OA/ arthroplasty practice questions

The nurse is educating a patient about glucosamine supplements. Which nursing instruction about glucosamine supplements is appropriate?

"The recommended dose of glucosamine is based on your body weight."

The student nurse is preparing a patient with osteoarthritis for home care self-management. Which nursing instruction needs correction?

"Turn doorknobs clockwise."

A patient with osteoarthritis wants to use capsaicin cream. Which information should the nurse provide to the patient?

"You may have a burning sensation for a short period after applying it."

The primary health care provider prescribes a medication to a patient with osteoarthritis. During the follow-up visit, the patient reports dark tarry stools and indigestion. Which medication may be the cause of this finding?

ibuprofen

Which finding in the physical assessment may be associated with osteoarthritis?

impaired mobility

A client is getting out of bed into the chair for the first time after an uncemented hip replacement. What action by the nurse is most important?

Have adequate help to transfer the client.

The nurse is teaching a patient who has undergone total joint arthroplasty about the measures to be followed at home. During a follow up visit, the nurse finds that the patient has developed complications associated with the surgery. Which actions of the patient may have contributed to complications? (3 things)

not drinking enough fluids flexing hips more than 90 degrees massaging the legs

Which element is a risk factor for osteoarthritis (OA)?

obesity

The nurse provides education about safety precautions to a patient who has undergone right total hip arthroplasty. Which statement from the patient indicates the need for additional teaching?

"I should avoid adaptive devices when putting on shoes and socks."

The nurse is educating an arthritis patient about joint protection. Which patient statement indicates a need for further learning? (2 things)

"I should hold objects using one hand." "I should turn doorknobs in a clockwise direction every time."

After teaching self-management measures to a patient with osteoarthritis, the nurse is evaluating adequate patient education. Which statements by the patient indicate the need for more education? (2)

"I should perform passive exercises whenever possible." "I should not reduce the number of repetitions of exercise though pain is increased."

The nurse is teaching a patient about the difference between rheumatoid arthritis (RA) and osteoarthritis (OA). Which statement by the patient indicates a need for further teaching?

"The disease pattern of RA is usually unilateral and is seen in a single joint, whereas OA is usually bilateral and symmetric, and is noted in multiple joints."

The primary health care provider prescribes epoetin alfa to a patient before knee replacement surgery. What is the reason behind this prescription?

prevent anemia

The nurse working in the orthopedic clinic knows that a client with which factor has an absolute contraindication for having a total joint replacement?

severe osteoporosis

What is the dosage limit of acetaminophen in the treatment of osteoarthritis (OA)?___ mg

3000

What action by the perioperative nursing staff is most important to prevent surgical wound infection in a client having a total joint replacement?

Administer preoperative antibiotic as ordered.

The nurse is caring for a postoperative patient with total joint arthroplasty. What actions does the nurse take to prevent venous thromboembolism (VTE) postoperatively? 2 things

Apply elastic stockings Administer anticoagulants

The nurse on the postoperative inpatient unit assesses a client after a total hip replacement. The clients surgical leg is visibly shorter than the other one and the client reports extreme pain. While a co-worker calls the surgeon, what action by the nurse is best?

Assess neurovascular status in both legs.

A client in the orthopedic clinic has a self-reported history of osteoarthritis. The client reports a low-grade fever that started when the weather changed and several joints started acting up, especially both hips and knees. What action by the nurse is best?

Assess the client for the presence of subcutaneous nodules or Bakers cysts.

An older client returning to the postoperative nursing unit after a hip replacement is disoriented and restless. What actions does the nurse delegate to the unlicensed assistive personnel (UAP)? (Select all that apply.) a. Apply an abduction pillow to the clients legs. b. Assess the skin under the abduction pillow straps. c. Place pillows under the heels to keep them off the bed. d. Monitor cognition to determine when the client can get up. e. Take and record vital signs per unit/facility policy.

a. Apply an abduction pillow to the clients legs. C. Place pillows under the heels to keep them off the bed. e. Take and record vital signs per unit/facility policy.

The nurse is caring for a patient who has undergone total hip arthroplasty. What interventions does the nurse provide to prevent the complication of dislocation?

Assesses the patient for extremity shortening rational: When caring for the patient who has undergone a total hip arthroplasty, the nurse assesses the patient for pain, rotation, and extremity shortening. An abduction pillow or splint helps prevent dislocation; abduction devices are used if the patient is restless or has an altered state of mind. A pillow is placed between the patient's legs to prevent adduction beyond the midline of the body. The patient's heels are kept off the bed to prevent skin breakdown, not to prevent dislocation.

A patient who has undergone total knee arthroplasty (TKA) is under postoperative care. The primary health care provider advised the patient to use a continuous passive motion (CPM) machine. Which nursing action is most important during use of the CPM machine?

Assessing the patient's response to the machine

A home health care nurse is visiting a client discharged home after a hip replacement. The client is still on partial weight bearing and using a walker. What safety precautions can the nurse recommend to the client? (Select all that apply.) a. Buy and install an elevated toilet seat. b. Install grab bars in the shower and by the toilet. c. Step into the bathtub with the affected leg first. d. Remove all throw rugs throughout the house. e. Use a shower chair while taking a shower.

a. Buy and install an elevated toilet seat. b. Install grab bars in the shower and by the toilet. d. Remove all throw rugs throughout the house. e. Use a shower chair while taking a shower.

