Med Surg Success Musculoskeletal Practice Test

42. The Jewish client with peripheral vascular disease is scheduled for a left AKA. Which question would be most important for the operating room nurse to ask the client? 1. "Have you made any special arrangements for your amputated limb?" 2. "What types of food would you like to eat while you're in the hospital?" 3. "Would like the rabbi to visit you while you are in the recovery room?" 4. "Will you start checking your other foot at least once a day for cuts?"

1. "Have you made any special arrangements for your amputated limb?"

7. The client is 12-hours post-lumbar laminectomy. Which nursing interventions should be implemented? 1. Assess ability to void and log roll every two (2) hours. 2. Medicate with IV steroids and keep the bed in a Trendelenburg position. 3. Place sand bags on each side of the head and give cathartic medications. 4. Administer IV anticoagulants and place on O2 at eight (8) L/min.

1. Assess ability to void and log roll every two (2) hours.

11. The nurse writes the problem of "pain" for a client diagnosed with lumbar strain. Which nursing interventions should be included in the plan of care? Select all that apply. 1. Assess pain on a 1-10 scale. 2. Administer pain medication PRN. 3. Provide a regular bed pan for elimination. 4. Assess surgical dressing every four (4) hours. 5. Perform a position change by the log roll method every two (2) hours.

1. Assess pain on a 1-10 scale. 2. Administer pain medication PRN.

53. The unlicensed nursing assistant (NA) notifies the nurse of the vital signs of a 28-year old male client admitted the previous day with a fractured femur. The NA reports a temperature of 101F; pulse 115; respiratory rate 28; copious amounts of thick, white sputum; and "globs" floating in the urinal. What intervention should the nurse implement first? 1. Assess the client for dyspnea, breath sounds, and altered mental status. 2. Draw blood for arterial blood gases and order a portable chest x-ray. 3. Call the health-care provider for an order to administer an antibiotic. 4. Instruct the assistant to encourage the client to deep breathe.

1. Assess the client for dyspnea, breath sounds, and altered mental status.

39. The 62-year-old client diagnosed with Type 2 diabetes who has a gangrenous right toe is being admitted for a BKA amputation. Which nursing intervention should the nurse implement? 1. Assess the client's nutritional status. 2. Refer the client to an occupational therapist. 3. Determine if the client is allergic to IVP dye. 4. Start a 22-gauge Angiocath in the right arm.

1. Assess the client's nutritional status.

49. The client is taken to the emergency department with an injury to the left arm. Which action should the nurse take first? 1. Assess the nail beds for capillary refill time. 2. Remove the client's clothing from the arm. 3. Call radiology for a STAT x-ray of the extremity. 4. Prepare the client for the application of a cast.

1. Assess the nail beds for capillary refill time.

13. The occupational health nurse is teaching a class on the risk factors for developing osteoarthritisoa (OA). Which is a modifiable risk factor for developing OA? 1. Being overweight. 2. Increasing age. 3. Previous joint damage. 4. Genetic susceptibility.

1. Being overweight.

46. The client with a right AKA is being taught how to toughen the residual limb. Which intervention should the nurse implement? 1. Instruct the client to push the residual limb against a pillow. 2. Demonstrate how to apply an elastic bandage around the residual limb. 3. Encourage the client to apply vitamin B12 to the surgical incision. 4. Teach the client to elevate the residual limb at least three times a day.

1. Instruct the client to push the residual limb against a pillow.

59. While caring for a client diagnosed with a fracture of the right distal humerus, what data would the nurse assess that would indicate a complication? Select all that apply. 1. Numbness and mottled cyanosis. 2. Paresthesia and paralysis. 3. Proximal pulses and point tenderness. 4. Coldness of the extremity and crepitus. 5. Palpable radial pulse and functional movement.

1. Numbness and mottled cyanosis. 2. Paresthesia and paralysis. 4. Coldness of the extremity and crepitus.

30. Which intervention is an example of a secondary nursing intervention when discussing osteoporosis? 1. Obtain a bone density evaluation test. 2. Perform non-weight-bearing exercises regularly. 3. Increase the intake of dietary calcium. 4. Refer clients to a smoking cessation program.

