Muscoskeletal/ Neuro NCLEX Questions

A 48 year old client experiences an exacerbation of multiple sclerosis after being asymptomatic for the past 6 months.How can the nurse best help the cleint deal with personal fears at this time? 1. Encourage the client to verbalize feelings 2. Provide a detailed explanation of the disease progression 3. Tell the client about physical assessment findings 4. Explain that the disease may become periodically acute

1

During an acute episode of rheumatoid arthitis, there is an order to apply a splint to each of the clients hands. What nursing explanation most accurately explains the primary purpose of splints? 1. Splints are used to rest affected joints 2. Splints are used to slow joint deterioration 3. Splints are used to improve hand strength 4. Splints are used to increase range of motion

1

The client with Parkisons disease takes levodopa/carbidopa three times a day. Because the client with Parkisons disease is prone to constipation the nurse should encourage increased consumption of which food? 1. Fresh fruits 2. Wheat pasta 3.Low-fat cheese 4. Canned vegetables

1

The nurse provides discharge instructions regarding positions to be temporarily avoided following a total hip replacement. What statement indicates to the nurse that the client understands the restrictions to be followed? 1. I shouldnt cross my legs 2. I should avoid pointing my toes 3. I shouldnt lie flat in bed 4. I shouldnt stand upright

1

The postoperative client will have antiembolism stockings 22. What nursing statement provide best explanation about the purpose of antiembolis stockings? 1.Antiembolism stockings preve blood from pooling 2.Antiembolism stockings reduce blood flow from the extremities 3. Antiembolism stockings keep blood presure lower in the legs 4. Antiemolism stockings keep the blood vessels constricted

1

The postoperative client will have antiembolism stockings. The nurse delegates the application of the clients antiembolism stockings to an unlicensed assisstive personnel. What is the correct technique for applying these stockings? 1. Apply the stockings before getting the client out of bed 2. Apply the stockings just before helping the client do leg exercises 3. Apply the stockings after noting that the clients legs are cool 4. Apply the stockings at night before the clients bedtime

1

The postoperative client will have antiembolism stockings. What nursing instruction should the nurse provide the unlicensed assistive personnel about turning the client onto the nonoperative side postoperatively? 1. Place pillows between the clients legs 2. Have the client point the toes downward 3.Flex the clients knee on the affected side 4. Elevate the head of the clients bed

1

What area of health teaching is essential to include the discharge instructions for a client who has undergone a total hip replacement? 1. Modifying ways of donning clothing 2. Using special equipment for bathing 3. Taking vigorous daily walks 4. Receiving a daily stool softener

1

When a nurse cares for a 75-year old client with osteoarthritis in the left hip, what nursing instruction is most beneficial to minimize stress on the client's painful joints? 1. Maintain a normal weight 2. Apply a topical analgesic cream 3. Take a calcium supplement 4. Become more physically active

1

When the client is allowed to ambulate with a walker using a three point partial weight- bearing gait, what nursing observation indicates that the client is ambulating correctly? 1. The client advances the walker and operative leg while putting most of the weight on the walkers handgrips 2.The client advances the walker and operative leg while putting most of the weight on the back legs of the walker 3. The client advances the walker and operative leg while putting most of the weight on the toes of the operative leg 4. The client advances the walker and operative leg while putting most of the weight on the heel of the nonoperative leg.

1

A total hip replacement( hip arthroplasty) is planned for a 70 year old client with osteoarthritis. The client is told to stop taking enteric coated aspirin 1 week before the surgery.What statement by the nurse is the best explanation for discontinuing the medication? 1. Aspirin can increase your risk of wound infection 2. Aspirin impairs your ability to control bleeding 3. Aspirin can make it difficult to assess your pain 4. Aspirin interferes with your ability to heal

2

An antibiotic is ordered to treat the infection at the pin site If the client is allergic to penicillin, the nurse must question a medical order for which type of antibiotic? 1. An aminoglycoside such as gentamicin sulfate 2. A cephalosporin such as cefaclor I 3. A tetracycline doxycycline 4. A sulfonamide such as trimethoprim/ sulfamethoxazole

2

Applying heat to the clients hands to relieve discomfort is recommended.What form of heat application is best for the nurse to suggest? 1. Melted wax treatment 2. Warm moist compresses 3. Electric heating pad 4. Infrared heat lamp

2

Before undergoing surgery for a fractured hip, older client is placed in Buck's traction. What nursing assessment technique is best for assessing circulation in the leg in Buck's traction? 1. Feel the temperature of the exposed toes 2.Palpate for pulsation of the dorsalis pedis artery 3. Take a leg blood pressure with a thigh cuff. 4. Determine whether the client can feel sharp dull sensations.

