EAQ Exam 4 PN-NCLEX: MS Disorders
Which term describes what the nurse is trying to maintain by placing pillows around the injured leg of a client with a hip fracture?
Abduction
When caring for a client recovering from a total hip replacement, in which position would the nurse place the client's affected limb?
Abduction and extension
Which explanation would a nurse use when writing a teaching plan about osteoporosis?
It involves a decrease in bone substance.
Which site is the most common source of major disability from osteoarthritis?
Knee
Which dietary goal would the nurse include in the education of a client experiencing gout?
Limit consumption of animal protein
The plan of care for a client with osteoporosis includes active and passive exercises, calcium supplements, and daily vitamins. What desired effect would the nurse look for if the therapy is effective?
Mobility increases.
A client with type 2 diabetes develops gout, and allopurinol is prescribed. The client is also taking metformin and an over-the-counter nonsteroidal antiinflammatory drug (NSAID). Which instruction would be provided by the nurse when teaching about administration of allopurinol?
Monitor blood glucose levels more frequently
The nurse would teach that direct pressure during active and passive range-of-motion exercises on a client with a subsiding acute episode of rheumatoid arthritis would not be applied to the client' s joints because this may precipitate what?
Pain
Which complication would a nurse warn may result from direct pressure to the joints of a client recovering from an acute episode of rheumatoid arthritis?
Pain
Which manifestation is associated with osteoarthritis?
Pain and stiffness of the joints
A nurse is caring for a 13-year-old child who has an external fixation device on a leg. Which goal is the nurse ' s priority when providing pin care?
Preventing infection
The nurse evaluates that the teaching before a scheduled bone scan for a client with cancer is effective when the client makes which statement?
"A substance of low radioactivity will be injected into my vein, and my body will be inspected with an instrument to detect where it is deposited."
Which statement by a female client with a non-weight-bearing long leg cast indicates the need for the nurse to reinforce discharge teaching?
"I am going to give myself a pedicure with red nail polish when I get home."
Which response by the nurse is appropriate when a client taking ibuprofen for rheumatoid arthritis asks if acetaminophen can be substituted instead?
"Ibuprofen has antiinflammatory properties and acetaminophen does not."
A nurse gives a teenager discharge instructions regarding cast care. Which statement made by the teenager indicates that teaching has been understood?
"If I get itchy around the cast, I'll rub the itchy area gently."
Which statement by the nurse best describes the arthroscopy of the knee procedure?
"It is a direct visualization of the joint to diagnose the extent of your knee injury."
Which statement regarding rheumatoid arthritis (RA) is true?
"It is a systemic condition."
Which response by the nurse would be appropriate when a client with fibromyalgia states, "I don 't know why the doctor has prescribed this amitriptyline depression medication for me. I'm just achy and tired; I'm not depressed"?
"It is prescribed to improve the quality of your sleep at night."
Which statement by the nurse indicates the need for further teaching?
"Logrolling requires one nurse to move the body and one to move the feet in coordination."
Which statement by a client with osteogenic sarcoma about the concept of metastasis indicates a need for further information?
"Since I have metastasis I don't have to worry about it traveling anymore."
A client admitted to the hospital with an acute episode of rheumatoid arthritis (RA) asks why physical therapy has not been prescribed. Which is the most appropriate nursing response?
"Your joints are still inflamed, and physical therapy can be harmful."
Which client is most at risk for osteoporosis?
A 66-year-old white woman, 5 ft, 1 in tall (155 cm) and 100 lb (45 kg), who is a paralegal
Which client is at greatest risk for the development of venous thrombosis?
A 68-year-old male on bed rest after a left hip fracture
A nurse is caring for a client who had an open reduction and internal fixation of a femoral neck fracture. The client has an order for ambulation with slight weight bearing on the affected extremity. During the physical assessment, the nurse identifies that the client has kyphosis and strong upper arm strength. Which assistive device would the nurse expect the primary health care provider to prescribe for this client?
A standard walker
Which effect does a below-the-knee amputation (BKA) have on a client's confidence and self-worth?
Affects an idealized self-image
Which factor would the nurse explain has contributed to the increased incidence of fractures associated with osteoporosis in the United States when presenting at a women's health conference?
Aging of the American population
Which action of a client with ankylosing spondylitis would be beneficial in treatment?
Applying heat to the back and hips
Which ethnic group has the highest incidence of osteoporosis in women?
Asian American
Which area would the nurse palpate to determine the status of a client' s carotid pulse?
At the anterior neck, lateral to the trachea
Which information would the nurse take into consideration when planning nursing care for a client experiencing an acute episode of rheumatoid arthritis?
Bony ankylosis of a joint is irreversible and causes immobility
Which drug is derived from a natural source and may be prescribed for the treatment of osteoporosis?
Calcitonin
Which client assessment finding reflects signs and symptoms of a fat embolism?
Tachycardia and petechiae over the chest
The nurse is caring for a client who had an open reduction and internal fixation of the head of the femur. Based on the vital signs in the chart, which action would the nurse take first
Check the dressing on the incision
Which type of amputation will the nurse explain to the client is done to create a weight-bearing stump that can be fitted with a prosthesis?
Closed amputation
Which action would the nurse take to assess the neurovascular status of an extremity casted from the ankle to the thigh?
Compress and release the toenails of the affected foot.
Which intervention would the nurse explain would be of benefit to a client with arthritis?
