Module 3 musculoskeletal and neuro practice questions

Risk factors for osteoporosis include....Select all that apply A. history of strength training exercise B. postmenopausal female C. history of smoking D. sedentary lifestyle

B, C, D

Client with diagnosis of SIADH. The nurse would expect to see what laboratory finding? A. Serum sodium 125 B. Serum potassium 2.7 C. Serum glucose 250 D. Serum chloride 110

A

Patient with head injury. Which of the following are manifestations of Increased ICP? Select all that apply A. Headache. B. Tachycardia C. Hypotension D. Pupillary changes E. Abnormal posturing

A, D, E

A child is admitted with a head injury after being in a MVA. After noting the presence of clear drainage from the left ear, the nurse would suspect which underlying problem commonly associated with this finding? A. Linear skull fracture B. Basilar skill fracture. C. Subdural hematoma D. Epidural hematoma

B

An obese client with DJD is being treated with aspirin. The nurse concludes that additional client teaching is needed when the client makes which statement? A. "I take aspirin only when I have extreme pain and stiffness." B. "I use heat sometimes to decrease pain and joint stiffness" C. "I frequently examine my stools for bleeding" D. "I started an exercise program to lose weight"

A

Before assisting a patient with ORIF in ambulation for the first time, the nurse will.... A. Review orders for weight-bearing status. B. Use mechanical lift to transfer bed to chair C. Administer pain medication 3 hours prior to ambulation D. Encourage patient to empty bladder to minimize interruption

A

Client is recovering from hip replacement but has sudden onset of restlessness/anxiety/complains of chest pain, SOB, and cough with frothy blood-tinged sputum, HR 110, temp 101.2. Based on these findings, which of the following complications is most likely? A. Pulmonary embolism. B. Atelectasis C. Pneumonia D. Pneumothorax

A

The client is diagnosed with Parkinson's disease states, "I just don't think I can handle having this disease" what is the nurse's best first response? A. "You sound overwhelmed. Can you tell me more." B. "I am sure you can. A lot of people do" C. "What do you think will be the hardest thing to handle" D. "The entire health care team will help you manage the disease"

A

The nurse is instructing the client who has been in the hospital with bacterial meningitis and will be going home soon. Which of the following will be of highest priority? A. take all the antibiotics as directed until they are gone B. eat a high protein, high calorie diet C. exercise daily, beginning with active ROM D. get at least 8 hours of sleep every night

A

Which assessment finding in a 35 year old client with an intracranial hematoma should concern the nurse? A. Hamstring pain when the hip and knee are flexed and then extended. B. Curling of the toes when the bottom of the foot is stroked in upward motion C. Muscle aches and cramping, especially at night D. Cogwheel and lead pipe rigidity

A

76 year old women history of osteoporosis has right hip fracture and admitted to hospital. Total hip replacement done. Most important nursing diagnosis is... A. Acute pain. B. Self-care deficit C. Risk for impaired skin integrity D. Imbalanced nutrition

A (?)

What is the leading cause of osteoporosis? Select all that apply A. Vitamin D deficiency B. Estrogen deficiency. C. Progesterone deficiency D. Folic acid deficiency

A, B

Which clinical manifestations ae associated with a fat embolism? Select all that apply A. Dyspnea. B. Decreased oxygen saturation. C. Tachycardia. D. Bradycardia

A, B, C

Client being discharged after hip replacement surgery. What adaptive equipment does the nurse expect the client will need initially at home? Select all that apply A. walker B. elevated toilet seat C. wheelchair D. reacher/grabber

A, B, D

Client with fracture of leg in MVC. Cast is applied. Nurse will assess which of the following? Select all that apply A. pulses B. capillary refill C. squeeze cast Q 1 hour for firmness D. assess for numbness/tingling

A, B, D

Client with osteoarthritis discomfort has been advise to take OTC drugs. Which of the following medications should the nurse advise the client are OTC drugs? Select all that apply A. NSAIDS B. Corticosteroids C. Acetaminophen D. Hydrocodone

A, C

Teaching client about risk factors for osteoporosis. Most important to include which factors. Select all that apply A. Decreased calcium intake B. BP Meds C. Family history D. Smoking E. Oral hypogycemics

A, C, D, E (?)

