Unit 8 Musculoskeletal Function

A nurse is caring for an older woman with a hip fracture. What are appropriate risk factors for the nurse to consider related to the client's hip fracture? Select all that apply.

-Presence of anemia -Female gender -Osteoporosis

Health education for a woman over age 50 includes providing information about the importance of adequate amounts of calcium and vitamin D to prevent osteoporosis. Select the daily dosage of calcium and vitamin D that the nurse should recommend.

1,200 mg; 1,000 IU

Two days after surgery to amputate the left lower leg, a client reports pain in the missing extremity. Which action by the nurse is most appropriate?

Administer medication, as ordered, for the reported discomfort.

A patient is diagnosed with osteogenic sarcoma. What laboratory studies should the nurse monitor for the presence of elevation?

Alkaline phosphatase

A client is evaluated for a diagnosis of Paget's disease. Which laboratory value would the nurse find to confirm the diagnosis?

Alkaline phosphate of 165 IU/L (2750 mmol/L)

A client arrives at the orthopedic physician's office stating knee pain sustained while playing soccer. A history and physical assessment is completed. The knee appears reddened with edema. Which other diagnostic testing would the nurse anticipate?

An arthroscopy

A client is experiencing muscle weakness in the upper extremities. The client raises an arm above the head but then loses the ability to maintain the position. Muscular dystrophy is suspected. Which diagnostic test would evaluate muscle weakness or deterioration?

An electromyography

When an infection is bloodborne, the manifestations include which symptom?

Chills

A nurse is caring for a client with eczema. Which medication would be prescribed when an allergy is a factor causing the skin disorder?

Chlorpheniramine

Which nursing intervention is appropriate for a client with a closed-reduction extremity fracture?

Encourage participation in ADLs

A patient in pelvic traction needs circulatory status assessed. How should the nurse assess for a positive Homans' sign?

Have the patient extend each leg and dorsiflex each foot to determine if pain or tenderness is present in the lower leg.

A patient is diagnosed with osteomyelitis of the right leg. What signs and symptoms does the nurse recognize that are associated with this diagnosis? (Select all that apply.)

Pain Erythema Fever

A patient comes to the clinic and informs the nurse of numbness, tingling, and a burning sensation in the arm from the elbow down to the fingers. What type of symptom would this be documented as?

Paresthesia

Which of the following positions should be avoided in severe back pain?

Prone

The nurse assesses soft subcutaneous nodules along the line of the tendons in a patient's hand and wrist. What does this finding indicate to the nurse?

The patient has rheumatoid arthritis.

The nurse is reviewing the client's admission assessment and notes that crepitus of the right knee joint was documented. What assessment will the nurse find as described by crepitus?

a grating sound when a joint is put through range of motion

A client is brought to the emergency department after being struck with a baseball bat on the upper arm while diving for a pitched ball. Diagnostic tests reveal that the humerus is not broken but that the client has suffered another type of injury. What type of injury would the physician likely diagnose?

contusion

A client with a right leg fracture is returning to the orthopedist to have the cast removed. During cast removal, it is important for the nurse to assure:

the client that he or she won't be cut.

A client asks the nurse why his residual limb cannot be elevated on a pillow. What is the best response by the nurse?

"Elevating the leg might lead to a flexion contracture."

The nurse is admitting a client who is to undergo an open reduction with internal fixation for a fractured femur. About which comment by the client should the nurse be most concerned?

"I was worried I would have an incision and scar."

The nurse has educated a patient with low back pain about techniques to relieve the back pain and prevent further complications. What statement by the patient shows understanding of the education the nurse provided?

"I will avoid prolonged sitting or walking."

A client has sustained a right tibial fracture and has just had a cast applied. Which instruction should the nurse provide in client cast care?

"Keep your right leg elevated above heart level."

A nursing student asks the nurse why older adults are at risk for falls. The best response by the nurse is:

"Muscles atrophy with aging."

A client has a plaster cast applied to the left leg. Which comment by the client following the procedure should the nurse address first?

"My toes are stiff."

On a visit to the family health care provider, a client is diagnosed with a bunion on the lateral side of the great toe at the metatarsophalangeal joint. Which statement should the nurse include in the teaching session?

"Some bunions are congenital; others are caused by wearing shoes that are too short or narrow."

