Mobility Quiz

A nurse in a medical clinic is providing teaching to an older adult client who has osteoarthritis that is affecting her knees. Which of the following client statements indicated an understanding of the teaching? A. "I can use either heat or ice to help relieve the discomfort." B. "Ibuprofen is the first step in medication therapy for osteoarthritis." C. "I should limit physical activity to prevent further injury." D. "I will elevate my legs by placing two pillows under my knees when I go to bed."

A. "I can use either heat or ice to help relieve the discomfort." The nurse should reinforce that different treatment modalities, such as heat or cold therapy, can be tried to determine which one is more effective for the client. Heat application can help with muscle relaxation in the area around the affected joint. The application of cold numbs nerve endings and decreases joint inflammation.

A nurse is teaching a client who is starting to take alendronate effervescent tablets to treat osteoporosis. Which of the following information should the nurse include? A. "Sit upright or stand for at least 30 minutes after taking this medication." B. "Take this medication with food." C. "Take this medication with orange juice." D. "Chew or suck on the tablet."

A. "Sit upright or stand for at least 30 minutes after taking this medication." The nurse should instruct the client to sit or stand for 30 minutes after administration of this medication to reduce prolonged contact of the medication with the esophageal mucosa that can cause esophagitis.

A nurse is teaching a client who is scheduled for dual-energy x-ray absorptiometry (DXA) to screen for osteoporosis. Which of the following instructions should the nurse include in the teaching? A. "You will need to remove all jewelry before the test." B. "You will need to lie flat for 4 hours following the test." C. "You will need to empty your bladder before the test." D. "You will need to fast for 12 hours before the test."

A. "You will need to remove all jewelry before the test." The nurse should instruct the client to remove all jewelry or metal objects that can interfere with the test. A DXA scan is the mostly commonly used screening and diagnostic tool for measuring bone mineral density.

A nurse in a clinic is talking with a client who has a new diagnosis of osteoarthritis. The nurse should anticipate that the client will require teaching about which of the following medications? A. Acetaminophen B. Celecoxib C. Cyclobenzaprine D. Ibuprofen

A. Acetaminophen According to the American Pain Society, acetaminophen is the primary drug of choice for treating osteoarthritis. The provider would likely begin with this medication.

A nurse is preparing a presentation at a community center about osteoarthritis. The nurse should plan to include which of the following information? A. Affects weight-bearing joints B. Crepitus can occur in affected joints C. Affects bilateral, symmetrical joints D. Causes joint stiffness E. Causes joint pain

A. Affects weight-bearing joints B. Crepitus can occur in affected joints D. Causes joint stiffness E. Causes joint pain

A nurse is assessing a client who has a cast in place for a fractured tibia. Which of the following actions should the nurse take first? A. Checking capillary refill B. Discussing cast care C. Managing pain D. Performing range of motion

A. Checking capillary refill The priority action the nurse should take when using the airway, breathing, and circulation (ABC) approach to client care is to check the client's capillary refill. Musculoskeletal injuries can cause changes in the neurovascular system, usually distal to the injury. Capillary refill provides data about the client's circulation.

A nurse is caring for a client who has a cast in place for a fractured tibia. Which of the following nursing actions is the priority immediately after the provider has applied the cast? A. Checking capillary refill distal to the cast B. Teaching the client about cast care C. Managing pain D. Performing range of motion

A. Checking capillary refill distal to the cast The priority action the nurse should take when using the airway, breathing, and circulation (ABC) approach to client care is to check capillary refill. Musculoskeletal injuries can cause changes in the neurovascular system, usually distal to the injury from the pressure of the cast. Capillary refill provides data about the client's circulation.

A nurse is developing a plan of care for a client who has a fracture to achieve the outcome of functional healing. To assist in meeting this goal, which of the following nursing interventions is the highest priority? A. Maintain immobilization and alignment. B. Provide optimal nutrition and hydration C. Promote independence in activities of daily living. D. Provide relief from pain and discomfort.

A. Maintain immobilization and alignment. Maintaining the prescribed immobilization and body alignment will keep the fracture fragments in close anatomical proximity, thereby promoting functional fracture healing. According to the safety and risk reduction priority setting framework, this goal should receive the highest priority.

A nurse is teaching a client about risk factors for osteoporosis. Which of the following factors should the nurse include in the teaching? A. Sedentary lifestyle B. Obesity C. Aging D. Caffeine intake E. Secondhand smoke

A. Sedentary lifestyle C. Aging D. Caffeine intake E. Secondhand smoke

A nurse is reviewing risk factors for osteoporosis with a group of nursing students. The nurse should include that which of the following types of medication therapy is a risk factor for osteoporosis? A. Thyroid hormones B. Anticoagulants C. NSAIDs D. Cardiac glycosides

A. Thyroid hormones Long-term use of a synthetic thyroid hormone, such as levothyroxine, can accelerate bone loss.

A nurse is providing nutritional teaching to a client who has osteoporosis. Which of the following foods should the nurse recommend as being the highest in calcium? A. 1 cup carrot strips B. 3 oz canned salmon C. 1 cup chopped chicken breast D. 1 plain baked potato

B. 3 oz canned salmon The nurse should recommend canned salmon as a food to increase calcium intake. A 3 oz serving of canned salmon contains 197 mg of calcium.

