MedSurg Exam #5

Which client would the nurse identify as having the greatest risk for osteoporosis? A small-framed, thin 45-year-old white woman A 20-year-old male athlete with repeated injuries A 16-year-old male with a history of asthma A 40-year-old overweight African American woman

A small-framed, thin 45-year-old white woman

A client has undergone a leg amputation. What teachings should the nurse offer such a client to prevent abduction deformity? Select all that apply. Advise the client to place pillows between the legs. Advise the client to adduct the stump so it presses against the other leg when the client is lying on the stomach. Advise the client to use a trochanter roll. Advise the client to use antiembolism stockings on both legs.

Advise the client to adduct the stump so it presses against the other leg when the client is lying on the stomach. Advise the client to use a trochanter roll.

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

Administering large doses of IV antibiotics as ordered

A client comes to the emergency department and reports localized pain and swelling in the lower leg. Ecchymotic areas are noted. History reveals that the client got hit in the leg with a baseball bat. What will the nurse most likely suspect? Fracture Strain Contusion Sprain

Contusion

The nurse is assessing the feet of a patient and observes an overgrowth of the horny layer of the epidermis. What does the nurse recognize this condition as? Bunion Hammer Toe Corn Clawfoot

Corn

Radiographic evaluation of a client's fracture reveals that a bone fragment has been driven into another bone fragment. The nurse identifies this as which type of fracture? Compression Comminuted Greenstick Impacted

Impacted

Which of the following is the most common and most fatal primary malignant bone tumor?

Osteogenic sarcoma (osteosarcoma)

Which may occur if a client experiences compartment syndrome in an upper extremity? Callus Volkmann's contracture Whiplash injury Subluxation

Volkmann's contracture

The nurse is employed at a long-term care facility caring for geriatric clients. Which assessment finding is characteristic of an age-related change? A) loss of height B) Depressive symptoms C) cognitive decline D) increased muscle mass

loss of height

The nurse is caring for a client who has a deficiency in the formation of cartilage in joints. Which essential substance is absent?

matrix

A fracture is considered pathologic when it results in a fragment of bone being pulled away by a ligament or tendon and its attachment. presents as one side of the bone being broken and the other side being bent. involves damage to the skin or mucous membranes. occurs through an area of diseased bone.

occurs through an area of diseased bone

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? Open reduction Arthroscopy Arthroplasty Needle aspiration

Arthroscopy

A patient sustains a fracture of the arm. When does the nurse anticipate pendulum exercise should begin? In 2 to 3 weeks, when callus ossification prevents easy movements of bony fragments In about 4 to 5 weeks, after new bone is well established In 2 to 3 months, after normal activities are resumed As soon as tolerated, after a reasonable period of immobilization

As soon as tolerated, after a reasonable period of immobilization

A nurse is caring for a client placed in traction to treat a fractured femur. Which nursing intervention has the highest priority? Assessing the extremity for neurovascular integrity Ensuring that the weights hang free at all times Keeping the client from sliding to the foot of the bed Keeping the ropes over the center of the pulley

Assess the extremity for neurovascular integrity

A client has a Fiberglass cast on the right arm. Which action should the nurse include in the care plan? Avoiding handling the cast for 24 hours or until it is dry Keeping the casted arm warm by covering it with a light blanket Evaluating pedal and posterior tibial pulses every 2 hours Assessing movement and sensation in the fingers of the right hand

Assessing movement and sensation in the fingers of the right hand

Which action would be most important postoperatively for a client who has had a knee or hip replacement? Assisting in early ambulation. Encouraging expressions of anxiety. Providing crutches to the client. Using a continuous passive motion (CPM) machine.

Assisting in early ambulation

When teaching a client how to prevent low back pain as a result of lifting, the nurse should instruct the client to: bend the knees and loosen the abdominal muscles. place the load away from the body. avoid overreaching. use a narrow base of support.

Avoid overreaching

A nurse is performing discharge teaching for an elderly client with osteoporosis. Which instruction about a calcium supplement should the nurse include? Take the supplement with meals or with orange juice. Take weekly on the same day and at the same time. Take the supplement on an empty stomach with a full glass of water. Remain in an upright position 30 minutes after taking the supplement.

Take the supplement with meals or with orange juice

Two days after application of a cast to treat a fractured femur, the client reports severe, deep, and constant pain in the leg. What will the nurse suspect? Phlebitis. Compartment syndrome. Infection. Chronic venous insufficiency.

Compartment syndrome

Which is a neurovascular problem caused by pressure within a muscle area that increases to such an extent that microcirculation diminishes?

Compartment syndrome

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 complex regional pain syndrome. a reaction to an internal fixation device. heterotrophic ossification. avascular necrosis of bone.

Complex regional pain syndrome

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? Compression fractures Hypertension Cardiac disease Diabetes

Compression fx

To reduce the incidence of complications in a client in traction, which intervention should be included in the care plan? Increase fiber intake. Reduce fluid intake. Remove the weights during linen changes. Increase calorie intake.