A client diagnosed with a right ulnar fracture asks why the cast needs to go all the way up the arm. What is the best response by the nurse?

"The joint above the fracture and below the fracture must be immobilized."

The nurse is assessing a client with a musculoskeletal system condition. Which statement indicates to the nurse that the client is experiencing bone pain?

"The pain feels deep in my legs and keeps me awake at night."

The older client asks the nurse how best to maintain strong muscles. What is the nurse's best response?

"Weight-resistance exercises can strengthen muscles."

A nurse is educating a client diagnosed with osteomalacia. Which statement by the nurse is appropriate?

"You may need to be evaluated for an underlying cause, such as renal failure."

A 14-year-old client is treated in the emergency room for an acute knee sprain sustained during a soccer game. The nurse reviews discharge instructions with the client's parent. The nurse instructs the parent that the acute inflammatory stage will last how long?

24 to 48 hours

An older woman's X-rays reveal a diagnosis of osteoporosis. The nurse advises the woman that the radiolucency seen in the bones indicates a minimal level of demineralization of which percentage?

25%

The nurse is caring for a patient with a total hip replacement. How should the nurse allow the patient to turn?

45 degrees onto the unoperated side if the affected hip is kept abducted

Which evaluation finding requires follow up by the nurse caring for a client with a total knee replacement? Select all that apply.

650 ml bloody drainage in drain wound Knee flexion at 30 degrees

A client with suspected osteomalacia has a fractured tibia and fibula. What test would give a definitive diagnosis of osteomalacia?

A bone biopsy

The client displays manifestations of compartment syndrome. What treatment will the nurse expect the client to be scheduled for?

A fasciotomy

Which term refers to moving away from midline?

Abduction

Which body movement involves moving toward the midline?

Adduction

A client is admitted with acute osteomyelitis that developed after an open fracture of the right femur. When planning this client's care, the nurse should anticipate which measure?

Administering large doses of I.V. antibiotics as ordered

The nurse is providing care to a client following a knee arthroscopy. What would the nurse expect to include in the client's plan of care?

Administering the prescribed analgesic.

A client is having repeated tears of the joint capsule in the shoulder, and the health care provider orders an arthrogram. What intervention should the nurse provide after the procedure is completed? Select all that apply.

Apply a compression bandage to the area. Administer a mild analgesic. Inform the client that a clicking or crackling noise in the joint may persist for a couple of days.

Which is useful in identifying acute or chronic tears of the joint capsule or supporting ligaments of the knee, shoulder, ankle, hip, or wrist?

Arthrography

The nurse is preparing a client for a surgical procedure that will allow visualization of the extent of joint damage of the knee for a client with rheumatoid arthritis and also obtain a sample of synovial fluid. What procedure will the nurse prepare the client for?

Arthroscopy

The nurse is performing a neurological assessment. What will this assessment include?

Ask the client to plantar flex the toes.

A client who has sustained a fracture reports an increase in pain and decreased function of the affected extremity. What will the nurse suspect?

Avascular necrosis

An emergency department client is diagnosed with a hip dislocation. The client's family is relieved that the client has not suffered a hip fracture, but the nurse explains that this is still considered to be a medical emergency. What is the rationale for the nurse's statement?

Avascular necrosis may develop at the site if it is not promptly resolved.

A nurse is reviewing a client's activities of daily living prior to discharge from total hip replacement. The nurse should identify what activity as posing a potential risk for hip dislocation?

Bending down to put on socks

A client has been admitted to the medical unit for the treatment of Paget disease. When reviewing the medication administration record, the nurse should anticipate what medication?

Bisphosphonates

Which hormone inhibits bone reabsorption and increases calcium deposit in the bone?

Calcitonin

Which hormone inhibits bone resorption and increases the deposit of calcium in the bone?

Calcitonin

Which medication directly inhibits osteoclasts, thereby reducing bone loss and increasing BMD?

Calcitonin (Miacalcin)

A nurse provides health information to a postmenopausal woman who has been diagnosed with osteopenia. What mineral would the nurse recommend for this client?

Calcium

The nurse is assessing a client for dietary factors that may influence the risk for osteoporosis. The nurse will question the client about their intake of which nutrients? Select all that apply.

