Musculoskeletal Board Vitals

A nurse is assessing a client who has HIV. Which findings should the nurse identify as a manifestation of HIV associated muscle wasting?

diminished strength

After knee arthroscopy, the client has SCDs. Which of the following should the nurse include in this client's care?

discontinue the SCD when the client is ambulatory

A nurse is providing education to a client with chronic low back pain on non pharm pain management strategies. The nurse knows that ambulation and music are non pharm modalities of pain relief that use which of the following strategies?

distraction

The nurse is teaching a client with RA about how to manage the fatigue associated with RA. Which statement indicates the client understands how to manage the fatigue?

"I schedule afternoon rest periods for myself in addition to sleeping 10 hours a night"

A nurse is teaching the guardian of a toddler who has developmental dysplasia of the hip about care of the toddler's hip spica cast. The guardian asks why a Pavlik harness is not being used. Which of the following responses should the nurse make?

"The Pavlik harness is used for infants less than 6 months of age"

A nurse is teaching the parent of a child who has growth hormone deficiency. Which of the following statements should the nurse make?

"This disorder will not affect your child's ability to gain weight"

A nurse has given a client a nursing diagnosis of self care deficit related to a musculoskeletal disorder. Which intervention regarding activities of daily living would be most appropriate?

encourage the patient to be independent, but help when necessary

A nurse is developing a plan of care for a 4 year old child who had cerebral palsy. Which of the following actions should the nurse include?

evaluate the child's need for referral to a speech language therapist

A nurse is caring for a client admitted a day earlier after repair of a femur fracture who is agitated and short of breath. Physical examination reveals petechiae on the chest and abdomen. Which of the following is most likely the cause of these symptoms?

fat embolism

Assessing the client using the bulge sign would most likely check for which type of injury?

fluid in the knee joint

Your client has just arrived at the ED, via ambulance, with an open fracture of the arm that is accompanied by excessive tissue, nerves, and vascular damage. What grade open fracture does this client have?

grade III

A nurse is creating a plan of care for a child who has a fractured femur and is in Buck's traction. Which of the following interventions should the nurse include?

maintain the affected leg in an extended position

A nurse is caring for a client in Buck's traction after a femur fracture. When repositioning the client toward the head of the bed, which of the following should the nurse do?

maintain the same degree of traction tension while repositioning the client

A nurse is assessing the mobility of a client's shoulder. Which of the following actions should the nurse take to test extension ROM?

move the arm from a position above the head to the client's side using forward motion

A nurse in the ICU is caring for a client who has been sedated and on a mechanical ventilator for 10 days. Which of the following is a hazard associated with immobility?

muscular atrophy

A nurse is caring for a client who has just had a plaster cast applied after a fracture of the ulna. Which of the following is the most appropriate nursing intervention?

observe edges of the cast to ensure they do not cut the skin

A nurse is caring for an older adult client with impaired mobility. Which of the following should the nurse consider when planning the client's daily activities?

older adults who have been sedentary for long periods may be more likely to develop orthostatic hypotension

Which of the following findings should the nurse prioritize for immediate action when assessing a client 1 day after a cast was placed on a reduced fracture of the tibia?

paresthesias and pallor

X-ray films reveal that a client has closed fractures of the right femur and tibia. In addition, multiple soft-tissue contusions are present. Which action is most important for the nurse to take?

perform a neurovascular assessment of the extremity

A nurse is caring for a new client in the PACU after amputation of the left leg. Which of the following is the priority nursing action in the immediate post op period?

place a surgical tourniquet at the bedside

A nurse is caring for a client who has undergone total hip replacement and is now in the PACU. Which of the following is an element of post op care provided by the nurse for client who are post op hip replacement?

place pillows between the clients legs

A nurse is preparing to perform passive ROM exercises for a client who is experiencing restrictions in activity. Which of the following action should the nurse plan to take?

placed a cupped hand under the extremity during the exercise

The nurse is caring for a client with a fracture of the talus. At what mark on the drawing is the talus located?