Increase fiber intake (Immobility causes complication w/ constipation)

A client has undergone an external fixation. Which actions would be the priority for this client? Monitoring the client's urine output. Maintaining pin care. Planning the client's diet. Monitoring the client's blood pressure.

Maintaining pin care

After a traumatic back injury, a client requires skeletal traction. Which intervention takes priority? Supporting the traction weights with a chair or table to prevent accidental slippage Monitoring the client for skin breakdown Restricting the client's fluid and fiber intake to reduce the movement required for bedpan use Maintaining traction continuously to ensure its effectiveness

Maintaining traction continuously to ensure its effectiveness

A client undergoes an invasive joint examination of the knee. What will the nurse closely monitor the client for?

Serous drainage

Which laboratory study indicates the rate of bone turnover?

Serum osteocalcin

A group of students are studying for an examination on joints. The students demonstrate understanding of the material when they identify which of the following as an example of a synarthrodial joint?

Skull at the temporal and occipital bones

A client sustains an injury to the ligaments surrounding a joint. What will the nurse identify this injury as? Fracture Sprain Strain Contusion

Sprain

A nurse practitioner assesses a patient's movement in his left hand after a cast is removed. The nurse asks the patient to turn his wrist so the palm of his hand is facing up. This movement is known as: A) Pronation B) Supination C) Extension D) Eversion

Supination

In chronic osteomyelitis, antibiotics are adjunctive therapy in which situation? Wound packing Vitamin supplements Wound irrigation Surgical debridement

Surgical debridement

Which should be included in the teaching plan for a client diagnosed with plantar fasciitis? Plantar fasciitis presents as an acute onset of pain localized to the ball of the foot. The pain of plantar fasciitis diminishes with soaking the foot in warm water. Complications of plantar fasciitis include neuromuscular damage and decreased ankle range of motion. Management of plantar fasciitis includes stretching exercises.

Management of plantar fasciitis includes stretching exercises

A nurse knows that a person with a 3-week-old femur fracture is at the stage where angiogenesis is occurring. What are the characteristics of this stage?

New capillaries producing a bridge between the fractured bones

A nurse is caring for a client with an undiagnosed bone disease. When instructing on the normal process to maintain bone tissue, which process transforms osteoblasts into mature bone cells?

Ossification and calcification

A client is informed that he has a benign bone tumor but that this type of tumor that may become malignant. The nurse knows that this is characteristic of which type of tumor? Enchondroma Osteochondroma Osteoclastoma Osteoid osteoma

Osteoclastoma

A client presents to the emergency department with fever, chills, restlessness, and limited movement of a fractured jaw. What complication should the nurse interpret as the findings? Avascular necrosis Osteomyelitis Fat embolism Compartment syndrome

Osteomyelitis

Localized rapid bone turnover, most commonly affecting the skull, femur, tibia, pelvic bones, and vertebrae, is characterized by which bone disorder? Osteomalacia Paget disease Ganglion Osteomyelitis

Paget disease

A patient comes to the clinic and informs the nurse of numbness, tingling, and a burning sensation in the arm from the elbow down to the fingers. What type of symptom would this be documented as? A) Flaccidity B) Paresthesia C) Atonia D) Effusion

Paresthesia

The nurse observes a client with a shuffling gait. What disease is commonly associated with a shuffling gait?

Parkinson's disease

A patient had hand surgery to correct a Dupuytren's contracture. What nursing intervention is a priority postoperatively? Applying a cock-up splint and immobilization Performing hourly neurovascular assessments for the first 24 hours Having the patient exercise the fingers to avoid future contractures Changing the dressing

Performing hourly neurovascular assessments for the first 24 hours

Which nerve is being assessed when the nurses asks the client to dorsiflex the ankle and extend the toes? A) Median B) Ulnar C) Radial D) Peroneal

Peroneal

A 10-year-old boy who was brought to the emergency room after a skiing accident is diagnosed with a fracture of the distal end of the femur. Why is this type of fracture significant?

Potential growth problems may result from damage to the epiphyseal plate.

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

Promote pain relief and quality of life

Which nursing instruction is most important to stress when teaching on calcium intake?

Provide age-related calcium intake recommendations

The nurse is caring for a patient who had a total hip replacement. What lethal postoperative complication should the nurse closely monitor for? Hypovolemia Pulmonary embolism Urinary tract infection Atelectasis

Pulmonary embolism

The nurse is educating the patient with low back pain about the proper way to lift objects. What muscle should the nurse encourage the patient to maximize? Latissimus dorsi Gastrocnemius Rectus abdominis Quadriceps

Quadriceps

Which term refers to a disease of a nerve root? Involucrum Sequestrum Contracture Radiculopathy

Radiculopathy

A client with osteoporosis is prescribed a selective estrogen receptor modifier (SERM) as treatment. The nurse would identify which drug as belonging to this class? Tamoxifen (Nolvadex) Calcium gluconate Raloxifene (Evista) Alendronate (Fosamax)

Raloxifene (Evista)

A patient has a fracture of the right femur sustained in an automobile accident. What process of fracture healing does the nurse understand will occur with this patient?