Calcium Vitamin D

A home care nurse assesses for disease complications in a client with bone cancer. Which laboratory value may indicate the presence of a disease complication?

Calcium level of 11.6 mg/dl

The nurse is caring for a pregnant patient with pregnancy-induced hypertension. When assessing the reflexes in the ankle, the nurse observes rhythmic contractions of the muscle when dorsiflexing the foot. What would the nurse document this finding as?

Clonus

An x-ray demonstrates a fracture in which a bone has splintered into several pieces. Which type of fracture is this?

Comminuted

In a client with a dislocation, the nurse should initially perform neurovascular assessments a minimum of every 15 minutes until stable. Which complication does the assessments help the nurse to monitor?

Compartment syndrome

Which is a neurovascular problem caused by pressure within a muscle area that increases to such an extent that microcirculation diminishes?

Compartment syndrome

Two days after application of a cast to treat a fractured femur, the client reports severe, deep, and constant pain in the leg. What will the nurse suspect?

Compartment syndrome.

A client who has extremity right wrist fracture complains of severe burning pain, frequent changes in the skin from hot and dry to cold, and feeling clammy skin that is shiny and growing more hair in the injured extremity. The nurse should anticipate providing care for what complication?

Complex regional pain syndrome

A client is admitted to the emergency room after being hit by a car while riding a bicycle. The client sustained a fracture of the left femur, and the bone is protruding through the skin. What type of fracture does the nurse recognize requires emergency intervention?

Compound

The nurse is assessing the feet of a patient and observes an overgrowth of the horny layer of the epidermis. What does the nurse recognize this condition as?

Corn

A client was climbing a ladder, slipped on a rung, and fell on the right side of the chest. X-ray studies reveal three rib fractures, and the client reports pain with inspiration. What is the anticipated treatment for this client?

Coughing and deep breathing with pillow splinting

The nurse is caring for a client who sustained rib fractures in an automobile accident. What symptoms does the nurse recognize as a complication of rib fractures and should immediately be reported to the physician?

Crackles in the lung bases

Which would be consistent as a component of self-care activities for the client with a cast

Cushion rough edges of the cast with tape

A client has a cast applied to the leg for treatment of a tibia fracture and also has a wound on the leg that requires dressing changes due to drainage. For what should the nurse prepare the client?

Cutting a cast window

The nurse suspects "compartment syndrome" for a casted extremity. What characteristic symptoms would the nurse assess that would confirm these suspicions? (Select all that apply.)

Decreased sensory function Excruciating pain Loss of motion

A client comes to the emergency department complaining of pain in the right leg. When obtaining the history, the nurse learns that the client has a history of obesity and hypertension. Based on this information the nurse anticipates the client having which musculoskeletal disorder?

Degenerative joint disease

Which term refers to the shaft of the long bone?

Diaphysis

The nurse in an orthopedic clinic is caring for a new client. What sign or symptom would lead a nurse to suspect that a client has a rotator cuff tear?

Difficulty lying on affected side

Which of the following disorders results in widespread hemorrhage andmicrothrombosis with ischemia?

Disseminated intravascular coagulation (DIC)

The nurse is performing a neurovascular assessment of a client's injured extremity. Which would the nurse report?

Dusky or mottled skin color

A client is diagnosed with a fracture of a diarthrosis joint. What is an example of this type of joint?

Elbow

A client has delayed bone healing in a fractured right humerus. What should the nurse prepare the client for that promotes bone growth?

Electrical stimulation

Which diagnostic test would the nurse expect to be ordered for a client with lower extremity muscle weakness?

Electromyograph (EMG)

The primary nursing intervention that will control swelling while treating a musculoskeletal injury is:

Elevate the affected area.

A client with arterial insufficiency undergoes below-knee amputation of the right leg. Which action should the nurse include in the postoperative care plan?

Elevating the stump for the first 24 hours

A teenage client is brought to the clinic by a parent and reports pain in the arm. The client is a member of a high school crew team and practices for 2 ½ hours every day after school. Which of the following would the nurse suspect?

Epicondylitis

Meniscectomy refers to the

Excision of damaged joint fibrocartilage

A client with a fractured ankle is having a fiberglass cast applied. The client starts yelling, "My leg is burning, take it off." What action by the nurse is most appropriate?