The nurse is planning for care for a client who has meningitis and is at risk for increased intracranial pressure (ICP). Which of the following are appropriate nursing actions? Select All That Apply A. Implement seizure precautions. B. Perform neurological checks four times a day C. Administer morphine for the report of neck & generalized pain D. Turn off room lights and television. E. Encourage the client to cough frequently

A, D

Client with osteoporosis. Which statement should be included when teaching client about disease?Select all that apply A. Common in females. B.Avoid weight-bearing exercises C.Degenerative disease. D.Can cause pain and injury.

A, D, C

A client in skeletal traction for right femur fracture reports pain in the affected limb. After assessing that the right foot is pale and without a pulse, what should the nurse do next? Select all that apply A.Ensure that the leg is not raised above the heart. B. Administer analgesics as ordered C. Release the traction D. Recheck the pulse in an hour E. Document the finding and call the provider.

A, E

A client calls the telephone triage nurse to report fever nausea, chills, and malaise. The nurse instructs the client to come immediately to the ED after the client shares which additional data? A. bad headache B. stiff sore neck. C. heart rate of 110 D. roommate with the same symptoms

B

70 year old women complains of lower back pain and diagnosed with osteoporosis. The nurse is aware that client is most at risk for... A. Pain B. Fracture C. Hardening of bones D. Increased bone matrix and remineralization

B

A client has been placed in balanced suspension traction after a fracture. The nurse explains that which of the following is an advantage of this type of traction? A. It eliminates the risk for skin breakdown B. It allows the client to raise the buttocks off the bed for bedpan use. C. It is more effective in reducing hip contracture D. It requires only one weight to maintain traction

B

A nurse is assessing a client who reports severe headache and a stiff neck. The nurse's assessment reveals positive Kernig's and Brudzinski's sign. Which of the following actions should the nurse perform first? A. Administer antibiotics B. Implement droplet isolation precautions. C. Initiate IV access D. Decrease bright lights

B

An 87 year old client who sustained aright hip fracture asks the nurse how long it will take for the fracture to heal. The nurse's response includes consideration of which client factor that influences the rate of bone healing? A. Frequency of PT B. Age of the patient. C. Weight of the patient D. Early ambulation

B

An older client who has undergone internal fixation after fracturing a left hip has developed a reddened left heel. The nurse obtains which of the following as a priority item to manage this problem? A. trapeze B. sheepskin C. bed cradle D. draw sheet

B

Nurse is assessing neuro status of client who had craniotomy 3 days ago. Nurse should notify surgeon immediately if client exhibits which of the following? A. Pupils equal and reactive at 4 mm in size B. Pain with forward flexion of the neck onto the chest. C. Mild headache relieved by codeine sulfate D. Disorientation to date

B

The client recently diagnosed with Guillain Barre syndrome is drooling and having difficulty swallowing secretions. When the family asks why this occurs, the nurse indicates that which of the following is the cause? A. Obstructed blood flow to the midbrain B. Demyelination of cranial nerves responsible for swallow and gag reflex. C. Enlargement of the parotid and salivary glands D. Deficiency in thiamin and pyridoxine in the CNS

B

The nurse is providing care for a patient in halo traction due to a spinal cord injury. Which assessment is the first priority for the nurse? A. loosen connections on the vest to assess skin B. assess pin sites C. ask how the client is able to reposition self in bed D. ask about client's ability to perform range of motion

B

The nurse is teaching a postmenopausal client about the use of calcium to reduce the risk of osteoporosis. The client asks: "why to I have to take Vitamin D with my Calcium" what is the nurse's best response? A. "Vitamin D prevents OP" B. "Vitamin D increases the intestinal absorption of Ca" C. "You are most likely to be deficient in Vitamin D" D. "Using calcium and vitamin D supplements is the only way to prevent osteoporosis"

B

The nurse would prevent corneal abrasion in a client with MG by performing which nursing intervention? A. Doing saline eye irrigation every shift B. Instilling artificial tears in the eyes every 1-2 hours C. Ensuring the client's contact lenses are on while awake D. Providing sunglasses when client is outside

B

What is the priority nursing diagnosis for a patient with an ORIF? A. Risk for constipation B. Risk for infection. C.Risk for injury D.Activity intolerance