Reactive phase, reparative phase, remodeling phase

After a fracture, during which stage or phase of bone healing is devitalized tissue removed and new bone reorganized into its former structural arrangement? A) Reparative B) Inflammation C) Revascularization D) Remodeling

Remodeling

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

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

A client has just undergone arthrography. What is the most important instruction for the nurse to include in the teaching plan?

Report joint crackling or clicking noises occurring after the second day.

A nurse is giving instructions to a client who's going home with a leg cast. Which teaching point is most critical? Exercising joints above and below the cast, as ordered Avoiding walking on a leg cast without the health care provider's permission Using crutches properly Reporting signs of impaired circulation

Reporting signs of impaired circulation

Morton neuroma is exhibited by which clinical manifestation? Swelling of the third (lateral) branch of the median plantar nerve High arm and a fixed equinus deformity Diminishment of the longitudinal arch of the foot Inflammation of the foot-supporting fascia

Swelling of the third (lateral) branch of the median plantar nerve

A client's left leg is in skeletal traction with a Thomas leg splint and Pearson attachment. Which intervention should the nurse include in this client's care plan? Apply the traction straps snugly. Teach the client how to prevent problems caused by immobility. Remove the traction at least every 8 hours. Assess the client's level of consciousness.

Teach the client how to prevent problems caused by immobility

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? Dislocated jaw Loose teeth Trigeminal neuralgia Temporomandibular disorder

Temporomandibular disorder

A client is seen in the emergency room for a knee injury that happened during a basketball game. Diagnostic tests reveal torn cords of fibrous connective tissue that connect muscles to bones. What type of tear has this client sustained?

Tendon

Which statement is accurate regarding care of a plaster cast? The cast can be dented while it is damp. The cast must be covered with a blanket to keep it moist during the first 24 hours. A dry plaster cast is dull and gray. The cast will dry in about 12 hours.

The cast can be dented while it is damp

The nurse assesses subtle personality changes, restlessness, irritability, and confusion in a client who has sustained a fracture. The nurse suspects which complication? Compartment syndrome Fat embolism syndrome Hypovolemic shock Reflex sympathetic dystrophy syndrome

fat embolism syndrome

Arthrodesis is: fusion of a joint (most often the wrist or knee) for stabilization and pain relief. total reconstruction or replacement of a joint (most often the knee or hip) with an artificial joint to restore function and relieve pain. cutting and removal of a wedge of bone (most often the tibia or femur) to change the bone's alignment, thereby improving function and relieving pain. replacement of one of the articular surfaces in a joint, such as the femoral head but not the acetabulum.

fusion of a joint (most often the wrist or knee) for stabilization and pain relief

A client who has injured a hip in a fall cannot place weight on the leg and is in significant pain. After radiographs indicate intact yet malpositioned bones, what repair would the physician perform? ice and immobilization heat and immobilization joint manipulation and immobilization analgesia and immobilization

joint manipulation and immobilization

A variety of complications can occur after a leg amputation. Which is not a possibility in the immediate postoperative period? hematoma infection osteomyelitis hemorrhage

osteomyelitis (Chronic osteomyelitis may occur after persistent infection in the late postoperative period.)

A client presents at the emergency department with a compound fracture of the right femur. Skeletal traction is applied to align the bones. What type of traction would be used? Russell traction Steinmann traction Thomas splint Buck's traction

steinmann traction (pins)

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

stretched or pulled beyond its capacity

After bone fracture, fibrocartilaginous callus formation normally occurs at the same time as which process?

Fibroblast migration

A client has come to the clinic with foot pain. The physician has described the client's condition as a flexion deformity of the proximal interphalangeal joint. What is the name of this disorder? hammer toe hallux valgus (bunion) Heberden's nodes mallet toe

Hammer toe

During a routine physical examination of a client, the nurse observes a flexion deformity of the proximal interphalangeal (PIP) joint of two toes on the right foot. How would the nurse document this finding? Mallet toe Bunion Hammer toe Hallux valgus

Hammer toe

A nurse is caring for a client after stabilization of a radial fracture. Which actions by the nurse would be appropriate for the client following arm casting? Select all that apply. Elevate the arm on a plastic-covered pillow Petal and smooth the edges of the cast Protect the cast by covering with a sheet Handle the cast with the palms of hands Circulate room air with a portable fan

Handle the cast with the palms of the hands Circulate room air with a portable fan Petal and smooth the edges of the cast

A healthcare provider asks a nurse to test a client for Tinel's sign to diagnose carpal tunnel syndrome. What should the nurse do to perform this assessment? Have the client make a fist and open the hand against resistance. Have the client hold the palm of the hand up while the nurse percusses over the median nerve. Have the client stretch the fingers around a ball and squeeze with force. Have the client pronate the hand while the nurse palpates the radial nerve.