2

Before undergoing surgery for older client is placed in Buck's traction. What nursing technique is best planning to change the client's bed linens? 1. Roll client from one side of the bed to the other 2. Apply the linens from the foot to the top of bed 3. Leave the bottom sheets in place until after surgery 4.Raise the client from the bed with a mechanical lift

2

How should the nurse position the affected hip after the client undergoes a total hip replacement? 1. Adduct the hip 2. Abduct the hip 3. Flex the hip 4. Extend the hip

2

The client with gout is at risk for forming kidney stones and has been instructed by the nurse to drink 3000mL of fluid daily. When the client describes usual fluids in the diet what would the nurse instruct the client to avoid following discharge? 1. Coffee 2. Alcohol 3. Cranberry juice 4. Carbonated drinks

2

The client's fractured hip is stabilized with an open reduction and internal fixation (ORIF) using a Smith- Peterson nail. Postoperatively, when the nurse teaches the clhens how to perform isometric quadriceps setting exercises what instruction accurate? 1. Move your toes toward and away from your head 2. Contract and relax your thigh muscles 3. Lift your lower leg up and down from the bed 4. Bend your knee and pull your lower leg upward.

2

What equipment is best for preventing external rotation of the operative leg when caring for a client with a total hip replacement? 1. A footboard 2. A trochanter roll 3. A turning sheet 4. A foam mattress

2

What is the best evidence that the client who had a knee arthroplasty is recovering and no longer needs the continuous passive motion(CPM) machine? 1. The client has minimal pain when ambulating 2. The client can flex the operative knee 90 degrees 3. The client can perform straight-leg raising 4. The clients surgical wound is approximated.

2

What is the priority nursing intervention in the postictal phase of a seizure? 1. Assess the clients level of arousal 2. Assess the clients breathing 3. Reorient the client to surroundings 4.Change the clients clothing

2

What nursing recommendation has the greatest potiental for helping the client maintain the ability to perform self-care? 1. Move to a warm climate like Arizona 2.Buy clothes that are easy to pull up or slip on 3. Enroll in an aerobics exercise class 4. Sleep on a warm water bed or heating pad

2

When documenting a seizure, what information is most important to include initially? 1. The time the seizure started 2. The duration of the seizure 3. The clients mood just before the seizure 4. The clients comments after the seizure

2

Before undergoing surgery for a fractured hip, an older client is placed in Buck's traction. What nursing finding warrants immediate action when inspecting the traction? 1.The traction weights are hanging floor. 2.The leg is in line with the pull of the traction. 3. The client's foot is touching the end of the bed 4. The rope is in groove of the traction pulley

3

What goal is most realistic when the nurse cares for the client with Parkisons disease? 1. To reverse the symptoms and cure the disease 2. To stop the progression of the disease process 3. To maintain optimal muscle and motor function 4. To prepare for a progressive terminal disease

3

What nursing action should the nurse take when preparing the client for an EEG? 1. Administer a sedative 1 hour before the test 2.Withold food and water after midnight 3. Assist with shampooing the clients hair 4. Assess the clients current level of pain

3

What nursing assessment indicate an autonomic nervous sysytem manifestation of a seizure? 1.Numbness and tingling of the hands 2. Changes in taste and speech 3. Flushing and increased sweating 4. A subjective aura or sensation

3

What piece of equipment is most appropriate to obtain for the clients postoperative care with a total hip replacement? 1. A bed cradle 2. A bed board 3. An overhead trapeze 4. Lower side rails

3

When coordinating discharge care with a home health nurse, what piece of equipment is essential for home care? 1. A wheelchair 2. A hospital bed 3. A raised toilet seat 4. A mechanical lift

3

When implementing seizure precautions what nursing action is most appropriate to include? 1. Move the client to a room close to the nurses station 2. Serve the clients food in paper and plastic containers 3. Avoid restraining the clients movement during a seizure 4. Keep the clients airway clear with a padded tongue blade.