B

A nurse is caring for a child with developmental dysplasia of the hip. Which of the following is the primary intervention for this child?

abduction of the hip

A nurse is working in a clinic is providing discharge teaching to the parent of a school age child who has juvenile arthritis. Which of the following instructions should the nurse include?

administer prednisone on an alternate day schedule

A flight nurse arrives at the scene of a motor vehicle collision and observes that the victim has had a traumatic amputation. What action is a nursing priority?

apply pressure to the stump with sterile gauze to prevent hemorrhage

A nurse is caring for a client who has chronic back pain and requests pain medication. Which of the following actions should the nurse take first?

ask the client to rate the level of pain on a scale of 0-10

A nurse is caring for a 6 year old client with a greenstick fracture of the femur who has returned to the ED after immobilization and casting. The mother states that the child is in intense pain even when the leg is elevated and the child has taken an NSAID for the relief of pain. What is the priority nursing action?

assess limb color and pulses

A charge nurse notices that a nursing assistant is lifting a client from the bed to the chair, in an erect position with straight stiffened knees. Which of the following is an appropriate response by the nurse?

use this observation to re educate the staff member about the center of gravity

A nurse is caring for a client who was admitted to the unit during the previous shift, after undergoing an orthopedic procedure to repair a fractured ankle. The client has been in bed but now asks the nurse to assist with the transfer to a chair. Which of the following should the nurse do first?

verify the surgeons prescription for this client

A nurse is providing home care for a toddler with multiple developmental disabilities who rarely goes outdoors because of photosensitivity. Which nutritional deficit is this client most likely to have?

vitamin D

Which of the following nursing instructions should be given to a 13 year old female with scoliosis who is discharged with a TLSO brace?

wear a cotton t shirt underneath the brace

Which of the following conditions would be an indication for gallows traction?

weight less than 12 kg

A nurse is teaching a group of parents about fractures. Which of the following statements by a parent indicates an understanding of the teaching?

"A fracture to an arm can cause it to be shorter than the non-injured arm"

A client presents to the clinic with a cast on the upper extremity after a fracture of the distal humerus. Which of the following statements is the most urgent priority for assessment?

"I can't extend my fingers today"

A nurse is reinforcing pre op teaching with an adolescent client who is scheduled for surgical correction of severe scoliosis. Which of the following statements should the nurse make?

"You may need to receive blood"

A nurse is providing discharge teaching for client who has RA. Which of the following statements should the nurse include in the teaching?

"You might experience joint stiffness when you get out of bed"

A nurse is caring for a client who has RA. The nurse should identify that which of the following lab tests are used to diagnose this disease?

- ESR - ANA - CRP

A nurse is teaching a client who has osteoarthritis of the hip and knee about self management of the disease. Which of the following statements should the nurse include in the teaching?

- apply heat to your joints to alleviate pain - avoid bending your joints to the point it becomes painful when exercising - use a firm mattress for sleeping

A nurse is caring for a client with a spica cast. Which of the following interventions involves proper skin care?

- check exposed areas for signs or redness or irritation - inspect the inside edges of the cast to look for extra pieces of cast material - provide regular sponge baths for the client

A nurse is admitting a client who has been immobile due to a spinal cord injury. Which of the following findings should the nurse identify as complications of immobility?

- contractures of the extremities - crackles in the lungs - pressure ulcers

Which of the following findings are most likely when assessing an elderly individual who fell and now presents with a probably hip fracture?

- groin pain with weight bearing - ecchymosis over the hip and thigh - muscle spasm around the fracture site

A nurse is caring for an adolescent who has muscular dystrophy and is taking corticosteroids. Which of the following statements about corticosteroids should the nurse include in teaching?

- help to preserve respiratory functioning - slow the progression of muscle weakness - increase muscle bulk and power - decrease the incidence of scoliosis

A nurse is caring for a child who has Legg-Calve-perthes disease. Which of the following manifestation should the nurse expect?

- hip stiffness - limited ROM - limp when walking

A nurse is caring for a client who has undergone placement of an external fixation device for a bone fracture. Which of the following actions should the nurse take?

- keep the affected extremity above the level of the heart - use a separate cotton swab for cleansing each pin - report increased redness at the pin sites

A client with RA is undergoing assessment for joint pain and swelling. Which of the following chemical mediators are responsible for the client's inflammatory process?

- leukotriene - prostaglandin - histamine - bradykinin

A nurse is reviewing the medical record of a client who has osteoporosis. Which of the following findings should the nurse expect?

- loss in height of 5.1 cm - kyphotic curve at upper thoracic spin - history of lactose intolerance

A nurse is caring for a school age child who has juvenile idiopathic arthritis and it returning to school. Which of the following instructions should the nurse include regarding successful school attendance and performance?