1. Obtain a bone density evaluation test.

2. The 34-year-old male client presents to the outpatient clinic complaining of numbness and pain radiating down the left leg. Which further data would the nurse assess? 1. Posture and gait. 2. Bending and stooping. 3. Leg lifts and arm swing. 4. Waist twists and neck mobility.

1. Posture and gait.

48. The 32-year old male client with a traumatic left AKA is being discharged from the rehabilitation department. Which discharge instructions should be included in the teaching? Select all that apply. 1. Report any pain that is not relieved with analgesics. 2. Eat a well-balanced diet and increase protein intake. 3. Be sure to attend all outpatient rehabilitation appointments. 4. Encourage the client to attend a support group for amputations. 5. Stay at home as much as possible for the first couple of months. Fractures

1. Report any pain that is not relieved with analgesics. 2. Eat a well-balanced diet and increase protein intake. 3. Be sure to attend all outpatient rehabilitation appointments. 4. Encourage the client to attend a support group for amputations.

33. The nurse is teaching a class to pregnant teenagers. Which information is most importantwhen discussing ways to prevent osteoporosis? 1. Take at least 1200 mg of calcium supplements a day. 2. Eat foods low in calcium and high in phosphorus. 3. Osteoporosis does not occur until around age 50 years. 4. Remain as active as possible until the baby is born.

1. Take at least 1200 mg of calcium supplements a day.

4. The occupational health nurse is planning health promotion activities for a group of factory workers. Which activity would be an example of primary prevention for clients at risk for low back pain? 1. Teach back exercises to workers after returning from an injury. 2. Place signs in the work area about how to perform first aid. 3. Start a weight-reduction group that would meet at lunchtime. 4. Administer a nonnarcotic analgesic to a client complaining of back pain.

1. Teach back exercises to workers after returning from an injury. 2. Place signs in the work area about how to perform first aid. 3. Start a weight-reduction group that would meet at lunchtime. 4. Administer a nonnarcotic analgesic to a client complaining of back pain.

69. When developing the plan of care for the client having a total knee repair, which of the expected outcomes would the nurse include? Select all that apply. 1. The client has effective pain management. 2. The client does not smoke or use tobacco products. 3. The client ambulates within the weight-bearing limits. 4. The client participates in activities of daily living. 5. The client is able to return to his or her previous lifestyle.

1. The client has effective pain management. 2. The client does not smoke or use tobacco products. 3. The client ambulates within the weight-bearing limits. 4. The client participates in activities of daily living. 5. The client is able to return to his or her previous lifestyle.

27. Which signs/symptoms would make the nurse suspect that the client has developed osteoporosis? 1. The client has lost one (1) inch in height. 2. The client has lost 12 pounds in the last year. 3. The client's hands are painful to the touch. 4. The client's serum uric acid level is elevated.

1. The client has lost one (1) inch in height.

58. When preparing the nursing care plan for a client with a fractured lower extremity, which would be the most appropriate treatment outcome for the nurse to include? 1. The client will maintain function of the leg. 2. The client will ambulate with assistance. 3. The client will be turned every two (2) hours. 4. The client will have no infection.

1. The client will maintain function of the leg.

24. The nurse is caring for the following clients. After receiving the shift report, which client should the nurse assess first? 1. The client with a total knee replacement who is complaining of a cold foot. 2. The client diagnosed with osteoarthritis who is complaining of stiff joints. 3. The client who needs to receive a scheduled intravenous antibiotic. 4. The client diagnosed with back pain who is scheduled for a lumbar myelogram.

1. The client with a total knee replacement who is complaining of a cold foot.

20. The nurse is discussing the importance of an exercise program for pain control to a client diagnosed with OA. Which intervention should the nurse include in the teaching? 1. Wear supportive tennis shoes with white socks when walking. 2. Carry a complex carbohydrate while exercising. 3. Alternate walking briskly and jogging when exercising. 4. Walk at least 30 minutes three (3) times a week.

1. Wear supportive tennis shoes with white socks when walking.

65. Which topics should the nurse include in the discharge teaching plan for a client after having a total hip replacement? Select all that apply. 1. Weight-bearing limits. 2. Use of assistive devices. 3. Gradual increase in activity. 4. Medication therapy. 5. Periods of rest.