Have the client hold the palm of the hand up while the nurse percusses over the median nerve.

A patient has suffered a femoral shaft fracture in an industrial accident. What is an immediate nursing concern for this patient? Infection Hypovolemic shock Pain resulting from muscle spasm Knee and hip dislocation

Hypovolemic shock

The client returns to the nursing unit following an open reduction with internal fixation of the right hip. Nursing assessment findings include temperature 100.8 degrees Fahrenheit, heart rate 112 beats per minute, respiratory rate 28 breaths per minute, and blood pressure 86/58. There is no urine in the Foley catheter collection bag. The nurse interprets these findings as indicating which complication? Atelectasis Urinary retention Hypovolemic shock Osteomyelitis

Hypovolemic shock (Indicators of hypovolemic shock include a heart rate greater than 100 beats per minute, a blood pressure less than 90/60 mm Hg, and urine output less than 30 ml per hour.)

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? surgical repair immobilization external rotation enhancing complications

Immobilization

A client in the emergency department is being treated for a wrist fracture. The client asks why a splint is being applied instead of a cast. What is the best response by the nurse? "Not all fractures require a cast." "A splint is applied when more swelling is expected at the site of injury." "It is best if an orthopedic doctor applies the cast." "You would have to stay here much longer because it takes a cast longer to dry."

"A splint is applied when more swelling is expected at the site of injury"

During a routine physical examination on an older female client, a nurse notes that the client is 5 feet, 3/8 inches (1.6 m) tall. The client states, "How is that possible? I was always 5 feet and 1/2? (1.7 m) tall." Which statement is the best response by the nurse? "There may be some slight discrepancy between the measuring tools used." "After age 40, height may show a gradual decrease as a result of spinal compression" "The posture begins to stoop after middle age." "After menopause, the body's bone density declines, resulting in a gradual loss of height."

"After menopause, the body's bone density declines, resulting in a gradual loss of height"

The older client asks the nurse how best to maintain strong bones. What is the nurse's best response?

"Weight-bearing exercises can strengthen bones."

A nurse is educating a client diagnosed with osteomalacia. Which statement by the nurse is appropriate? "You will need to avoid foods high in phosphorus and vitamin D." "You will need to engage in vigorous exercise three times a week for 30 minutes." "You may need to be evaluated for an underlying cause, such as renal failure." "You will need to decrease the amount of dairy products you consume."

"You may need to be evaluated for an underlying cause, such as renal failure"

A nurse is planning discharge instructions for the client with osteomyelitis. What instructions should the nurse include in the discharge teaching? "You need to perform weight-bearing exercises twice a week." "You will receive IV antibiotics for 3 to 6 weeks." "Use your continuous passive motion machine for 2 hours each day." "You need to limit the amount of protein and calcium in your diet."

"You will receive IV antibiotics for 3 to 6 weeks"

When is it advisable for the nurse to apply heat to a sprain or a contusion? Immediately After 2 days Only after a week Do not apply at all

After 2 days

Which of the following are common primary sites of tumors that metastasize to the bone? Select all that apply. Prostate Kidney Ovary Breast Lung

All of them

Which would be an inappropriate initial pain relief measure for the client with a cast? Application of a new cast Application of cold packs Elevation of the involved part Administration of analgesics

Application of a new cast

Which nursing action is most important in caring for the client following an arthrogram? A) Apply ice to the joint. B) Keep the joint below the level of the heart. C) Assist the client with passive range of motion. D) Administer morphine sulfate.

Apply ice to the joint

The nurse is preparing the client with a right neck mass for magnetic resonance imaging (MRI). Which question should the nurse ask? Select all that apply.

Are you wearing any jewelry?""Have you removed your hearing aid?""Do you have a pacemaker?"

Which is useful in identifying acute or chronic tears of the joint capsule or supporting ligaments of the knee, shoulder, ankle, hip, or wrist? A) Meniscography B) Bone densitometry C) Arthrography D) EMG

Arthrography

A patient is scheduled for a procedure that will allow the physician to visualize the knee joint in order to diagnose the patient's pain. What procedure will the nurse prepare the patient for?

Arthroscopy

A group of students are reviewing information about cast composition in preparation for a discussion on the advantages and disadvantages of each. The students demonstrate understanding of the topic when they cite which of the following as an advantage of a plaster cast? Better molding to the client Quicker drying Longer-lasting More breathable

Better molding to the client

A patient has stepped in a hole in the yard, causing an ankle injury. The ankle is edematous and painful to palpation. How long should the nurse inform the patient that the acute inflammatory stage will last? At least 1 week About 72 hours Less than 24 hours Between 24 and 48 hours

Between 24 and 48 hours

An important nursing assessment, post fracture, is to evaluate neurovascular status. Therefore, the nurse should check for: Crepitus. Capillary refill. Shortening and deformity. Swelling and discoloration.

