musculoskeletal med surg II

Which clinical manifestation would the nurse interpret as a manifestation of neurogenic shock in a patient with acute spinal cord injury? a. Bradycardia b. Hypertension c. Neurogenic spasticity d. Bounding pedal pulses

Bradycardia

When the patient is diagnosed with muscular dystrophy, what information should the nurse include in the teaching plan? a. Use prolonged bed rest to decrease fatigue. b. Continuous positive airway pressure will facilitate sleeping. c. An orthotic jacket will limit mobility and may contribute to deformity. d. Remain active to prevent skin breakdown and respiratory complications

d. Remain active to prevent skin breakdown and respiratory complications

when grading muscle strength, the nurse records a score of 3/5 which indicates a. no detection of contraction b. barely detectable flicker of contraction c. active movement against gravity without fatigue d. active movement against gravity but not against resistance

d. active movement against gravity but not against resistance

a patient with comminuted fracture of the tibia is to have an open reduction with internal fixation of the fracture. the nurse explains that ORIF is indicated when a. the patient is unable to tolerate prolonged immobilization b. the patient cannot tolerate the surgery for a closed reduction c. a temporary case would be too unstable to provide normal mobility d. adequate alignment cannot be obtained by other nonsurgical methods

d. adequate alignment cannot be obtained by other nonsurgical methods

a nurse is caring for a client who had an above the knee amputation. the client reports a sharp, stabbing type of phantom pain. which of the following actions should the nurse take. a. facilitate counseling services b. encourage use of cold therapy c. question whether the pain is real d. administer an anti epileptic medication

d. administer an anti epileptic medication

a nurse is reviewing the health record of a client who is to undergo total joint arthroplasty. the nurse should recognize which of the following findings as a contraindication to this procedure a. age 78 b. history of cancer c. previous joint replacement d. bronchitis 2 weeks ago

d. bronchitis 2 weeks ago

the nurse is admitting a client with multiple trauma injuries to the nursing unit. the client has a leg fracture and had a plaster cast applied. which position would be best for the casted leg? a. elevated for 3 hours then flat for 1 hour b. flat for 3 hours, then flat for 1 hour c. flat for 12 hours then elevated for 12 d. elevated on pillows continually for 24 hours to 48 hours

d. elevated on pillows continually for 24 hours to 48 hours

the nurse has given instructions to a client returning home after knee arthroscopy. Which statements by the client indicates that the instructions are understood a. i can resume regular exercise tomorrow b. i can't eat food for the remainder of the day c. I need to stay off of the leg entirely for the rest of the day d. i need to report a fever or swelling to my health care provider

d. i need to report a fever or swelling to my health care provider

to prevent muscle atrophy, the nurse teaches the patient with a leg immobilized in traction to perform (select all that apply) a. flexion b. tetanic c. isotonic d. isometric e. extension

d. isometric

a patient with a stable, closed humeral fracture has a temporary splint with bulky padding applied with an elastic bandage. the nurse notifies the surgeon of possible early compartment syndrome when the patient experiences a. increasing edema of the limb b. muscle spasms of the lower arm c. bounding pulse at the fracture site d. pain when passively extending the fingers

d. pain when passively extending the fingers

during routine assessment of a patient with Guillain-Barre syndrome, the nurse finds the patient is short of breath. The patient's respiratory distress is caused by a. elevated protein in CSF b. immobility resulting from ascending paralysis c. degeneration of motor neurons in the brainstem and spinal cord. d. paralysis ascending to the nerves that stimulate the thoracic area

d. paralysis ascending to the nerves that stimulate the thoracic area

a patient with suspected disc herniation is experiencing acute pain and muscle spasms. the nurse's responsibility is to a. encourage total bed rest for several days b. teach principles of back strengthening exercises c. stress the importance of straight leg raises to decrease pain d. promote use of cold and hot compresses and pain medication

d. promote use of cold and hot compresses and pain medication

a client with a hip fracture asks the nurse about Buck's extension traction that is being applied before surgery and what is involved. the nurse shoudl provide which information to the client a. allows bony healing to begin which surgery and involves pins and screws b. provides rigid immobilization of the fracture site and involves pulleys and wheels c. lengthens the fractured leg to prevent severing of blood vessels and involves pins and screws d. provides comfort by reducing muscle spasms, provides fracture immobilization and involves pulleys and wheels

d. provides comfort by reducing muscle spasms, provides fracture immobilization and involves pulleys and wheels

the nurse is conducting health screening for osteoporosis. which client is at greatest risk of developing this disorder? a. 25 year old woman who runs b. 36 year old man who has asthma c. 70 year old man who consumes excess alcohol d. sedentary 65 year old woman who smokes cigarettes

d. sedentary 65 year old woman who smokes cigarettes

a client with DM has had a right below knee amputation. given the client's history of DM, which complication is the client at most risk for after surgery a. hemorrhage b. edema at the residual limb c. slight redness of incision d. separation of the wound edges

d. separation of the wound edges

the nurse witnessed a vehicle hit a pedestrian. the victim is dazed and tries to get up. A leg appears fractured. which intervention should the nurse take? a. try to reduce the fracture manually b. assist the victim to get up and walk to sidewalk c. leave the victim to call ambulance d. stay with victim and encourage him to stay still

d. stay with victim and encourage him to stay still

alendronate is prescribed for a client with osteoporosis and the nurse is providing instructions on administration of the medication. which instruction should the nurse provide a. take it at bedtime b. take the med in the morning with breakfast c. lie down for 30 minutes after taking the medication d. take the medication with a full glass of water after rising in the morning

d. take the medication with a full glass of water after rising in the morning

in teaching a patient with SLE about the disorder, the nurse knows the pathophysiology of SLE includes a. circulating immune complexes formed from IgG autoantibodies reacting with IgG b. an autoimmune T cell reaction that results in destruction of the deep dermal layer of skin c. immunologic dysfunction leading to chronic inflammation in the cartilage and muscles d. the production of a variety of autoantibodies directed against components of cell nucleus

d. the production of a variety of autoantibodies directed against components of cell nucleus

the nurse suspects an ankle sprain when a patient at the urgent care center describes a. being hit by another soccer player during a game b. having ankle pain after sprinting on a track c. dropping a 10 pound weight on his lower leg d. twisting his ankle while running bases during a baseball game

d. twisting his ankle while running bases during a baseball game

a nurse is teaching a client who is going to have a bone scan. which of the following statements should the nurse include a. you will receive an injection of a radioactive isotope when the scanning procedures begins b. you will be inside tube like structure during the procedure c. you will need to take radioactive precautions with your urine for 24 hours after d. you will have to urinate just before the procedure

d. you will have to urinate just before the procedure

a patient is scheduled for a total ankle replacement. the nurse should tell the patient that after surgery he should avoid a. lifting heavy objects b. sleeping on the back c. abduction exercises of the affected ankle d. bearing weight on the affected leg for 6 weeks

e. bearing weight on the affected leg for 6 weeks

cyclobenzaprine is prescribed for a client for muscle spasms and the nurse is reviewing the clients record. which disorder if noted in the record would indicate a need to contact the health care provider about the administration of this medication a. glaucoma b. emphysema c. hypothyroidism d. DM

glaucoma

a client has sustained a closed fracture and has just had a cast applied to the affected arm. the client is complaining of intense pain. the nurse elevates the limb, applies an ice bag, and administers an analgesic with little relief. which problem may be causing this pain. a. infection under cast b. anxiety of client c. impaired tissue perfusion d. the recent occurance of the fracture

impaired tissue perfusion

the nurse is analyzing the lab studies on a client receiving dantrolene. which lab test would identify an adverse effect associated with the administration of this medication a. platelet count b. creatinine level c. liver function test d. blood urea nitrogen level

liver function tests

When administered long-term, which medication requires ongoing musculoskeletal assessment? a. Corticosteroids b. β-Adrenergic blockers c. Antiplatelet aggregators d. Calcium-channel blockers

Corticosteroids

Four patients have been newly diagnosed with connective tissue disorders. The nurse should be aware of safety issues and interstitial lung involvement for the patient with which diagnosis? a. Polymyositis b. Reactive arthritis c. Sjögren's syndrome d. Systemic lupus erythematosus (SLE)

Polymyositis

The nurse performs discharge teaching for a 34-yr-old male patient with a thoracic spinal cord injury (T2) from a construction accident. Which patient statement indicates teaching about autonomic dysreflexia is successful? a. "I will perform self-catheterization at least six times per day." b. "A reflex erection may cause an unsafe drop in blood pressure." c. "If I develop a severe headache, I will lie down for 15 to 20 minutes." d. "I can avoid this problem by taking medications to prevent leg spasms."

a. "I will perform self-catheterization at least six times per day."

