NU 325 Musculoskeletal Exam (PrepU)

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

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

A client with a fractured femur is admitted to the nursing unit. Which assessment finding requires follow up by the nurse? Select all that apply.

-"I cannot seem to catch my breath." -"I have a pins-and-needles sensation in my toes." -Dorsoplantar weak and unequal bilaterally -T 101.2 degrees F; HR 110; RR 28; pulse oximetry 90%

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

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

The nurse suspects "compartment syndrome" for a casted extremity. What characteristic symptoms would the nurse assess that would confirm these suspicions? (Select all that apply.)

-Decreased sensory function -Excruciating pain -Loss of motion

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

-Placing a trapeze on the bed -Ensuring that the weights are hanging freely -Assessing the client's alignment in the bed -Frequently assessing pain level

A nurse is planning the care of an older adult client who will soon be discharged home after treatment for a fractured hip. In an effort to prevent future fractures, the nurse should encourage what actions? Select all that apply.

-Regular bone density testing -A high-calcium diet -Use of falls prevention precautions -Weight-bearing exercise

A client comes back to the clinic with a continued complaint of back pain. What time frame does the nurse understand constitutes "chronic pain"?

3 months

A client with diabetes punctured his foot with a broken acorn in the yard. Within a week, the client developed osteomyelitis of the foot. The client was admitted for IV antibiotic therapy. How long does the nurse anticipate the client will receive IV antibiotics?

3 to 6 weeks

A client is hospitalized for open reduction of a fractured femur. During the postoperative assessment, the nurse notes that the client is restless and observes petechiae on the client's chest. Which nursing action is indicated first?

Administer oxygen.

Which action would be most important postoperatively for a client who has had a knee or hip replacement?

Assisting in early ambulation.

A client who has sustained a fracture reports an increase in pain and decreased function of the affected extremity. What will the nurse suspect?

Avascular necrosis

Which of the following is the first-line medication that would be used to treat and prevent osteoporosis?

Bisphosphonates

A client has had a cast placed for the treatment of a humeral fracture. The nurse's most recent assessment shows signs and symptoms of compartment syndrome. What is the nurse's most appropriate action?

Contact the primary provider immediately.

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

Educate the client on cast care and complications

The primary nursing intervention that will control swelling while treating a musculoskeletal injury is:

Elevate the affected area.

A client with a right below-the-knee amputation is being transferred from the postanesthesia care unit to a medical-surgical unit. What is the highest priority nursing intervention by the receiving nurse?

Ensure that a large tourniquet is in the room.

The nurse is providing care for a client who has had a below-the-knee amputation. The nurse enters the client's room and finds the client resting in bed with his residual limb supported on pillow. What is the nurse's most appropriate action?

Explain the risks of flexion contracture to the client.

A nurse is assigned to support a patient while a cast is being applied to treat a greenstick fracture. The nurse documents that this fracture is classified as what type of fracture?

Incomplete

A female client is at risk for developing osteoporosis. Which action will reduce the client's risk?

Initiating weight-bearing exercise routines

A client has undergone an external fixation. Which actions would be the priority for this client?

Maintaining pin care.

The client with a newly applied cast reports severe unrelenting pain. What is the nurse's best response?

Make the client NPO and notify the health care provider.

An unresponsive client had a plaster cast applied to the right lower leg 8 hours ago. When moving the client, the nurse notices an indentation on the posterior lower portion of the cast. What is the best action by the nurse?

Notify the physician.

A client was fitted with an arm cast after fracturing her humerus. Twelve hours after the application of the cast, the client tells the nurse that her arm hurts. Analgesics do not relieve the pain. What would be the most appropriate nursing action?

Prepare the client for opening or bivalving of the cast.

A client reports phantom limb pain to the nurse two months after a leg amputation. Which intervention should the nurse implement when caring for the client?

Reassure the client that phantom pain is common.

Which nursing diagnosis takes highest priority for a client with a compound fracture?

Risk for infection related to effects of trauma

The nurse has identified the diagnosis of Risk for Impaired Tissue Perfusion Related to Deep Vein Thrombosis in the care of a client receiving skeletal traction. What nursing intervention best addresses this risk?

Teach the client to perform ankle and foot exercises within the limitations of traction.

A client had a total left hip arthroplasty. What clinical manifestation would indicate to the nurse that the prosthesis is dislocated?

The left leg is internally rotated.

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

Use the large muscles of the leg when lifting items.

While reading a client's chart, the nurse notices that the client is documented to have paresthesia. The nurse plans care for a client with?

abnormal sensations.

The nurse is conducting an admission history of a client admitted with a fracture. The nurse recognizes that which of the client's medications placed the client at risk for fractures?

prednisone (Deltasone)