Mobility

A patient in the emergency department is being treated for a wrist fracture. The patient asks why a splint is being applied instead of a cast. What is the best response by the nurse?

"A splint is applied when more swelling is expected at the site of injury.

Which instruction should the nurse include when teaching the client following hip replacement surgery? (Select all that apply.)

"Avoid bending forward when sitting in a chair." • "Use a raised toilet seat and high-seated chair." • "Place pillows between your legs when you lay on your side."

Following a total knee replacement, the surgeon orders a continuous passive motion (CPM) device. The client asks about the purpose of this treatment. The best response by the nurse is:

"CPM increases range of motion of the joint."

The nurse has been educating a patient newly diagnosed with MS. Which of the following statements by the patient indicates an understanding of the education?

"I will stretch daily as directed by the physical therapist."

When discussing physical activities with the client who has just undergone a right total hip replacement, which instruction should the nurse provide?

"Limit hip flexion to 90 degrees."

The nurse is providing instructions to the client following application of a fiberglass cast. Which statement by the client indicates teaching was ineffective?

"Under no circumstances should I get my cast wet."

A client has been hospitalized for diagnostic testing. The client has just been diagnosed with multiple sclerosis, which the physician explains is an autoimmune disorder. How would the nurse explain an autoimmune disease to the client?

A disorder in which killer T cells and autoantibodies attack or destroy natural cells—those cells that are "self"

Which of the following nursing interventions is appropriate for a patient with double vision in the right eye due to MS?

Apply an eye patch to the right eye

A patient with a long arm cast continues to complain of unrelieved throbbing pain even after receiving opioid pain medication. Which of the following is the priority action by the nurse?

Assess for complications

Which nursing intervention is appropriate for monitoring the client for the development of Volkmann's contracture?

Assess the radial pulse.

A 12-year-old girl fractured her right leg several weeks ago while skiing and is returning to the orthopedist to have her cast removed. What is of primary importance in your nursing management during cast removal?

Assuring the client she won't be cut

A nurse is providing education to a client with newly diagnosed multiple sclerosis (MS). Which of the following will the nurse include?

Avoid hot temperatures

The client is admitted to the hospital with a diagnosis of left femoral neck fracture. Which treatment modality would the nurse expect the physician to order?

Buck's traction

Which nursing assessment finding would be indicative of compartment syndrome in the client with a cast applied to the left forearm 3 hours earlier?

Capillary refill of left fingers greater than 3 seconds

Which of the following is the most effective cleansing solution to complete pin site care?

Chlorhexidine

Which of the following type of fracture is associated with osteoporosis?

Compression

A 13-year-old client is brought to the emergency department. The client's mother reports that the client was struck with a baseball bat on his upper arm while diving for a pitched ball. After diagnostic tests are completed, the physician reassures the mother that her son's humerus is not broken but he has suffered another type of injury. What type of injury would you expect the physician to diagnose?

Contusion

Which of the following would be inconsistent as a component of self-care activities for the patient with a cast?

Cover the cast with plastic to insulate it

A client presents to the emergency department with an open fracture. What is the first action the nurse should take?

Cover the exposed bone with sterile dressing.

An x-ray demonstrates a fracture in which the fragments of bone are driven inward. This type of fracture would be which of the following?

Depressed

Pulselessness, a very late sign of compartment syndrome, may signify which of the following?

Lack of distal tissue perfusion

Which of the following is a chronic, degenerative, progressive disease of the central nervous system characterized by the occurrence of small patches of demyelination in the brain and spinal cord?

MS

The diagnosis of multiple sclerosis is based on which of the following tests?

Magnetic resonance imaging (MRI)

The client with a newly applied cast complains of severe unrelenting pain. Which of the following nursing actions should the nurse do next?

Make the client NPO and notify the physician.

A patient with a short arm cast is suspected to have compartment syndrome. What actions should the nurse include in the plan of care? Select all that apply

Prepare for cast removal. • Provide support to the injured extremity

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

Prone

Which of the following is an inappropriate nursing diagnosis for the client following casting?

Risk for deficient knowledge: procedure

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

Rotator cuff tears

Which of the following principles apply to the patient in traction?

Skeletal traction is never interrupted.

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

Splint

Which of the following terms refers to an injury to ligaments and other soft tissues of a joint?

Sprain

A 19-year-old client presents at the emergency department with a compound fracture of the right femur. Skeletal traction is applied to align the bones. What type of traction would you expect to be used?

Steinmann traction

Which of the following statements describes external fixation?

The surgeon inserts metal pins into the bone or bones from outside the skin surface and then attaches a compression device to the pins.

Nursing students are reviewing information about Parkinson's disease in preparation for class the next day. The students demonstrate understanding of the material when they identify which of the following as a cardinal sign of this disorder? Select all that apply.

Tremor • Rigidity • Bradykinesia • Postural instability

A client with low back pain is being seen in the clinic. In planning care, which teaching point should the nurse include?

Use the large muscles of the leg when lifting items.

A patient is newly diagnosed with relapsing-remitting multiple sclerosis (RRMS). Which instruction should the nurse provide?

You must avoid stress and extreme fatigue, because these can trigger a relapse."

The type of fracture described as having one side of the bone broken and the other side bent would be

greenstick.

With fractures of the femoral neck, the leg is

shortened, adducted, and externally rotated.

Which intervention would the nurse implement with the client in skeletal traction? Select all that apply.

• Ensure the pins or wires are covered with caps. • Position trapeze within the client's reach. • Instruct the client on isometric exercises for immobilized extremity.

A bone graft may be used for which of the following reasons? Select all that apply.