Explain that the sensation being felt is normal and will not burn the client.

The nurse is caring for a patient postoperatively following orthopedic surgery. The nurse assesses an oxygen saturation of 89%, confusion, and a rash on the upper torso. What does the nurse suspect is occurring with this patient?

Fat emboli syndrome

The nurse assesses subtle personality changes, restlessness, irritability, and confusion in a client who has sustained a fracture. The nurse suspects which complication?

Fat embolism syndrome

The femur fracture that commonly leads to avascular necrosis or nonunion because of an abundant supply of blood vessels in the area is a fracture of the:

Femoral neck.

The nurse is performing a musculoskeletal assessment for a client whose right leg muscles exhibit no tone and are limp. Which descriptor should the nurse use to document this condition?

Flaccid

The nurse is preparing to perform a musculoskeletal assessment for a client with chronic muscle pain. Which assessment technique would be an appropriate tool to evaluate this type of pain?

Flex the bicep against resistance.

The nurse is very concerned about the potential debilitating complication of peroneal nerve injury. What symptom does the nurse recognize as a result of that complication?

Foot drop

Dupuytren's contracture causes flexion of which area(s)?

Fourth and fifth fingers

In which deformity does the great toe deviate laterally?

Hallux valgus

The nurse notes that the client's left great toe deviates laterally. This finding would be recognized as

Hallux valgus

Which of the following was formerly called a bunion?

Hallux valgus

During a routine physical examination of a client, the nurse observes a flexion deformity of the proximal interphalangeal (PIP) joint of two toes on the right foot. How would the nurse document this finding?

Hammer toe

A healthcare provider asks a nurse to test a client for Tinel's sign to diagnose carpal tunnel syndrome. What should the nurse do to perform this assessment?

Have the client hold the palm of the hand up while the nurse percusses over the median

Which type of cast encloses the trunk and a lower extremity?

Hip spica

Which type of fracture involves a break through only part of the cross-section of the bone?

Inadequate immobilization

A client experienced an open fracture to the left femur during a horse-riding accident. For which complication is this client at highest risk?

Infection

Which of the following are common primary sites of tumors that metastasize to the bone? Select all that apply.

Kidney Prostate Lung Breast Ovary

Which of the following is the most common site of joint effusion?

Knee

The nurse is performing an assessment on an older adult patient and observes the patient has an increased forward curvature of the thoracic spine. What does the nurse understand this common finding is known as?

Kyphosis

Pulselessness, a very late sign of compartment syndrome, may signify

Lack of distal tissue perfusion

Which term refers to mature compact bone structures that form concentric rings of bone matrix?

Lamellae

A client is seen in the orthopedic clinic for complaints of severe pain in the left hip. After a series of diagnostic tests, the client is diagnosed with severe degenerative joint disease of the left hip and suggested to have the hip reconstructed. What procedure will the nurse schedule the client for?

Left hip arthroplasty

Which factor inhibits fracture healing?

Local malignancy

Assessment of a client reveals signs and symptoms of Paget's disease. Which of the following would be most likely?

Long bone bowing

The client presents with an exaggeration of the lumbar spine curve. How does the nurse interpret this finding?

Lordosis

Which of the following deformity causes a exaggerated curvature of the lumbar spine?

Lordosis

The nurse is employed at a long-term care facility caring for geriatric clients. Which assessment finding is characteristic of an age-related change?

Loss of height

Which area of the spinal column is subject to the greatest mechanical stress and degenerative changes?

Lower lumbar

After a traumatic back injury, a client requires skeletal traction. Which intervention takes priority?

Maintaining traction continuously to ensure its effectiveness

The client with a newly applied cast reports severe unrelenting pain. What is the nurse's best response?

Make the client NPO and notify the health care provider.

The nurse is working on an orthopedic floor caring for a client injured in a football game. The nurse is reviewing the client's chart noting that the client has previously had an injured tendon. The nurse anticipates an injury between the periosteum of the bone and which of the following?

Muscle

A client scheduled to undergo an electromyography asks the nurse what this test will evaluate. What is the correct response from the nurse?

Muscle weakness

After a person experiences a closure of the epiphyses, which statement is true?

No further increase in bone length occurs.