B

When assessing a client with increased ICP, the nurse looks for which manifestation as a first sign of increased ICP? A. rising BP B. change in mood or attention level C. irregular respiratory rate and depth D. bounding radial pulse

B

The nurse is planning care for a client who has bacterial meningitis. Which of the following actions should the nurse include in the plan of care? Select All That Apply A. Monitor for bradycardia B. Provide an emesis basin at the bedside. C. Administer antipyretic medication as prescribed. D. Perform a skin assessment. E. Keep the head of the bed flat

B, C, D

Client is having tonic-clonic seizure. Nurse should take which of the following actions? Select all that apply A. Restrain client B. Maintain airway C. Turn client to side D. Place tongue blade in mouth E. Protect client from injury

B, C, E

Client preparing for lumbar puncture. Nurse will assist client into which position for procedure? A. Prone, slight Trendelenburg position B. Prone, pillow under abdomen C. Side-lying with legs pulled up and head bent down onto chest. D. Side-lying with pillow under hip

C

Client scheduled for ORIF of right hip. Which nursing intervention should be performed first? A. Provide home care teaching plan B. Encourage cough, turn, deep breath C. Complete history/physical exam. D. Monitor vital signs

C

The nurse has formulated a nursing diagnosis of Ineffective Family Processes r/t to hospitalization of a child with a potentially fatal condition for the family of a child who sustained a brain injury during a MVA. Which interventions would have the highest priority? A. Teach the family the importance of using seatbelts B. Refer the family to support services in the community C. Encourage the family to ask questions. D. Explain rules for visiting in the ICU

C

What strategy would the nurse suggest to the family of the client with PD as the best approach to helping the client maintain as much functional independence as possible? A. Assist the client to take a warm bath every morning B. Perform passive range of motion every am C. Display an unhurried manner that allows the client sufficient time to respond or act D. Obtain assistive devices that will make activities of daily living easier

C

Which instructions will the nurse include in teaching about alendronate (Fosamax)? A. A.Take with food and a full glass of water B. Take at bedtime with a full glass of water C. Take before breakfast and remain upright for 30 minutes. D. Lie down for at least 30 min after ingestion

C

In providing for the safety of the client during a grand mal seizure, the nurse performs which of the following interventions? Select all that apply A. Position the client on the back B. Gently place a padded tongue blade between the teeth C. Remove nearby objects that could lead to injury. D. Apply oxygen immediately via face mask E. Note the length and progression of the seizure.

C, E

A client with a femoral fracture is in Buck's traction. While making rounds the nurse notices that the client's foot is touching the footboard of the bed. What is the appropriate action by the nurse? A. Wedge a pillow between the footboard and the client's foot B. Praise the client for maintaining countertraction C. Center the client on the bed D. Ask the client to pull up in the bed while holding the weights.

D

A client with a short leg plaster cast complains of an intense itching under the cast. The nurse provides instructions to the client regarding relief measures for the itching. Which statement by the client indicates an understanding of the measures used to relieve the itching? A. I can use the blunt part of a ruler to scratch the area B. I can trickle small amounts of water down inside the cast C. I need to obtain assistance when placing an object into the cast for the itching D. I can use a hair dryer on the low setting and allow the air to blow into the cast

D

A truck driver sees the PCP because of persistent back pain. The nurse explains that which client activity documented during the nursing history may contribute to further back injury? A. Lifting objects close to the body B. Shifting positions when sitting for long periods of timeC. Providing back support with a pillow when sitting D. Prolonged standing or sitting.

D

Abnormal extension (Decerebrate) posturing is characterized by which of the following? A. Extension of extremities and pronation of the arms B. Flexion of extremities and pronation of arms C. Upper extremity flexion with lower extremity extension D. Upper extremity extension with lower extremity flexion.

D

Client sustained closed head injury. Nurse assess for which early sign of impending neurological deterioration? A. Loss of corneal reflex B. Increased visual acuity C. Bilateral pupil equality and reactivity D. Ipsilateral pupil dilation.

D

The nurse anticipates that the client with a increased ICP would most likely exhibit which set of VS? A. BP 190/85, HR 150, and an irregrespiratory pattern B. BP 80/50, HR 50 and kussmaulrespirations C. BP 80/50, HR 150, and Cheyne stoke respirations D. BP 190/85, HR 50, and irregular respirations.

D