Capillary refill

While the nurse is performing a physical assessment, the client reports numbness, tingling, and pain when the nurse percusses lightly over the median nerve. What should this assessment indicate to the nurse? Morton's neuroma Dupuytren's contracture Impingement syndrome Carpal tunnel syndrome

Carpal tunnel syndrome

A client who is undergoing skeletal traction reports pressure on bony areas. Which action would be most appropriate to provide comfort for the client? Applying warm compresses. Changing the client's position within prescribed limits. Administering prescribed analgesics. Assisting with range-of-motion and isometric exercises.

Changing the client's position within prescribed limits

What is the term for a rhythmic contraction of a muscle? A) Hypertrophy B) Crepitus C) Atrophy D) Clonus

Clonus

An x-ray demonstrates a fracture in which a bone has splintered into several pieces. Which type of fracture is this? Depressed Compound Impacted Comminuted

Comminuted

A client has experienced increasing pain and progressing inflammation of the hands and feet. The rheumatologist has prescribed NSAID use to treat the condition. What client education is most important for the nurse to address with the use of these medications? dietary restrictions common adverse effects activity restrictions loading-dose schedule

Common adverse effects

The nurse is asked to explain to the client the age-related processes that contribute to bone loss and osteoporosis. What is the nurse's best response? Decrease in estrogen Increase of vitamin D Increase in calcitonin Decrease in parathyroid hormone

Decrease in estrogen

The nurse is admitting an older adult to a skilled nursing facility. What assessment parameters will the nurse expect to find with the musculoskeletal assessment? Select all that apply. decreased range of motion decreased endurance increase in height increased muscle strength joint stiffness

Decreased ROM Decreased endurance Joint stiffness

The femur fracture that commonly leads to avascular necrosis or nonunion because of an abundant supply of blood vessels in the area is a fracture of the: Shaft of the femur. Femoral neck. Trochanteric region. Condylar area.

Femoral neck

Which of the following disorders results in widespread hemorrhage and microthrombosis with ischemia? Avascular necrosis (AVN) Fat embolism syndrome (FES) Complex regional pain syndrome (CRPS) Disseminated intravascular coagulation (DIC)

Disseminated intravascular coagulation (DIC)

Which term refers to a flexion deformity caused by a slowly progressive contracture of the palmar fascia? Dupuytren's contracture Hammertoe Callus Hallux valgus

Dupuytren's contracture

A client is diagnosed with a fracture of a diarthrosis joint. What is an example of this type of joint?

Elbow

The nurse is caring for a patient postoperatively following orthopedic surgery. The nurse assesses an oxygen saturation of 89%, confusion, and a rash on the upper torso. What does the nurse suspect is occurring with this patient? Disseminated intravascular coagulation Pneumonia Polyethylene-induced infection Fat emboli syndrome

Fat-emboli syndrome

A patient has had a stroke and is unable to move the right upper and lower extremity. During assessment the nurse picks up the arm and it is limp and without tone. How would the nurse document this finding? A) Rigidity B) Tetanic C) Flaccidity D) Atonic

Flaccidity

Dupuytren contracture causes flexion of which area(s)? Thumb Index and middle fingers Fourth and fifth fingers Ring finger

Fourth and fifth fingers

In which deformity does the great toe deviate laterally? Hammertoe Hallux valgus Plantar fasciitis Pes cavus

Hallux valgus

A patient in pelvic traction needs circulatory status assessed. How should the nurse assess for a positive Homans' sign?

Have the patient extend each leg and dorsiflex each foot to determine if pain or tenderness is present in the lower leg.

Which type of cast encloses the trunk and a lower extremity? Short-leg Hip spica Long-leg Body cast

Hip spica

A nurse is assigned to support a patient while a cast is being applied to treat a greenstick fracture. The nurse documents that this fracture is classified as what type of fracture? Incomplete Closed Stress Compression

Incomplete

Which of the following is the most common site of joint effusion? A) Shoulder B) Elbow C) Knee D) Hip

Knee

The nurse is performing an assessment on an older adult patient and observes the patient has an increased forward curvature of the thoracic spine. What does the nurse understand this common finding is known as?

Kyphosis

A client is scheduled to undergo an electromyography. When performed, what will this test evaluate?