Which term refers to the failure of fragments of a fractured bone to heal together?

Nonunion

An instructor is describing the process of bone development. Which of the following would the instructor describe as being responsible for the process of ossification?

Osteoblasts

A client is informed of having a benign bone tumor but that this type of tumor that may become malignant. The nurse knows that this is characteristic of which type of tumor?

Osteoclastoma

Elderly clients who fall are most at risk for which injuries?

Pelvic fractures

A nurse is caring for a client following foot surgery. Which nursing intervention is most important for the nurse to include in the nursing care plan?

Perform neuromuscular assessment every hour.

A patient had hand surgery to correct a Dupuytren's contracture. What nursing intervention is a priority postoperatively?

Performing hourly neurovascular assessments for the first 24 hours

Which nerve is being assessed when the nurses asks the client to dorsiflex the ankle and extend the toes?

Peroneal

A client comes to the emergency department with reports of pain in the left ankle. The client states, "I missed a step coming down the stairs, and landed funny." The ankle is swollen and tender to the touch. What will the nurse do to help control the swelling?

Raise the left leg above the level of the heart.

Which of the following is the only selective estrogen receptor modulator approved for osteoporosis in post menopausal women?

Raloxifene

A client with osteoporosis is prescribed a selective estrogen receptor modifier (SERM) as treatment. The nurse would identify which drug as belonging to this class?

Raloxifene (Evista)

Which of the following is the final stage of fracture repair?

Remodeling

A client diagnosed with osteoporosis is being discharged home. Which priority education should the nurse should provide?

Remove all small rugs from the home

A client has just undergone arthrography. What is the most important instruction for the nurse to include in the teaching plan?

Report joint crackling or clicking noises occurring after the second day.

A client has Paget's disease. An appropriate nursing diagnosis for this client is:

Risk for falls

Which of the following is an appropriate priority nursing diagnosis for the client following an arthrocentesis?

Risk for infection

Which of the following musculoskeletal injuries is manifested by acromioclavicular joint pain?

Rotator cuff tears

A client has a fracture that is being treated with open rigid compression plate fixation devices. What teaching will the nurse reinforce to the client about how the progress of bone healing will be monitored?

Serial x-rays will be taken.

Which laboratory study indicates the rate of bone turnover?

Serum osteocalcin

Which is an inaccurate principle of traction?

Skeletal traction is interrupted to turn and reposition the client.

A group of students are studying for an examination on joints. The students demonstrate understanding of the material when they identify which of the following as an example of a synarthrodial joint?

Skull at the temporal and occipital bones

Which device is designed specifically to initially support and immobilize a body part in a desired position until swelling subsides?

Splint

A client is diagnosed with osteomyelitis. This is most commonly caused by which of the following?

Staphylococcus aureus

A patient is having low back pain. What position can the nurse suggest to relieve this discomfort?

Supine, with the knees slightly flexed and the head of the bed elevated 30 degrees

In chronic osteomyelitis, antibiotics are adjunctive therapy in which situation?

Surgical debridement

Morton neuroma is exhibited by which clinical manifestation?

Swelling of the third (lateral) branch of the median plantar nerve

A nurse is performing discharge teaching for an elderly client with osteoporosis. Which instruction about a calcium supplement should the nurse include?

Take the supplement with meals or with orange juice.

A client has been treated for migraine headaches for several months and comes to the clinic reporting no improvement. The nurse is talking with the client and hears an audible click when the client is moving the jaw. What does the nurse suspect may be happening?

Temporomandibular disorder

A client experiences a musculoskeletal injury that involves the structure that connects a muscle to the bone. The nurse understands that this injury involves which structure?

Tendon

A client is seen in the emergency room for a knee injury that happened during a basketball game. Diagnostic tests reveal torn cords of fibrous connective tissue that connect muscles to bones. What type of tear has this client sustained?

Tendon

Which client(s) is most likely to have compartment syndrome after sustaining a fracture? Select all that apply.

The client with elevated pressure within the muscles The client with hemorrhage in the site of injury The client with a plaster cast applied immediately after injury

A nurse is caring for a client who's experiencing septic arthritis. This client has a history of immunosuppressive therapy and the immune system is currently depressed. Which assignment is the most appropriate for the nurse caring for this client?

