Musculo Prep U Review

Which statement by the client with rheumatoid arthritis would indicate the need for additional teaching to safely receive the maximum benefit of aspirin therapy?

"I try to take aspirin only on days when the pain seems particularly bad." (should be used continuously for therapeutic effect)

What is the most important assessment for the nurse to make when assessing peripheral pulses on a client who is post limb fracture?

Amplitude and symmetry of both extremities

The nurse advises the client who has had a femoral head prosthesis placement on the type of chair to sit in during the first 6 to 8 weeks after surgery. Which would be the correct type to recommend?

High backed chair w/ armrest (high-backed straight chair with armrests is recommended to help keep the client in the best possible alignment after surgery for a femoral head prosthesis placement. Use of this type of chair helps to prevent dislocation of the prothesis from the socket.)

A client is scheduled to undergo an open reduction internal fixation of the right femur. The night before surgery, the nurse administers zolpidem as ordered. Which statement about zolpidem is correct?

The nurse should administer the drug immediately before bedtime. (rapid onset)

A client with osteoarthritis tells the nurse she is concerned that the disease will prevent her from doing her chores. Which suggestion should the nurse offer?

pace yourself and rest frequently (OA: pain with activity RA: pain in morning - passive range of motion)

Which of the following activities should the nurse plan to teach the client to strengthen the hand muscles in preparation for using crutches?

squeeze rubber ball (strengthen the hands in preparation for weight bearing with the hands)

A client has a Pearson attachment on the traction setup. Which of the following is the purpose of this attachment?

supports lower portion of leg

The nurse teaches a client about heat and cold treatments to manage arthritis pain. Which of the following client statements indicates that the client still has a knowledge deficit?

"Heat-producing liniments can be used with other heat devices." (Heat-producing liniment can produce a burn if used with other heat devices that could intensify the heat reaction. Heat and cold can be used as often as the client desires. However, each application of heat should not exceed 20 minutes, and each application of cold should not exceed 10 to 15 minutes.)

A client has bursitis in the subacromial bursa. A nurse determines that the client understands teaching when the client says which of the following?

"I will apply moist heat to my shoulder for 20 minutes three times each day." (non pharmacologic measure

A client with a fractured leg has been instructed to ambulate without weight bearing on the affected leg. The nurse evaluates that the client is ambulating correctly if the client uses which of the following crutch-walking gaits?

3 point gait (client advances the crutches and the affected leg at the same time while weight is supported on the unaffected extremity

After total hip replacement, a client is receiving epidural analgesia to relieve pain. Which action is a nursing priority for this client?

assess for sensation in legs

A nurse is teaching a client with left leg weakness how to walk with a cane. The nurse should instruct the client to proceed in which manner?

hold cane in RIGHT hand (COAL: CANE OPPOSITE AFFECTED LEG - Cane moves with affected leg)

A 30-year-old client, hospitalized with a fractured femur being treated with skeletal traction, has not had a bowel movement for 2 days. Which of the following interventions is most appropriate at this time?

increase fluid intake to 3000 mL/day

A client was undergoing conservative treatment for a herniated nucleus pulposus, at L5 - S1, which was diagnosed by magnetic resonance imaging. Because of increasing neurological symptoms, the client undergoes lumbar laminectomy. The nurse should take which step during the immediate postoperative period?

logroll client from side to side

A physician orders chlorzoxazone, 500 mg P.O. t.i.d for a client. The nurse knows that chlorzoxazone, a centrally acting skeletal muscle relaxant, is commonly used to treat:

severe muscle spasm (Centrally acting skeletal muscle relaxants such as chlorzoxazone are ineffective in treating spasticity associated with chronic neurologic disease, such as cerebral palsy, and they treat acute musculoskeletal disorders, not chronic ones. Chlorzoxazone and the other relaxants are used to treat spasticity of any extremity, not just lower extremity spasiticity.)

