Med Surg: Musculoskeletal ATI practice questions

a nurse is caring for a client who is wearing a halo fixator. which of the following interventions should the nurse implement? (select all that apply) A. monitor the client's vital gins every 4 hours B. monitor the client's pin sites for loosening C. hold the halo device when turning the client D. check the client's skin to ensure the jacket is not applying pressure E. adjust the screws holding the client's halo device in place to ensure a proper fit

A, B, D

a nurse is determining a client's risk of developing osteoporosis. the nurse should identify which of the following as risk factors for bone loss? (select all that apply) A. small body frame B. hypertension C. african-american ethnicity D. low vitamin D intake D. smoking

A, D, E

a nurse in the emergency department is assessing a client who was in a motor-vehicle crash 2 days ago and sustained fractures of his tibia, ulna, and several ribs. the client is now disoriented to time and place and has a SaO2 of 87%. the nurse notes generalized petechiae on the client's skin. which of the following complications should the nurse expect? A. hypovolemic shock B. fat embolism syndrome C. thrombophlebitis D. avascular bone necrosis

B

a nurse is caring for a client immediately following application of a plaster cast. the nurse should monitor for and report which of the following findings as an indication of compartment syndrome? A. sensation of heat on the surface of the cast B. paresthesias of the extremity C. pruritus of the extremity D. musty odor notes from cast materials

B

a nurse is caring for a client who has a fractured hip and was placed in Buck's traction 4 hr ago. which of the following actions should the nurse take? A. insect the client's skin underneath the boot every 12 hr B. encourage the client to perform dorsiflexion of the affected extremity every 2 hr C. remove the weights from the traction while repositioning the client in bed D. loosen the ropes if the client reports muscle spasms in the affected extremity

B

a nurse is caring for a client who has a pelvic fracture. the client reports sudden shortness of breath, stabbing chest pain, and feelings of doom. this client is experiencing which of the following complications? A. pneumonia B. pulmonary embolus C. tension pneumothorax D. tuberculosis

B

a nurse is caring for a client who is 3 days postoperative following a below-the-knee amputation. which of the following actions should the nurse take? A. place the client on a soft mattress B. rewrap the residual limb with a bandage 3 times per day C. assist the client into a prone position for 20 min every 8 hr daily D. turn the client every 4 hr while in bed

B

a nurse is caring for a client who is 3 days postoperative following a right total hip arthroplasty. while transferring to a chair, the client cries out in pain. the nurse should assess the client for which of the following manifestations of dislocation of the hip prosthesis? A. bulging in the area over the surgical incision B. shortening of the right leg C. sensation of warmth over the surgical incision D. pallor following elevation of the right leg

B

a nurse is preparing a client for a bone scan. which of the following statements indicates that the client understands the pre-procedure teaching? (select all that apply) A. "I will have to drink a radioactive solution before the test begins" B. "A special camera will scan the bones in my entire body C. "There will be better absorption on the radiation by healthy bone" D. "I'll have to drink a lot of water to help get the radiation out of my body" E. "I understand the radiation is harmless, and I don't have to worry about it"

B, D, E

a home health nurse is performing an assessment on a client who is 1 week postoperative following a total knee replacement. which of the following statements by the client indicates an understand of the teaching? A "I will discontinue the blood thinner my doctor prescribed once I am at home" B. "I will keep a pillow under my knee when I am in bed" C. "I plan to use a walker to help me get around" D. "I will discontinue using the CPM machine when I get home"

C

a nurse in the emergency department is caring for a client who reports pain in her left leg following a motor-vehicle crash. the client's left leg has bruising, swelling, and displacement of the bones. which of the following actions should the nurse take first? A. obtain an x-ray of the injured leg B. apply ice packs to the affected area C. check neurovascular status distal to the injury D. elevate the affected leg on 2 pillows

C

a nurse is assessing a client who has a fractures left femur and is in skeletal traction. which of the following findings should the nurse report to the provider? A. ecchymosis of the thigh B. serous drainage at the pin site C. chest petechiae D. muscle spasms in the left leg