1. Weight-bearing limits. 2. Use of assistive devices. 3. Gradual increase in activity. 4. Medication therapy. 5. Periods of rest.

29. Which foods should the nurse recommend to a client when discussing sources of dietary calcium? 1. Yogurt and dark-green, leafy vegetables. 2. Oranges and citrus fruits. 3. Bananas and dried apricots. 4. Wheat bread and bran.

1. Yogurt and dark-green, leafy vegetables.

37. The nurse instructs the client with a right BKA to lie on the stomach for at least 30 minutes a day. The client asks the nurse, "Why do I need to lie on my stomach?" Which statement would be the most appropriate statement by the nurse? 1. "This position will help your lungs expand better." 2. "Lying on your stomach will help prevent contractures." 3. "Many times this will help decrease pain in the limb." 4. "The position will take pressure off your backside."

2. "Lying on your stomach will help prevent contractures."

47. The 27-year-old client has a right above-the-elbow amputation secondary to a boating accident. Which statement by the rehabilitation nurse indicates the client has accepted the amputation? 1. "I am going to sue the guy that hit my boat." 2. "The therapist is going to help me get retrained for another job." 3. "I decided not to get a prosthesis. I don't think I need it." 4. "My wife is so worried about me and I wish she wouldn't."

2. "The therapist is going to help me get retrained for another job."

51. Which interventions should the nurse implement for the client diagnosed with an open fracture of the left ankle? Select all that apply. 1. Apply an immobilizer snugly to prevent edema. 2. Apply an ice pack for 10 minutes and remove for 20 minutes. 3. Place the extremity in the dependent position to allow drainage. 4. Obtain an x-ray of the ankle after applying the immobilizer. 5. Administer tetanus, 0.5 mL intramuscularly, in the deltoid.

2. Apply an ice pack for 10 minutes and remove for 20 minutes. 5. Administer tetanus, 0.5 mL intramuscularly, in the deltoid.

5. The client with a cervical neck injury as a result of 6. The client diagnosed with cervical neck disc degeneration has undergone a laminectomy. Which interventions should the nurse implement? 1. Position the client prone with the knees slightly elevated. 2. Assess the client for difficulty speaking or breathing. 3. Measure the drainage in the Jackson-Pratt bulb every day. 4. Encourage the client to postpone the use of narcotic medications.

2. Assess the client for difficulty speaking or breathing.

44. The nurse is caring for a client with a right below the knee amputation. There is a large amount of bright red blood on the client's residual limb dressing. Which intervention should the nurse implement first? 1. Notify the client's surgeon immediately. 2. Assess the client's blood pressure and pulse. 3. Reinforce the dressing with additional dressing. 4. Check the client's last hemoglobin and hematocrit level.

2. Assess the client's blood pressure and pulse.

54. During the morning assessment, the nurse determines that the 80-year-old client admitted with a fractured right femoral neck is confused. Which action should the nurse implement first? 1. Check for a positive Homans' sign. 2. Encourage the client to take deep breaths and cough. 3. Assess the left pedal pulse. 4. Monitor the client's Buck's traction.

2. Encourage the client to take deep breaths and cough.

55. The client admitted with a diagnosis of a fractured hip is complaining of severe pain. Which pain management technique would be best for the nurse to implement for this client? 1. Adjust the patient-controlled analgesia (PCA) machine for a lower dose. 2. Ensure that the weights of the Buck's traction are off the floor and hang freely. 3. Raise the head of the bed to 45 degrees and the foot to 15 degrees. 4. Turn the client to the affected leg using pillows to support the other leg.

2. Ensure that the weights of the Buck's traction are off the floor and hang freely.

31. The female client diagnosed with osteoporosis tells the nurse that she is going to perform swim aerobics for 30 minutes every day. Which response would be most appropriate by the nurse? 1. Praise the client for committing to do this activity. 2. Explain that walking 30 minutes a day is a better activity. 3. Encourage the client to swim every other day instead of daily. 4. Discuss that sedentary activities help prevent osteoporosis.