Muscle weakness

The nurse is caring for a client who lives alone and had a total knee replacement. An appropriate nursing diagnosis for the client is: Disturbed body image Situational low self-esteem Risk for ineffective therapeutic regimen management Risk for avascular necrosis of the joint

Risk for ineffective therapeutic regimen management

A client has severe osteoarthritis in the left hip and is having surgery to replace both articular surfaces of the hip. What type of surgical procedure will the nurse prepare the client for? Arthrodesis Total arthroplasty Osteotomy Hemiarthroplasty

Total arthroplasty

Which nerve is assessed when the nurse asks the client to spread all fingers? A) Median B) Peroneal C) Radial D) Ulnar

Ulnar

A client is treated in the emergency department for acute muscle strain in the left leg caused by trying a new exercise. During discharge preparation, the nurse should provide which instruction? "Apply heat packs for the first 24 to 48 hours." "Apply ice packs for the first 12 to 18 hours." "Apply heat packs for the first 24 hours, then apply ice packs for the next 48 hours." "Apply ice packs for the first 24 to 48 hours, then apply heat packs."

"Apply ice packs for the first 24 to 48 hours, then apply heat packs"

Following a total knee replacement, the surgeon orders a continuous passive motion (CPM) device. The client asks about the purpose of this treatment. What is the best response by the nurse? "CPM prevents injury by limiting flexion of the knee." "CPM strengthens the muscles of the leg." "CPM delivers analgesic agents directly into the joint." "CPM increases range of motion of the joint."

"CPM increased range of motion of the joint" - Also increases circulation

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

"Difficult lying on affected side"

A client asks the nurse why his residual limb cannot be elevated on a pillow. What is the best response by the nurse? "I am sorry. We ran out of pillows. I can elevate it on a few blankets." "You need to turn yourself side to side. If your leg is on a pillow, you would not be able to do that." "Elevating the extremity may increase your chances of compartment syndrome." "Elevating the leg might lead to a flexion contracture."

"Elevating the leg might lead to a flexion contracture"

The nurse has educated a patient with low back pain about techniques to relieve the back pain and prevent further complications. What statement by the patient shows understanding of the education the nurse provided? "I will lie prone with my legs slightly elevated." "I will avoid prolonged sitting or walking." "Instead of turning around to grasp an object, I will twist at the waist." "I will bend at the waist when I am lifting objects from the floor."

"I will avoid prolonged sitting or walking"

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

"Keep your right leg elevated above heart level"

When discussing physical activities with the client who has just undergone a right total hip replacement, which instruction should the nurse provide? "Avoid weight bearing until the hip is completely healed." "Perform rotation exercises each day." "Limit hip flexion to 90 degrees." "Intermittently cross and uncross your legs several times each day."

"Limit hip flexion to 90 degrees"

The nurse is providing instructions to the client who is being prepared for skeletal traction. Which statement by the client indicates teaching was effective? "The traction can be removed once a day so I can shower." "A belt will go around my pelvis and weights will be attached." "I will wear a boot with weights attached." "Metal pins will go through my skin to the bone."

"Metal pins will go through my skin to the bone"

A client with a sports injury undergoes a diagnostic arthroscopy of the left knee. What comment by the client following the procedure will the nurse address first? A) "My feet are cold" B) "My knee aches" C) "My toes are numb" D) "My foot is swollen"

"My toes are numb"

A client has a plaster cast applied to the left leg. Which comment by the client following the procedure should the nurse address first? "My toes are stiff." "My cast is still wet." "My pain is a 3." "My toes are pink."

"My toes are stiff" (concerns for Compartment syndrome)

On a visit to the family health care provider, a client is diagnosed with a bunion on the lateral side of the great toe at the metatarsophalangeal joint. Which statement should the nurse include in the teaching session? "Bunions may result from wearing shoes that are too big, causing friction when the shoes slip back and forth." "Bunions are caused by a metabolic condition called gout." "Bunions are congenital and can't be prevented." "Some bunions are congenital; others are caused by wearing shoes that are too short or narrow."

"Some bunions are congenital; others are caused by wearing shoes that are too short or narrow"

Which statement by a staff nurse on the orthopedic floor indicates the need for further staff education? "Bleeding is a complication associated with the continuous passive motion device." "The continuous passive motion device can decrease the development of adhesions." "The client is receiving physical therapy twice per day, so the client doesn't need a continuous passive motion device." "Monitoring skin integrity is important while the continuous passive motion device is in place."

"The client is receiving physical therapy twice per day, so the client doesn't need a continuous passive motion device"

The client displays manifestations of compartment syndrome. What treatment will the nurse expect the client to be scheduled for? A total knee replacement A fasciotomy A total hip replacement An open reduction

A fasciotomoy

The client displays manifestations of compartment syndrome. What treatment will the nurse expect the client to be scheduled for? A total knee replacement A total hip replacement An open reduction A fasciotomy

A fasciotomy

A patient had a total hip replacement. What recommended leg position should the nurse ensure is maintained to prevent prosthesis dislocation? Adduction Internal rotation Flexion Abduction

Abduction

While reading a client's chart, the nurse notices that the client is documented to have paresthesia. The nurse plans care for a client with

Abnormal sensations

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

Administer prescribed analgesics around the clock

The nurse is discussing an older adult's risk for skeletal fractures with a group of students assigned to the clinical area. Which of the following would the nurse most likely explain as the underlying reason for the increased risk?