The nurse is caring for this client on the intensive care unit.

The nurse is preparing a client to have his cast cut off after having it for 6 weeks to treat a fractured tibia. What should the nurse inform the client prior to the cast being removed?

The skin may be covered with a yellowish crust that will shed in a few days.

A client visits the health care provider for a routine checkup. The history reveals that the client was diagnosed with a spinal curvature. Which region of the spine should the nurse assess for complications?

Thoracic

A client is being discharged home with a long arm cast. What education should the nurse include to prevent disuse syndrome in the arm?

Use of isometric exercises

The nurse teaches the client with a high risk for osteoporosis about risk-lowering strategies, including which action?

Walk or perform weight-bearing exercises outdoors

A nurse is planning discharge teaching regarding exercise for a client at risk for osteoporosis. Which exercise would the nurse be most likely to suggest?

Walking

The nurse is checking the traction apparatus for a client in skin traction. Which finding would require the nurse to intervene?

Weights hanging and touching the floor

The nurse is helping to set up Buck's traction on an orthopedic client. How often should the nurse assess circulation to the affected leg?

Within 30 minutes, then every 1 to 2 hours

A client sustains an injury to the left ankle in a fall. There was immediate swelling and pain from the injury, and the client was taken to the local emergency department. What initial test does the nurse anticipate the physician will order to rule out a fracture?

X-ray

A client was seen in the clinic for musculoskeletal pain, fatigue, mood disorders, and sleep disturbances. The physician has diagnosed fibromyalgia. What would not be a part of teaching plan for this condition?

applications of ice

The nurse is performing a musculoskeletal assessment of a client in a nursing home who had a stroke 2 years ago and who has right-sided hemiplegia. The nurse notes that the girth of the client's right calf is 2 inches less in diameter than the left calf. The nurse attributes the decreased girth to

atrophy of right calf muscle.

When teaching a client how to prevent low back pain as a result of lifting, the nurse should instruct the client to:

avoid overreaching.

To help minimize calcium loss from a hospitalized client's bones, the nurse should:

encourage the client to walk in the hall.

A client has come to the clinic with foot pain. The physician has described the client's condition as a flexion deformity of the proximal interphalangeal joint. What is the name of this disorder?

hammer toe

A client who has injured a hip in a fall cannot place weight on the leg and is in significant pain. After radiographs indicate intact yet malpositioned bones, what repair would the physician perform?

joint manipulation and immobilization

A client has an exaggerated convex curvature of the thoracic spine. What is this condition called?

kyphosis

A fracture is considered pathologic when it

occurs through an area of diseased bone.

A variety of complications can occur after a leg amputation. Which is not a possibility in the immediate postoperative period?

osteomyelitis

Choose the correct statement about the endosteum, a significant component of the skeletal system:

overs the marrow cavity of long bones

A client has had surgical repair of a hip injury after joint manipulation was unsuccessful. After surgery, the nurse implements measures to prevent complications. Which complications is the nurse seeking to prevent? Select all that apply.

skin breakdown wound infection pneumonia

A client has been diagnosed with a muscle strain. What does the physician mean by the term "strain"?

stretched or pulled beyond its capacity

A client has recently undergone an invasive joint examination to enable the identification of bone composition. Which signs and symptoms should the nurse monitor in this client?

swelling and bleeding

A physician writes a prescription to discontinue skeletal traction on an orthopedic client. The nurse should anticipate what subsequent intervention?

Application of a cast

A nurse is caring for a client who is in skeletal traction. To prevent the complication of skin breakdown in a client with skeletal traction, what action should be included in the plan of care?

Assess the pin insertion site every 8 hours.

A client is transported to the emergency department for a femur fracture following a motor vehicle crash. What action by the nurse is the highest priority?

Assess vital signs and level of consciousness.

A nurse is caring for an elderly female client with osteoporosis. When teaching the client, the nurse should include information about which major complication?

Bone fracture

A patient has been diagnosed with osteomalacia. What common symptoms does the nurse recognize that correlate with the diagnosis?

Bone pain and tenderness

What food can the nurse suggest to the client at risk for osteoporosis?

Broccoli

Which of the following is an example of a gliding joint?

Carpal bones in the wrist

The nurse is asked to explain to the client the age-related processes that contribute to bone loss and osteoporosis. What is the nurse's best response?

