings are limited to the hands. -Heberden nodes are located on the finger joints.

Health history includes weight loss and fever.

The nurse is assessing a patient with osteoarthritis. Which is a priority assessment that the nurse should include in relation to the diagnosis? Heberden or Bouchard nodes Sensory function Vascular function Trophic changes

Heberden or Bouchard nodes

The nurse reviews genetic factors that might affect mobility during a community health fair. For which genetic factor identified by a community member should the nurse provide further teaching? Sickle cell disease Muscular dystrophy Marfan syndrome Scleroderma

Sickle cell disease