A 54-yr-old patient with acute osteomyelitis asks the nurse how this problem will be treated initially. Which response by the nurse is most appropriate? a. "IV antibiotics are usually required for several weeks." b. "Oral antibiotics are often required for several months." c. "Surgery is almost always necessary to remove the dead tissue that present." d. "Drainage of the foot and instillation of antibiotics into the affected area are the usual therapy."

a. "IV antibiotics are usually required for several weeks."

A 24-yr-old female patient with systemic lupus erythematosus (SLE) tells the nurse she wants to have a baby and is considering getting pregnant. Which response by the nurse is most appropriate? a. "Infertility can result from some medications used to control your disease." b. "Temporary remission of your signs and symptoms is common during pregnancy." c. "Autoantibodies transferred to the baby during pregnancy will cause heart defects." d. "The baby is at high risk for neonatal lupus erythematosus being diagnosed at birth."

a. "Infertility can result from some medications used to control your disease."

A nurse performs discharge teaching for a 58-yr-old woman after a left hip arthroplasty using the posterior approach. Which statement by the patient indicates teaching is successful? a. "Leg-raising exercises are necessary for several months." b. "I should not try to drive a motor vehicle for 2 to 3 weeks." c. "I will not have any restrictions now on hip and leg movements." d. "Blood tests will be done weekly while taking enoxaparin (Lovenox)."

a. "Leg-raising exercises are necessary for several months."

which individuals would be at high risk for low back pain. (select all that apply) a. 63 year old man who is long distance truck driver b. 36 year old construction worker who is 6'2 and weights 260lbs c. 44 year old female chef with prior compression fracture of the spine d. 30 year old nurse who works on an orthopedic unit and smokes e. 28 year old female yoga instructor who is 5'6 and weighs 130

a. 63 year old man who is long distance truck driver b. 36 year old construction worker who is 6'2 and weights 260lbs c. 44 year old female chef with prior compression fracture of the spine d. 30 year old nurse who works on an orthopedic unit and smokes

While on a mission trip, the nurse is caring for a patient diagnosed with tetanus. The patient has been given tetanus immune globulin (TIG). What interprofessional care is appropriate (select all that apply.)? a. Administer penicillin. b. Administer polyvalent antitoxin. c. Control spasms with diazepam (Valium). d. Teach correct processing of canned foods. e. Provide analgesia with opioids (morphine). f. Prepare for tracheostomy for mechanical ventilation.

a. Administer penicillin. c. Control spasms with diazepam (Valium). e. Provide analgesia with opioids (morphine). f. Prepare for tracheostomy for mechanical ventilation.

The patient has frostbite on the distal toes of both feet. The patient is scheduled for amputation of damaged tissue. Which assessment finding or diagnostic study is most objective in determining tissue viability? a. Arteriogram showing blood vessels b. Peripheral pulse palpation bilaterally c. Patches of black, indurated, cold tissue d. Bilateral pale, cool skin below the ankles

a. Arteriogram showing blood vessels

The nurse admits a 55-yr-old woman with multiple sclerosis to a long-term care facility. Which finding represents a safety concern? a. Ataxic gait b. Radicular pain c. Severe fatigue d. Urinary retention

a. Ataxic gait

The nurse is admitting a patient with a history of a herniated lumbar disc and low back pain. Which action would most likely aggravate the pain? a. Bending or lifting b. Application of warm moist heat c. Sleeping in a side-lying position d. Sitting in a fully extended recliner

a. Bending or lifting

The nurse is caring for a patient hospitalized with a herniated lumbar disc and an exacerbation of chronic bronchitis. Which breakfast choice would be most appropriate for the patient to select from the breakfast menu? a. Bran muffin b. Scrambled eggs c. Puffed rice cereal d. Buttered white toast

a. Bran muffin

A 50-yr-old patient reports shoulder discomfort after raking the yard. Which problem should the nurse suspect? a. Bursitis b. Fasciitis c. Sprained ligament d. Achilles tendonitis

a. Bursitis

A 40-yr-old African American woman has longstanding Raynaud's phenomenon. Currently, she reports red spots on her hands, forearms, palms, face, and lips. Which additional findings will the nurse expect (select all that apply.)? a. Calcinosis b. Weight loss c. Sclerodactyly d. Difficulty swallowing e. Weakened leg muscles f. Skin thickening below the elbow and knee

a. Calcinosis c. Sclerodactyly d. Difficulty swallowingf. Skin thickening below the elbow and knee

The nurse teaches a 64-yr-old man with gouty arthritis about food that may be consumed on a low-purine diet. The patient's choice of which food item would indicate an understanding of the instructions? a. Eggs b. Liver c. Salmon d. Chicken

a. Eggs

A 19-yr-old male patient has a plaster cast applied to the right arm for a Colles' fracture after a skateboarding accident. Which nursing action is most appropriate? a. Elevate the right arm on two pillows for 24 hours. b. Apply heating pad to reduce muscle spasms and pain. c. Limit movement of the thumb and fingers on the right hand. d. Place arm in a sling to prevent movement of the right shoulder.

a. Elevate the right arm on two pillows for 24 hours.

Which manifestations in a patient with a thoracic spinal cord injury (T4) should alert the nurse to possible autonomic dysreflexia? a. Headache and rising blood pressure b. Irregular respirations and shortness of breath c. Decreased level of consciousness or hallucinations d. Abdominal distention and absence of bowel sounds

a. Headache and rising blood pressure

The nurse understands that patients have the most difficulties with diarthrodial joints. Which joints are included in this group (select all that apply.)? a. Hinge joint of the knee b. Ligaments joining the vertebrae c. Gliding joints of the wrist and hand d. Fibrous connective tissue of the skull e. Ball and socket joint of the shoulder or hip f. Cartilaginous connective tissue of the pubis joint

a. Hinge joint of the knee c. Gliding joints of the wrist and hand e. Ball and socket joint of the shoulder or hip

The nurse is caring for a patient with a halo vest after cervical spine injury. Which care instructions should the nurse include in the patient's discharge plan? a. Keep a wrench close or attached to the vest. b. Use the frame and vest to assist in positioning. c. Clean around the pins using betadine swab sticks. d. Loosen both sides of the vest to provide skin care.

a. Keep a wrench close or attached to the vest.

during rehab, a patient with spinal cord injury begins to ambulate with long leg braces. which level of injury does the nurse associate with this degree of recovery a. L1-2 b. T6-7 c. T1-2 d. C7-8

a. L1-2

A patient with fibromyalgia has pain at 12 of the 18 identified tender sites, including the neck, upper back, and knees. The patient also reports nonrefreshing sleep, depression, and anxiety when dealing with multiple tasks. Which treatments will be included in the plan of care (select all that apply.)? a. Massage therapy b. Low-impact aerobic exercise c. Relaxation strategy (biofeedback) d. Antiseizure drug pregabalin (Lyrica) e. Morphine sulfate extended-release tablets f. Serotonin reuptake inhibitor (e.g., sertraline [Zoloft])

a. Massage therapy b. Low-impact aerobic exercise c. Relaxation strategy (biofeedback) d. Antiseizure drug pregabalin (Lyrica) f. Serotonin reuptake inhibitor (e.g., sertraline [Zoloft])

A 28-yr-old woman with a fracture of the proximal left tibia in a long leg cast and complains of severe pain and a prickling sensation in the left foot. The toes on the left foot are pale and cool. Which nursing action is a priority? a. Notify the health care provider immediately. b. Elevate the left leg above the level of the heart. c. Administer prescribed morphine sulfate intravenously. d. Apply ice packs to the left proximal tibia over the cast.

a. Notify the health care provider immediately.

The nurse is performing a musculoskeletal assessment on an 81-yr-old patient whose mobility has been progressively declining. How should the nurse safely assess range of motion (ROM) in the affected leg? a. Observe the patient's unassisted ROM in the affected leg. b. Perform passive ROM, asking the patient to report any pain. c. Ask the patient to lift progressive weights with the affected leg. d. Move both the patient's legs from a supine position to full flexion.

a. Observe the patient's unassisted ROM in the affected leg.

