Musculoskeletal ATI practice

A nurse is teaching a client who has osteoarthritis. Which of the following instructions should the nurse include in the teaching?

"Take acetaminophen as the primary medication to treat the pain."

A nurse is reviewing the medication history of a client who has a new prescription for colchicine. Which of the following medications increases the client's risk when used in combination with colchicine for developing rhabdomyolysis?

Atorvastatin

A nurse is assessing a client who has a hip fracture. Which of the following findings should the nurse expect?

Muscle spasms

A nurse is giving instructions to a client who had a surgical correction of a bunion. Which of the following information should the nurse include?

Place pillows under the knee to elevate the foot.

A nurse is teaching an older adult client who has osteoporosis about beginning a program of regular physical activity. Which of the following recommendations should the nurse make?

Walking briskly

A nurse is providing teaching for a client who has a new diagnosis of fibromyalgia. Which of the following client statements indicates the need for further teaching?

"Fibromyalgia causes joint inflammation."

A nurse is caring for a client who has osteoarthritis and asks about the use of glucosamine. Which of the following statements should the nurse make? (Select all that apply.)

"Glucosamine might increase bleeding" "Glucosamine can increase blood glucose levels" "Clients who have shellfish allergies might experience reactions when taking glucosamine"

A nurse is teaching a client who is perimenopausal and has recurrent lower back pain. Which of the following client statements indicates an understanding of the teaching?

"I should keep my weight within 10 percent of my ideal weight."

A nurse is completing discharge instructions with a client following an acute onset of gout. Which of the following client statements indicates an understanding of the treatment regimen?

"I will limit my alcohol intake."

A nurse is providing teaching for a client who is scheduled for a myelogram. Which of the following statements indicates the client understands the teaching?

"I will need to keep my head elevated after the procedure."

A nurse is assessing a client who is in skeletal traction. The nurse should correct which of the following findings?

The weights rest against the foot of the bed.

A nurse in a one-day surgery center is providing discharge teaching for a client who is postoperative following a partial meniscectomy. Which of the following instructions should the nurse include?

perform quadriceps setting practice

A nurse is teaching a client who has rheumatoid arthritis about self-care strategies for managing the disease. Which of the following activities should the nurse include in the teaching?

press water from a sponge rather than wringing it.

A nurse is caring for a client who is 4 hr postoperative following a hip replacement. The nurse should instruct the client to avoid which of the following activities?

putting on shoes and socks (more than a 90 flexion)

A nurse in a provider's office is providing teaching to a client about modifiable risk factors for osteoporosis. Which of the following factors should the nurse include? (Select all that apply.)

sedentary lifestyle carbonated drinks caffeine intake smoking tobacco

A nurse is caring for a client who reports low back pain and asks the nurse for specific exercise recommendations. Which of the following activities should the nurse suggest?

swimming

A nurse is teaching a client who has a pelvic fracture about manifestations of fat embolism syndrome. The nurse should include which of the following findings as an early manifestation?

tachypnea

A nurse is caring for a child who has a fracture of the forearm. The parent tells the nurse that the provider said it was a greenstick fracture and asks what that means. Which of the following statements should the nurse make?

"The bone is broken on one side and bent on the other side."

A nurse is teaching an assistive personnel (AP) about the purpose of a footplate on the bed of a client whose leg is in Buck's traction. Which of the following statements indicates the AP understands the teaching?

"The footplate helps to prevent foot drop."

A nurse is reviewing the cause of gout with a group of nurses. Which of the following statements should the nurse make?

"The intra-articular deposition of urate crystals causes inflammation."

A nurse is teaching a client who is scheduled for a gallium bone scan of his knee. Which of the following instructions should the nurse include?

"The isotope is excreted in your stool following the test."

A nurse is teaching a client who will receive a prosthetic leg. Which of the following statements should the nurse identify as an indication that the client needs further instruction?

"The technician will complete the prosthesis fitting at the time the surgeon removes the staples."

A nurse in a provider's office is providing teaching a client who is scheduled for electromyography. Which of the following information should the nurse include?

"You will have thin needles inserted into your muscles."