Decrease in estrogen

What clinical manifestation would the nurse expect to find in a client who has had osteoporosis for several years?

Decreased height

A nurse notices a client lying on the floor at the bottom of the stairs. The client is alert and oriented and denies pain other than in the arm, which is swollen and appears deformed. After calling for help, what should the nurse do?

Immobilize the client's arm.

Which type of fracture occurs when a bone fragment is driven into another bone fragment?

Impacted

A client with carpal tunnel syndrome has had limited improvement with the use of a wrist splint. The nurse knows that which procedure will show the greatest improvement in treatment for this client?

Open nerve release

Which is a hallmark sign of compartment syndrome?

Pain

A 10-year-old boy who was brought to the emergency room after a skiing accident is diagnosed with a fracture of the distal end of the femur. Why is this type of fracture significant?

Potential growth problems may result from damage to the epiphyseal plate.

The nurse is preparing the client for computed tomography. Which information should be given by the nurse?

"You must remain very still during the procedure."

The client scheduled for a Syme amputation is concerned about the ability to eventually stand on the amputated extremity. How should the nurse best respond to the client's concern?

"You will eventually be able to withstand full weight-bearing after the amputation."

A nurse is planning discharge instructions for the client with osteomyelitis. What instructions should the nurse include in the discharge teaching?

"You will receive IV antibiotics for 3 to 6 weeks."

A patient tells the nurse, "I was working out and lifting weights and now that I have stopped, I am flabby and my muscles have gone!" What is the best response by the nurse?

"Your muscles were in a state of hypertrophy from the weight lifting but it will persist only if the exercise is continued."

The nurse is caring for a 24-year-old female client with a right tibial fracture treated with a cast 2 hours ago. The client now reports unrelenting pain, rated as 7/10, despite taking oxycodone, and decreased sensation in the right foot. A nursing assessment reveals the right foot is cooler and paler than the left foot, with delayed capillary refill and a weak pulse. Based on the nursing assessment, the priority action the nurse should take is to____________ and prepare the client for _______________

1. notify the orthopedic health care provider immediately 2. bivalving of the cast

A physician prescribes raloxifene to a hospitalized client. The client's history includes a right hip fracture, hysterectomy, deep vein thrombosis, and hypertension. Which action by the nurse demonstrates safe nursing care?

Holding the raloxifene and notifying the physician

The nurse is monitoring a patient who sustained a fracture of the left hip. The nurse should be aware that which kind of shock can be a complication of this type of injury?

Hypovolemic

A client broke his arm in a sports accident and required the application of a cast. Shortly following application, the client reported an inability to straighten his fingers and was subsequently diagnosed with Volkmann contracture. What pathophysiologic process caused this complication?

Obstructed arterial blood flow to the forearm and hand

Which of the following is the most common and most fatal primary malignant bone tumor?

Osteogenic sarcoma (osteosarcoma)

Localized rapid bone turnover, most commonly affecting the skull, femur, tibia, pelvic bones, and vertebrae, is characterized by which bone disorder?

Paget disease

A client with metastatic bone cancer sustained a left hip fracture without injury. What type of fracture does the nurse understand occurs without trauma or fall?

Pathologic fracture

A nurse performs a neurovascular assessment on a client 2 weeks after a wrist cast had been removed. The nurse documents in the client's chart that there is normal sensation in the ulnar nerve. What finger assessment test will the nurse perform on this client?

Prick the distal fat pad on the small finger.

The nurse is performing an assessment for a patient who may have peripheral neurovascular dysfunction. What signs does the patient present with that indicate circulation is impaired? (Select all that apply.)

-Pale, cyanotic, or mottled color -Cool temperature of the extremity -More than 3-second capillary refill

The nurse is collaborating with the health care provider on a plan of care for a 54-year-old male client with osteomyelitis of the left femur secondary to uncontrolled type 1 diabetes.

-Perform neurovascular checks of lower extremities every 8 hours. -Administer IV antibiotic based on culture and sensitivity report. -Administer ibuprofen 400 mg orally three times daily, as needed for pain. -Make referral to dietitian to discuss nutrition for healing and blood glucose control. -Provide education on self-blood glucose monitoring and insulin administration.