C

a nurse is performing medication reconciliation for newly admitted client who has rheumatoid arthritis (RA). which of the following medications should the nurse identify as the treatment for this condition? A. Misoprostol B. Dantrolene C. Celecoxib D. Colchicine

C

a nurse is preparing a client for discharge who is postoperative following a conventional lumbar disk excision. which of the following statements indicates that the client understands the nurse's instructions? A. "I should have no problem climbing stairs when I get home" B. "I'll wait about 3 weeks before I return to my usual activities" C. "I'll use my heating pad if I feel any muscle spasms in my back" D. "I can go back to driving in about 2 weeks or so"

C

a nurse is preparing a client who is postoperative following total hip arthroplasty for discharge. which of the following statements indicates that the client understands the instructions? A. "I'll use alcohol pads to clean my incision each day" B. "When I'm doing my exercises, I'll include bent-leg raises" C. "I'll use a reacher to help me pick up anything I drop on the floor" D. "When I can walk without my walker, I can stop attending physical therapy"

C

a nurse is preparing a community education program about reducing the risk of osteoporosis. which of the following pieces of information should the nurse include? A. avoid sun exposure B. take a calcium supplement once each day if at risk for osteoporosis C. walking is the preferred mode of exercise to maintain strong bones D. caffeine intake minimizes the risk of developing osteoporosis

C

a nurse is providing nutrition education to a client who has osteomalacia. the nurse should identify that this condition is caused by a deficiency in which of the following nutrients? A. fluoride B. vitamin A C. vitamin D D. phosphorous

C

a nurse is providing preoperative teaching for a client who is scheduled for a total knee arthroplasty. which of the following statements by the client indicates an understanding of the teaching? A. "I will wear a continuous movement machine on my knee for 24 hr a day" B. "I should avoid taking NSAID medications for pain after surgery" C. "I should wear elastic stockings on both of the legs" D. "I will begin exercising my legs the day after surgery"

C

a nurse is reviewing the medical record of a client who has a prescription for probenecid to treat gout. the nurse should identify that which of the following medications can interact with probenecid? A. Colchicine B. Naproxen C. Aspirin D. Predisone

C

a nurse in the emergency department is preparing to discharge a client following a grade II (moderate) ankle sprain. which of the following instructions should the nurse plan to give the client? A. perform passive range-of-motion exercises of the ankle hourly B. keep the affected extremity in a dependent position C. wrap a loose dressing around the affected ankle D. apply cold compresses to the extremity intermittently

D

a nurse is assessing a client who has osteoarthritis. the client's medical record indicates the presence of Heberden's nodes. which of the following findings should the nurse expect? A. inflamed, fluid-filled sacs over the joints B. clubbing of the fingernails C. flexion contracture of the fingers D. hard lumps over the joints of the fingers

D

a nurse is assessing a client who has several risk factors for osteoporosis. which of the following findings indicates that the client requires further evaluation for this disorder? A. leg cramps with exercise B. stress incontinence C. abdominal distention D. lower back pain

D

a nurse is caring for a client following a hip arthroplasty. the nurse places an abduction pillow on the client for which of the following purposes? A. to rain the bed linens off the client's feet to prevent plantar flexion B. to keep the client's heels off the bed to prevent pressure ulcers C. to position the client off the operative site while in bed D. to prevent dislocation of the hip during position changes or movement

D

a nurse is discussing the difference between rheumatoid arthritis (RA) and osteoarthritis with a newly licensed nurse. which of the following pieces of information should the nurse include about osteoarthritis? A. "Osteoarthritis is caused by autoimmune processes" B. "osteoarthritis leads to a decreased erythrocyte sedimentation rate" C. "Osteoarthritis affects other organ systems" D. "osteoarthritis can impair a joint on a single side of the body"