A nurse is teaching a client who is scheduled for dual-energy x-ray absorptiometry (DXA) to screen for osteoporosis. Which of the following instructions should the nurse include in the teaching?

"You will need to remove all jewelry before the test."

A nurse is caring for a client following a right total hip arthroplasty. Postoperatively the nurse should maintain the right leg in which of the following positions?

Abduction.

A nurse in a clinic is talking with a client who has a new diagnosis of osteoarthritis. The nurse should anticipate that the client will require teaching about which of the following medications?

Acetaminophen

A nurse is caring for a client who is postoperative following knee arthroplasty and has a continuous passive motion (CPM) machine. Which of the following actions should the nurse take?

Apply ice to the operative knee.

A nurse is assessing a client who has a cast in place for a fractured tibia. Which of the following actions should the nurse take first?

Checking capillary refill

A nurse is caring for a client who has a fractured tibia as a result of a fall. The client x-ray shows that the bone is splintered into several pieces around the shaft. The nurse should identify that the client has which of the following types of fractures?

Comminuted

A nurse is teaching a class about providing emergency care for clients who have a sports-related injury. Which of the following information should the nurse include?

Compress the injury for 24 hr.

A nurse is caring for an older adult client who had a femoral head fracture 24 hr ago and is in skin traction. The client reports shortness of breath and dyspnea. The nurse should suspect that the client has developed which of the following complications?

Fat embolism (develops within 12 to 48 hr of a fracture)

A nurse is assessing a client for early manifestations of rheumatoid arthritis (RA). Which of the following changes is an early manifestation of RA?

Fatigue (weakness and anorexia also)

A nurse is caring for a client who is postoperative following a total hip arthroplasty. The nurse assists the client into a supine position. Which of the following actions is appropriate to prevent dislocation of the hip?

Place a wedge pillow between the legs.

A nurse is caring for a client who is postoperative following an inner mandibular fixation for a fractured mandible. Which of the following actions should the nurse take?

Place wire cutters at the client's bedside.

A nurse is assessing a client who has carpal tunnel syndrome. The nurse should expect which of the following findings?

Positive Phalen's sign

A nurse is assessing a client who is postoperative following a right below-the-knee amputation. Which of the following findings should the nurse identify as a possible complication?

Presence edema above the stump dressing

A nurse is assessing a client who has systemic lupus erythematosus (SLE). Which of the following findings is the highest priority for the nurse to report to the provider?

Presence of peripheral edema.

A nurse is planning care for a client who is postoperative following a total hip arthroplasty. Which of the following interventions should the nurse include in the plan of care?

Prevent hip flexion of the affected extremity

A nurse is teaching a client about medications that prevent osteoporosis. The nurse should instruct the client that which of the following medications is prescribed to prevent osteoporosis?

Raloxifene

A nurse is caring for a client who has a fractured right femur and is in balanced suspension traction. The client is reporting pain from muscle spasms. Which of the following actions should the nurse take first?

Realign the client's position.

A nurse is teaching a client who has rheumatoid arthritis about increasing physical rest as part of her treatment plan. Which of the following outcomes of this intervention should the nurse document as a goal for this client?

Reduced joint stress

A nurse is providing discharge teaching to a client who has a Plaster of Paris walking cast on his left lower leg. Which of the following instructions should the nurse include?

Report any numbness or pain in your toes.

A nurse is providing discharge teaching to a client who has a fracture of the right tibia and a fiberglass cast. Which of the following instructions should the nurse include in the teaching?

Report any worsening or unrelieved pain.

A nurse is caring for a client who has a prescription for balanced skeletal traction with a Thomas splint for the treatment of a fractured femur. Which of the following interventions should the nurse implement to prevent pressure points from developing around the edges of the splint?

Reposition the client to keep him from staying in the same position in bed.

A nurse is discussing Russell's traction with a newly licensed nurse. Which of the following statements about this form of traction should the nurse include in the teaching?

Russell's traction uses a sling under the knee to treat a fracture of the femur.

A nurse is teaching a client who has gout about medications. The nurse should teach the client to avoid the use of which of the following types of medication?

Salicylates

A home health nurse is assessing an older adult client in the home who has decreased vision due to a history of glaucoma. Which of the following findings should the nurse identify as a safety risk?