A nurse is planning care for an adolescent who has scoliosis and requires surgical intervention. Which of the following behaviors by the adolescent should the nurse anticipate because it is most common reaction? A. Identity crisis B. Body image changes C. Feelings of displacement D. Loss of privacy

B. Body image changes Body image changes are the most common behaviors observed in adolescents who have scoliosis and require surgery.

A nurse is teaching a client at high risk for osteoporosis about dietary measures she can take to increase her calcium level. Which of the following foods should the nurse advise the client to increase in her diet? A. Carrots B. Broccoli C. Cabbage D. Potatoes

B. Broccoli Broccoli is high in calcium. Most vegetables contain considerably less calcium, except for kale, collard greens with stems, and turnip greens, which are also good sources of calcium.

A nurse is teaching an older adult client who has an intracapsular fracture of the right hip following a fall about the purpose of Buck's extension traction. The nurse should include which of the following information in the teaching? A. Buck's extension traction will reduce the fracture. B. Buck's extension traction will relieve muscle spasms. C. Buck's extension traction will maintain alignment of the pins. D. Buck's extension traction will allow supported movement of the extremity.

B. Buck's extension traction will relieve muscle spasms. Buck's extension traction immobilizes the fractured bone to relieve associated muscle spasms and thereby relieve pain. Any movement of the fractured extremity will aggravate severe muscle spasm and trigger pain.

A nurse is completing a physical assessment of a client who has early osteoarthritis. Which of the following manifestations should the nurse expect? A. Symmetric joints affected B. Pain worsens with activity C. Weight loss D. Ulnar deviation

B. Pain worsens with activity The typical cycle of pain and relief in a client who has early osteoarthritis consists of pain with activity and pain relief with rest. As the disorder progresses, clients typically experience pain even while the joint is at rest.

A nurse is assessing a client following the application of a leg cast for the treatment of a fracture. If the cast is too tight, which of the following findings should the nurse expect to observe first? A. Change in temperature of the toes. B. Pallor of the toes. C. Edema of the toes. D. Inability to move toes.

B. Pallor of the toes. If a cast is too tight it will increase pressure on the blood vessels, impairing circulation. When this occurs, pallor of the toes is the initial finding. The nurse should immediately report this finding to the provider.

A nurse in a provider's office is collecting a health history from a client who is at risk for primary osteoporosis. Which of the following findings is a risk factor for the development of osteoporosis? A. Obesity B. Sedentary lifestyle C. Long-term use of diuretics D. Prolonged stress

B. Sedentary lifestyle A sedentary lifestyle places the client at risk for osteoporosis. Regular, weight-bearing exercises help to build bone tissue.

A nurse in a clinic is assessing a client. Which of the following findings should the nurse identify as a risk factor for osteoporosis? A. Drinks one alcoholic beverage per day B. Smokes 1 pack of cigarettes per day C. Large body stature D. History of bone fracture during childhood

B. Smokes 1 pack of cigarettes per day The nurse should identify active or passive smoking as a risk factor for osteoporosis.

A nurse is caring for a client who sustained a femur fracture in an automobile accident and is placed into skeletal traction. The nurse may remove the weights from the traction device if which of the following occurs? A. The client complains of pain. B. The client develops a life-threatening situation. C. The client needs to have an x-ray of the femur performed. D. The client has to be repositioned in the bed.

B. The client develops a life-threatening situation. Traction weights, which are to hang freely at all times, are never to be removed without a specific provider prescription unless there is a life-threatening situation.

A nurse is teaching a client about risk factors for osteoarthritis. Which of the following factors should the nurse include in the teaching? A. Bacteria B. Diuretics C. Aging D. Obesity E. Smoking

C. Aging D. Obesity E. Smoking

A nurse is talking with a young adult client who has a family history of osteoporosis. Which health promotion activity should the nurse recommend as a possible preventative measure? A. Increase sodium intake. B. Have a bone-density scan each year. C. Engage in weight-bearing exercise regularly. D. Drink a cup of coffee each morning.

C. Engage in weight-bearing exercise regularly. Regular weight-bearing exercise, such as walking and stair-climbing, increases bone density and can reduce the risk for osteoporosis.

A nurse is assessing an older adult client who has osteoporosis. Which of the following spinal deformities should the nurse expect to find in this client? A. Lordosis B. Ankylosis C. Kyphosis D. Scoliosis

C. Kyphosis Kyphosis, a forward "stooping" posture with a loss of height, is an angulation of the posterior curve of the thoracic spine, usually a result of osteoporosis. It is most common in older adults and increases with aging and vertebral fractures.

A nurse is teaching a group of clients about osteoarthritis. Which of the following recommendations should the nurse include in the teaching? A. Use Echinacea to manage joint pain. B. Apply ice to the joint before exercising. C. Maintain healthy weight. D. Reduce the amount of purine in the diet.