A nurse assesses a 38-yr-old patient with joint pain and stiffness who was diagnosed with stage III rheumatoid arthritis (RA). Which additional characteristics should the nurse expect (select all that apply.)? a. Presence of nodules b. Consistent muscle strength c. Localized disease symptoms d. No destructive changes on x-ray e. Subluxation of joints without fibrous ankyloses f. Joint space narrowing and formation of osteophytes

a. Presence of nodules e. Subluxation of joints without fibrous ankyloses

The nurse is caring for a 76-yr-old man who has undergone left total knee arthroplasty to relieve the pain of severe osteoarthritis. What care would be expected postoperatively? a. Progressive leg exercises to obtain 90-degree flexion b. Early ambulation with full weight bearing on the left leg c. Bed rest for 3 days with the left leg immobilized in extension d. Immobilization of the left knee in 30-degree flexion to prevent dislocation

a. Progressive leg exercises to obtain 90-degree flexion

An injured soldier underwent left leg amputation 2 weeks ago, but now reports shooting pain and heaviness in the left leg. What action by the nurse is supported by research findings? a. Use mirror therapy. b. Give opioid analgesics. c. Rebandage the residual limb. d. Show the patient the leg is gone.

a. Use mirror therapy.

a nurse is performing health screenings at a health fair. which of the following clients are at risk for osteoporosis (select all that apply) a. a 40 year old client who takes prednisone for asthma b. 30 year old who jogs 3 miles a day c. 45 year old who takes phenytoin for seizures d. 65 year old who has a sedentary lifestyle e. 70 year old who has smoked for 50 years

a. a 40 year old client who takes prednisone for asthma d. 65 year old who has a sedentary lifestyle e. 70 year old who has smoked for 50 years

for a 65 year old woman who has lived with a T1 spinal cord injury for 20 years, which health teaching instructions should the nurse emphasize a. a mammogram is needed every year b. bladder function tends to improve with age c. heart disease is not common in people with spinal cord injury d. as a person ages, the need to change body position is less important

a. a mammogram is needed every year

a nurse is assessing a client who has a casted compound fracture of the femur. Which of the following findings is a manifestation of a fat emboli. a. altered mental status b. reduced bowel sounds c. swelling of the toes distal to the injury d. pain with passive movement of the foot distal to the injury

a. altered mental status

a nurse is completing discharge teaching to a client who had a wound debridement for osteomyelitis. which of the following information should the nurse include in the teaching? a. antibiotic therapy should continue for 3 months b. relief of pain indicates the infection is eradicated c. airborne precautions are used during wound care d. expect paresthesia distal to the wound

a. antibiotic therapy should continue for 3 months

a nurse is providing information to a client who has osteoarthritis of the hip and knee. which of the following information should the nurse include in the information? (select all that apply) a. apply heat to joints to alleviate pain b. ice inflamed joints following activity c. install an elevated toilet seat d. take tub baths e. complete high energy activities in the morning

a. apply heat to joints to alleviate pain b. ice inflamed joints following activity c. install an elevated toilet seat e. complete high energy activities in the morning

a nurse is planning care for a client who is post operative following an arthroscopy of the knee. which of the following actions should the nurse take? (select all that apply) a. assess color and temperature of the extremity b. apply warm compresses to incision sites c. place pillows under the extremity d. administer analgesic medication e. assess pulse and sensation in the foot

a. assess color and temperature of the extremity c. place pillows under the extremity d. administer analgesic medication e. assess pulse and sensation in the foot

a nurse is planning care for a client who will undergo an EMG. which of the following actions should the nurse include in the plan of care (select all that apply) a. assess for bruising b. apply ice to insertion sites c. determine whether the client takes a muscle relaxant d. instruct the client to flex her muscles during needle insertion e. expect swelling, redness, and tenderness at the insertion sites

a. assess for bruising b. apply ice to insertion sites c. determine whether the client takes a muscle relaxant d. instruct the client to flex her muscles during needle insertion

the increased risk for falls in older adult is most likely due to a. changes in balance b. decrease in bone mass c. loss of ligament elasticity d. erosion of articular cartilage

a. changes in balance

a patient with a pelvic fracture should be monitored for a. changes in urine output b. petechiae on the abdomen c. palpable lump in butt d. sudden increase in bp.

a. changes in urine output

a nurse is admitting a client to the orthopedic unit following a total knee arthroplasty. which of the following actions by the nurse are appropriate a. check continuous passive motion device settings b. palpate dorsal pedal pulses c. place a pillow behind the knees d. elevate heels off bed e. apply heat therapy to incision

a. check continuous passive motion device settings b. palpate dorsal pedal pulses d. elevate heels off bed

a nurse is planning discharge teaching for a client who had a total hip arthroplasty. which of the following should the nurse include in the teaching? (select all that apply) a. clean the incision daily with soap and water b. turn the toes inward when sitting or lying c. sit in a straight backed armchair d. bend at the waist when putting on socks e. use a raised toilet seat

a. clean the incision daily with soap and water c. sit in a straight backed armchair e. use a raised toilet seat

the nurse is caring for a client bieng treated for fat embolus after multiple fractures. which data would the nurse evaluate as the most favorable indication of resolution of the fat embolus. a. clear mentation b. minimal dyspnea c. oxygen saturation of 85% d. arterial oxygen level of 78 mmHg

a. clear mentation

a patient with tendonitis asks what the tendon does. the nurse's response is based on the knowledge that tendons a. connect bone to muscle b. provide strength to muscle c. lubricate joints with synovial fluid d. relieve friction between moving parts

a. connect bone to muscle

in monitoring a client's response to disease modifying anti rheumatic drugs, which assessment findings would the nurse consider acceptable responses? select all that apply a. control of symptoms during periods of emotional stress b. normal white blood cell platelet and neutrophil count c. radiological findings that show no progression of joint degeneration d. an increased range of motion in the affected joints 3 months into therapy e. inflammation and irritation at the injection site 3 days after the injection is given. f. low grade temperature on rising in the morning that remains throughout the day

a. control of symptoms during periods of emotional stress b. normal white blood cell platelet and neutrophil count c. radiological findings that show no progression of joint degeneration d. an increased range of motion in the affected joints 3 months into therapy

allopurinol is prescribed for a client and the nurse provides medication instructions to the client. which instruction should the nurse provide? a. drink 3000 mL of fluid a day b. take the medication on an empty stomach c. the effect of the medication will occur immediately d. any swelling of the lips is a normal expected response

a. drink 3000 mL of fluid a day

a nurse is presenting information to a group of clients at a health fair about measures to reduce the risk of amputation. which of the following information should the nurse provide? (select all that apply) a. encourage clients who smoke to consider smoking cessation programs b. encourage clients who have DM to maintain blood glucose within the expected reference range c. instruct clients to unplug electrical equipment when performing repairs d. encourage clients who have vascular disease to maintain good foot care e. advise clients to wait 2 hours after taking pain meds before driving

a. encourage clients who smoke to consider smoking cessation programs b. encourage clients who have DM to maintain blood glucose within the expected reference range c. instruct clients to unplug electrical equipment when performing repairs d. encourage clients who have vascular disease to maintain good foot care

a nurse is completing a preoperative teaching plan for a client who is scheduled to have a total hip arthroplasty. which of the following should the nurse include in the teaching plan. (select all that apply) a. encourage complete autologous blood donation b. sit in a low reclining chair c. instruct the client to roll onto the operative hip d. use an abductor pillow when turning the patient e. perform isometric exercises

a. encourage complete autologous blood donation d. use an abductor pillow when turning the patient e. perform isometric exercises

a nurse is caring for a client following a below the elbow amputation. which of the following actions should the nurse take (select all that apply) a. encourage dependent positioning of the residual limb b. inspect for presence and amount of drainage c. implement shrinkage intervention of the residual limb d. wrap the residual limb in a circular manner using gauze e. assess for feelings of body image changes

a. encourage dependent positioning of the residual limb b. inspect for presence and amount of drainage c. implement shrinkage intervention of the residual limb e. assess for feelings of body image changes

a nurse is providing teaching for a client who has a history of low back injury. which of the following instructions should the nurse give the client to prevent future problems with low back pain? select all that apply a. engage in regular exercise including walking b. sit for up to 10 hours each day to rest the back c. maintain weight within 25% of ideal body weight d. create a smoking cessation plan e. wear low heeled shoes

