Passpoint exam 2 AH
The nurse teaches a client about heat and cold treatments to manage arthritis pain. Which statement indicates that the client still has a knowledge deficit? a. "Ten to 15 minutes per application is the maximum time for cold applications." b. "I can use heat and cold as often as I want." c. "With heat, I should apply it for no longer than 20 minutes at a time." d. "Heat-producing liniments can be used with other heat devices."
d. "Heat-producing liniments can be used with other heat devices."
The nurse assigns an unlicensed assistive personnel (UAP) to care for a client who has a newly applied long-leg plaster cast. What should the nurse tell the UAP about proper care of the cast while it is drying? a. "Carefully use your fingers to lift the cast and reposition the legs." b. "Keep the cast covered with a sheet to protect it while drying." c. "Use a blow dryer on the cast for 15 minutes every 2 hours until the cast is dry." d. "Turn the client every 2 hours to promote even drying of the cast."
d. "Turn the client every 2 hours to promote even drying of the cast."
A client presents at an ambulatory clinic with reports of pain and aching in the lower left leg. After examining the client, a health care provider determines the client has experienced a strain related to the client's exercise regimen. The treatment plan includes analgesics, rest, and cold and heat therapies. Which guideline should be included in the care plan? a. Begin physical training for 30 minutes, gradually increasing to 45 minutes over the next several days. b. Apply cold packs to extremity continuously for the first 48 hours. c. Alternate heat and cold applications to the extremity continuously. d. After 24 hours, apply heat for periods of 15 to 30 minutes.
d. After 24 hours, apply heat for periods of 15 to 30 minutes.
The nurse is planning a health promotion class with a group of middle-age clients. What information should the nurse include in the lesson plan about reducing the risk for developing osteoarthritis? a.Take a multivitamin supplement daily. b. Exercise at least twice a week. c. Follow a high-protein diet. d. Maintain a normal weight.
d. Maintain a normal weight.
The nurse should closely monitor the client with an open fracture for which complication? a.fat embolism syndrome b. compartment syndrome c. avascular necrosis d. osteomyelitis
d. osteomyelitis
A client is ordered diazepam to treat severe skeletal muscle spasms. During this therapy, the nurse monitors the client closely for adverse reactions. Which adverse reaction is most likely to occur? a. bradycardia b. hypotension c. skin rash d. sedation
d. sedation
A client reports to the emergency department after experiencing pain in the left arm. The client reports that they extended their arms in an attempt to prevent a fall. Which fracture type does the nurse anticipate? a.greenstick fracture b. compound fracture c. spiral fracture d.Colles' fracture
d.Colles' fracture
The nurse is planning a presentation on the topic of osteoporosis to a group of middle-age clients. Which information should the nurse include in the presentation? a.Maintain a normal weight. b.Take a multivitamin supplement daily. c.Exercise at least twice a week. d.Follow a high-protein diet.
d.Follow a high-protein diet.
A client with septic arthritis of the knee is admitted to the orthopedic floor. The nurse should consult the case manager if which complication occurs during hospitalization? a. temperature elevation b.allergic reaction to antibiotics c.wound drainage d.decreased mobility
d.decreased mobility
The nurse is caring for an older adult who has hip pain related to rheumatoid arthritis. The client is practicing appropriate self-care activities when the client chooses to sit in which type of chair? a.curved-back rocking chair b. recliner chair with arms to support wrists and hands c. couch with soft cushions to support thighs d.straight-back chair with elevated seat
d.straight-back chair with elevated seat
The nurse is evaluating the pin insertion site of a client's skeletal traction. Which finding indicates a complication? A. presence of crusts around the pin insertion site B. serous drainage on the dressing C. client does not feel pain at insertion site D. pin moves slightly at insertion site
D. pin moves slightly at insertion site
A nurse is assigned a client with an acute exacerbation of rheumatoid arthritis (RA). Which medical facts about RA are essential in developing a plan of care? Select all that apply. a. Inflamed cartilage triggers complement activation, which stimulates the release of additional inflammatory mediators. b. Onset is acute and usually occurs between ages 20 and 40. c. Erythrocyte sedimentation rate (ESR) is elevated, and x-rays show erosions and decalcification of involved joints. d. The client experiences stiff, swollen joints bilaterally. e. The client may not exercise once the disease is diagnosed. f. The first-line treatment is gold salts and methotrexate.
a. Inflamed cartilage triggers complement activation, which stimulates the release of additional inflammatory mediators. c. Erythrocyte sedimentation rate (ESR) is elevated, and x-rays show erosions and decalcification of involved joints. d. The client experiences stiff, swollen joints bilaterally.