Scatter rugs are present in the kitchen

A nurse in a provider's office is collecting a health history from a client who is at risk for primary osteoporosis. Which of the following findings is a risk factor for the development of osteoporosis?

Sedentary lifestyle

A nurse is caring for a client who has a herniated lumbar disc and reports pain. The nurse should assist the client into which of the following positions to help reduce the pain?

Semi-Fowler's with a pillow under her knees

A nurse is teaching a client who is starting to take alendronate effervescent tablets to treat osteoporosis. Which of the following information should the nurse include?

Sit upright or stand for at least 30 minutes after taking this medication.

A nurse is discussing the differences between skeletal and skin traction with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates understanding?

Skeletal traction is more appropriate than skin traction for reducing a fracture.

A nurse is caring for a client who is postoperative and in skeletal traction. When assessing the client, the nurse should expect which of the following findings? (Select all that apply.)

Slight pain at the insertion site Serous drainage on the dressing Minimal edema around the pin

A nurse is caring for a client who is 1 day postoperative following a mastectomy. Which of the following exercises should the nurse assist the client to perform on the affected side? (Select all that apply.)

Squeezing a rolled washcloth Flexing and extending her hand Flexing and extending her elbow

A nurse is caring for a client who is postoperative following a below-the knee-amputation and will soon undergo fitting for a leg prosthesis. Which of the following is an appropriate nursing intervention for this client at this time?

Wrap the residual limb with an elastic bandage in a figure-eight configuration.

A nurse is teaching a client who has gout about dietary recommendations. The nurse should teach the client that which of the following beverages can trigger an attack?

alcohol

A nurse is teaching a client who is starting to take methotrexate to treat rheumatoid arthritis. Which of the following instructions should the nurse include in the teaching?

drink at least 2 liters of water daily

A nurse is caring for a client who is 1-day postoperative following total hip arthroplasty. It is 0830 and the client is schedule for physical therapy (PT) at 0900. Which of the following interventions should the nurse take?

identify pain level and medicate if needed

A nurse is caring for a client who has a new short-leg cast on his lower leg to treat an ankle fracture. Which of the following findings requires immediate notification of the provider?

inability to flex the toes of the casted foot

During the assessment of a client who has a cast on his right leg, a nurse locates an area on the cast that feels warm to the touch. Which of the following complications should the nurse suspect?

infection

A nurse in a provider's office is assessing a client who has rheumatoid arthritis (RA). Which of the following findings is a late manifestation of this condition?

knuckle deformity

A nurse is preparing to turn a client who is obese following a spinal fusion. The nurse should plan to use which of the following techniques to turn this client?

log roll

A nurse is completing a physical assessment of a client who has early osteoarthritis. Which of the following manifestations should the nurse expect?

pain worsens with activity

A nurse is providing nutritional teaching to a client who has osteoporosis. Which of the following foods should the nurse recommend as being the highest in calcium?

3 oz canned salmon

A nurse is assessing a client who has a herniated cervical intervertebral disc. Which of the following findings should the nurse expect? (Select all that apply.)

Tingling in the arms Shoulder pain Stiff neck

A nurse is teaching with a client about taking high doses of oral glucocorticoids for an extended period of time to treat rheumatoid arthritis. Which of the following instructions should the nurse include in the teaching?

"Monitor for compression fractures of the back and neck."

A nurse is providing postoperative teaching with a client who had a surgical correction of hallux valgus. Which of the following information should the nurse include in the teaching?

"Rest frequently with your foot elevated."

A nurse is providing care for four clients on a medical-surgical unit. Which of the following clients should the nurse identify as being at risk for the development of pressure ulcers? (Select all that apply.)

A client who has protein calorie malnutrition A client who has right-sided heart failure and 4+ edema to the lower extremities A client who has postoperative delirium

A nurse is providing discharge teaching to a client following hip arthroplasty. Which of the following pieces of furniture should the nurse instruct the client to sit in at home?

A straight-backed chair with an elevated seat

A nurse is teaching a newly licensed nurse about the difference between a plaster cast and a synthetic cast. Which of the following information should the nurse include in the teaching?