a. engage in regular exercise including walking d. create a smoking cessation plan e. wear low heeled shoes

while performing passive range of motion for a patient, the nurse puts the ankle joint through the movements of (select all the apply) a. flexion and extension b. inversion and eversion c. pronation and supination d. flexion, extension, abduction, and adduction e. pronation, supination, rotation, circumduction

a. flexion and extension b. inversion and eversion

a patient with a humeral fracture is returning for a 4 week checkup. the nurse explains that initial evidence of healing on x ray is indicated by a. formation of callus b. complete bony union c. hematoma at the fracture site d. presence of granulation tissue

a. formation of callus

a nurse is assessing a client who has osteoarthritis of the knees and fingers. Which of the following manifestations should the nurse expect to find? (select all that apply) a. heberden's nodes b. swelling of all joints c. small body frame d. enlarged joints e. limp when walking

a. heberden's nodes d. enlarged joints e. limp when walking

a client is being discharged to home after application of a plaster leg cast. which statement indicates that the client understands proper care of the cast? a. i need to avoid getting the cast wet b. i need to cover the casted leg with warm blankets c. i need to use my fingertips to lift and move my leg d. i need to use something like a padded coat hanger end to scratch under the cast

a. i need to avoid getting the cast wet

the nurse has given the client instructions about crutch safety. which statement indicates that the client understands the instructions (select all that apply) a. i should not use someone else's crutches b. i need to remove any scatter rugs at home c. i can use crutch tips even when they are wet d. i need to have spare crutches and tips available e. when I'm using the crutches, my arms need to be completely straight

a. i should not use someone else's crutches b. i need to remove any scatter rugs at home d. i need to have spare crutches and tips available

a nurse is teaching a client how to manage an external fixation device upon discharge. Which of the following indicates an understanding of the teaching? (select all that apply) a. i will clean the pins twice a day b. i will use a separate cotton swab for each pin c. i will report loosening of the pins to my doctor d. i will move my leg by lifting the device in the middle e. i will report increased redness at the pin sites

a. i will clean the pins twice a day b. i will use a separate cotton swab for each pin c. i will report loosening of the pins to my doctor e. i will report increased redness at the pin sites

during assessment of the patient with trigeminal neuralgia, the nurse should (select all that apply) a. inspect all aspects of the mouth and teeth b. assess the gag reflex and respiratory rate and depth c. lightly palpate the affected side of the face for edema d. test for temperature and sensation perception of the face e. ask the patient to describe factors that initiate an episode

a. inspect all aspects of the mouth and teeth d. test for temperature and sensation perception of the face e. ask the patient to describe factors that initiate an episode

a nurse is assessing a client who had an external fixation device applied 2 hours ago for a fracture of the left tibia and fibula. which of the following findings is a manifestation of compartment syndrome? (select all that apply) a. intense pain when the client's left foot is passively moved b. capillary refill of 3 seconds on the client's left toes c. hard, swollen muscle in the client's left leg d. burning and tingling of the client's left foot e. client report of minimal pain relief following a second dose of opioid medication

a. intense pain when the client's left foot is passively moved c. hard, swollen muscle in the client's left leg d. burning and tingling of the client's left foot e. client report of minimal pain relief following a second dose of opioid medication

which cast care instructions should the nurse provide to a client who just had a plaster cast applied to the right forearm? (select all that apply) a. keep the cast clean and dry b. allow the cast 24-72 hours to dry c. keep the cast and extremity elevated d. expect tingling and numbness in the extremity e. use a hair dryer set on a warm to hot setting to dry cast f. use a soft, padded object that will fit under the cast to scratch the skin under the cast

a. keep the cast clean and dry b. allow the cast 24-72 hours to dry c. keep the cast and extremity elevated

a normal assessment finding of the musculoskeletal system is a. no deformity or crepitation b. muscle and bone strength of 4 c. ulnar deviation and subluxation d. angulation of bone toward midline

a. no deformity or crepitation

the nurse should teach the patient with ankylosing spondylitis the importance of a. regularly exercising and maintaining proper posture b. avoiding extremes in environmental temperatures c. maintaining patient's usual physical activity during flares d. applying hot and cool compresses for relief of local symptoms

a. regularly exercising and maintaining proper posture

a nurse is planning discharge teaching on home safety for an older adult client who has osteoporosis. which of teh following information should the nurse include in the teaching. (select all that apply) a. remove throw rugs in walkways b. use prescribed assistive devices c. remove clutter from the environment d. walk with caution on icy surfaces e. maintain lighting of doorway areas

a. remove throw rugs in walkways b. use prescribed assistive devices c. remove clutter from the environment e. maintain lighting of doorway areas

a nurse is assessing an older adult client who has arteriosclerosis and is scheduled for a possible right lower extremity amputation. which of the following are expected findings in the affected extremity (select all that apply) a. skin cool to touch from mid calf to the toes b. lower leg appearing dusky when client is sitting c. palpable pounding pedal pulse d. lack of hair on lower leg e. blackened areas on several toes

a. skin cool to touch from mid calf to the toes b. lower leg appearing dusky when client is sitting d. lack of hair on lower leg e. blackened areas on several toes

what would the nurse recognize as a possible difference in the assessment of a gerontologic patient. a. slowed reaction time b. quicker reflex response c. decreased joint stiffness d. increased fine motor dexterity

a. slowed reaction time

teach the patient with fibromyalgia the importance of limiting intake of which foods? a. sugar b. alcohol c. caffeine d. red meat e. root vegetables

a. sugar b. alcohol c. caffeine

the nurse is caring for a client who has had spinal fusion, with insertion of hardware. the nurse would be most concerned with which assessment finding a. temperature of 101.6 orally b. complaints of discomfort during repositioning c. old bloody drainage outlined on the surgical dressing d. discomfort during coughing and deep breathing exercises

a. temperature of 101.6 orally

the nurse is preparing discharge instructions for a client receiving baclofen. which instruction should be included in the teaching plan. a. restrict fluid intake b. avoid the use of alcohol c. stop the medication if diarrhea occurs d. notify the HCP if fatigue occurs

avoid the use of alcohol

The nurse provides instructions to a 30-yr-old female office worker who has low back pain. Which statement indicates additional patient teaching is required? a. "Switching between hot and cold packs may relieve pain and stiffness." b. "Acupuncture to the lower back would cause irreparable nerve damage." c. "Smoking may aggravate back pain by decreasing blood flow to the spine." d. "Sleeping on my side with knees and hips bent reduces stress on my back."

b. "Acupuncture to the lower back would cause irreparable nerve damage."

A 66-yr-old man with type 2 diabetes mellitus and atrial fibrillation has begun taking glucosamine and chondroitin for osteoarthritis. Which question is most important for the nurse to ask? a. "Did you have any hypoglycemic reactions?" b. "Have you noticed any bruising or bleeding?" c. "Have you had any dizzy spells when standing up?" d. "Do you have any numbness or tingling in your feet?"

b. "Have you noticed any bruising or bleeding?"

A 54-yr-old patient admitted with cellulitis and probable osteomyelitis received an injection of radioisotope at 9:00 AM for a bone scan. Which statement by the nurse is correct? a. "Decreased isotope uptake is seen with osteomyelitis." b. "Isotopes injected for the scan are not harmful to you." c. "The scan will be performed in one hour at 10:00 AM." d. "The procedure takes approximately 10 minutes to complete."

b. "Isotopes injected for the scan are not harmful to you."

A 42-yr-old man who is scheduled for arthrocentesis arrives at the outpatient surgery unit and states, "I do not want this procedure done today." Which response by the nurse is most appropriate? a. "When would you like to reschedule the procedure?" b. "Tell me what your concerns are about this procedure." c. "The procedure is safe, so why should you be worried?" d. "The procedure is not painful because an anesthetic is used."

b. "Tell me what your concerns are about this procedure."

The nurse is caring for a 63-yr-old woman taking prednisone (Deltasone) for Bell's palsy. Which statement by the patient requires correction by the nurse? a. "I can take the medication with food or milk." b. "The medication should be started 1 week after paralysis." c. "I can take acetaminophen with the prescribed medications." d. "Chances of a full recovery are good if I take the medication

b. "The medication should be started 1 week after paralysis."