• Joint stabilization • Defect filling • Stimulation of bone healing

client who has fractured the radial head asks the nurse about factors that will promote bone healing. Which statement should the nurse include when responding to the client? Select all that apply.

"Immobilization of the fracture will promote healing by maximizing contact of bone fragments." • "Fractured bones require a good blood supply and adequate nutrition for healing." • "Weight bearing stimulates healing of the long bones of the leg, if the fracture is stabilized."

A client who suffers an injury in a local high school hockey game presents with left shoulder pain. The client cannot move the left arm, and the left shoulder is lower than the right shoulder. The nurse recognizes the client most likely has a:

Dislocated shoulder Explanation: Clinical manifestations of a dislocated shoulder include pain, lack of motion, feeling of an empty shoulder socket, and uneven posture.

Colles' fracture occurs in which of the following areas?

Distal radius

A nurse is providing care to a client with Parkinson's disease. The nurse understands the the client's signs and symptoms are related to a depletion of which of the following?

Dopamine

Mr. Williams returned to the nursing unit following orthopedic surgery and is complaining of pain. Which of the following interventions will help relieve pain?

Elevate the affected extremity and use cold applications.

The patient is scheduled for a meniscectomy of the right knee. The nurse would plan postoperative care based on what surgical procedure?

Excision of damaged joint fibrocartilage

The nurse recognizes that proper positioning of an amputated lower extremity for the prevention of contractures is:

Extension

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

Fat embolism syndrome

Which of the following is the most common clinical manifestation of multiple sclerosis?

Fatigue

Of the definitions for surgical procedures to correct joint deformities listed as follows, which describes arthrodesis?

Fusion of a joint (most often the wrist or knee) for stabilization and pain relief

A patient suffered an open fracture to the left femur during a horseback riding accident. For which of the following complications is this patient at highest risk?

Infection

Which intervention should the nurse implement with the client who has undergone a hip replacement?

Instruct the client to avoid internal rotation of the leg.

Which of the following orthopedic surgeries is done to correct and align a fracture after surgical dissection and exposure of the fracture?

Open reduction

Sarah Butler, age 26 years, has been participating in a tennis tournament. She is being seen in the clinic for elbow discomfort. The physician has given her a diagnosis of tendinitis, epicondylitis, or tennis elbow. What symptoms and signs did she have? Choose all that are correct.

Pain radiating down the dorsal surface of the forearm • Weak grasp

The nurse teaches the patient with which disorder his or her disease is due to decreased levels of dopamine in the basal ganglia of the brain?

Parkinsons Disease

Which action by the nurse would be inappropriate for the client following casting?

Protect the cast by covering with a sheet.

A patient is placed in traction for a femur facture. The nurse would document what as the expected outcomes of traction? Select all that apply

Realignment of a fracture • Reduction of deformity • Minimization of muscle spasms

A client is admitted to the hospital for a fracture of the right femur. Which clinical manifestation supports the diagnosis?

Right leg shorter than left

A 45-year-old softball player arrives at the emergency department following his injury while sliding into a base during a game. After his examination and radiographs, the physician diagnoses muscle strain and prescribes appropriate treatment. What does the physician mean with the term "strain"?

Stretched or pulled beyond its capacity

Which intervention should the nurse implement with the client who has an external fixator? Select all that apply.

Supervise the client during transfers. • Perform pin care as ordered. • Inspect pin sites for signs of infection. • Perform neurovascular assessment.

The nurse is educating a patient with lower back pain on proper lifting techniques. The nurse would document what behavior as evidence the education was effective?

The patient placed the load close to the body.

Which type of fracture produces several bone fragments?

Comminuted

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

Comminuted Explanation: A comminuted fracture may require open reduction and internal fixation

The nurse teaching the patient with a cast about home care includes which of the following instructions?

Dry a wet fiberglass cast thoroughly using a hair dryer on a cool setting to avoid skin problems

A client with Parkinson's disease has been receiving levodopa as treatment for the past 7 years. The client comes to the facility for an evaluation and the nurse observes facial grimacing, head bobbing, and smacking movements. The nurse interprets these findings as which of the following?

Dyskinesia Explanation: Most clients within 5 to 10 years of taking levodopa develop a response to the medication called dyskinesia, manifested as facial grimacing, rhythmic jerking movements of the hands, head bobbing, chewing and smacking movements, and involuntary movements of the trunk and extremities.

What is the best action by the nurse to achieve the optimal outcomes when caring for a patient with a musculoskeletal disorder that is using a cast?

Educating the patient on cast care and complications

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

Incomplete

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

My toes are stiff.

Which actions by the nurse demonstrate an understanding of caring for a patient in traction? Select all that apply.

Placing a trapeze on the bed • Ensuring that the weights are hanging freely • Assessing patient's alignment in the bed • Assessing pain level frequently

s. Bixley has been gardening all season and has come to the clinic with a complaint of shoulder pain. The physician assesses the shoulder and decided that she probably has a rotator cuff tear. What are the possible treatment options for treating this condition? Select all that apply.

NSAIDs • Modify activities and rest the joint • Arthroscopic surgery

A 17-year-old high school junior was involved in a motor vehicle collision and brought to the ED via squad. His left arm was severely traumatized in the accident and he was taken immediately to surgery. He is admitted to the ICU where you practice nursing, and the physician has ordered close monitoring for compartment syndrome. What musculoskeletal structure does compartment syndrome affect?

Nerve

The client presents with nausea and vomiting, sluggish bowel sounds, and abdominal distention. The nurse interprets these findings as suggestive of

Physiologic cast syndrome