D

a nurse is assessing a client who is 24 hr postoperative following an above-the-elbow amputation. which of the following findings should the nurse identify as the priority? A. client report of muscle spasms B. inability to get dressed without assistance C. client report of feelings of anger D. refusal to look at the affected limb

A

a nurse is assessing a client who is 48 hr postoperative following open reduction and internal fixation of a fractured tibia. which of the following findings should the nurse report to the provider? A. toes that are cold to the touch B. serous drainage from the pin sites C. blanching of the toenail beds with pressure D. pink tissue around the fixator insertion sites

A

a nurse is caring for a client who had a below-the-knee amputation for gangrene of the right foot. the client reports sensations of burning and crushing pain the the toes of the absent right foot. which of the following statements should the nurse make? A. "This type of pain usually decreases over time as the limb becomes less sensitive" B. "Try to look at the surgical wound as a reminder the limb is gone" C. "Use a cold compress intermittently to decrease these pain sensations" D. "Grief over the lost limb can sometimes cause denial that the limb is really gone"

A

a nurse is caring for a client who had a fiberglass cast placed on her left arm several hours ago and now reports itching under the cast. which of the following actions should the nurse plan to take? A. use a hair dryer on a cool setting to blow air into the cast B. ask the provider to bivalve the cast C. provide the client with a sterile cotton swab to rub the affected area D. wrap the extremity with a dry heating pad

A

a nurse is caring for a client who has chronic phantom limb pain following an above-knee amputation. which of the following medication prescriptions should the nurse verify with the provider? A. Meperidine B. Amitriptyline C. Gabapentin D. Propranolol

A

a nurse is caring for a client who has osteoporosis and a new prescription for calcium supplements. which of the following foods should the nurse recommend to promote calcium absorption? A. fortified milk B. ripe bananas C. steamed broccoli D. green leafy vegetables

A

a nurse is preparing a client for magnetic resonance imaging (MRI) of the spine. which of the following pieces of information should the nurse give the client prior to the procedure? A. "You can have a mild sedative before the procedure" B. "You'll have to lie still on your back for 15 to 20 min" C. "You can't have this test if you've had cataract surgery" D. "Your exposure to radiation will be minimal"

A

a nurse is preparing to care for a client who is in balanced skeletal traction to stabilize a femur fracture. which of the following actions should the nurse include in the client's plan of care? A. offering the client a diet high in fluid and fiber B. encouraging active range of motion of the affected leg C. removing the weights prior to reposition the client D. inspecting pin sites every 24 hr for drainage

A

a nurse is providing discharge instructions for a client who is postoperative following inner maxillary fixation with wiring. which of the following pieces of information should the nurse include? A. cut the wiring if emesis occurs B. consume 3 meals daily as part of a low-protein diet C. swab the mouth with hydrogen peroxide if wiring produces oral irritation D. resume a soft diet in 3 to 5 days

A

a nurse is providing teaching for a client following a below-the-knee amputation. which of the following pieces of information should the nurse include in the teaching? A. instruct the client to lie prone while in bed B. ensure the client sleeps on a soft mattress C, pull up the residual limb while in bed D. keep the residual limb exposed to air to heal

A

a nurse is teaching a client who has a cast on his left arm to treat a forearm fracture. which of the following indicates that the client understands the teaching? A. "I'll call the doctor's office if my fingers get colder on the arm with the cast" B. "If I have any itching under the cast, I'll try to reach the area with a cotton swab" C. "f my fingers swell, I should put a heating pad on them and rest" D. "If I have any tingling under my cast, I'll know I need to move my fingers more"

A

a nurse is caring for a client with a hip fracture who has Buck's extension traction in place. Which of the following pieces of information should the nurse give the client about this type of traction? (select all that apply) A. "You'll have considerably less pain with the traction in place" B. "You'll have the traction in place for a week or so" C. "The traction will help decrease muscle spams" D. "The weights act as a pulling force to keep your leg and hip still" E. "We have to make sure the weights are just barely touching the floor"