2. Explain that walking 30 minutes a day is a better activity.

21. The HCP prescribes glucosamine and chondroitin for a client diagnosed with OA. What is the scientific rationale for prescribing this medication? 1. It will help decrease the inflammation in the joints. 2. It improves tissue function and retards breakdown of cartilage. 3. It is a potent medication that decreases the client's joint pain. 4. It increases the production of synovial fluid in the joint.

2. It improves tissue function and retards breakdown of cartilage.

14. The client is diagnosed with osteoarthritis. Which sign/symptom would the nurse expect the client to exhibit? 1. Severe bone deformity. 2. Joint stiffness. 3. Waddling gait. 4. Swan neck fingers

2. Joint stiffness.

18. Which client goal would be most appropriate for a client diagnosed with OA? 1. Perform passive range-of-motion exercises. 2. Maintain optimal functional ability. 3. Client will walk three (3) miles every day. 4. Client will join a health club.

2. Maintain optimal functional ability.

43. The client is three (3) hours postoperative left AKA. The client tells the nurse, "My left foot is killing me. Please do something." Which intervention should the nurse implement? 1. Explain to the client that his left leg has been amputated. 2. Medicate the client with a narcotic analgesic immediately. 3. Instruct the client on how to perform biofeedback exercises. 4. Place the client's residual limb in the dependent position.

2. Medicate the client with a narcotic analgesic immediately.

71. The nurse is assessing the client who is immediately postoperative from a total knee replacement. Which assessment data would warrant immediate intervention? 1. T 99F, HR 80, RR 20, and BP 128/76. 2. Pain in the unaffected leg during dorsiflexion of the ankle. 3. Bowel sounds heard intermittently in four quadrants. 4. Diffuse, crampy abdominal pain.

2. Pain in the unaffected leg during dorsiflexion of the ankle.

72. The nurse is working on an orthopedic floor. Which client should the nurse assess first after the change of shift report? 1. The 84-year-old female with a fractured right femoral neck in Buck's traction. 2. The 64-year-old female who had a left total knee replacement with confusion. 3. The 88-year-old male who had a right total hip replacement with an abduction pillow. 4. The 50-year-old postoperative client who has a continuous passive motion (CPM) device.

2. The 64-year-old female who had a left total knee replacement with confusion.

10. The nurse is administering 0730 medications to clients on a medical orthopedic unit. Which medication would be administered first? 1. The daily cardiac glycoside to a client diagnosed with back pain and heart failure. 2. The routine insulin to a client diagnosed with neck strain and Type 1 diabetes. 3. The oral proton pump inhibitor to a client scheduled for a laminectomy this A.M. 4. The fourth dose of IV antibiotic for a client diagnosed with a surgical infection.

2. The routine insulin to a client diagnosed with neck strain and Type 1 diabetes.

3. The occupational health nurse is preparing an in-service for a group of workers in a warehouse. Which information should be included to help prevent on-the job-injuries? 1. Increase sodium and potassium in the diet during the winter months. 2. Use the large thigh muscles when lifting and hold the weight near the body. 3. Use soft-cushioned chairs when performing desk duties. 4. Have the employee arrange for assistance with household chores.

2. Use the large thigh muscles when lifting and hold the weight near the body.

22. The nurse is admitting the client with OA to the medical floor. Which statement by the client indicates an alternative form of treatment for OA? 1. "I take medication every two (2) hours for my pain." 2. "I use a heating pad when I go to bed at night." 3. "I wear a copper bracelet to help with my OA." 4. "I always wear my ankle splints when I sleep."

3. "I wear a copper bracelet to help with my OA."

56. When preparing the discharge teaching for the 12-year-old with a fractured humerus, which information should the nurse include regarding cast care? 1. Keep the arm at heart level. 2. Handle the cast with the tips of the fingers only. 3. Apply an ice pack to any area that itches. 4. Foul smells are expected occurrences.

3. Apply an ice pack to any area that itches.

40. The male nurse is helping his friend cut wood with an electric saw. His friend cut two fingers of his left hand off with the saw. Which action should the nurse implement first? 1. Wrap the left hand with towels and apply pressure. 2. Instruct the neighbor to hold his hand above his head. 3. Apply pressure to the radial artery of the left hand. 4. Go into the neighbor's house and call 911.