3

When nursing action should be the nurses priority when caring for the client with Parkisons disease? 1. Preventing muscle weakness 2. Maintaining a balance diet 3. Removing safety hazards 4. Promoting social interactions

3

When the client has difficulty ambulating who should the nurse consult regarding a refferal to an extended care facility? 1. The physican therapist 2. The clients spuse 3. The discharge planner 4. A home health agency

3

When the nurse is providing shift report for the client diagnosed with gout, what lab result is essential to communicate with the next shift? 1. Creatitine clearance 2. Blood urea nitrogen 3. Serum uric acid 4. Serum calcium

3

When the nurse observes the client walking with a cane,what assessment finding indicates the need for more instruction? 1. The tip of the cane is covered with a rubber cap 2. The client wears athletic shoes with nonskid soles 3. The client uses the cane on the painful side 4. The client looks straight ahead when walking

3

When the nurse obtains the client s health history, when is the most likely time the client began developing symptoms of RA? 1. In very early childhood 2. At the onset of puberty 3. During young adulthood 4. Within older adulthood

3

A 60 year old client in the late stage of amyotrophic lateral sclerosis is admitted to the hopital.On the basis of the usual course of this disease, what nursing diagnosis is most likely included in the clients care plan? 1. Sexual dysfunction 2. Disturbed body image 3. Impared memory 4. Self care deficit

4

A client who has degenerative arthritis is admitted for a total hip replacement. When the nurse reviews new medical orders, one order says, Furosemide 20mg q.o.d. by mouth. What is the best action the nurse should take? 1. Record the order on the Medication Administration Record 2. Consult the pharmacist about the medical order 3. Give the first dose today without delay 4.Clarify the medical order with the prescriber

4

A corticosteriod is ordered as an adjunct to aspirin. What statement made by the client indicates to the nurse that further instruction regarding corticosteriod therapy is necessary? 1. Im susceptible to getting infections 2. I should never stop taking my mesications abruptly 3. I may become very depressed and prehaps suicidal 4. I may develop low blood sugar and need glucose

4

What nursing actions are essential when finding a client experiencing a tonic-clonic seizure? Select all that apply 1. calling out the cleints name 2. Holding the clients body during the seizure activity 3. Placing an emesis basin close to the clients mouth 4. Rolling the clients body to the side 5. Removing environmental hazards to protect the client 6. Calling the respiratory therapy department

4,5,6

An 80 year old client who sustained a fall at a long term care facility is suspected of having a fractured right hip.When the nurse reviews the clients medical record,what risk factor is most significant for predisposing the client to a fracture? A. The client is post menopausal B. The client is somewhat obese C. The client has type 2 diabetes D. The client is lactose intolerant

A

A low purine diet is ordered for the client. The nurse would be correct to request a consultation with a dietitian if the client chooses a meal that includes which food? 1. Beets 2. Milk 3. Eggs 4. Liver

4

While planning care for the client,when would the nurse expect a need for more time and assistance with activities of daily living? 1. In the early morning 2. At noon 3. In the late afternoon 4. Before bed

1

When the client tells the nurse he is allergic to kiwi fruit, to what other hospital substance should the nurse anticipate the client may develop an allergic reaction? 1.Iodine 2.Latex 3. Laundry soap 4.Hand sanitizer

2

A 54 year old client is being treated for gout. When the nurse examines the client, what body part is usually affected by gout? 1. Great toe 2. Index finger 3. Sacrococcygeal vertebrae 4. Temporomandibular joint

1

An adult has been experiencing persistent joint pain and stiffness. What laboratory test, if elevated, is the best diagnostic indicator of rheumatoid arthritis? 1. Erythrocyte sedimentation rate (ESR) 2. Partial thromboplastin time (PTT) 3.Fasting blood sugar (FBS) 4. Blood nitrogen (BUN)

1

An older adult diagnosed with parkinsons disease is admitted to a nursing home for basic nursing care.What nursing assessment is most important to consider before developing the clients care plan? 1. The client ability to perform activities of daily living 2. The clients preferences for and dislikes of various foods 3. The family members views about nursing home placement 4. The client feelings about giving up independent living

1

Because the cleint takes large amounts of aspirin daily, the nurse monitors for signs and symptoms of toxicity. What assessment finding is the best indication of aspirin toxicity? 1.Ringing of the ears 2. Dizziness 3. Metallic taste in the mouth 4. Proteinuria