A 57-yr-old postmenopausal woman is scheduled for dual-energy x-ray absorptiometry (DXA). Which statement by the patient indicates understanding of the procedure? a. "The bone density in my heel will be measured." b. "This procedure will not cause any pain or discomfort." c. "I will not be exposed to any radiation during the procedure." d. "I will need to remove my hearing aids before the procedure."

b. "This procedure will not cause any pain or discomfort."

A female patient with a history of rheumatoid arthritis complains of stiffness in her right knee and complete fixation of the joint. What problem does the nurse anticipate will be identified in the patient's history and physical examination? a. Atrophy b. Ankylosis c. Crepitation d. Contracture

b. Ankylosis

The public health nurse is providing community education to increase the number of people who seek care after a tick bite. What priority information should the nurse provide to people at risk for tick bites? a. The best therapy for the acute illness is an IV antibiotic. b. Check for an enlarging reddened area with a clear center. c. Surveillance is necessary during the summer months only. d. Antibiotics will prevent Lyme disease if taken for 10 days.

b. Check for an enlarging reddened area with a clear center.

The nurse completes an admission history for a 73-yr-old man with osteoarthritis scheduled for total knee arthroplasty. Which response is expected when asking the patient the reason for admission? a. Recent knee trauma b. Debilitating joint pain c. Repeated knee infections d. Onset of frozen knee joint

b. Debilitating joint pain

A nurse is working with a 73-yr-old patient with osteoarthritis. Which description of the disorder should be included in the teaching plan? a. Joint destruction caused by an autoimmune process b. Degeneration of articular cartilage in synovial joints c. Overproduction of synovial fluid resulting in joint destruction d. Breakdown of tissue in non-weight-bearing joints by enzymes

b. Degeneration of articular cartilage in synovial joints

A 68-yr-old patient with a spinal cord injury has a neurogenic bowel. Beyond the use of bisacodyl suppositories and digital stimulation, which measures should the nurse teach the patient and caregiver to assist with bowel evacuation (select all that apply.)? a. Drink more milk. b. Eat 20-30 g of fiber per day. c. Use oral laxatives every day. d. Limit caffeinated beverages. e. Drink 1800 to 2800 mL of water or juice. f. Establish bowel evacuation time at bedtime.

b. Eat 20-30 g of fiber per day. d. Limit caffeinated beverages. e. Drink 1800 to 2800 mL of water or juice.

The nurse identifies a nursing diagnosis of pain related to muscle spasms for a 45-yr-old patient who has low back pain from a herniated lumbar disc. Which nursing intervention would be most appropriate? a. Provide gentle ROM to the lower extremities. b. Elevate the head of the bed 20 degrees and flex the knees. c. Place a small pillow under the patient's upper back to gently flex the lumbar spine. Incorrect d. Place the bed in reverse Trendelenburg with the patient's feet firmly against the footboard.

b. Elevate the head of the bed 20 degrees and flex the knees.

The home care nurse visits a 74-yr-old man diagnosed with Parkinson's disease who fell while walking this morning. What observation is of most concern to the nurse? a. 2 × 6 cm right calf abrasion with sanguineous drainage b. Left leg externally rotated and shorter than the right leg c. Stooped posture with a shuffling gait and slow movements d. Mild pain and minimal swelling of the right ankle and foot

b. Left leg externally rotated and shorter than the right leg

The nurse is caring for a patient admitted to the nursing unit with osteomyelitis of the tibia. When completing a focused assessment, which symptom will the nurse expect? a. Nausea and vomiting b. Localized pain and warmth c. Paresthesia in the affected extremity d. Generalized bone pain throughout the leg

b. Localized pain and warmth

During a health screening event, which assessment finding in a white, 61-yr-old woman would alert the nurse to the possible presence of osteoporosis? a. Presence of bowed legs b. Measurable loss of height c. Poor appetite and aversion to dairy products d. Development of unstable, wide-gait ambulation

b. Measurable loss of height

The home care nurse visits an 84-yr-old woman with pneumonia after her discharge from the hospital. Which age-related change in the musculoskeletal system is expected? a. Positive straight-leg-raising test b. Muscle strength is scale grade 3/5 c. Lateral S-shaped curvature of the spine d. Fingers drift to the ulnar side of the forearm

b. Muscle strength is scale grade 3/5

What should the nurse explain to the student regarding normal bone remodeling? a. Osteoclasts add canaliculi. b. Osteoblasts deposit new bone. c. Osteocytes are immature bone cells. d. Osteons synthesize organic bone matrix.

b. Osteoblasts deposit new bone.

The nurse is admitting a patient who is scheduled for knee arthroscopy related to osteoarthritis. Which finding should the nurse expect when examining the patient's knees? a. Ulnar drift b. Pain with joint movement c. Reddened, swollen affected joints d. Stiffness that increases with movement

b. Pain with joint movement

Which nursing intervention is most appropriate when turning a patient after spinal surgery? a. Having the patient turn to the side by grasping the side rails to help turn b. Placing a pillow between the patient's legs and turning the body as a unit c. Elevating the head of bed 30 degrees and having the patient extend the legs while turning d. Turning the patient's head and shoulders and then the hips, keeping the patient's body centered in the bed

b. Placing a pillow between the patient's legs and turning the body as a unit

The nurse is caring for a patient admitted with a spinal cord injury after a motor vehicle accident. The patient exhibits a complete loss of motor, sensory, and reflex activity below the injury level. The nurse recognizes this condition as which of the following? a. Central cord syndrome b. Spinal shock syndrome c. Anterior cord syndrome d. Brown-Séquard syndrome

b. Spinal shock syndrome

Which nursing intervention would be most appropriate for a patient with Sjögren's syndrome? a. Ambulate with assistive devices b. Use lubricating eye drops frequently c. Administer acetaminophen as needed d. Apply ice or heat compresses to affected areas

b. Use lubricating eye drops frequently

The nurse is planning health promotion teaching for a 45-yr-old patient with asthma who is experiencing low back pain from herniated lumbar disc. What activity will the nurse include in an individualized exercise plan for the patient? a. Yoga b. Walking c. Calisthenics d. Weight lifting

b. Walking

the most common early symptom of spinal cord tumor is a. urinary incontinence b. back pain that worsens with activity c. paralysis below the the level of involvement d. impaired sensation of pain, temperature, and light touch

b. back pain that worsens with activity

the nurse instructs the patient with an above the knee amputation that the residual limb should not be routinely elevated because this position promotes a. hip flexion contracture b. clot formation at the incision c. skin irritation and breakdown d. increased risk of wound dehiscence

b. clot formation at the incision

when administering meds to the patient with chronic gout, the nurse would recognize which drug is used as a treatment for this disease a. colchicine b. febuxostat c. sulfasalazine d. cyclosporine

b. febuxostat

a patient with a T4 spinal cord injury experiences neurogenic shock as a result of sympathetic nervous system dysfunction. What would the nurse recognize as a characteristic of this condition a. tachycardia b. hypotension c. increased CO d. peripheral vasoconstriction

b. hypotension

in assessing the joints of a patient with OA, the nurse understands that Bouchard's nodes a. are often red, tender, and swollen b. indicate osteophyte formation at the PIP joints c. are the result of pannus formation at the DIP joints d. occur from deterioration of cartilage by proteolytic enzymes

b. indicate osteophyte formation at the PIP joints

a client being measured for crutches asks the nurse why the crutches cannot rest up underneath the arm for extra support. the nurse responds knowing that which would most likely result from this improper crutch measurement a. fall and further injury b. injury to the brachial plexus nerves c. skin breakdown in the area of the axilla d. impaired range of motion while the client ambulates

b. injury to the brachial plexus nerves

a patient is scheduled for an electromyogram. the nurse explains that this diagnostic test involves a. incision or puncture of the joint capsule b. insertion of small needles into certain muscles c. administration of a radioisotope before the procedure. d. placement of skin electrodes to record muscle activity

b. insertion of small needles into certain muscles

a nurse is providing information about capsaicin cream to a client who reports continuous knee pain from osteoarthritis. which of the following information should the nurse include in the teaching a. continuous pain relief is provided b. inspect for skin irritation and cuts prior to application c. cover the area with tight bandages after application d. apply the medication every 2 hours during the day

b. inspect for skin irritation and cuts prior to application

a nurse is completing preoperative teaching for a client who is to undergo an arthroscopy to repair a shoulder injury. which of the following statements should the nurse include (select all that apply) a. avoid damage or moisture to the cast on your arm b. inspect your incision daily for indications of infection c. apply ice packs to the area for the first 24 hours d. keep your arm in a dependent position e. perform isometric exercises