A client has had a total hip replacement. Which of the following signs most likely indicates that the hip has dislocated?

shortening of affected leg (also increasing pain, loss of function to the extremity, and deformity. Abduction of the leg after total hip replacement - prevent dislocation)

Which of the following exercises should the nurse advise the client to avoid after a lumbar laminectomy?

sit ups (stress on back)

The client with an above-the-knee amputation is to use crutches while the prosthesis is being adjusted. Which of the following exercises will best prepare the client for using crutches?

triceps stretching exercises (Use of crutches requires significant strength from the triceps muscles)

To protect a client's skin under a back brace, the nurse should:

wear thin cotton shirt

A client is diagnosed with osteoporosis. Which statements should the nurse include when teaching the client about the disease? Select all that apply.

• "It's common in females after menopause." • "It's a degenerative disease characterized by a decrease in bone density." • "It can cause pain and injury."

A client is being discharged to a transitional rehabilitation care facility following a hip replacement due to degenerative arthritis. When reporting to the LPN, which nursing actions would the orthopedic nurse stress as essential? Select all that apply.

• Avoid any hip flexion exercises. • Place two pillows between the client's knees. • Place a raised toilet seat in the bathroom.

A nurse is teaching a client with osteomalacia how to take ordered vitamin D supplements. Which adverse effects should the nurse instruct the client to report?

Gi up set/metallic taste (early s/s of vit d toxicity)

A nurse is caring for a client with lower back pain who is scheduled for myelography using metrizamide (a water-soluble contrast dye). After the test, the nurse should place the client in which position?

HOB elevated 45 degrees (water soluble dye - slows upward dispersion. Air contrast: supine with feet above level of head "trendelenberg")

The nurse is evaluating a client in skin traction. Which of the following indicate the traction is applied for maximum effectiveness?

The ropes are in the wheel grooves of the pulleys.

A client, age 50, visits the physician for a routine checkup. The history reveals that the client was diagnosed with a spinal curvature at age 45. The nurse knows that life-threatening complications can occur if the progressive spinal curvature exceeds 65 degrees. Which region of the spine should the nurse assess for complications?

Thoracic (The nurse should assess the thoracic region of the spine because a progressive curvature of more than 65 degrees in this region may lead to cardiopulmonary failure as well as less serious signs and symptoms, such as fatigue, back pain, decreased height, and cosmetic deformity)

The nurse is instructing a nursing assistant on how to correctly position a client who has had a recent total hip replacement. In which position should the nurse tell the assistant to place the operated leg when the client is lying on the nonoperative side?

abduction extension

A nurse is assessing a client with possible osteoarthritis. The most significant risk factor for primary osteoarthritis is:

age (more signif than obesity)

On the evening of surgery for total knee replacement, a client wants to get out of bed. To safely assist the client the nurse should do which of the following?

apply a knee immobilizer. (The knee is usually protected with a knee immobilizer -splint, cast, or brace- and is elevated when the client sits in a chair. Pre- and post-surgery, the physician prescribes weight-bearing limits and use of assistive devices for progressive ambulation. Positioning a straight-backed chair at the foot of the bed is not an action conducive for getting the client out of bed on the evening of surgery for a total knee replacement. )

When developing a teaching plan for a client who is prescribed acetaminophen for muscle pain, which information should the nurse expect to include? Select all that apply.

can be used in those allergic to aspirin doesn't cause platelet aggregation causes little to no GI aggrivation

A client with a fracture develops compartment syndrome. Which of the following signs should alert the nurse to impending organ failure?

dark scanty urine (compartment syn may release myoglobin - obstruction of kidneys - renal failure)

Which of the following goals is a priority for a client with rheumatoid arthritis? The client will:

demonstrate use of adaptive equipment (hand deformities)

A client who has been diagnosed with osteoarthritis asks if he'll eventually begin to notice deformities in his hands and fingers as the condition progresses. Which concept should the nurse include in her response?

hand deformities are associated with RA (RA: morning stiffness OA: pain with activity RA: joint deformity OA: Heberden's/bouchard nodes)

Following a total hip replacement, the nurse should do which of the following? Select all that apply.

• Encourage the client to use the overhead trapeze to assist with position changes. • Use a fracture bedpan when needed by the client. • When the client is in bed, prevent thromboembolism by encouraging the client to do toe-pointing exercises.