A synthetic cast weighs less (less restrictive)

A nurse assessing a client who has multiple fractures in his left leg notes increasing edema. The nurse should recognize this finding as an early manifestation of which of the following complications?

Acute compartment syndrome

A nurse notes increasing edema in the calf of a client who has multiple fractures of the leg. The nurse should recognize that increasing edema is a manifestation of which of the following complications?

Acute compartment syndrome

A nurse is caring for a client who has acute osteomyelitis. Which of the following interventions is the nurse's priority?

Administer antibiotics to the client.

A nurse is preparing a presentation at a community center about osteoarthritis. The nurse should plan to include which of the following information? (Select all that apply.)

Affects weight-bearing joints Crepitus can occur in affected joints Causes joint stiffness Causes joint pain

A nurse is caring for a client with a new diagnosis of Paget's disease. The nurse anticipates the provider will prescribe which of the following medications for this client?

Alendronate

A nurse in the emergency department is assessing a newly admitted client who has facial trauma. Which of the following assessments is the nurse's priority?

Altered respirations

A nurse is caring for a client who has right-sided paralysis from a stroke. Which of the following interventions should the nurse implement to prevent footdrop?

Apply a protective boot to the right ankle.

A nurse is completing discharge teaching with a client following arthroscopic knee surgery. Which of the following instructions should the nurse include in the teaching?

Apply ice to the affected area.

A nurse in an urgent care center is caring for a client who fell and injured her ankle. The ankle appears swollen and ecchymotic. While the client waits for the technician to take x-rays, which of the following actions should the nurse take? (Select all that apply.)

Apply ice to the ankle Apply a compression bandage Elevate the foot

A nurse is preparing a community presentation about repetitive motion injuries. Which of the following occupations should the nurse identify as increasing a client's risk for carpal tunnel syndrome?

Assembly line worker

A nurse is educating coworkers about how to minimize back strain and avoid repeated episodes of low back pain. Which of the following strategies should the nurse include? (Select all that apply.)

Avoid prolonged sitting Sleeping in a side-lying position with flexed knees Try padded shoe insoles

A nurse is assessing a client following the application of a leg cast for the treatment of a fracture. If the cast is too tight, which of the following findings should the nurse expect to observe first?

Pallor of the toes.

A nurse is teaching a client at high risk for osteoporosis about dietary measures she can take to increase her calcium level. Which of the following foods should the nurse advise the client to increase in her diet?

Broccoli

A nurse is teaching an older adult client who has an intracapsular fracture of the right hip following a fall about the purpose of Buck's extension traction. The nurse should include which of the following information in the teaching?

Buck's extension traction will relieve muscle spasms.

A nurse is teaching a client who is to begin long-term therapy with prednisone to treat rheumatoid arthritis. The nurse should instruct the client to take which of the following supplements while taking this medication?

Calcium and vitamin D

A nurse is planning care for a newly admitted client who has skeletal traction for a fractured femur. Which of the following interventions should the nurse include in the plan?

Monitor the client's pedal pulses every hour.

A nurse is assessing a client who has Paget's disease of the bone. Which of the following findings should the nurse expect? (Select all that apply.)

Cranial enlargement Skeletal pain Abnormal gait

A nurse is caring for a client who is 1 day postoperative following hip open reduction with internal fixation. The client is scheduled to begin physical therapy in 30 min. Which of the following actions should the nurse take?

Offer to administer analgesia.

A nurse is caring for an older adult client who has had surgery for an intestinal obstruction and has an NG tube to wall suction. Which of the following interventions should the nurse include in the client's postoperative plan of care? (Select all that apply.)

Discontinue suction when assessing for peristalsis Irrigate the NG tube with 0.9% sodium chloride irrigation solution Place sequential compression devices on the bilateral lower extremities Reposition the client from side to side every 2 hr

A nurse is teaching a client who has a new prescription of allopurinol for the treatment of gout. Which of the following instructions should the nurse include?

Drink 2 liters of fluid each day while taking the medication."

A nurse is teaching a client who has a prosthetic limb due to a right below-the-knee amputation about prosthesis and stump care. Which of the following instructions should the nurse include in the teaching?