A client who has had a total hip replacement has a dislocated hip prosthesis. What should the nurse do first? a. Notify the orthopedic surgeon. b. Stabilize the leg with Buck's traction. c. Position the client toward the opposite side of the hip. d. Apply an ice pack to the affected hip.
a. Notify the orthopedic surgeon.
A client is being discharged to a rehabilitation care facility following a hip replacement using the posterior surgical approach. When reporting to the licensed practical/vocational nurse (LPN/VN), which nursing actions would the orthopedic nurse stress as essential? Select all that apply. a. Place two pillows between the client's knees. b. Place a raised toilet seat in the bathroom. c. Avoid any hip flexion exercises. d. Maintain the client on bed rest until the incision heals. e. Place the client in high Fowler's position. f. Keep the client's feet elevated.
a. Place two pillows between the client's knees. b. Place a raised toilet seat in the bathroom. c. Avoid any hip flexion exercises.
The nurse is assessing a client who had a left hip replacement 36 hours ago. Which finding(s) would indicate the prosthesis is dislocated? Select all that apply. a. The client reported a "popping" sensation in the hip. b. The client cannot wiggle the toes on the left leg. c. The left leg is shorter than the right leg. d. The client has sharp pain in the groin. e. The client cannot move the right leg.
a. The client reported a "popping" sensation in the hip. b. The client cannot wiggle the toes on the left leg. d. The client has sharp pain in the groin.
The nurse has established a goal with a client to improve mobility following hip replacement. Which outcome is realistic at the time of discharge from the surgical unit? The client can: a. be more independent when transferring from bed to chair. b.raise the affected leg 6 inches (15.2 cm) with assistance. c. walk throughout the nursing unit with a walker. d. walk the length of a hospital hallway with minimal pain.
a. be more independent when transferring from bed to chair.
A client diagnosed with rheumatoid arthritis reports that pain and stiffness are worse when arising in the morning. What interventions can the nurse suggest to assist the client in decreasing the pain? Select all that apply a. hot bath to alleviate stiffness b. energy conservation techniques c. adaptive equipment d. around the clock opioids for pain e. splint the joints in the same position
a. hot bath to alleviate stiffness b. energy conservation techniques e. splint the joints in the same position
A client has a history of osteoarthritis. Which signs and symptoms should the nurse expect to find on physical assessment? a. joint pain, crepitus, Heberden's nodes b. swelling, joint pain, and tenderness on palpation c. hot, inflamed joints; crepitus; joint pain d. tophi, enlarged joints, Bouchard's nodes
a. joint pain, crepitus, Heberden's nodes
Which nursing goal should take priority when planning for the client's physical mobility immediately after amputation? a. preventing contractures b. preventing phantom-limb pain c.preventing edema d.promoting comfort
a. preventing contractures
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? a."Apply ice packs for the first 24 to 48 hours, then apply heat packs." b."Apply heat packs for the first 24 to 48 hours." c."Apply heat packs for the first 24 hours, then apply ice packs for the next 48 hours." d."Apply ice packs for the first 12 to 18 hours."
a."Apply ice packs for the first 24 to 48 hours, then apply heat packs."
A client is diagnosed with rheumatoid arthritis and is ordered oral indomethacin. What should the nurse include in the client's teaching concerning the administration of indomethacin? Select all that apply. a."Avoid any hazardous activity until you know how you react to this drug." b. "Tell your health care provider immediately about changes in your hearing." c. "Do not use aspirin while taking this drug." d. "Take the drug with a glass of water only." e."It is OK to continue to consume alcohol at dinner."
a."Avoid any hazardous activity until you know how you react to this drug." b. "Tell your health care provider immediately about changes in your hearing." c. "Do not use aspirin while taking this drug."
A nurse is performing discharge teaching for a mobile older adult client diagnosed with osteoporosis. Which statement about home safety should the nurse include? a."Lower yourself onto chairs slowly and use padded seating as much as possible." b. "You should use a wheeled walker at home to increase your stability." c. "Avoid performing activities that require any impact or a lot of weight-bearing." d. "If there are steps outside your home, installing a ramp is recommended."
a."Lower yourself onto chairs slowly and use padded seating as much as possible."
The nurse is planning a presentation on the topic of osteoporosis to a group of middle-age clients. Which information should the nurse include in the presentation? a.Loss of height is an early symptom of the disease. b. An early symptom of osteoporosis is the dowager's hump. c. Conventional radiographs are usually used to confirm the disease. d. Females of African and Latinx origin are at greater risk.
a.Loss of height is an early symptom of the disease.
