NUR 323: Practice Quiz 2

Following a total knee replacement, the surgeon orders a continuous passive motion (CPM) device. The client asks about the purpose of this treatment. What is the best response by the nurse? A. "CPM increases range of motion of the joint." B. "CPM strengthens the muscles of the leg." C. "CPM delivers analgesic agents directly into the joint." D. "CPM prevents injury by limiting flexion of the knee."

A. "CPM increases range of motion of the joint."

A client asks the nurse why his residual limb cannot be elevated on a pillow. What is the best response by the nurse? A. "Elevating the leg might lead to a flexion contracture." B. "You need to turn yourself side to side. If your leg is on a pillow, you would not be able to do that." C. "Elevating the extremity may increase your chances of compartment syndrome." D. "I am sorry. We ran out of pillows. I can elevate it on a few blankets."

A. "Elevating the leg might lead to a flexion contracture."

The nurse is providing instructions to the client who is being prepared for skeletal traction. Which statement by the client indicates teaching was effective? A. "Metal pins will go through my skin to the bone." B. "I will wear a boot with weights attached." C. "A belt will go around my pelvis and weights will be attached." D. "The traction can be removed once a day so I can shower."

A. "Metal pins will go through my skin to the bone."

An older adult patient had a hip replacement. When should the patient begin with assisted ambulation with a walker? A. 24 hours B. 72 hours C. 1 week D. 2 to 3 weeks

A. 24 hours

Upon reporting to work and receiving report, a nurse has been assigned to provide care for three clients. Each of the clients has called out to the nurses' station requesting assistance. Which client should the nurse see first? A. A 32-year-old male, who had a plaster cast applied to his leg 2 hours ago, who complains that the cast feels as if it's getting tighter B. A 56-year-old male, who had an arthroscopy of his left knee 3 hours ago, who is asking to be discharged C. A 60-year-old female, who is in traction to manage chronic muscle spasms, who is requesting assistance to order her evening meal D. The order doesn't matter; all clients are of equal priority

A. A 32-year-old male, who had a plaster cast applied to his leg 2 hours ago, who complains that the cast feels as if it's getting tighter

An older adult client slipped on an area rug at home and fractured the left hip. The client is unable to have surgery immediately and is having severe pain. What interventions should the nurse provide for the patient to minimize energy loss in response to pain? A. Administer prescribed analgesics around the clock. B. Avoid administering too much medication because the client is older. C. Administer prescribed pain medication only when the client requests it. D. Give pain medication to the client after providing care.

A. Administer prescribed analgesics around the clock.

A group of students is reviewing information about cast composition in preparation for a discussion on the advantages and disadvantages of each. The students demonstrate understanding of the topic when they cite which of the following as an advantage of a plaster cast? A. Better molding to the client B. Quicker drying C. Longer lasting D. More breathable

A. Better molding to the client

A patient sustains an open fracture of the left arm after an accident at the roller skating rink. What does emergency management of this fracture involve? (Select all that apply.) A. Covering the area with a clean dressing if the fracture is open B. Immobilizing the affected site C. Splinting the injured limb D. Asking the patient if he or she is able to move the arm E. Wrapping the arm in an ace bandage

A. Covering the area with a clean dressing if the fracture is open B. Immobilizing the affected site C. Splinting the injured limb

A client has delayed bone healing in a fractured right humerus. What should the nurse prepare the client for that promotes bone growth? A. Electrical stimulation B. Administration of low-dose heparin C. Joint fusion D. Administration of antibiotics

A. Electrical stimulation

A client is reporting pain following orthopedic surgery. Which intervention will help relieve pain? A. Elevate the affected extremity and use cold applications. B. Breathe deeply and cough every 2 hours until ambulation is possible. C. Do ROM exercises as indicated. D. Apply antiembolism stockings as indicated.