A, C, D

a nurse is caring for a client who is in skeletal traction following a femur fracture. on entering, the nurse finds that the client has slid toward the foot of the bed, and the traction weight is resting on the floor. which of the following actions should the nurse take? A. remove the weight temporarily to reposition the client to the correct alignment in bed B. have the client use a trapeze to pull himself up while ensuring the weight hangs freely C. life the rope off the pulley while the client rocks back and forth to reposition himself D. lift the weight manually while another staff member moves the client up in bed

B

a nurse is preparing a client who is scheduled to have an arthroscopy the following day. which of the following statements indicates that the client understands the pre-procedure teaching? A. "I have to keep my leg straight throughout the whole procedure B. "The doctor will be able to see if I have signs of rheumatoid arthritis" C. "I should expect to stay overnight until I can walk around" D. "I'll have a scar that will be about an inch long"

B

a nurse is preparing an in-service presentation about the basics of bone injuries. which of the following types of fractures results when a client's bone breaks into multiple pieces? A. avulsion B. comminuted C. compression D. spiral

B

a nurse is providing post-procedural teaching to a client who had a diagnostic knee arthroscopy. which of the following statements indicates that the client understands the nurse's instructions? A. "I'll take aspirin to relieve my pain" B. "I'll keep my leg elevated for the first day" C. "I'll put a heating pad on my knee for the first day" D. "I'll resume my usual activities as soon as I leave"

B

a nurse is teaching a client who had an amputation of the left lower leg 3 days ago. which of the following statements indicates that the client understands how to care for the incision and his left upper leg? A. "I should use powder inside my limb sock to keep it cool" B. "I will lie on my stomach for 30 min a few times a day" C. "I should expect some drainage with a strong odor because I had gangrene" D. "I will keep elevating my leg on 2 pillows to keep the swelling down"

B

a nurse is teaching a client who is on bed rest about preventing complications. which of the following client statements indicates an understanding of the teaching? A. "I should perform range-of-motion exercises once per day" B. "I should cough and deep breath every hour" C. "I should change my position every 4 hours" D. "I should perform foot and ankle pumps every 3 hours"

B

a nurse is assessing a female client who reports severe joint pain. the nurse should identify that which of the following factors places the client at risk for gout? A. perimenopause B. migraine headaches C. diuretic use D. irritable bowel syndrome

C

a nurse is caring for a client who has a depressed skill fracture of the bone that makes up the larger part of the upper and side wall of the cranium. the fracture is located on which of the following bones? A. sphenoid B. occipital C. parietal D. frontal

C

a nurse is caring for a client who is scheduled to undergo surgery to repair an open hip fracture. in which of the following positions should the nurse plan to place the client postoperatively? A. with the leg on the affected side adducted B. with the hip externally rotated on the affected side C. with the leg on the affected side abducted D. with the hip flexed to 90 degrees on the affected side

C

a nurse is reviewing the medical record of a female client. which of the following findings should the nurse identify as a risk factor for osteoporosis? A. decreased intake of phosphate-containing foods B. spending several hours in the sun daily C. increased estrogen levels D. history of anorexia nervosa

D

a nurse is teaching a client who has a new prescription for alendronate for the treatment of osteoporosis. which of the following statements by the client indicates an understanding of the teaching? A. "I will take the medication in the evening" B. "I will drink a full glass of milk with the medication" C. "I will take the medication at mealtime D. "I will sit upright after taking the medication"

D

a nurse is teaching a client who has osteoporosis. which of the following instructions should the nurse include in the teaching? A. reduce dietary protein intake B. apply ice to painful areas C. increase calcium intake to 900 mg per day D. perform weight-bearing exercises

D

a nurse is teaching a client with arthritis who is experiencing joint pain that impairs mobility. which of the following instructions should the nurse include? A. "Engage your joints in resistance exercises" B. "Avoid using assistive devices when walking" C. "Perform passive exercises" D. "Apply heat to your joints prior to exercising"

D