- make arrangements to have a set of books at school and a set at home - involve the school nurse in medication management - request an individualized education plan for patients that require extensive modifications for school

A nurse is caring for a client who has had orthopedic surgery. The nurse has given the client a nursing diagnosis of ineffective tissue perfusion based on the client's symptoms. As part of the nurse's teaching the client, which of the following signs or symptoms should the nurse tell the client to report if they occur?

- numbness or tingling in the extremities - weak pulses - inability to move the extremities

A nurse is caring for a client who requires lifting assistance. Which of the following practices will the nurse implement to avoid low back strain or injury?

- obtain help if possible - keep the trunk straight in alignment

A nurse is assessing an infant who has spina bifida cystica located below the second lumbar vertebrae. Which of the following findings should the nurse expect?

- partial paralysis of lower extremities - sensory deficits

A nurse is providing foot care instructions to a client who has DM. Which of the following instructions should the nurse include?

- perform nail care after bathing - trim toenails straight across - wear closed toe shoes

A nurse is planning care for a child who is in skeletal traction. Which of the following interventions should the nurse include in the plan?

- provide a high fiber diet - assess the pin sites every 4 hours

A client is in the acute phase of RA. In which order of priority should the nurse establish the following goals:

- relieving pain - preventing joint deformity - preserving joint function - maintaining usual ways of accomplishing tasks

Which of the following would a nurse expect on assessment of a client with fat embolism syndrome after femur fracture?

- restlessness and confusion - fever - petechial rash on neck, chest, and axilla

A nurse is assessing a client who has RA. Which of the following manifestations should the nurse expect?

- swelling of bilateral joints - ulnar deviation - morning joint stiffness

A nurse is providing education for a group of senior at a health fair concerning osteoporosis. Which of the following lifestyle modifications should the nurse recommend to decrease the risk of fracture?

- weight bearing exercise, including regular walks - tobacco cessation

A nurse is to administer 10 mg of morphine sulfate to a client with three fractured ribs. The available concentration for this drug is 15 mg per mL. How many mL should the nurse administer?

0.7

A nurse is providing instructions concerning the proper use of crutches for a client who is non weight bearing for 4-6 weeks after an ankle injury. The nurse knows to provide instructions about which of the following crutch gaits?

3 point

Which of the following call devices should the nurse provide when caring for a client who is quadriplegic?

A

A nurse is caring for a client who has a simple fracture of the humerus. Which of the following images represents a simple fracture?

B

Match each bone described below with the correct classification of bone type.

BCABAC

A nurse is caring for a client with a cartilaginous tumor on the antihelix of the ear. At what mark on the drawing is the tumor situated?

C

The nurse is assessing a client with ankylosing spondylitis that could affect the pubic symphsis. Where on the drawing is the pubic symphysis located?

C

Which of the following images represents a greenstick fracture?

C

A nurse is assigned to care for a client who is immobile because of an injury. She must perform range of motion exercises on a regular basis. Read the following descriptions of range of motion exercises and match them with their correct definitions.

CDAEB

A client with malunion of healing bones is undergoing assessment. The navicular bone of the foot is mainly affected. At what mark on the drawing is the navicular bone?

D

A nurse in the ED receives handoff report concerning a client with a comminuted fracture. Which of the following fracture configurations does the nurse expect to see?

E

Which best best describes placement of a spica cast?

a cast applied from the chest to the thighs or knees

Which of the following clients would benefit from the application of warm moist heat?

a client with chronic low back pain

A nurse in the ED is assigned to care for 4 clients. Which client is a priority for assessment and treatment?

a patient who takes warfarin and fell from a ladder, who had a brief loss of consciousness and now complains of a severe headache

Which of the following tasks should the nurse prioritize when caring for a client in the PACU who is one hour post op total hip replacement?

assessment of bloody drainage in a suction drainage device

A nurse is caring for a client who is post op lumbar laminectomy. Which of the following is appropriate when caring for this client?

assist with repositioning by using the draw sheet and log rolling the client

A nurse is assisting a client to ambulate on the first day after a knee replacement. The nurse is using a gait belt and is the only person assisting the client. As soon as they enter the hallway, the client's leg slides out from under him and he begins to fall. What is the most appropriate action for the nurse to take?

assume a wide stance and use her body to break the client's fall

A nurse is providing discharge instructions to the guardian of an infant who has developmental hip dysplasia and has a newly applied plaster spica cast. Which of the following instructions should the nurse include ?

