LPN MEd Surge Musculoskeletal

The nurse is reinforcing discharge teaching with the caregivers of a child who is going home after a cast has been applied. The nurse explains to the caregivers that which issues should be reported if they occur or are seen related to this child? Select all that apply.

A. Any area on the cast that is warm to the touch B. A foul odor under the cast C. Looseness of the cast on the extremity D. Drainage from under the cast

A client is scheduled for a total left knee arthroplasty in 2 weeks. When would the best time for postoperative nursing management begin?

A. Before surgery

A client is scheduled to undergo an electromyography. The nurse understands that this test is performed to evaluate which of the following?

A. Muscle weakness

The nurse is caring for a child who has had a cast applied to treat a fracture of the fibula. To monitor the pulse of the child's involved extremity the nurse will monitor which of the following?

A. Tibial pulse

A client is having a cast applied for a fractured leg that extends from below the knee to the base of the toes. The foot is flexed at a right angle in a neutral position. What type of cast is the client having applied?

A. Short leg cast

A client has just undergone a leg amputation. The nurse would closely monitor the client for which of the following during the immediate postoperative period?

Hematoma

The nurse is discussing the new medication that a client will be taking for treatment of rheumatoid arthritis. Which disease-modifying antirheumatic drug 1 NONBIOLOGIC (DMARD) will the nurse educate the client about? Methotrexate Etanercept Methylprednisolone Infliximab

Methotrexate

The nurse is caring for a middle-aged female client who is experiencing premenopausal symptoms. Which client statement indicates the need for further teaching?

"Bone resorption slows with aging due to a decrease in estrogen levels."

A nurse in a clinic is teaching a group of parents about scoliosis screening. Which of the following statements by a parent indicates an understanding of the teaching? A. "Boys should be screened for scoliosis at a younger age than girls." B. "Children who have scoliosis will often report back pain." C. "Scoliosis is associated with some form of childhood trauma." D. "During the screening, the child is asked to stand and bend forward at the waist with his arms hanging."

"During the screening, the child is asked to stand and bend forward at the waist with his arms hanging."

A nurse is caring for a client whose right leg is in Buck's traction. Which of the following should the nurse implement to promote mobility? A. Log rolling every 2 hr B. Isometric exercises of both legs. C. Active range-of-motion exercises of the left leg D. Passive range-of-motion exercises of the right leg

Active range-of-motion exercises of the left leg

A nurse is reinforcing teaching about colchicine with client who has gout. Which of the following statements by the client indicates understanding of the teaching? A. "This medication should eliminate the swelling in 2 to 3 days." B. "Colchicine will decrease formation of uric acid crystals." C. "Colchicine does not help with long-term management." D. "This medication will help my osteoarthritis too."

"This medication will help my osteoarthritis too."

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 client to minimize energy loss in response to pain? Administer prescribed analgesics around the clock. Avoid administering too much medication because the client is older. Administer prescribed pain medication only when the client requests it. Give pain medication to the client after providing care.

Administer prescribed analgesics around the clock.

The nurse is employed at a long-term care facility caring for geriatric clients. Which assessment finding is characteristic of an age-related musculoskeletal change?

B. Loss of height

A client is having traction applied to a fractured left lower extremity prior to surgery. What outcomes does the nurse expect from the application of the traction for the client? Select all that apply.

B. Muscle spasms will be relieved. C. The bones of the left leg will be aligned. D. Immobilization of the left leg will be maintained.

A type of traction sometimes used in the treatment of the child with scoliosis is called:

B. halo traction.

The type of traction in which a pin, wire, tongs, or other device is surgically inserted through a bone is:

B. skeletal traction.

The nurse is preparing a client for a surgical procedure that will allow visualization of the extent of joint damage of the knee for a client with rheumatoid arthritis and also obtain a sample of synovial fluid. What procedure will the nurse prepare the client for? Arthroscopy Open reduction Needle aspiration Arthroplasty

Arthroscopy

A nurse is reinforcing teaching with a client who has rheumatoid arthritis (RA) about self-care techniques. Which of the following strategies should the nurse include in the teaching? A. Avoid exercising joints that are swollen. B. Lift objects instead of sliding or pushing them. C. Push up with the fingers when going from a sitting to a standing position. D. Complete housekeeping tasks in the afternoon.

Avoid exercising joints that are swollen.

The nurse is caring for a client who sustained rib fractures in an automobile accident. What symptoms does the nurse recognize as a complication of rib fractures and should immediately be reported to the physician?

B. Crackles in the lung bases

The nurse admits an 11-year-old boy who is complaining of lower leg pain after he was hit with a lacrosse stick during a game. The level of pain is not consistent with the description of the incident. With further questioning the nurse discovers the child has had pain in that spot off and on for several months. The child has a biopsy, a bone scan and a bone marrow aspiration ordered by the care provider. What is the most likely condition the care provider is looking for?