Bone resorption is more rapid than bone formation.

A client has low back pain and the healthcare provider needs to rule out the presence of a tumor. Which diagnostic procedure would the nurse anticipate to be ordered for the client? Electromyogram Magnetic resonance imaging Bone scan Computed tomography

Bone scan

Which hormone inhibits bone reabsorption and increases calcium deposit in the bone? A) Vitamin D B) Calcitonin C) Growth hormone D) Sex hormones

Calcitonin

Which medication directly inhibits osteoclasts, thereby reducing bone loss and increasing bone mass density (BMD)? Calcitonin Vitamin D Raloxifene Teriparatide

Calcitonin

Which of the following inhibits bone resorption and promotes bone formation? Calcitonin Corticosteroids Parathyroid hormone Estrogen

Calcitonin

When an infection is bloodborne, the manifestations include which symptom? Chills Hypothermia Hyperactivity Bradycardia

Chills

A nurse is caring for a client with eczema. Which medication would be prescribed when an allergy is a factor causing the skin disorder? Dicloxacillin Bupivacaine Chlorpheniramine Dexamethasone

Chlorpheniramine

Which nursing diagnosis is the most appropriate for a client with a strained ankle? Disturbed body image Impaired physical mobility Impaired skin integrity Risk for deficient fluid volume

Impaired physical mobility

A client was climbing a ladder, slipped on a rung, and fell on the right side of the chest. X-ray studies reveal three rib fractures, and the client reports pain with inspiration. What is the anticipated treatment for this client? Mechanical ventilation Chest strapping Thoracentesis Coughing and deep breathing with pillow splinting

Coughing and deep breathing with pillow splinting

Which would be contraindicated as a component of self-care activities for the client with a cast? Elevate the casted extremity to heart level frequently Do not attempt to scratch the skin under a cast Cushioning rough edges of the cast with tape Cover the cast with plastic to insulate it

Cover the cast with plastic to insulate it

Choose the correct statement about the endosteum, a significant component of the skeletal system: Facilitates bone growth Contains blood vessels and lymphatics Supports the attachment of tendons to bones Covers the marrow cavity of long bones

Covers the marrow cavity of long bones

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? Crackles in the lung bases Blood pressure of 140/90 mm Hg Client complains of pain in the affected rib area when taking a deep breath Heart rate of 94 beats/minute

Crackles in the lung bases

A client with a fractured distal left radius reports discomfort at the cast site, with pain specifically in the upper forearm. What would the nurse expect the physician to do? Remove the cast. Cut a cast window. Initiate physical therapy. Apply a fiberglass cast.

Cut a cast window

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? Discuss the complications that the client may experience if there is lack of cooperation with the care plan. Tell the client that this noncompliance will be reported to the health care provider. Document the client's refusal to ambulate. Do nothing because the client has the ultimate right to determine the degree of participation.

Discuss the complication that the client may experience if there is a lack of cooperation with the care plan

The client who had a total hip replacement was discharged home and developed acute groin pain in the affected leg, shortening of the leg, and limited movement of the fractured leg. The nurse interprets these findings as indicating which complication? Re-fracture of the hip Contracture of the hip Avascular necrosis of the hip Dislocation of the hip

Dislocation of the hip

The nurse caring for a client, who has been treated for a hip fracture, instructs the client not to cross their legs and to have someone assist with tying their shoes. Which additional instruction should the nurse provide to client? Do not flex the hip more than 60 degrees. Do not flex the hip more than 30 degrees. Do not flex the hip more than 90 degrees. Do not flex the hip more than 120 degrees.

Do not flex the hip more than 90 degrees

What is the best action by the nurse to achieve optimal outcomes when caring for a client with a musculoskeletal disorder who is using a cast? Educate the client on cast care and complications Provide effective pain control Assess for neurovascular compromise Prepare the client for cast application

Educate the client on cast care and complications

The health care provider is preparing to bivalve the client's cast. Which supplies should the nurse assemble? Gauze bandages and tape Stockinette and cotton padding Sterile saline and basin Elastic compression bandages

Elastic compression bandages

Which of the following diagnostics are used to evaluate spinal nerve root disorders (radiculopathies)? Electromyogram Magnetic resonance imaging Computed tomography Bone scan

Electromyogram

Which general nursing measure is used for a client with a fracture reduction? Examine the abdomen for enlarged liver or spleen Promote intake of omega-3 fatty acids Encourage participation in ADLs Assist with intake of immune-enhancing tube feeding formulas

Encourage participation in ADLs

Which intervention should the nurse implement with the client who has undergone a hip replacement? Have the client bend forward to rise from the chair. Adduct the legs by placing a pillow between the legs. Instruct the client to avoid internal rotation of the leg. Place the client in high Fowler's position for meals.