A. Elevate the affected extremity and use cold applications.

A client with arterial insufficiency undergoes below-knee amputation of the right leg. Which action should the nurse include in the postoperative care plan? A. Elevating the stump for the first 24 hours B. Maintaining the client on complete bed rest C. Applying heat to the stump as the client desires D. Removing the pressure dressing after the first 8 hours

A. Elevating the stump for the first 24 hours

A client has undergone an external fixation. Which actions would be the priority for this client? A. Maintaining pin care. B. Planning the client's diet. C. Monitoring the client's urine output. D. Monitoring the client's blood pressure.

A. Maintaining pin care.

Which term refers to an injury to ligaments and other soft tissues surrounding a joint? A. Sprain B. Dislocation D. Subluxation C. Strain

A. Sprain

A nurse is preparing to provide care for a client whose exacerbation of ulcerative colitis has required hospital admission. During an exacerbation of this health problem, the nurse would anticipate that the client's stools will have what characteristics? A. Watery with blood and mucus B. Hard and black or tarry C. Dry and streaked with blood D. Loose with visible fatty streaks

A. Watery with blood and mucus

A client is brought to the emergency department after being struck with a baseball bat on the upper arm while diving for a pitched ball. Diagnostic tests reveal that the humerus is not broken but that the client has suffered another type of injury. What type of injury would the physician likely diagnose? A. contusion B. sprain C. strain D. subluxation

A. contusion

A client has symptoms suggestive of peritonitis. Nursing management would not include: A. limiting analgesics to avoid the formation of paralytic ileus. B. accurate recording of input and output. C. inserting a nasogastric tube. inserting a urinary retention catheter.

A. limiting analgesics to avoid the formation of paralytic ileus.

A client with a right leg fracture is returning to the orthopedist to have the cast removed. What would the physician prescribe as further treatment? A. physical therapy B. discontinue use of crutches D. cold compresses to leg for swelling E. No options are correct.

A. physical therapy

An older adult client in a long-term care facility is concerned about bowel regularity. During a client education session, the nurse reinforces the medically acceptable definition of "regularity." What is the actual measurement of "regular"? A. stool consistency and client comfort B. one bowel movement daily C. one bowel movement every other day D. two bowel movements daily

A. stool consistency and client comfort

Which drug is considered a stimulant laxative? A. Magnesium hydroxide B. Bisacodyl D. Mineral oil E. Psyllium hydrophilic mucilloid

B. Bisacodyl

Which is one of the primary symptoms of irritable bowel syndrome (IBS)? A. Pain B. Diarrhea C. Bloating D. Abdominal distention

B. Diarrhea

Which of the following would lead a nurse to suspect that a client has a rotator cuff tear? A. Increased ability to stretch arm over the head B. Difficulty lying on affected side C. Pain worse in the morning D. Minimal pain with movement

B. Difficulty lying on affected side

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? A. Closed B. Incomplete D. Stress C. Compression

B. Incomplete

A client undergoes open reduction with internal fixation to treat an intertrochanteric fracture of the right hip. The nurse should include which intervention in the postoperative care plan? A. Performing passive range-of-motion (ROM) exercises on the client's legs once each shift B. Keeping a pillow between the client's legs at all times C. Turning the client from side to side every 2 hours D. Maintaining the client in semi-Fowler's position

B. Keeping a pillow between the client's legs at all times

The nurse is caring for a client with intussusception of the bowel. What does the nurse understand occurs with this disorder? A. The bowel twists and turns itself and obstructs the intestinal lumen. B. One part of the intestine telescopes into another portion of the intestine. C. The bowel protrudes through a weakened area in the abdominal wall. D. A loop of intestine adheres to an area that is healing slowly after surgery.

B. One part of the intestine telescopes into another portion of the intestine.

A client is admitted with a diagnosis of acute appendicitis. When assessing the abdomen, the nurse would expect to find rebound tenderness at which location? A. Right upper quadrant B. Right lower quadrant C. Left upper quadrant D. Left lower quadrantRight lower quadrant

B. Right lower quadrant

Which principle applies to the client in traction? A. Weights should rest on the bed. B. Skeletal traction is never interrupted. C. Knots in the ropes should touch the pulley. D. Weights are removed routinely.