b. inspect your incision daily for indications of infection c. apply ice packs to the area for the first 24 hours e. perform isometric exercises

colchicine is prescribed for a client with a diagnose of gout. the nurse reviews the client's record, knowing that this medication would be used with caution in which disorder a. myxedema b. kidney disease c. hypothyroidism d. diabetes mellitus

b. kidney disease

a nurse is admitting an older adult client who has suspected osteoporosis. which of the following is an expected finding. (select all that apply) a. history of consuming one glass of wine daily b. loss in height of 2 inches c. body mass index of 21 d. kyphotic curve at upper thoracic spine e. history of lactose intolerance

b. loss in height of 2 inches c. body mass index of 21 d. kyphotic curve at upper thoracic spine e. history of lactose intolerance

a nurse is caring for a patient newly diagnosed with chronic inflammatory demyelinating polyneuropathy. which statement can the nurse accurately use to teach the patient about CIDP a. corticosteroids have little effect on the disease b. maintenance therapy will be needed to prevent relapse c. you will go into remission in approximately 8 weeks d. you should be able to walk without help within three months

b. maintenance therapy will be needed to prevent relapse

a patient with rheumatoid arthritis is experiencing articular involvement. the nurse recognizes these characteristic changes include (select all that apply) a. bamboo-shaped fingers b. metatarsal head dislocation in feet c. noninflammatory pain in large joints d. asymmetric involvement of small joints e. morning stiffness lasting 60 minutes or more

b. metatarsal head dislocation in feet e. morning stiffness lasting 60 minutes or more

the nurse has conducted teaching with a client in an arm cast about the signs and symptoms of compartment syndrome. the nurse determines that the client understands the information if the client states that he or she should report which early symptom of compartment syndrome. a. cold, bluish colored fingers b. numbness and tingling in the fingers c. pain that increases when the arm is dependent d. pain that is out of proportion to the severity of the fracture

b. numbness and tingling in the fingers

a nurse is assessing a client who is scheduled to undergo a right knee arthroplasty. The nurse should expect which of the following findings? (select all that apply) a. skin reddened over the joint b. pain when bearing weight c. joint crepitus d. swelling of the affected joint e. limited joint motion

b. pain when bearing weight c. joint crepitus d. swelling of the affected joint e. limited joint motion

in caring for a patient after a spinal fusion, the nurse would immediately report which of the following to the surgeon a. the patient experiences a single episode of emesis b. patient is unable to move the lower extremities c. patient is nauseated and has not voided in 4 hours d. patient complains of pain at the bone graft donor site

b. patient is unable to move the lower extremities

a nurse is providing care for a client who had a vertebropasty of the thoracic spine. which of the following is an appropriate action by the nurse? a. apply heat to the puncture site b. place the client in a supine position c. turn the client every hour d. ambulate the client within the first hour postprocedure

b. place the client in a supine position

a nurse is preparing a plan of care to prevent a client from developing flexion contractions following a below the knee amputation 24 hours ago. which of the following actions should the nurse include in the plan of care a. limit any type of exercise to the residual limb for the first 48 hours after surgery b. position the client prone several times each day c. wrap the stump in a figure 8 pattern d. encourage sitting a chair during the day

b. position the client prone several times each day

a patient with osteoarthritis is scheduled for a total hip arthroplasty. the nurse explains the purpose of this procedure is to (select all that apply) a. fuse the joint b. replace the joint c. prevent further damage d. improve or maintain ROM e. decrease the amount of destruction in the joint

b. replace the joint e. decrease the amount of destruction in the joint

a patient who has had surgical correction of bilateral hallux valgus is being discharged from the same day surgery unit. the nurse will instruct the patient to a. expect continued pain in the feet b. rest frequently with feet elevated c. soak the feet in warm water several times a day d. expect the feet to be numb for the next few days

b. rest frequently with feet elevated

a nurse is caring for a client who injured her lower back during a fall and describes sharp pain in her back and down her left leg. in which of the following positions should the nurse plan to place the client to attempt to decrease her pain a. prone without use of pillows b. semi fowler's with a pillow under the knees c. high fowlers with the knees flat on bed d. supine with the head flat

b. semi fowler's with a pillow under the knees

what is important to include in the teaching plan for a patient with osteopenia a. lose weight b. stop smoking c. eat a high protein diet d. start swimming for exercise

b. stop smoking

a client has been on treatment for rheumatoid arthritis for 3 weeks during the administration of etanercept, which is the most important for the nurse to assess? a. the injection site for itching and edema b. the WBC and platelet count c. whether the client is experiencing fatigue and joint pain d. whether the patient is experieicing a metallic taste in mouth and loss of appetite

b. the WBC and platelet count

a patient with osteomyelitis undergoes surgical debridement with implantation of antibiotic beads. when the patient asks why the beads are used, the nurse answers (select all that apply) a. oral or IV antibiotics are no effective in most cases of bone infection b. the beads are an adjunct to debridement and antibiotics for deep infections c. the beads are used to deliver antibiotics directly to the site of the infection d. this is the safest method to deliver long term antibiotic therapy for bone infection e. ischemia and bone death related to osteomyelitis are impenetrable to IV antibiotics.

b. the beads are an adjunct to debridement and antibiotics for deep infections c. the beads are used to deliver antibiotics directly to the site of the infection

a patient diagnosed with osteosarcoma of the humerus demonstrates understanding of his treatment options when he states a. i accept that i have to lose my arm with surgery b. the chemotherapy before surgery will shrink the tumor c. the tumor is related to the melanoma i had 3 years ago d. i am glad they can take out the cancer with such a small scar

b. the chemotherapy before surgery will shrink the tumor

a nurse is educating clients at a health fair about dual energy x-ray absorptiometry scans. which of the following information should the nurse include in the teaching. (select all that apply) a. the test requires the use of contrast material b. the hip and spine are the usual areas of the device scans c. the scan detect osteoarthritis d. bone pain can indicate a need for a scan e. at age 40, you should have a baseline scan

b. the hip and spine are the usual areas of the device scans d. bone pain can indicate a need for a scan e. at age 40, you should have a baseline scan

the nurse is caring for a client with a diagnosis of gout. which lab findings would the nurse expect to note a. calcium level of 9 b. uric acid level of 9 c. potassium level of 4.1 d. phosphorous level of 3.1

b. uric acid level of 9

a nurse is providing dietary teaching about calcium-rich foods to a client who has osteoporosis. which of the following foods should the nurse include in the instructions a. white bread b. white beans c. white meat chicken d. white rice

b. white beans

the nurse is administering an IV dose of methocarbamol to a client with MS. for which adverse effect should the nurse monitor a. tachycardia b. rapid pulse c. bradycardia d. hypertension

bradycardia

a nurse in the emergency department is planning care for a client who has a right hip fracture. which of the following immobilization devices should the nurse anticipate in the plan of care a. skeletal traction b. buck's traction c. halo traction d. bryant's traction

buck's traction

A 24-yr-old male patient has come to the clinic with a gradual onset of pain and swelling in the left knee. The patient is diagnosed with osteosarcoma without metastasis. Chemotherapy is ordered before surgery. How will the nurse explain the reason for preoperative chemotherapy? a. "The chemotherapy is being used to save your left leg." b. "Chemotherapy will increase your 5-year survival rate." c. "Chemotherapy is being used to decrease the tumor size." d. "Chemotherapy will help decrease the pain before and after surgery.

c. "Chemotherapy is being used to decrease the tumor size."

The nurse is admitting a patient who complains of new onset of lower back pain. To differentiate between the pain of a lumbar herniated disc from other causes, what is the best question for the nurse to ask the patient? a. "Is the pain worse in the morning or in the evening?" b. "Is the pain sharp and stabbing or burning and aching?" c. "Does the pain radiate down the buttock or into the leg?" d. "Is the pain totally relieved by acetaminophen (Tylenol)?"

c. "Does the pain radiate down the buttock or into the leg?"

A 21-yr-old soccer player has injured the anterior crucial ligament (ACL) and is having reconstructive surgery. Which patient statement indicates more teaching is required? a. "I probably won't be able to play soccer for 6 to 8 months." b. "They will have me do range of motion with my knee soon after surgery." c. "I can't wait to get this done now so I can play soccer for the next tournament." d. "I will need to wear an immobilizer and progressively bear weight on my knee."

c. "I can't wait to get this done now so I can play soccer for the next tournament."