The nurse finds lidocaine 5% patch in the prescription of a patient with osteoarthritis. Upon examining, the nurse finds that the patient is on procainamide therapy, a class I antiarrhythmia drug. What is the nurse's appropriate course of action?

Avoid applying lidocaine 5% to the patient and tell the primary healthcare provider

What nursing interventions may be performed to prevent dislocation of the hip joint in a patient who has undergone total hip arthroplasty (THA)?

Avoid hip flexion beyond 90 degrees Assess acute pain, rotation, and extremity shortening

The nurse is preparing a patient with osteoarthritis for self-management. What does the nurse tell the patient about exercising?

Avoid resistive exercises when the joints are inflamed.

What is the characteristic feature of Bouchard's nodes? Hint: Ring

Bony nodules at the proximal interphalangeal joints

Which drug may be administered to a patient undergoing knee arthroplasty to reduce postoperative pain?

Capsaicin

Which dietary supplements may be prescribed specifically to a patient with osteoarthritis (OA)? (2 )

Chondroitin Glucosamine

A client takes celecoxib (Celebrex) for chronic osteoarthritis in multiple joints. After a knee replacement, the health care provider has prescribed morphine sulfate for postoperative pain relief. The client also requests the celecoxib in addition to the morphine. What action by the nurse is best?

Consult with the health care provider about administering both drugs to the client.

During a patient's follow-up visit, the nurse finds that the patient's osteoarthritis does not improve with the prescribed systemic and topical medications. What medication does the nurse anticipate to be beneficial?

Cortisone injection

A patient is diagnosed with osteoarthritis (OA). Which medication is considered the primary drug of choice for treatment?

acetaminophen

What are the factors that may lead to osteoarthritis (OA)? (3 things)

age, genetics, obesity

What is the cause of primary osteoarthritis?

aging

Which drug is beneficial for a patient with osteoarthritis who is having painful muscle spasms?

Cyclobenzaprine hydrochloride

Which medications does the nurse expect to find as prescriptions for a patient with osteoarthritis?

Diclofenac (voltaren); topical acetaminophen rational: Diclofenac is a nonsteroidal anti-inflammatory drug that is used for a short period for the treatment of osteoarthritis. Acetaminophen is also prescribed for patients with osteoarthritis.

The nurse is teaching a client with gout dietary strategies to prevent exacerbations or other problems. Which statement by the nurse is most appropriate?

Drink 1 to 2 liters of water each day.

A client is scheduled to have a hip replacement. Preoperatively, the client is found to be mildly anemic and the surgeon states the client may need a blood transfusion during or after the surgery. What action by the preoperative nurse is most important?

Ensure that a consent for transfusion is on the chart.

After assessing a patient with osteoarthritis, the nurse suspects crepitus. Which finding supports the nurse's assessment?

Grating heard when the joint is palpated

A patient is prescribed lidocaine 5% patches for knee pain. What does the nurse teach this patient about this therapy?

apply this to clean, intact skin Rational: Lidocaine patches should be placed on clean, intact skin. The patch can be kept in place for 12 hours a day. Three patches may be used at a time.

A nurse is discharging a client after a total hip replacement. What statement by the client indicates good potential for self-management?

I will not sit with my legs crossed.

A client comes to the family medicine clinic and reports joint pain and stiffness. The nurse is asked to assess the client for Heberdens nodules. What assessment technique is correct?

Inspect the clients distal finger joints.

The student nurse is providing postoperative care to an older adult who has undergone total hip arthroplasty. Which actions of the nurse indicate the need for further teaching? (3 things)

Keeping the patient's heels on the bed Preventing the patient from getting out of the bed Using the incentive spirometer every five hours

A patient who recently underwent total hip arthroplasty and is on anticoagulants is preparing for discharge from the hospital. Which information is most important for the nurse to provide to the patient and caregiver?

avoid using a straight razor

A nurse works with several clients who have gout. Which types of gout and their drug treatments are correctly matched? (Select all that apply.) a. Allopurinol (Zyloprim) Acute gout b. Colchicine (Colcrys) Acute gout c. Febuxostat (Uloric) Chronic gout d. Indomethacin (Indocin) Acute gout e. Probenecid (Benemid) Chronic gout

b. Colchicine (Colcrys) Acute gout c. Febuxostat (Uloric) Chronic gout d. Indomethacin (Indocin) Acute gout e. Probenecid (Benemid) Chronic gout

Which laboratory and diagnostic tests are used to detect osteoarthritis (OA)? (3 things)

c-reactive protein XRAY MRI

Before administering low-molecular-weight heparin (LMWH) to an older adult patient after total knee arthroplasty, the nurse notes that the patient's platelet count is 50,000/mm 3. What action is most important for the nurse to take?

Notify the health care provider of the platelet count. If the platelet count falls below 20,000/mm 3, spontaneous bleeding could occur.