C. Maintain healthy weight. Obesity is a risk factor for the development of osteoarthritis. Maintenance of an ideal weight is one way a client can prevent added wear and tear on joints and promote overall joint health.

A nurse is assessing a client who has a hip fracture. Which of the following findings should the nurse expect? A. Leg lengthening B. Hip pallor C. Muscle spasms D. Leg abduction

C. Muscle spasms The nurse should expect muscle spasms with a hip fracture.

A nurse is caring for a client who is postoperative following an open reduction and internal fixation of a fractured femur. Which of the following actions is the most important for the nurse to complete in the postoperative period? A. Medicate the client for pain. B. Instruct the client on use of crutches. C. Perform neurovascular checks of the extremities. D. Direct the client to perform exercises of the ankle and toes.

C. Perform neurovascular checks of the extremities. The priority action the nurse should take when using the airway, breathing, circulation approach to client care is the performance of neurovascular checks. These are a vital aspect of care for the client who has a sustained a fracture and should be monitored every hour for the first 24 hr. Circulation can easily become impaired due to constriction, which develops as the extremity swells from edema. This may cause nerve damage and tissue anoxia.

A nurse working in a community health center is preparing a flow sheet detailing essential screenings according to age group. At which developmental stage on the chart should the nurse add scoliosis screening? A. Infant B. Toddler/Preschooler C. Pre-adolescent/adolescent D. Older Adult

C. Pre-adolescent/adolescent Scoliosis is a condition involving a lateral curvature to the spine. The nurse should include screening for scoliosis during the pre-adolescence/adolescence age group: for girls in grades 5 through 7 and for boys in grade 8 or 9.

A nurse is teaching a client about medications that prevent osteoporosis. The nurse should instruct the client that which of the following medications is prescribed to prevent osteoporosis? A. Levothyroxine B. Calcitonin C. Raloxifene D. Allopurinol

C. Raloxifene Raloxifene is prescribed for the prevention and treatment of osteoporosis in postmenopausal women.

A nurse is providing discharge teaching to a client who has a fracture of the right tibia and a fiberglass cast. Which of the following instructions should the nurse include in the teaching? A. Use a blow dryer on a moderate heat setting to dry the cast after showering. B. Use a cotton swab to relieve itching under the cast. C. Report any worsening or unrelieved pain. D. Avoid moving the affected leg.

C. Report any worsening or unrelieved pain. Pain can be a sign of complications such as compartment syndrome or skin breakdown. The client should report it to the provider.

A nurse is assessing a client who has a left lower arm fracture. Which of the following findings indicates impaired venous return in the client's arm? A. A bounding distal pulse B. Acute pain C. Ecchymosis of the surrounding skin D Increasing edema

D Increasing edema Increasing edema is a sign of impaired circulation. It is important for client who has a limb fracture to keep the limb elevated to reduce edema.

A nurse is teaching a client about preventing osteoporosis. Which of the following statements by the client indicates a need for further teaching? A. "I will reduce my intake of sodium." B. "I will decrease my intake of caffeine." C. "I will limit my intake of soft drinks." D. "I will reduce my intake of vitamin K-rich foods."

D. "I will reduce my intake of vitamin K-rich foods." Vitamin K is necessary for bone health. The nurse should instruct the client to increase her intake of vitamin K-rich foods—such as green, leafy vegetables—to promote bone health.

A nurse is planning care for an adolescent who is postoperative following scoliosis repair with Harrington rod instrumentation. Which of the following interventions should the nurse include in the plan of care? A. Keep the head of the bed at a 30° angle. B. Reposition the client by log rolling every 4 hr. C. Place the client in protective isolation. D. Initiate the use of a PCA pump for pain control.

D. Initiate the use of a PCA pump for pain control. The nurse should initiate the use of a PCA pump for an adolescent who is postoperative following scoliosis repair. The PCA pump allows the client to control the delivery of pain medications.

A nurse is caring for a client who has an un-repaired femur fracture of the mid-shaft. Which of the following techniques should the nurse use when performing an assessment of the client's neurovascular status? A. Measure the circumference of the thigh. B. Palpate the femoral pulse. C. Monitor the client's calf for edema. D. Instruct the client to wiggle his toes.

D. Instruct the client to wiggle his toes. The nurse should observe the client's ability to move his toes when collecting data regarding neurovascular status distal to the fracture. Other means of evaluating neurovascular status include assessing skin color and temperature, sensation, pain, and capillary refill.

A nurse is caring for a client who has a fractured right femur and is in balanced suspension traction. The client is reporting pain from muscle spasms. Which of the following actions should the nurse take first? A. Administer an opioid analgesic. B. Obtain a prescription to adjust the weight amount. C. Offer a muscle relaxant to the client. D. Realign the client's position.

D. Realign the client's position. The greatest risk to this client is injury form circulatory compromise and tissue damage; therefore, the first action the nurse should take is to realign the client's position.

A nurse is providing teaching to a client who has osteoporosis and a new prescription for alendronate. Which of the following adverse effects should the nurse instruct the client to report to the provider? Tinnitus Jaw pain Blurred vision Drowsiness Dysphagia

Jaw pain Blurred vision Dysphagia