3. Apply pressure to the radial artery of the left hand.

60. An 88-year-old client is admitted to the orthopedic floor with the diagnosis of fractured pelvis. What intervention should the nurse implement first? 1. Insert an indwelling catheter. 2. Administer a Fleet's enema. 3. Assess abdomen for bowel sounds. 4. Apply Buck's traction. 5. Joint Replacements

3. Assess abdomen for bowel sounds.

52. When assessing a client with a fractured left tibia and fibula, which data should the nurse report to the health-care provider immediately? 1. Localized edema and discoloration occurring hours after the injury. 2. Generalized weakness and increasing sensitivity to touch. 3. Capillary refill time of nine (9) seconds and increasing pain. 4. Pain relieved after taking four (4) mg hydromorphone, a narcotic analgesic.

3. Capillary refill time of nine (9) seconds and increasing pain.

28. The client is being evaluated for osteoporosis. Which diagnostic test is the most accurate when diagnosing osteoporosis? 1. X-ray of the femur. 2. Serum alkaline phosphatase. 3. Dual-energy x-ray absorptiometry (DEXA). 4. Serum bone Gla-protein test.

3. Dual-energy x-ray absorptiometry (DEXA).

25. The nurse is discussing osteoporosis with a group of women. Which factor will the nurse identify as a nonmodifiable risk factor? 1. Calcium deficiency. 2. Tobacco use. 3. Female gender. 4. High alcohol intake.

3. Female gender.

62. The client that is one (1) day postoperative total hip replacement complains of hearing a "popping sound" when turning. What assessment data should the nurse report immediately to the surgeon? 1. Dark red-purple discoloration. 2. Equal length of lower extremities. 3. Groin pain in the affected leg. 4. Edema at the incision site.

3. Groin pain in the affected leg.

50. The nurse is preparing the plan of care for the client with an open fracture of the right arm. Which problem has the highest priority? 1. Anger related to the inability to perform ADLs. 2. Sleep disturbances related to loss of work. 3. Infection related to exposed tissue. 4. Altered body image related to scarring.

3. Infection related to exposed tissue.

12. The nurse working on a medical-surgical floor feels a pulling in the back when lifting a client up in the bed. Which should be the first action taken by the nurse? 1. Continue working until the shift is over and then try to sleep on a heating pad. 2. Go immediately to the emergency department for treatment and muscle relaxants. 3. Inform the charge nurse and nurse manager on duty and document the occurrence. 4. See a private health-care provider on the nurse's off time but charge the hospital.

3. Inform the charge nurse and nurse manager on duty and document the occurrence.

35. The client is taking calcium carbonate (Tums) to help prevent further development of osteoporosis. Which teaching should the nurse implement? 1. Encourage the client to take Tums with at least eight (8) ounces of water. 2. Teach the client to take Tums with the breakfast meal only. 3. Instruct the client to take Tums 30 to 60 minutes before a meal. 4. Discuss the need to get a monthly serum calcium level.

3. Instruct the client to take Tums 30 to 60 minutes before a meal.

38. The recovery room nurse is caring for a client that has just had a left BKA. Which intervention should the nurse implement? 1. Assess the client's surgical dressing every two (2) hours. 2. Do not allow the client to see the residual limb. 3. Keep a large tourniquet at the client's bedside. 4. Perform passive range-of-motion exercises to the right leg.

3. Keep a large tourniquet at the client's bedside.

19. Which member of the health-care team should the nurse refer the client diagnosed with OA who is complaining of not being able to get in and out of the bathtub? 1. Physiatrist. 2. Social worker. 3. Physical therapist. 4. Counselor.

3. PT

8. The nurse is working with an unlicensed nursing assistant. Which action by the assistant warrants immediate intervention? 1. The assistant feeds a client 2 days postoperative cervical laminectomy a regular diet. 2. The assistant calls for help when turning to the side a client who is post-lumbar laminectomy. 3. The assistant is helping the client who weighs 300 pounds and diagnosed with back pain to the chair. 4. The assistant places the call light within reach of the client who had a disc fusion.