Instruct the patient to avoid internal rotation of the leg

Which statements describe open reduction of a fracture? Select all that apply. It is performed in the operating room. The bone is restored to its normal position by external manipulation. The bone is surgically exposed and realigned. The client usually receives general or spinal anesthetic.

It is performed in the operating room The bone is surgically exposed and realigned The client usually receives general or spinal anesthetic

Which is a benefit of a continuous passive motion (CPM) device when applied after knee surgery? It prevents infection and controls edema and bleeding. It provides active range of motion. It promotes healing by immobilizing the knee joint. It promotes healing by increasing circulation and movement of the knee joint.

It promotes healing by increasing circulation and movement of the knee joint

A client undergoes open reduction with internal fixation to treat an intertrochanteric fracture of the right hip. The nurse should include which intervention in the postoperative care plan? Turning the client from side to side every 2 hours Maintaining the client in semi-Fowler's position Performing passive range-of-motion (ROM) exercises on the client's legs once each shift Keeping a pillow between the client's legs at all times

Keeping a pillow between the client's legs at all times

A client visits an orthopedic specialist because of pain beginning in the low back and radiating behind the right thigh and down below the right knee. The doctor suspects a diagnosis of sciatica. The nurse knows that the origin of the pain is between which intervertebral disks? L2, L3, and L5 L4, L5, and S1 C3, C4, and L1 L1, L2, and L4

L4, L5, and S1

A client is seen in the orthopedic clinic for complaints of severe pain in the left hip. After a series of diagnostic tests, the client is diagnosed with severe degenerative joint disease of the left hip and suggested to have the hip reconstructed. What procedure will the nurse schedule the client for? Left hip arthroscopy Open reduction and internal fixation of the left hip. Closed reduction of the left hip. Left hip arthroplasty

Left hip arthroplasty

Assessment of a client reveals signs and symptoms of Paget's disease. Which of the following would be most likely? Lordosis Upright gait Skull narrowing Long bone bowing

Long bone bowing

Which of the following deformity causes a exaggerated curvature of the lumbar spine? A) Lordosis B) Kyphosis C) Steppage gait D) Scoliosis

Lordosis

The nurse assesses soft subcutaneous nodules along the line of the tendons in a patient's hand and wrist. What does this finding indicate to the nurse? A) The patient has rheumatoid arthritis. B) The patient has osteoarthritis. C) The patient has neurofibromatosis. D) The patient has lupus erythematosus.

The patient has rheumatoid arthritis

A nurse is teaching a client about preventing osteoporosis. Which teaching point is correct? To prevent fractures, the client should avoid strenuous exercise. The recommended daily allowance of calcium may be found in a wide variety of foods. Obtaining an X-ray of the bones every 3 years is recommended to detect bone loss. Obtaining the recommended daily allowance of calcium requires taking a calcium supplement.

The recommended daily allowance of calcium may be found in a wide variety of foods

The nurse is preparing a client to have his cast cut off after having it for 6 weeks to treat a fractured tibia. What should the nurse inform the client prior to the cast being removed? The skin may be covered with a yellowish crust that will shed in a few days. The leg strength is enforced by the wearing of the cast. The leg will look as it did prior to the cast being applied. The leg will look moist and will have small bumps that will go away in a few days.

The skin may be covered with a yellowish crust that will shed in a few days

A client is being discharged home with a long arm cast. What education should the nurse include to prevent disuse syndrome in the arm? Use of isometric exercises Repositioning the arm in the cast Proper use of a sling Abduction and adduction of the shoulder

Use of isometric exercises

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

Use the large muscles of the leg when lifting items

The nurse teaches the client with a high risk for osteoporosis about risk-lowering strategies, including which action? Increase fiber in the diet Decrease the intake of vitamin A and D Walk or perform weight-bearing exercises outdoors Reduce stress

Walk or perform weight-bearing exercises outdoors

A nurse is planning discharge teaching regarding exercise for a client at risk for osteoporosis. Which exercise would the nurse be most likely to suggest? Swimming Yoga Walking Bicycling

Walking

An older adult patient had a hip replacement. When should the patient begin with assisted ambulation with a walker? 24 hours 72 hours 2 to 3 weeks 1 week

after 24 hours

Which is an indicator of neurovascular compromise? A) Capillary refill of more than 3 seconds B) Pain upon active stretch C) Warm skin temperature D) Diminished pain

capillary refill >3 seconds

Which is a circulatory indicator of peripheral neurovascular dysfunction?

cool skin

Which of the following is an appropriate priority nursing diagnosis for the client following an arthrocentesis?

risk for infection

A client has a fracture that is being treated with open rigid compression plate fixation devices. What teaching will the nurse reinforce to the client about how the progress of bone healing will be monitored?

serial x-rays will be taken

A client arrives in the emergency department with a suspected bone fracture of the right arm. How does the nurse expect the client to describe the pain? Sore and aching Similar to "muscle cramps" A dull, deep, boring ache Sharp and piercing

sharp and piercing