The nurse has reviewed proper body mechanics with a patient who has a history of low back pain caused by a herniated lumbar disc. Which patient statement indicates a need for further teaching? a. "I should sleep on my side or back with my hips and knees bent." b. "I should exercise at least 15 minutes every morning and evening." c. "I should pick up items by leaning forward without bending my knees." d. "I should try to keep one foot on a stool whenever I have to stand for a period of time."

c. "I should pick up items by leaning forward without bending my knees."

When reinforcing health teaching on management of osteoarthritis (OA), which patient statement indicates additional instruction is needed? a. "I can use a cane to relieve the pressure on my back and hip." b. "I should take the Naprosyn as prescribed to help control the pain." c. "I should try to stay standing all day to keep my joints from becoming stiff." d. "A warm shower in the morning will help relieve the stiffness I have when I get up."

c. "I should try to stay standing all day to keep my joints from becoming stiff."

A female patient's complex symptomatology over the past year has led to a diagnosis of systemic lupus erythematosus (SLE). Which statement demonstrates the patient's need for further teaching about the disease? a. "I'll try my best to stay out of the sun this summer." b. "I know that I have a high chance of getting arthritis." c. "I'm hoping surgery will be an option for me in the future." d. "I understand I'm going to be vulnerable to getting infections."

c. "I'm hoping surgery will be an option for me in the future."

The nurse receives report from the licensed practical nurse about care provided to patients on the orthopedic surgical unit. It is most important for the nurse to follow up on which statement? a. "The patient who had a spinal fusion 12 hours ago has hypoactive bowel sounds and is not passing flatus." b. "The patient who had cervical spine surgery 2 days ago wants to wear her soft cervical collar when out of bed." c. "The patient who had spinal surgery 3 hours ago is complaining of a headache and has clear drainage on the dressing." d. "The patient who had a laminectomy 24 hours ago is using patient-controlled analgesia with morphine for pain management."

c. "The patient who had spinal surgery 3 hours ago is complaining of a headache and has clear drainage on the dressing."

The nurse is caring for patients in a primary care clinic. Which individual is most at risk to develop osteomyelitis caused by Staphylococcus aureus? a. 22-yr-old female patient with gonorrhea who is an IV drug user b. 48-yr-old male patient with muscular dystrophy and acute bronchitis c. 32-yr-old male patient with type 1 diabetes mellitus and stage IV pressure ulcer d. 68-yr-old female patient with hypertension who had a knee arthroplasty 3 years ago

c. 32-yr-old male patient with type 1 diabetes mellitus and stage IV pressure ulcer

When entering the grocery store, a patient trips on the curb and sprains the right ankle. Which initial care is appropriate (select all that apply.)? a. Apply ice directly to the skin. b. Apply heat to the ankle every 2 hours. c. Administer antiinflammatory medication. d. Compress ankle using an elastic bandage. e. Rest and elevate the ankle above the heart. f. Perform passive and active range of motion.

c. Administer antiinflammatory medication. d. Compress ankle using an elastic bandage. e. Rest and elevate the ankle above the heart.

The patient developed gout while hospitalized for a heart attack. Because the patient takes aspirin for its antiplatelet effect, what should the nurse recommend in preventing future attacks of gout? a. Limited fluid intake. b. Administration of probenecid c. Administration of allopurinol d. Administration of nonsteroidal antiinflammatory drugs (NSAIDs)

c. Administration of allopurinol

The patient with peripheral facial paresis on the left side is diagnosed with Bell's palsy. What should the nurse teach regarding self-care (select all that apply.)? a. Administration of antiseizure medications b. Preparing for a nerve block to manage pain c. Administration of corticosteroid medications d. Surgery if conservative therapy is not effective e. Dark glasses and artificial tears to protect the eyes f. A facial sling to support the muscles and facilitate eating

c. Administration of corticosteroid medications e. Dark glasses and artificial tears to protect the eyes f. A facial sling to support the muscles and facilitate eating

A 22-yr-old woman with paraplegia after a spinal cord injury tells the home care nurse she experiences bowel incontinence two or three times each day. Which action by the nurse is most appropriate? a. Insert a rectal stimulant suppository. b. Teach the patient to gradually increase intake of high-fiber foods. c. Assess bowel movements for frequency, consistency, and volume. d. Instruct the patient to avoid all caffeinated and carbonated beverages.

c. Assess bowel movements for frequency, consistency, and volume.

A 63-yr-old woman with a kidney transplant has been taking prednisone (Deltasone) daily for several years to prevent organ rejection. What is the most important assessment for the nurse to perform? a. Staggering gait b. Ruptured tendon c. Back or neck pain d. Tardive dyskinesia

c. Back or neck pain

The nurse is caring for a patient with bilateral knee osteoarthritis. Which measure will the nurse recommend to slow progression of the disease? a. Use a wheelchair to avoid walking as much as possible. b. Sit in chairs that cause the hips to be lower than the knees. c. Eat a well-balanced diet to maintain a healthy body weight. d. Use a walker for ambulation to relieve the pressure on the hips.

c. Eat a well-balanced diet to maintain a healthy body weight.

Which intervention should the nurse perform first in the acute care of a patient with autonomic dysreflexia? a. Urinary catheterization b. Check for bowel impaction c. Elevate the head of the bed d. Administer intravenous hydralazine

c. Elevate the head of the bed

A 25-yr-old male patient who is a professional motocross racer has anterior spinal cord syndrome at T10. His history is significant for tobacco, alcohol, and marijuana use. What is the nurse's priority when planning for rehabilitation? a. Prevent urinary tract infection. b. Monitor the patient every 15 minutes. c. Encourage him to verbalize his feelings. d. Teach him about using the gastrocolic reflex.

c. Encourage him to verbalize his feelings.

The nurse is caring for a patient with osteoarthritis scheduled for total left knee arthroplasty. Preoperatively, the nurse assesses for which contraindication to surgery? a. Pain b. Left knee stiffness c. Left knee infection d. Left knee instability

c. Left knee infection

A 42-yr-old man underwent amputation below the knee on the left leg after a recent heavy farm machinery accident. Which intervention should the nurse include in the plan of care? a. Sit in a chair for 1 to 2 hours three times each day. b. Dangle the residual limb for 20 to 30 minutes every 6 hours. c. Lie prone with hip extended for 30 minutes four times per day. d. Elevate the residual limb on a pillow for 4 to 5 days after surgery.

c. Lie prone with hip extended for 30 minutes four times per day.

An older adult is diagnosed with Paget's disease. Which finding would indicate improvement in the condition? a. Waddling gait b. Curvature in affected bones c. Lower serum alkaline phosphatase d. Uptake of radiolabeled bisphosphonate in affected bones

c. Lower serum alkaline phosphatase

The nurse is completing discharge teaching with an 80-yr-old male patient who is recovering from a right total hip arthroplasty by posterior approach. Which patient action indicates further instruction is needed? a. Uses an elevated toilet seat b. Sits with feet flat on the floor c. Maintains hip in adduction and internal rotation d. Verifies need to notify future caregivers about the prosthesis

c. Maintains hip in adduction and internal rotation

A nurse is assessing the recent health history of a 63-yr-old patient with osteoarthritis. Which activity pattern will the nurse recommend? a. Bed rest with bathroom privileges b. Daily high-impact aerobic exercise c. Regular exercise program of walking d. Frequent rest periods with minimal exercise

c. Regular exercise program of walking

The nurse is providing care for a patient diagnosed with Guillain-Barré syndrome. Which assessment should be the nurse's priority? a. Pain assessment b. Glasgow Coma Scale c. Respiratory assessment d. Musculoskeletal assessment

c. Respiratory assessment

The nurse determines dietary teaching for a 75-yr-old patient with osteoporosis has been successful when the patient selects which meal as highest in calcium? a. Chicken stir fry with 1 cup each onions and green peas, and 1 cup of steamed rice b. Ham and Swiss cheese sandwich on whole wheat bread, steamed broccoli, and an apple c. Sardine (3 oz) sandwich on whole wheat bread, 1 cup of fruit yogurt, and 1 cup of skim milk d. A two-egg omelet with 2 oz of American cheese, one slice of whole wheat toast, and a half grapefruit