3. The assistant is helping the client who weighs 300 pounds and diagnosed with back pain to the chair.

9. The nurse is caring for clients on an orthopedic floor. Which client should be assessed first? 1. The client diagnosed with back pain who is complaining of a "4" on a 1-10 scale. 2. The client who has undergone a myelogram who is complaining of a slight headache. 3. The client 2 days postop disc fusion that has a T 100.4, P 96, R 24, and BP 138/78. 4. The client diagnosed with back pain who is being discharged and whose ride is here.

3. The client 2 days postop disc fusion that has a T 100.4, P 96, R 24, and BP 138/78.

70. The nurse is caring for the client who had a total knee replacement (TKR). Which data would the nurse observe to determine if the nursing interventions are effective? 1. The client's lungs have bilateral crackles. 2. The client's knee has flexion of 45 degrees. 3. The client participates in self-care activities. 4. The client has reduced pain using a single approach.

3. The client participates in self-care activities.

64. When assessing the wound of a client who had a total hip replacement, the nurse finds small, fluid-filled lesions on the right side of the dressing. What explanation is the most probable rationale for this occurrence? 1. These were caused by the cautery unit in the operating room. 2. These are papular wheals from herpes zoster. 3. These are blisters from the tape used to anchor the dressing. 4. These macular lesions are from a latex allergy.

3. These are blisters from the tape used to anchor the dressing.

15. The client diagnosed with OA is a resident in a long-term care facility. The resident is refusing to bathe because she is hurting. Which instruction should the nurse give the unlicensed nursing assistant? 1. Allow the client to stay in bed until the pain becomes bearable. 2. Tell the assistant to give the client a bed bath this morning. 3. Try to encourage the client to get up and go to the shower. 4. Notify the family that the client is refusing to be bathed.

3. Try to encourage the client to get up and go to the shower.

5. The client with a cervical neck injury as a result of a motor-vehicle injury is complaining of unrelieved pain after administration of a narcotic analgesic. Which alternative method of pain control would be an independent nursing action? 1. Medicate the client with a muscle relaxant. 2. Heat alternating with ice applied by a physical therapist. 3. Watch television or listen to music. 4. Discuss surgical options with the health-care provider.

3. Watch television or listen to music.

63. The nurse is preparing the client who received a total hip replacement for discharge. Which statement would indicate that further teaching is needed? 1. "I should not cross my legs because my hip may come out of the socket." 2. "I will call my HCP if I have a sudden increase in pain." 3. "I will sit on a chair with arms and a firm seat." 4. "After three (3) weeks, I don't have to worry about infection."

4. "After three (3) weeks, I don't have to worry about infection."

57. Which statement by the client diagnosed with a fractured ulna would indicate that the nurse needs to do further teaching? 1. "I need to eat a high-protein diet to ensure healing." 2. "I need to wiggle my fingers every hour to increase circulation." 3. "I need to take my pain medication before my pain is too bad." 4. "I need to keep this immobilizer on when lying down only."

4. "I need to keep this immobilizer on when lying down only."

26. The client diagnosed with osteoporosis asks the nurse, "Why does smoking cigarettes cause my bones to be brittle?" Which response by the nurse would be most appropriate? 1. "Smoking causes nutritional deficiencies that contribute to osteoporosis." 2. "Tobacco causes an increase in blood supply to the bones, causing osteoporosis." 3. "Smoking low-tar cigarettes will not cause your bones to become brittle." 4. "Nicotine impairs the absorption of calcium, causing decreased bone strength."

4. "Nicotine impairs the absorption of calcium, causing decreased bone strength."

45. The nurse is caring for clients on a surgical unit. Which nursing task would be most appropriate for the nurse to delegate to an unlicensed nursing assistant? 1. Help the client with a 2-day postop amputation put on the prosthesis. 2. Request the assistant double-check a unit of blood that is being hung. 3. Change the surgical dressing on the client with a Syme amputation. 4. Ask the assistant to take the client to the physical therapy department.

4. Ask the assistant to take the client to the physical therapy department.

1. The nurse is caring for an elderly client diagnosed with a herniated nucleus pulposus of L4-L5. Which scientific rationale explains the incidence of a ruptured disc in the elderly? 1. The client did not use good body mechanics when lifting an object. 2. There is an increased blood supply to the back as the body ages. 3. Older clients develop atherosclerotic joint disease as a result of fat deposits. 4. Clients develop intervertebral disc degeneration as they age.