Dry the prosthesis socket completely before applying it to the limb.

A nurse is teaching a client who has a new diagnosis of gout about managing the disorder. Which of the following instructions should the nurse include in the teaching?

Eat less liver, sardines, and shrimp.

A nurse is reviewing the provider's history and physical form for a client who has advanced multiple myeloma. Which of the following findings should the nurse expect?

Ecchymoses

A nurse is talking with a young adult client who has a family history of osteoporosis. Which health promotion activity should the nurse recommend as a possible preventive measure?

Engage in weight-bearing exercise regularly.

A nurse is caring for an older adult client who has rheumatoid arthritis (RA) and is taking aspirin 650 mg every 4 hours. Which of the following diagnostic tests should the nurse monitor to evaluate the effectiveness of this medication?

Erythrocyte sedimentation rate (ESR)

A nurse is caring for a client who received a diagnosis of systemic scleroderma 5 years ago. The nurse plans to assess the client to document the disease's progression. In addition to skin changes, which of the following findings should the nurse expect?

Finger contractures

A nurse is caring for a client who is 2 days postoperative following an above-the knee-amputation. Which of the following is an appropriate nursing intervention for this client at this time?

Have the client lie prone every 3 hr for 20 min at a time.

A nurse is caring for a client who is 3 days postoperative following an above-the-knee amputation. Which of the following actions should the nurse take?

Have the client lie prone several times per day.

A nurse is assessing a client who reports numbness and pain in his right palm, index finger, and middle finger. The client reports working with a keyboard most of the time while at work. The nurse suspects carpal tunnel syndrome. Which of the following tests should the nurse request that the client perform?

Hold the wrist at a 90-degree flexion.

A nurse is caring for a client who has a femur fracture. The nurse suspects that the client has fat embolism syndrome. Which of the following findings should the nurse identify as an early manifestation of fat embolism syndrome

Hypoxemia

A nurse in a medical clinic is providing teaching to an older adult client who has osteoarthritis that is affecting her knees. Which of the following client statements indicates an understanding of the teaching?

I can use either or ice to help relieve the discomfort

A nurse is teaching a client about preventing osteoporosis. Which of the following statements by the client indicates a need for further teaching?

I will reduce my intake of vitamin K-rich foods.

A nurse in a provider's office is assessing a client who reports shoulder pain. Which of the following findings by the nurse indicates rotator cuff injury?

Inability to abduct the arm at the shoulder

A nurse witnesses a motor vehicle crash and finds a client who is not breathing. The nurse suspects the client has a cervical vertebrae fracture. Which of the following actions should the nurse take first?

Open the client's airway using the jaw-thrust maneuver.

A nurse is assessing a client who has a left lower arm fracture. Which of the following findings indicates impaired venous return in the client's affected arm?

Increasing edema

A nurse is caring for a client who has an unrepaired femur fracture of the midshaft. Which of the following techniques should the nurse use when performing an assessment of the client's neurovascular status?

Instruct the client to wiggle his toes.

A nurse is teaching a client who has a new diagnosis of acute bursitis in her right shoulder. Which of the following self-care strategies should the nurse recommend?

Intermittent ice and heat

A nurse is caring for a client who is scheduled for an electromyography. The client asks the nurse about the purpose of the procedure. Which of the following responses should the nurse give?

It involves the placement of thin needles into the muscles with recording of responses to stimuli

A nurse is planning care for a client who is 1 day postoperative following spinal fusion. Which of the following actions should the nurse include?

Log roll the client every 2 hr.

A nurse is providing teaching to a client who has a new diagnosis of fibromyalgia. Which of the following client statements indicates an understanding of the teaching?

Low-impact aerobics can help reduce episodes of pain.

A nurse is teaching a group of clients about osteoarthritis. Which of the following recommendations should the nurse include in the teaching?

Maintain a recommended body weight.

A nurse is caring for a client who had a left hip arthroplasty. Which of the following interventions should the nurse use to prevent dislocation?

Maintain foam wedge between legs.

A nurse is developing a plan of care for a client who has a fracture to achieve the outcome of functional healing. To assist in meeting this goal, which of the following nursing interventions is the highest priority?

Maintain immobilization and alignment.