After a total knee replacement, a client is on the postoperative nursing unit with a continuous femoral nerve blockade. On assessment, the nurse notes the clients pulses are 2+/4+ bilaterally; the skin is pale pink, warm, and dry; and the client is unable to dorsiflex or plantarflex the affected foot. What action does the nurse perform next?

Notify the surgeon or anesthesia provider immediately.

Which statements may be used to describe osteoarthritis (OA)?

Obesity is a risk factor. its disease process is degenerative

An older client is scheduled to have hip replacement in 2 months and has the following laboratory values: white blood cell count: 8900/mm3, red blood cell count: 3.2/mm3, hemoglobin: 9 g/dL, hematocrit: 32%. What intervention by the nurse is most appropriate?

Prepare to administer epoetin alfa (Epogen).

A nurse is discharging a client to a short-term rehabilitation center after a joint replacement. Which action by the nurse is most important?

Providing a verbal hand-off report to the facility

A client has a continuous passive motion (CPM) device after a total knee replacement. What action does the nurse delegate to the unlicensed assistive personnel (UAP) after the affected leg is placed in the machine while the client is in bed?

Raise the lower siderail on the affected side.

The nurse is assisting a patient who had a right total hip arthroplasty with getting up from bed. What action does the nurse take?

Reminds the patient to stand on the left leg after getting out of bed rational: The nurse should remind the patient to stand on the left leg after getting out of bed, which prevents the patient from putting undue pressure on the right leg. The nurse should stand on the same side of the bed as the patient's affected side to provide support. The nurse should not lift the patient and assist the patient to stand. The patient should pivot on the stronger left side to sit in the chair.

Which parameters should be monitored in an older adult patient with osteoarthritis (OA) who is taking 3500 g of acetaminophen daily? (3 things)

Serum bilirubin Serum albumin Prothrombin time

he nurse is caring for a client using a continuous passive motion (CPM) machine and has delegated some tasks to the unlicensed assistive personnel (UAP). What action by the UAP warrants intervention by the nurse?

Storing the CPM machine under the bed after removal

A patient who has undergone total hip arthroplasty is advised to do exercises. Which action made by the patient indicates a quadriceps-setting exercise?

Straightening the legs and pushing the back of the knees into the bed

Which parameter is assessed before prescribing epoetin alfa to a patient who has undergone total hip arthroplasty (THA)?

decreased hemoglobin

Which metabolic disorder may be responsible for the development of joint degradation in the patient with osteoarthritis (OA)?

diabetes

A patient who is undergoing treatment for osteoarthritis reports black-colored stools, stomach upset, and difficulty breathing. The patient's blood work reveals abnormal levels of urea and creatinine. The nurse identifies that which medication is the likely cause of the patient's symptoms?

ibuprofen

The nurse is attending to a patient with osteoarthritis. What nonpharmacologic interventions does the nurse suggest to this patient? (3 things)

Use a small pillow under the head or neck Use moist heating pads that are not heavy Wear supportive shoes with foot insoles

A patient who had a total hip arthroplasty will be discharged from the hospital shortly. What teaching does the nurse provide for this patient? (3 things)

Use a walker as an ambulatory aid. Sit up in a firm, supporting chair during the daytime Avoid bending the hips more than 90 degrees rational: The patient should be taught to use a walker as an ambulatory aid and asked to avoid putting more weight on the affected leg than allowed. The patient should avoid prolonged sitting in a 90-degree position to prevent dislocation of the prosthesis. The patient should be taught to avoid bending the hips more than 90 degrees. The hip incision should be cleaned with mild soap and water and the area dried thoroughly. Postoperative exercises include straight leg raises, gluteal sets, ankle pumps, and "ham" sets. The patient should not cross the legs to prevent blood clots.

An older client has returned to the surgical unit after a total hip replacement. The client is confused and restless. What intervention by the nurse is most important to prevent injury?

Use an abduction pillow.

A nurse is caring for a client after joint replacement surgery. What action by the nurse is most important to prevent wound infection?

Use aseptic technique for dressing changes.

What causes osteonecrosis?

Use of corticosteroids

Which is the best nursing action to prevent complications in an older adult patient who has undergone total hip arthroplasty and is under postoperative care?

Using an abduction pillow to prevent adduction

The nurse encourages a patient who has undergone total hip joint arthroplasty to drink fluids and instructs the patient's caregivers not to massage the leg. The nurse also observes for signs of redness, swelling, and pain in the patient's leg. Which complication is the nurse seeking to avoid with these interventions?

Venous thromboembolism

A construction worker who reports pain in the vertebral column and hips is diagnosed with secondary osteoarthritis (OA). What does the nurse tell the patient may have been the cause?

trauma or abuse Rational: Secondary OA occurs from trauma to the joints due to excessive use or abuse. Heavy manual occupations such as construction work causes high-intensity or repetitive stress to the joints.

The nurse is developing a teaching plan for a patient diagnosed with osteoarthritis (OA). The nurse includes which instruction in the teaching plan?

wear supportive shoes

Pain is caused by spasms of the surrounding muscles. Is this statement is true regarding osteoarthritis?

yes, true