B. Skeletal traction is never interrupted.

A client comes to the emergency department and it is found that the client's radial head is partially dislocated. What is this partially dislocated radial head documented as? A. Volkmann's contracture B. Subluxation C. Compartment syndrome D. Sprain

B. Subluxation

An elite high school football player has been diagnosed with a shoulder dislocation. The client has been treated and is eager to resume his role on his team, stating that he is not experiencing pain. What should the nurse emphasize during health education? A. The need to take analgesia regardless of the short-term absence of pain B. The importance of adhering to the prescribed treatment and rehabilitation regimen C. The fact that he has a permanently increased risk of future shoulder dislocations D. The importance of monitoring for intracapsular bleeding once he resumes playing

B. The importance of adhering to the prescribed treatment and rehabilitation regimen

The presence of mucus and pus in the stools suggests which condition? A. Small-bowel disease B. Ulcerative colitis C. Disorders of the colon D. Intestinal malabsorption

B. Ulcerative colitis

Which may occur if a client experiences compartment syndrome in an upper extremity? A. Whiplash injury B. Volkmann's contracture C. Callus D. Subluxation

B. Volkmann's contracture

A nurse is preparing a presentation for a local community group of older adults about colon cancer. What would the nurse include as the primary characteristic associated with this disorder? A. Abdominal distention B. Frank blood in the stool C. A change in bowel habits D. Abdominal pain

C. A change in bowel habits

A client reports constipation. Which nursing measure would be most effective in helping the client reduce constipation? A. Provide adequate quantity of food. B. Obtain medical and allergy history. C. Assist client to increase dietary fiber. D. Obtain complete food history.

C. Assist client to increase dietary fiber.

The nurse is irrigating a client's colostomy when the client begins to report cramping. What is the appropriate action by the nurse? A. Increase the rate of administration. B. Discontinue the irrigation immediately. C. Clamp the tubing and allow the client to rest. D. Change irrigation fluid to normal saline.

C. Clamp the tubing and allow the client to rest.

The nurse is caring for a client who was involved in an automobile accident and sustained multiple trauma. The client has a Volkmann's contracture to the right hand. What objective data does the nurse document related to this finding? A. Extension of the fingers of the right hand B. Nodules on the knuckles of the third and fourth finger C. Claw-like deformity of the right hand without ability to extend fingers D. Dislocation of the fingers

C. Claw-like deformity of the right hand without ability to extend fingers

An emergency department client is diagnosed with a hip dislocation. The client's family is relieved that the client has not suffered a hip fracture, but the nurse explains that this is still considered to be a medical emergency. What is the rationale for the nurse's statement? A. The longer the joint is displaced, the more difficult it is to get it back in place. B. The client's pain will increase until the joint is realigned. C. Dislocation can become permanent if the process of bone remodeling begins. D. Avascular necrosis may develop at the site if it is not promptly resolved.

C. Dislocation can become permanent if the process of bone remodeling begins.

A nurse is planning the care of a client with osteomyelitis that resulted from a diabetic foot ulcer. The client requires a transmetatarsal amputation. When planning the client's postoperative care, which of the following nursing diagnoses should the nurse most likely include in the plan of care? A. Ineffective Thermoregulation B. Risk-Prone Health Behavior C. Disturbed Body Image D. Deficient Diversion Activity

C. Disturbed Body Image

A client with a fracture develops compartment syndrome that requires surgical intervention. What treatment will the nurse would most likely prepare the client for? A. Bone graft B. Joint replacement C. Fasciotomy D. Amputation

C. Fasciotomy

Radiographic evaluation of a client's fracture reveals that a bone fragment has been driven into another bone fragment. The nurse identifies this as which type of fracture? A. Comminuted B. Compression C. Impacted D. Greenstick