c. Sardine (3 oz) sandwich on whole wheat bread, 1 cup of fruit yogurt, and 1 cup of skim milk

a client is complaining of low back pain that radiates down the left posterior thigh. the nurse should ask the client if the pain is worsened or aggravated by which factor a. bed rest b. ibuprofen c. bending or lifting d. application of heat

c. bending or lifting

in teaching a patient with Sjogren's syndrome about drug therapy for this disorder, the nurse includes instruction on use of which drug a. pregabalin b. etanercept c. cyclosporine d. cyclobenzaprine

c. cyclosporine

the nurse suspects a neurovascular problem based on assessment of a. exaggerated strength with movement b. increased redness and heat below the injury c. decreased sensation distal to the fracture site c. purulent drainage at the site of an open fracture

c. decreased sensation distal to the fracture site

while obtaining subjective assessment data related to musculoskeletal system, the nurse must ask a patient about other medical problems such as a. hypertension b. thyroid problems c. diabetes mellitus d. chronic bronchitis

c. diabetes mellitus

a patient with spinal cord injury is experiencing severe neurologic deficits. what is the most likely mechanism of injury for this patient. a. compression b. hyperextension c. flexion rotation d. extension rotation

c. flexion rotation

the bone cells that function in the resorption of bone tissue are called a. osteoids b. osteocytes c. osteoclasts d. osteoblasts

c. osteoclasts

the nurse is assessing the casted extremity of a client. which sign is indicative of infection a. dependent edema b. diminished distal pulse c. presence of a hot spot on the cast d. coolness and pallor of the extremity

c. presence of a hot spot on the cast

the nurse is caring for a client who had an above the knee amputation 2 days ago. the residual limb was wrapped with an elastic compression bandage, which has come off. which immediate action should the nurse take a. apply ice to the site b. call the HCP c. rewrap the residual limb with an elastic compression bandage d. apply a dry, sterile dressing and elevate the residual limb on 1 pillow

c. rewrap the residual limb with an elastic compression bandage

a patient with a C7 spinal cord injury undergoing rehabilitation tells the nurse he must have the flu because he has a bad headache and nausea. The nurse's first priority is to a. call the HCP b. check the patients temp c. take the patient's blood pressure d. elevate the head of bed to 90 degrees

c. take the patient's blood pressure

the nurse is evaluating a client in skeletal traction. when evaluating the pin sites, the nurse would be most concerned with which finding a. redness around the pin sites b. pain on palpation at the pin sites c. thick, yellow drainage from the pin sites d. clear, water drainage from the pin sites

c. thick, yellow drainage from the pin sites

An 82-yr-old patient is frustrated by loose abdominal tissue and rigid hips. How should the nurse respond? a. "You should go on a diet and exercise more to feel better about yourself." b. "Something must be wrong with you because you should not have these problems." c. "You have arthritis and need to take nonsteroidal antiinflammatory drugs (NSAIDs)." d. "Decreased muscle mass and strength and increased hip rigidity are expected with aging."

d. "Decreased muscle mass and strength and increased hip rigidity are expected with aging."

This morning a 21-yr-old male patient had a long leg cast applied, and he asks to crutch walk before dinner. Which statement explains why the nurse will decline the patient's request? a. "No one is available to assist and accompany the patient." b. "The cast is not dry yet, and it may be damaged while using crutches." c. "Rest, ice, compression, and elevation are in process to decrease pain." d. "Excess edema and complications are prevented when the leg is elevated for 24 hours."

d. "Excess edema and complications are prevented when the leg is elevated for 24 hours."

The nurse obtains a history from a 46-yr-old woman with rheumatoid arthritis. The nurse should follow up on which patient statement? a. "I perform range of motion exercises at least twice a day." b. "I use a heating pad for 20 minutes to reduce morning stiffness." c. "I take a 20-minute nap in the afternoon even if I sleep 9 hours at night." d. "I restrict fluids to prevent edema when taking methotrexate (Rheumatrex)."

d. "I restrict fluids to prevent edema when taking methotrexate (Rheumatrex)."

Which patient statement suggests a need to assess the patient for ankylosing spondylitis (AS)? a. "My right elbow has become red and swollen over the last few days." b. "I wake up stiff every morning, and my knees just don't want to bend." c. "My husband tells me that my posture has become so stooped this winter." d. "My lower back pain seems to be getting worse and nothing seems to help."

d. "My lower back pain seems to be getting worse and nothing seems to help."

A patient learns about rehabilitation for a spinal cord tumor. Which statement by the patient reflects appropriate understanding of this process? a. "I want to be rehabilitated for my daughter's wedding in 2 weeks." b. "Rehabilitation will be more work done by me alone to try to get better." c. "I will be able to do all my normal activities after I go through rehabilitation." d. "With rehabilitation, I will be able to function at my highest level of wellness."

d. "With rehabilitation, I will be able to function at my highest level of wellness."

A 54-yr-old patient is about to have a bone scan. In teaching the patient about this procedure, the nurse should include what information? a. "Only mild pain is associated with the procedure." b. "Two additional follow-up scans will be required." c. "The procedure takes approximately 15 to 30 minutes." d. "You will need to drink increased fluids after the procedure."

d. "You will need to drink increased fluids after the procedure."

The nurse formulates a nursing diagnosis of Impaired physical mobility related to decreased muscle strength for an older adult patient recovering from left total knee arthroplasty. What nursing intervention is appropriate? a. Promote vitamin C and calcium intake in the diet. b. Provide passive range of motion to all of the joints q4hr. c. Keep the left leg in extension and abduction to prevent contractures. d. Encourage isometric quadriceps-setting exercises at least four times a day.

d. Encourage isometric quadriceps-setting exercises at least four times a day.

The nurse is reinforcing health teaching about osteoporosis with a 72-yr-old patient admitted to the hospital. What should the nurse explain to the patient? a. With a family history of osteoporosis, you cannot prevent or slow bone resorption. b. Estrogen therapy must be maintained to prevent rapid progression of the osteoporosis. c. Continuous, low-dose corticosteroid treatment is effective in stopping the course of osteoporosis. d. Even with a family history of osteoporosis, the calcium loss from bones can be slowed by increased calcium intake and exercise.

d. Even with a family history of osteoporosis, the calcium loss from bones can be slowed by increased calcium intake and exercise.

The patient is brought to the emergency department after a car accident and is diagnosed with a femur fracture. What nursing intervention should the nurse implement at this time to decrease risk of a fat embolus? a. Administer enoxaparin (Lovenox). b. Provide range-of-motion exercises. c. Apply sequential compression boots. d. Immobilize the fracture preoperatively.

d. Immobilize the fracture preoperatively.

When planning care for a patient with a cervical spinal cord injury (C5), which nursing diagnosis has the highest priority? a. Impaired urinary elimination related to tetraplegia b. Risk for impaired tissue integrity related to paralysis c. Disabled family coping related to the extent of trauma d. Ineffective airway clearance related to cervical spinal cord injury

d. Ineffective airway clearance related to cervical spinal cord injury

The nurse is caring for a patient placed in Buck's traction before open reduction and internal fixation of a left hip fracture. Which care can be delegated to the LPN/LVN? a. Assess skin integrity around the traction boot. b. Determine correct body alignment to enhance traction. c. Remove weights from traction when turning the patient. d. Monitor pain intensity and administer prescribed analgesics.

d. Monitor pain intensity and administer prescribed analgesics.

A 58-yr-old woman with breast cancer is admitted for severe back pain related to a vertebral compression fracture. The patient's laboratory values include serum potassium of 4.5 mEq/L, serum sodium of 144 mEq/L, and serum calcium of 14.3 mg/dL. Which signs and symptoms will the nurse expect the patient to exhibit? a. Anxiety, irregular pulse, and weakness b. Muscle stiffness, dysphagia, and dyspnea c. Hyperactive reflexes, tremors, and seizures d. Nausea, vomiting, and altered mental status

d. Nausea, vomiting, and altered mental status

A 67-yr-old patient hospitalized with osteomyelitis has an order for bed rest with bathroom privileges and elevation of the affected foot on two pillows. The nurse would place the highest priority on which intervention? a. Ambulate the patient to the bathroom every 2 hours. b. Ask the patient about preferred activities to relieve boredom. c. Allow the patient to dangle legs at the bedside every 2 to 4 hours. d. Perform frequent position changes and range-of-motion exercises.

d. Perform frequent position changes and range-of-motion exercises.