The nurse is preparing a client who underwent a knee replacement with a metal joint to go home. What should the nurse instruct the client to do? Select all that apply. a.Notify the health care provider (HCP) about the joint before undergoing invasive procedures. b. Inform the HCP before having magnetic resonance imaging (MRI) scans. c. Refrain from carrying items weighing more than 5 lb (2.3 kg). d. Eat a low-fat, low-carbohydrate diet. e.Notify airport security that the joint may set off alarms on metal detectors.
a.Notify the health care provider (HCP) about the joint before undergoing invasive procedures. b. Inform the HCP before having magnetic resonance imaging (MRI) scans. e.Notify airport security that the joint may set off alarms on metal detectors.
A client had a cast applied to the left femur to stabilize a fracture. To promote early rehabilitation, what should the nurse do? a.Teach the client how to do isometric exercises of the quadriceps. b. Call the physical therapy team to provide passive exercise of the affected limb. c. Obtain weights so the client can exercise the upper extremities. d. Show the family how to do active range-of-motion exercises of the unaffected limb.
a.Teach the client how to do isometric exercises of the quadriceps.
After the nurse teaches the client about the use of skeletal traction, which statement made by the client about the purpose of the traction indicates the need for additional teaching? a.to pull weight with a boot b. to align injured bones c. to provide long-term pull d. to apply 25 lb (11.3 kg) of traction
a.to pull weight with a boot
A client of African descent is admitted to the hospital after sustaining a hip fracture. The client is 5 feet, 4 inches (163 cm) tall and weighs 96 lb (44 kg). The client has five children and reports that they "just stepped forward and fell." The results of the client's bone density tests indicate they have osteoporosis. What is a risk factor for osteoporosis for this client? a.weight b.parity c.balance d.race
a.weight
A client is diagnosed with osteoporosis. Which statements would the nurse include when teaching the client about the disease? Select all that apply. a.Daily medication is needed to cure the disease. b. Osteoporosis is common in females after menopause. c. Limit weight bearing and repetitive exercises. d. Osteoporosis is a degenerative disease characterized by a decrease in bone density. e. Osteoporosis can cause pain and injury. f. Passive ROM exercises can promote bone growth.
b. Osteoporosis is common in females after menopause. d. Osteoporosis is a degenerative disease characterized by a decrease in bone density. e. Osteoporosis can cause pain and injury.
The nurse is advising a client who underwent femoral head prosthesis placement on the type of chair to sit in during the first 6 to 8 weeks after surgery. Which chair would be the correct type to recommend? a. a recliner with an attached footrest b. a high-backed chair with armrests c. a padded upholstered chair d. a desk-type swivel chair
b. a high-backed chair with armrests
An older adult is admitted with a fracture of the femur. What should the nurse assess first about this client? a.type of pain b. mechanism of injury c.ability to change positions d. extent of anxiety
b. mechanism of injury
A nurse is teaching a class about osteoporosis. Which factors place a client at greater risk for developing this disease? Select all that apply a.excessive intake of calcium supplements b. postmenopausal status c. long-term use of corticosteroids d. long-term use of ibuprofen e. sedentary lifestyle f.early onset of menses
b. postmenopausal status c. long-term use of corticosteroids e. sedentary lifestyle
A client is prescribed a brace to support a structural change to the foot. What should the nurse explain to the client about this device? a."The brace will be used for a few weeks." b."The brace will limit movement of the area." c."The brace will be uncomfortable to wear." d."The brace is custom-fitted to your foot."
b."The brace will limit movement of the area."
A client who has been diagnosed with osteoarthritis asks if deformities will eventually appear in the hands and fingers as the condition progresses. Which concept should the nurse include in the response? a.Some osteoarthritis sufferers develop hard swellings visible on the joints of the fingers. b.Hand and finger deformities are associated only with rheumatoid arthritis. c.The client should discuss this concern with the health care provider. d.It's impossible to determine at the time of diagnosis how the disease will progress.
b.Hand and finger deformities are associated only with rheumatoid arthritis.
A client has had a cast applied to the arm. When discharging the client, what should the nurse tell the client to: do? a.Use powder on the skin around the cast. b.Smell the cast for foul odors. c.Use a padded ruler to reach inside and rub under the cast. d.Apply a heating pad to the arm for 24 hours after the injury.
b.Smell the cast for foul odors.
The nurse is instructing an unlicensed assistive personnel (UAP) on how to move and position a client who had a total hip replacement yesterday. What should the nurse tell the UAP to do? Select all that apply. a. With the aid of a coworker, turn the client from the supine to the prone position every 2 hours. b.Use a fracture bedpan when needed by the client. c.Encourage the client to use the overhead trapeze to assist with position changes. d. When the client is in bed, prevent thromboembolism by encouraging the client to do toe-pointing exercises. e. For meals, elevate the head of the bed to 90 degrees.
b.Use a fracture bedpan when needed by the client. c.Encourage the client to use the overhead trapeze to assist with position changes. d. When the client is in bed, prevent thromboembolism by encouraging the client to do toe-pointing exercises.