B. Ewing sarcoma

The child diagnosed with muscular dystrophy uses a method of rising from the floor which is referred to as which of the following?

B. Gowers sign

The nurse is caring for a child admitted with juvenile idiopathic arthritis (JIA). Which of the clinical manifestation would likely have been noted in the child with this diagnosis?

B. Inflammation of the joints

The caregiver of a child who has had a cast applied to the leg observes the nurse putting adhesive tape strips around the edge of the cast. The caregiver asks the nurse why she is doing this. The best response by the nurse would be:

C. "These make a smooth edge on the cast so the skin is better protected."

The nurse is providing client education on growth and development throughout the life span. When stating periods of most rapid bone growth, which period is the nurse most correct to state?

C. From birth through puberty

The nurse is caring for a client who experienced a crushing injury of the lower extremities. Which of the following symptoms is essential to be reported to the physician?

C. Pulselessness

The nurse is discussing types of treatment used when working with children who have orthopedic disorders. Which form of treatment covers the lower part of the body, usually from the waist down, and either one or both legs while leaving the feet open?

C. Spica cast

Which of the following would the nurse expect a physician to use on a short-term basis for a client with an injured body part that does not require rigid immobilization?

C. Splint

A client is admitted to the emergency room after being hit by a car while riding a bicycle. The client sustained a fracture of the left femur, and the bone is protruding through the skin. What type of fracture does the nurse recognize requires emergency intervention? Compound Greenstick Oblique Spiral

Compound

A client comes to the emergency department complaining of localized pain and swelling of his lower leg. Ecchymotic areas are noted. History reveals that the client got hit in the leg with a baseball bat. Which of the following would the nurse suspect as most likely? Contusion Fracture Sprain Strain

Contusion

A nurse is completing a neurovascular check for a client who had an open reduction internal fixation surgery. Which of the following findings should the nurse identify as possible manifestations of compartment syndrome? (Select all that apply.) A. Cool skin B. Absence of pulse C. Pain relieved by narcotics D. Capillary refill 1 second E. Altered sensation of the toes

Cool skin Absence of pulse Altered sensation of the toes

The nurse is discussing the new medication that a client will be taking for treatment of rheumatoid arthritis. Which disease-modifying antirheumatic drug II BIOLOGIC (DMARD) will the nurse educate the client about? Methotrexate Etanercept Methylprednisolone Infliximab

Etanercept Infliximab

A client's cast is removed. The client is worried because the skin appears mottled and is covered with a yellowish crust. What advice should the nurse give the client to address the skin problem?

D. Apply lotions and take warm baths or soaks.

A 68-year-old female client who had a total hip replacement is to be discharged because her healing is almost complete. Which of the following would be most important for this client?

D. Exploring factors related to the client's home environment

The nurse is caring for a client who has had a fracture reduction using a cast and no other health history or concerns. Which of the following would be most important for the nurse to assess?

D. Sensation and mobility status

In caring for a child being treated for scoliosis, the highest priority goal is which of the following?

D. The child will remain free of injury.

A client is receiving treatment for an acute episode of gout with colchicine. The nurse is administering the medication every 2 hours. What should the nurse be sure the client communicates so that the drug can be temporarily stopped? Select all that apply. Diarrhea Tingling in the arms Intestinal cramping Increase in pain in the affected extremity Nausea and vomiting

Diarrhea Intestinal cramping Nausea and vomiting

Which of the following would lead a nurse to suspect that a client has a rotator cuff tear? Ability to stretch arm over the head Pain worse in the morning Minimal pain with movement

Difficulty lying on affected side

A nurse in an emergency department is reinforcing discharge teaching with a client who has a first-degree ankle sprain. Which of the following instructions should the nurse include in the discharge teaching? (Select all that apply.) A. Immobilize the ankle for 4 to 6 weeks. B. Elevate the ankle above the level of the heart. C. Apply a heating pad to the ankle several times daily. D. Wrap the ankle with an elasticized compression bandage. E. Apply intermittent cold compresses to the ankle for the first 24 to 48 hr.

Elevate the ankle above the level of the heart. Wrap the ankle with an elasticized compression bandage. Apply intermittent cold compresses to the ankle for the first 24 to 48 hr.

The nurse is reporting on the results of client blood work to the oncoming nurse. Upon reviewing the data, it is noted that the client has an elevated uric acid level. Which inflammatory process would the nurse screen for on shift rounds?

Gout

A client presents to the orthopedic floor after hip surgery, the nurse anticipates the physician to have ordered which medication in addition to narcotics to be gin IV prior to moving to oral ibuprophen? Ketorolac Methotrexate Gentamyacin Phenergan

Ketorolac

The nurse caring for a child diagnosed with juvenile idiopathic arthritis (JIA) should provide medication education to the caregivers for which first-choice medication to manage the child's pain and joint inflammation?