1

Colchicine is prescribed to be given every hour until the clients pain is relieved during an acute attack of gout. What client symptom indicates that the nurse should withhold the medication until checking with the prescriber even if the clients pain is unrelieved? 1. Vomiting 2. Dizziness 3. Drowsiness 4. Headache

1

What finger joints would the nurse expect to be most affected by the clients rheumatoid arthritis? 1. Proximal finger joints 2. Medial finger joints 3. Distal finger joints 4. Lateral finger joints

1

What seizure precautions should the nurse implement when caring for the client? Select all that apply 1.Keep the room dark and quiet 2. Lower the bed to the lowest position 3. Keep the side rails up and padded 4. Provide soft soothing music 5. Ensure a warm, well lit room 6. Make sure suction equipment is available

1, 2, 3, 6

A client who has degenerative arthritis is admitted for a total hip replacement. After the clients total hip replacement surgery,what nursing actions are essential? Select all that apply. 1.Keeping the cleints knees apart at all times 2.Avoiding more than 90 degrees of hip flexion 3. Having the cleint use a raised toilet seat 4.Raising the head of the clients bed 90 degrees 5.Placing two pillows beneath the clients knees 6.Keeping the client legs internally rotated

1,2,3

A 36 year old client undergoes an arthroscopy of the right knee for diagnosing and treating chronic joint pain. When the nurse prepares the client for discharge, what information is considered a priority? 1. Signs and symptoms of arthritis 2. Technique for using crutches 3. Adverse effects of drug therapy 4. The need to balance rest and exercise

2

A 48 year old client experiences an exacerbation of multiple sclerosis after being asymptomatic for the past 6 months.What assisting the client with activites of daily living what approach is best? 1. Limit the time for performing ADLs to 30 minutes 2.Eliminate whatever tasks the cleint cannot perform 3. Let the client rest between activites 4.Perform all of the cleints ADLs at this time

3

Before discharge, when the nurse provides drug teaching about self-adminstering phenytoin sodium, what hygiene measure should the nurse emphasize? 1. Frequent shampooing of the hair 2.Weekly trimming of the fingernails 3. Brushing teeth at least twice daily 4. Daily bathing using midl soap

3

The client with gout is at risk for forming kidney stones and has been instructed by the nurse to drink 3,000 mL of fluid daily. When implementing the plan of care, when should the nurse encourage the major intake of fluids for the daily? 1. Before bedtime 2. Early evening 3. In the morning 4. Midafternoon

3

A total of 5g of aspirin per day is prescribed .What modification in the client's nursing care plan is most appropriate when the client experiences stomach discomfort when taking aspirin? 1.Give aspirin before meals only 2. Give aspirin with cold water 3. Give aspirin with hot tea. 4. Give aspirin with food or meals

4

After a tonic clonic(Grand mal) seizure, the client progresses to the postictal phase. What clinical manifestation will the nurse most likely observe at this time? 1. Excessive jerking of the entire body 2. Starting with a brief loss of consciousness 3. Fluttering of the eyelids and movement of the lips 4. Confusion followed by deep sleep

4

If the cleint begins to have a seizure after the EEG, what action should the nurse take first? 1. Adminster the oxygen by nasal cannula 2. Measure the blood pressure and pulse 3. Check the clients pupils 4. Place the client in a side-lying position

4

The client with Parkisons disease takes levodopa/carbidopa three times a day.When the nurse observes that the client has difficulty swallowing the capsule of medication what action is best? 1. Soak the capsule in water until soft 2. Tell the client to chew the capsule 3. Empty the capsule in the clients mouth 4. Offer water before giving the capsule

4

The postoperative client will have antiembolism stockings. When the nurse makes out assignments for nursing staff, what is the major consideration determining the person assigned to care for clients? 1. The staff members' preferences 2. The workload staff member per 3. The location of clients on the unit 4. The current acuity level of clients

4

An 80 year old client sustained a fall at a long term care facility is suspected of having a fractured right hip. What nursing assessment support that the client has a fractured hip? Select all that apply A. The client has pain near the distal femur B. The client cannot bear weight on the affected leg C. The client affected leg is shorter D. The client affected leg is adducted E. The affected leg is externally rotated F. The client prefers to sit rather than lie flat

B,C,E