A nurse is teaching a client who has a new prescription for cyclosporine oral solution to treat rheumatoid arthritis. Which of the following information should the nurse include in the teaching?

Mix with chocolate milk

A nurse is caring for a client who is in Buck's traction. Which of the following actions should the nurse take? (Select all that apply.)

Monitor peripheral pulses in the affected extremity Examine the skin under the traction splint Assess the temperature of the affected extremity

A nurse is caring for an adolescent client who has a newly applied fiberglass cast for a fractured tibia. Which of the following is the priority action for the nurse to take?

Perform a neurovascular assessment.

A nurse is teaching a client who has a fractured femur about fat emboli syndrome. Which of the following findings should the nurse include as a manifestation of a fat embolism?

Petechiae on the chest

A nurse is assessing the elastic bandage on the stump of a client who had a right below-the-knee amputation. Which of the following findings should the nurse identify as a complication?

Pitting edema around the stump dressing

A nurse in a clinic is assessing a client. Which of the following findings should the nurse identify as a risk factor for osteoporosis?

Smokes 1 pack of cigarettes per day

A nurse is caring for a client who sustained a femur fracture in an automobile accident and is placed into skeletal traction. The nurse may remove the weights from the traction device if which of the following occurs?

The client develops a life-threatening situation

A nurse is teaching a client about the causes of osteoporosis. The nurse should include which of the following types of medication therapy as a risk factor for osteoporosis?

Thyroid hormones

A nurse at an urgent care center is caring for four clients who all have leg or foot injuries. Which of the following client reports should suggest to the nurse that the client has an ankle sprain?

Twisted his foot while running bases during a baseball game

An occupational health nurse is instructing workers at an industrial facility about emergency procedures to take in the event of a traumatic amputation of a finger. Which of the following guidelines should the nurse include for preserving an amputated part for possible surgical reattachment? (Select all that apply.)

Wrap the amputated finger in dry, sterile gauze. Put the amputated finger in a sealed, waterproof plastic bag. Prevent the amputated finger from contacting water.

An occupational health nurse is instructing workers at an industrial facility in emergency procedures in the event of a traumatic amputation. Which of the following guidelines should the nurse include for emergency care? (Select all that apply.)

Wrap the part in dry sterile gauze. Put the severed part in a dry, waterproof plastic bag. Elevate the extremity. Prevent contact of the severed part with water.

A nurse is providing teaching for a client who is preparing for a below the knee amputation. Which of the following statements is true regarding the postoperative placement of a prosthesis?

You will do special exercises in advance of getting your prosthesis.

A client is starting celecoxib to treat osteoarthritis. The nurse should instruct the client to watch for and report which of the following adverse effects?

black, tarry stools

A nurse is caring for a client who has a cast in place for a fractured tibia. Which of the following nursing actions is the priority immediately after the provider has applied the cast?

checking capillary refill distal to the cast

A nurse is assessing a client who is 24 hr postoperative following an open reduction and internal fixation to repair a fracture of the femur. Which of the following assessment findings is an early manifestation of fat embolism syndrome (FES)?

dyspnea

A rehabilitation nurse is caring for a client who has had a spinal cord injury that resulted in paraplegia. After a week on the unit, the nurse notes that the client is withdrawn and increasingly resistant to rehabilitative efforts by the staff. Which of the following actions should the nurse take?

establish a plan of care with the client that sets attainable goals

A nurse is teaching a client who has fibromyalgia about self-care strategies for managing the disorder. Which of the following information should the nurse include in the teaching?

establish a regular sleep schedule

A nurse is caring for a client who is scheduled for an arthroplasty. The nurse asks client to state if he understands the procedure that is being performed. Which of the following statements by the client indicates an understanding of the procedure?

this procedure will replace my joint to improve function

A nurse is teaching a client who has chronic tophaceous gout about his new prescription for allopurinol. The nurse should explain that the purpose of this medication is to reduce blood levels of which of the following substances?

uric acid

A nurse is preparing a client who is postoperative following a below-the knee amputation for a leg prosthesis fitting. Which of the following actions should the nurse take?

wrap the stump with an elastic bandage in a figure-eight configuration