Naproxen

A family member is caring for an older adult client with osteomalacia in the home. When the home health nurse comes to evaluate the client, what should be a focus point of the visit? Observing for safety hazards that could be a fall risk Making sure the client is receiving a daily bath Ensuring that the client is eating enough Making sure the client has adequate financial resources

Observing for safety hazards that could be a fall risk

The nurse is caring for a client in traction that is immobile. What measures can the nurse provide to prevent further injury and potential infection and promote circulation to the area?

Protect bony prominences from pressure by using pressure-relieving technique.

A client sustained a sprained ankle while skiing, and the physician ordered PRICE. What will the nurse inform the client to do related to the physician's order upon discharge? Protection, rest, ice, compression, elevation Prevention, rest, inflammation, compression, elevation Pulses, rate the pain, increase activity, compression, elevation Protection, range of motion, ice, circulation, elevation

Protection, rest, ice, compression, elevation

The nurse is caring for a client with a fractured right femur who is not a candidate to repair the femur immediately. What intervention should the nurse anticipate the physician will order to relieve muscle spasm and pain until surgery is perfor The nurse is caring for a client with a fractured right femur who is not a candidate to repair the femur immediately. What intervention should the nurse anticipate the physician will order to relieve muscle spasm and pain until surgery is performed?

Skin traction

A nurse is caring for a client who has acute osteomyelitis. The client asks the nurse to explain how she developed the infection. The nurse should respond that which of the following organisms is the most common cause? A. Pseudomonas aeruginosa B. Streptococcus B C. Staphylococcus aureus D. Escherichia coli

Staphylococcus aureus

A client has been prescribed nonsteroidal anti-inflammatory medications for treatment of carpal tunnel syndrome. What should the nurse be sure to include when educating the client about taking this medication? Take the medication on an empty stomach to assist in faster absorption. The medication may cause drowsiness, so do not operate machinery or drive a vehicle. The dosage may be exceeded if pain is not relieved by the prescribed dose.

Take the medication with food.

A client has been treated for migraine headaches for several months and comes to the clinic stating he is getting no better. The nurse is talking with the client and hears an audible click when the client is moving his jaw. What does the nurse suspect may be happening? Temporomandibular disorder Trigeminal neuralgia Dislocated jaw Loose teeth

Temporomandibular disorder

A client is diagnosed with a first-degree strain of the left ankle related to running 5 miles daily. How would the nurse differentiate the first-degree strain from other strains and sprains? The client has some edema of the left ankle with muscle spasms but is able to walk without assistive devices. The client is unable to bear weight on the left ankle and has a large ecchymotic area. The client has ecchymosis and edema and has no function of the left foot and ankle. The client complains of pain when the joint is moved and has mild edema.

The client has some edema of the left ankle with muscle spasms but is able to walk without assistive devices.

A client arrives in the emergency room complaining of severe pain in her left hip after falling out of the bed. What indication upon assessment does the nurse recognize as a dislocated left hip? Select all that apply. The left leg is shorter than the right. The left leg is shorter than the right. The skin over the left hip is warm. The skin of the lower left leg is pale. The client is able to bend the knee but not move toes.

The left leg is shorter than the right. The skin of the lower left leg is pale.

The nurse is caring for a child diagnosed with Legg-Calvé-Perthes disease. What is the most important nursing intervention for the nurse to include in working with this child and his caregivers?

The nurse should help the caregivers to understand and help the child to effectively use the corrective devices.

A client arrives at the orthopedic clinic and informs the nurse that he thinks he has another stress fracture of the right foot. The physician orders an x-ray with negative results. What does the nurse understand that these negative results can mean? The stress fracture may not be seen on x-ray for a few weeks. The physician may have misread the x-ray. The client probably has a strain. The client does not have a stress fracture.

The stress fracture may not be seen on x-ray for a few weeks.

A client was a passenger in a vehicle that was hit in the rear by another vehicle. The client is complaining of pain in the neck from the head rapidly moving forward and then back against the headrest. What type of injury does the nurse suspect the client sustained in the accident? Strain Whiplash injury Strain Avulsion fracture Contusion

Whiplash injury

Which of the following would the nurse expect to assess as the most common finding associated with fibromyalgia? Widespread chronic pain Butterfly facial rash Jaw locking Joint edema

Widespread chronic pain

A client is scheduled for a joint replacement surgery. Which action would be most important

Withhold administration of aspirin before the surgery.

The nurse is preparing to assess Phalen's sign. Which of the following would the nurse identify as indicative of a positive indicator for this sign? Wrist flexion for 30 seconds causes pain and numbness. Electrical stimulation shows a delay in motor responses. Percussion of the median nerve causes tingling and numbness. Shaking hands causes a reduction in the pain.

Wrist flexion for 30 seconds causes pain and numbness.

A client sustained 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? X-ray MRI Arthrography CT scan

X-ray