check the temp of the infant's toes every hour for at least the first 24 hr

A nurse is asked to speak to a group of women at a community health day about osteoporosis. Which of the following should she include when discussing the risk factors for osteoporosis?

cigarette smoking

A nurse in an outpatient clinic is assessing a client who presents with knee pain. The nurse knows that the most reliable indicator of a client's pain level is which of the following?

client's report of pain

A nurse is caring for a 6 month old infant who is scheduled for a LP. Which of the following actions should the nurse take?

hold the infant's chin to his chest and knees to his abdomen during the procedure

A nurse is assessing a client complaining of moderate low back pain after gardening. Which of the following statements is true?

if salicylate is prescribed, the client should be informed of possible side effects that may indicate toxicity

A nurse is providing information about capsaicin cream to a client who has osteoarthritis. Which of the following information should the nurse include in the teaching?

inspect for skin irritation and cuts prior to application

A nurse is caring for a toddler who is scheduled to have an LP. Which of the following actions should the nurse take?

instruct the parents to keep the toddler in a flat position for 30 minutes to one hour after the procedure

A nurse is caring for a client with a cast after reduction of a tibial fracture. The nurse understands that which of the following is a symptoms of compartment syndrome?

intense muscle pain, numbness, burning, and feelings of tight muscles

A client has just returned from surgery after below the knee amputation. The client has an immediate postop prosthesis in place. What is the purpose of an immediate post op prosthesis?

it promotes body image after surgery

The nurse is caring for a client with a new plaster cast on his left arm. Which of the following will the nurse NOT include in teaching this client about cast care?

keep the arm below the level of your heart

Which of the following should the nurse assess in a client diagnosed with osteoarthritis?

local joint pain

A nurse is assessing a client who presents to the ED complaining of low back pain which he describes an extremely severe. Which of the following doses the nurse understand when assessing this client's pain?

localized pain described as throbbing or aching is typical of nociceptive pain

A nurse is caring for a client with reduced mobility who has RA. To help prevent hip flexion deformities with RA; the nurse should help the client assume which of the following positions in bed several times a day?

prone

A nurse is caring for a child who is suspected of having Legge-Calve-Perthes disorder. The nurse should anticipate a prescription for which of the following diagnostic procedures?

radiographs

A nurse is caring for a client who has undergone chest surgery. Which of the following rehabilitative measures should the nurse stress to prevent shoulder ankylosis?

raise the arm on the affected side over the head

A nurse is caring for a client with osteoarthritis who is receiving an injection of hydrocortisone into the knee joint. Which of the following does the nurse understand is most significant reason for this treatment?

reduce inflammation caused by arthritis

Which of the following is a low risk therapy that the nurse can include in a discussion with a client who complains of stress and back pain?

relaxation techniques

A client with chronic low back pain has experienced an exacerbation after helping a friend move furniture over the weekend. When he calls the clinic, the nurse realizes the increased pain may be the result of inflammation. Which of the follow non pharm interventions should the nurse recommend?

resting from all activities that aggravate the pain

A client with ankylosing spondylitis is discouraged because of his inability to continue working as a carpenter without severe pain. He has received a new prescription for etanercept. Which of the following nursing diagnoses is the priority for this client with regards to the new prescription?

risk for infection

The nurse is caring for an elderly man who has hip pain related to RA. This client is practicing appropriate self care activities when the client chooses to sit in which of the following chairs?

straight backed chair with an elevated seat

A nurse is caring for a client with hip pain related to RA. Which of the following choices of chairs by the client demonstrates understanding of appropriate self care skills?

straight backed chair with elevated seat

A nurse is caring for a client who has a cast on his arm after reduction of a fracture of the ulna. What is a normal findings when checking neurovascular statue of the distal extremity?

strong pulse that is easily palpated

A nurse is caring for an elderly client with RA. The most effective intervention for relieving stiffness in this client in which of the following?

taking a warm shower or bath in the morning

A nurse is assessing a client with herniation of the L5-S1 disk. To which of the following does the nurse expect the client is most likely to experience radiation of pain?

the buttocks and lower extremities

A nurse places a hand roll for a client who has paralysis of the right hand and arm after a stroke. Which best describes the purpose of a hand roll?

to prevent contracture in the hand

A nurse is preparing a staff in service about developmental dysplasia of the hip in preschoolers. Which of the following assessments should the nurse include?

trendelenburg sign