A client involved in a motor vehicle accident (MVA) has a long leg cast applied to the right leg and is reporting heel pain. The nurse would assess for which items as part of a focused exam? Select all that apply. a.voiding since the accident b.drainage at the heel site c.recollection of the accident D. level of consciousness E. color and temperature of the toes
b.drainage at the heel site E. color and temperature of the toes
The nurse is teaching a client about using crutches. On which part of the body should the nurse instruct the client to support the body weight? a. elbows b.hands c. axillae d.upper arms
b.hands
To promote early and efficient ambulation for a client after an above-the-knee amputation, the nurse is aware that the leg will need to be positioned in which way? a.extended and abducted b.in functional alignment c.slightly raised when moving the stump d. in a flexed position
b.in functional alignment
A client has a Pearson attachment on the traction setup. What is the purpose of this attachment? a.to prevent flexion deformities in the ankle and foot b.to support the lower portion of the leg c.to support the thigh and upper leg d. to allow attachment of the skeletal pin
b.to support the lower portion of the leg
A nurse is evaluating the proper use of crutches by a client who has fractured the right leg. Which statement indicates the client is using the correct technique? a. "I move my left leg forward first as I swing forward on my crutches." b. "I need to increase my arm strength because my arms tingle after I use my crutches." c. "I feel pressure on the palms of my hands when I am walking with my crutches." c. "I padded the tops of my crutches so that I can lean more comfortably on my crutches."
c. "I feel pressure on the palms of my hands when I am walking with my crutches."
.A client has a total right knee replacement. In preparing the client for the first day after surgery, the nurse should instruct the client to do which action? a.Remain in bed for 24 to 48 hours after surgery. b. Dangle the legs at bedside for 20 minutes. c. Ambulate with a walker twice a day. d. Sit in a chair with the leg elevated.
c. Ambulate with a walker twice a day
A client who was involved in a motor vehicle accident has a fractured femur. The nurse caring for the client documents "acute pain" as a nursing diagnosis in the care plan. Which nursing interventions are appropriate? Select all that apply. a. Avoid alternative and supplementary pain control techniques. b.Encourage the client to use as little pain medication as possible to avoid addiction. c. Assess the client's perception of pain. d. Explain that pain management should leave the client pain-free. e. Ask the client about the methods used previously to alleviate pain. f. Tell the client which pain management option to use.
c. Assess the client's perception of pain e. Ask the client about the methods used previously to alleviate pain.
A nurse is caring for a client who has been immobilized in Buck's traction for 3 weeks. Which actions by the nurse is most important in preventing a metabolic complication related to the immobilization? a.Teach the client deep breathing exercises. b. Check the capillary refill of the lower extremities. c. Increase fluid intake and monitor urine output. d. Remove the traction and assess the skin daily.
c. Increase fluid intake and monitor urine output.
A client is in the advanced stages of osteoarthritis. Which statement best describes the pain that occurs in the advanced stage of the disease? a.Joints are symmetrically affected by pain. b. Fatigue accompanies pain. c. Pain occurs with minimal activity. d. Crepitation develops and intensifies pain.
c. Pain occurs with minimal activity.
The nurse is positioning a client who has had a total hip replacement. Which is the intended outcome of using an abduction pillow (or splint)? a. Increase peripheral circulation. b. Prevent hip flexion. c. Prevent dislocation of the prosthesis. d.Decrease formation of sacral pressure injuries.
c. Prevent dislocation of the prosthesis.
A client is hospitalized for open reduction of a fractured femur. During the postoperative assessment, the nurse notes that the client is restless and observes petechiae on the client's chest. Which nursing action is indicated first? a.Contact the nursing supervisor. b.Elevate the affected extremity. c.Administer oxygen. d.Contact the health care provider.
c.Administer oxygen.
The nurse is assessing a client who has had an internal fixation and hip pinning. Which nursing measure will likely decrease the risk for a surgical wound infection in this client? a.monitoring the incision for signs of redness, swelling, and warmth b.accurately measuring drainage from the surgical drainage tube c.changing the surgical dressings using sterile technique d.inserting an indwelling urinary catheter to prevent possible soiling of the dressing
c.changing the surgical dressings using sterile technique
A client with a fracture develops compartment syndrome. Which sign should alert the nurse to impending organ failure? a.generalized edema b. crackles c. dark, scanty urine d. jaundice
c.dark, scanty urine
A client has a pin inserted to stabilize a fractured femur. Which clinical sign at the pin site would alert the nurse to infection? a.lack of scab formation b.itching c.pain d.slight serous oozing
c.pain
Which laboratory study is most relevant to treating a client who has sustained a pelvic fracture? A. serum ethanol b. urine myoglobin c.type and crossmatch d.urinalysis
c.type and crossmatch