Craft activities planned by the activity director
Which type of equipment is a Buck extension to immobilize a fracture?
Cutaneous traction
Which medication may be used to improve the sleep pattern of a client with fibromyalgia syndrome?
Cyclobenzaprine
Which goal of therapy would the nurse anticipate when administering allopurinol to a client with gout?
Decrease uric acid production
Which instruction would the nurse give to prevent further problems with the hands when a carpenter returns to work after surgery for carpal tunnel syndrome of the right hand?
Do stretching exercises during breaks
When would the nurse remove the abductor splint for a client who had surgery in which a hip prosthesis was inserted?
During the client's skin care and physical therapy
Which action would the nurse include in the plan of care for a schoolage child after the application of a spica cast?
Evaluating neurovascular status of the legs
When would a nurse expect increased pain and limited movement of the joints in a client with rheumatoid arthritis?
In the morning on awakening
Which client, diagnosed with arthritis, has the greatest risk for developing activity limitations based on ethnicity?
Hispanic male
Which medication used for treatment of rheumatoid arthritis has a delay in absorption when taken with food?
Ibuprofen
Which finding indicates tophi in a client whose external ear assessment revealed hard nodules on the pinna?
Increased uric acid levels in the blood
Which explanation does the nurse make for swollen finger joints in a client who is having an episode of rheumatoid arthritis?
Inflammation in the joint's synovial lining
Which mechanism would the nurse conclude is responsible for swollen finger joints in a client experiencing an acute episode of rheumatoid arthritis?
Inflammation in the joint's synovial lining
Which would the nurse include in the postoperative plan of care of a client with chronic osteomyelitis in the leg who is scheduled to have a debridement of the infected bone?
Inform the client that the leg may be immobilized in a cast or splint
Which diagnosis would the nurse ensure receives immediate care?
Open fractures
Which condition occurs in part as a result of deficiencies in vitamin D and calcium?
Osteoporosis
Which term describes the fracture sustained while a client with osteoporosis was walking up the stairs?
Pathologic
Which action would a nurse perform on a client's cast to prevent skin irritation?
Petaling
Which statement regarding phantom limb pain is accurate?
Phantom pain is often described as a burning, stinging, or crushing pain in the amputated limb
Which activity would a nurse recommend to a client with a history of a herniated nucleus pulposus scheduled for total hip replacement surgery to prevent a common complication associated with this type of surgery?
Plantar flexion and dorsiflexion exercises
Which concern is the priority when health care instructions are discussed with a carpenter having trouble holding tools because of carpal tunnel syndrome who continues to work to meet financial obligations?
Potential for injury
Why would the nurse encourage active leg activities and foot exercise every 2 hours to the unaffected leg of a client with an open reduction and internal fixation of the hip?
Prevent clot formation
Which instruction would the nurse include in the discharge plan of an older adult client with a low body mass index (BMI) found to have osteoporosis?
Providing instructions relative to diet and exercise
Which complication is most common after hip surgery?
Pulmonary embolism
Which food would the nurse instruct a client to avoid in the dietary control of gout?
Shellfish
Which action by a 70-year-old female would limit further progression of osteoporosis?
Taking supplemental calcium and vitamin D
Which definition best describes a comminuted fracture?
The bone has broken into several fragments, and the skin is intact.
An adolescent sustains a sports-related fracture of the femur, and open reduction and internal fixation with a rod insertion is performed. After the surgery, a nurse notes that the adolescent is very upset. Which fear is a likely explanation for this reaction given the client' s developmental level?
The perception that the rod is a body intrusion
Which intervention would be included in the plan of care for an elderly client who has a right hip fracture?
Venous thromboembolism (VTE) prevention
Which vitamin and other dietary supplement would the nurse recommend to prevent osteoporosis?
Vitamin D and calcium citrate
A client with carpal tunnel syndrome reports increasing difficulty holding the tools needed for woodworking. The client states, "I must return to work tomorrow. I can 't get behind on my schedule." Which issue does the nurse conclude is the issue of most concern?
A client with carpal tunnel syndrome reports increasing difficulty holding the tools needed for woodworking. The client states, "I must return to work tomorrow. I can 't get behind on my schedule." Which issue does the nurse conclude is the issue of most concern?
Which nursing intervention would the nurse focus on when explaining the immediate postoperative care to a client scheduled for a total hip replacement?
Abducting the operative hip
Which instruction would a nurse give to a client who asks for assistance onto the bedpan on the first postoperative day after a total hip replacement?
Flex the knee on the unoperated leg and pull on the trapeze to lift the pelvis.
Which action would the nurse take to prevent immediate lifethreatening systemic complications when responding at the scene of an accident where a jogger sustained multiple fractures of the femur after being hit by a motor vehicle?
Handling and transporting the client gently
A client sustains a complex comminuted fracture of the tibia with soft tissue injuries after being hit by a car while riding a bicycle. Surgical placement of an external fixator is performed to maintain the bone in alignment. Which action is essential for the nurse to perform postoperatively?
Perform a neurovascular assessment of both lower extremities
Which intervention would the nurse expect to prevent the most common postsurgical complication after an open reduction and internal fixation of a fractured hip?
Sequential compression stockings
Which individual is most at risk of developing carpal tunnel syndrome?
Software engineer
Which population-level action would the nurse use to support tertiary prevention for clients with osteoporosis?
Support development of low-impact physical activity options for those diagnosed with osteoporosis.