4. Clients develop intervertebral disc degeneration as they age.

16. The client has been diagnosed with OA for the last seven (7) years and has tried multiple medical treatments and alternative treatments but still has significant joint pain. Which psychosocial client problem would the nurse identify? 1. Severe pain. 2. Body-image disturbance. 3. Knowledge deficit 4. Depression.

4. Depression.

68. When preparing the client for the transition to home rehabilitation after having a total knee replacement, which information regarding discharge teaching would the nurse include? 1. Deep breathe and cough every two (2) hours. 2. Procedure for emptying Jackson-Pratt drainage. 3. Burning or frequency of urination is expected. 4. Modify the home for altered mobility.

4. Modify the home for altered mobility.

17. The client diagnosed with OA is prescribed a nonsteroidal anti-inflammatory drug (NSAID). Which instruction should the nurse teach the client? 1. Take the medication on an empty stomach. 2. Make sure the client tapers the medication when discontinuing. 3. Apply the medication topically over the affected joints. 4. Notify the health-care provider if vomiting blood.

4. Notify the health-care provider if vomiting blood.

34. The 84-year-old client is a resident in a long-term care facility. Which intervention should be implemented to help prevent complications secondary to osteoporosis? 1. Keep the bed in the high position. 2. Perform passive range-of-motion exercises. 3. Turn the client every two (2) hours. 4. Provide nighttime lights in the room.

4. Provide nighttime lights in the room.

41. A person's right thumb was accidentally severed with an axe. The amputated right thumb was recovered. Which action would preserve the thumb so that it could possibly be reattached in surgery? 1. Place the right thumb directly on some ice. 2. Put the right thumb in a glass of warm water. 3. Wrap the thumb in a clean piece of material. 4. Secure the thumb in a plastic bag and place on ice.

4. Secure the thumb in a plastic bag and place on ice.

23. The client is complaining of joint stiffness, especially in the morning. Which diagnostic tests would the nurse expect the health-care provider to order to R/O osteoarthritis? 1. Full body magnetic resonance imaging scan. 2. Serum studies for synovial fluid amount. 3. X-ray of the affected joints. 4. Serum erythrocyte sedimentation rate (ESR).

4. Serum erythrocyte sedimentation rate (ESR).

61. The nurse is preparing the preoperative client for a total hip replacement (THR). Which information should the nurse include concerning postoperative care? 1. Keep abduction pillow in place between legs at all times. 2. Cough and deep breathe at least every four (4) to five (5) hours. 3. Turn to both sides every two (2) hours to prevent pressure ulcers. 4. Sit in a high-seated chair for a flexion of less than 90 degrees.

4. Sit in a high-seated chair for a flexion of less than 90 degrees.

32. The client newly diagnosed with osteoporosis is prescribed calcitonin by nasal spray. Which assessment data would indicate an adverse effect of the medication? 1. The client complains of nausea and vomiting. 2. The client is drinking two (2) glasses of milk a day. 3. The client has a runny nose and nasal itching. 4. The client has had numerous episodes of nosebleeds.

4. The client has had numerous episodes of nosebleeds.

66. The nurse is preparing a plan of care for the client who has had a total hip replacement. Which outcome would be most appropriate for this client? 1. The client has limited amount of pain relief. 2. The client will have limited ability to ambulate. 3. The client will have hip instability for several months. 4. The client will have adequate hip joint motion.

4. The client will have adequate hip joint motion.

67. When assessing the client six (6) hours after having a right total knee replacement, which data should the nurse report to the surgeon? 1. A total of 100 mL of red drainage in the autotransfusion drainage system. 2. Pain relief after using the patient-controlled analgesia (PCA) pump. 3. Cool toes, distal pulses palpable, and pale nail beds bilaterally. 4. Urinary output of 60 mL of clear yellow urine in three (3) hours.

4. Urinary output of 60 mL of clear yellow urine in three (3) hours.

36. The client must take three (3) grams of calcium supplement a day. The medication comes in 500 mg/tablets. How many tablets will the client need to take daily?_______

6 tabs