C. Impacted

A client is recovering from an ileostomy that was performed to treat inflammatory bowel disease. During discharge teaching, what would the nurse stress the importance of? A. Consuming a low-protein, high-fiber diet B. Taking only enteric-coated medications C. Increasing fluid intake to prevent dehydration D. Wearing an appliance pouch only at bedtime

C. Increasing fluid intake to prevent dehydration

Which of the following is considered a bulk-forming laxative? A. Milk of Magnesia B. Mineral oil C. Metamucil D. Dulcolax

C. Metamucil

Elderly clients who fall are most at risk for which injuries? A. Wrist fractures B. Humerus fractures C. Pelvic fractures D. Cervical spine fractures

C. Pelvic fractures

The nurse is caring for a client who underwent a total hip replacement yesterday. What should the nurse do to prevent dislocation of the new prosthesis? A. Keep the affected leg in a position of adduction. B. Have the client reposition himself independently. C. Protect the affected leg from internal rotation. D. Keep the hip flexed by placing pillows under the client's knee.

C. Protect the affected leg from internal rotation.

The nurse is caring for a patient who had a total hip replacement. What lethal postoperative complication should the nurse closely monitor for? A. Atelectasis B. Hypovolemia C. Pulmonary embolism D. Urinary tract infection

C. Pulmonary embolism

An elderly client's hip joint is immobilized prior to surgery to correct a femoral head fracture. What is the nurse's priority assessment? A. The presence of leg shortening B. The client's complaints of pain C. Signs of neurovascular compromise D. The presence of internal or external rotation

C. Signs of neurovascular compromise

Which is a true statement regarding regional enteritis (Crohn's disease)? A. It has a progressive disease pattern. B. It is characterized by pain in the lower left abdominal quadrant. C. The clusters of ulcers take on a cobblestone appearance. D. The lesions are in continuous contact with one another.

C. The clusters of ulcers take on a cobblestone appearance.

Meniscectomy refers to the A. replacement of one of the articular surfaces of a joint. B. incision and diversion of the muscle fascia. C. excision of damaged joint fibrocartilage. D. removal of a body part.

C. excision of damaged joint fibrocartilage.

A nurse is assessing a client and obtains the following findings: abdominal discomfort, mild diarrhea, blood pressure of 100/80 mm Hg, pulse rate of 88 beats/minute, respiratory rate of 20 breaths/minute, temperature 100° F (37.8° C). What diagnosis will the nurse suspect for this client? A. diverticulitis B. liver failure C. inflammatory bowel disease (IBD) D. colorectal cancer

C. inflammatory bowel disease (IBD)

Which term refers to a break in the continuity of a bone? A. Malunion B. Dislocation C.Fracture D. Subluxation

C.Fracture

A client undergoes a total hip replacement. Which statement made by the client indicates to the nurse that the client requires further teaching? A. "I'll need to keep several pillows between my legs at night." B. "I need to remember not to cross my legs. It's such a habit." C. "The occupational therapist is showing me how to use a sock puller to help me get dressed." D. "I don't know if I'll be able to get off that low toilet seat at home by myself."

D. "I don't know if I'll be able to get off that low toilet seat at home by myself."

The nurse is assigned to care for a client who has had a total knee arthroplasty yesterday. What type of pharmacologic therapy does the nurse anticipate administering to this client to prevent complications related to the surgery? A. Antidysrhythmic therapy B. Antianginal therapy C. Antineoplastic therapy D. Anticoagulation therapy

D. Anticoagulation therapy

A client has been recently diagnosed with an anorectal condition. The nurse is reviewing interventions that will assist the client with managing the therapeutic regimen. What would not be included? A. Instruct the client to cleanse perianal area with warm water. B. Teach the client how to do sitz baths at home using warm water three to four times each day. C. Encourage the client to follow diet and medication instructions. D. Encourage the client to avoid exercise.

D. Encourage the client to avoid exercise.

A nurse is providing discharge education to a client who is going home with a cast on his leg. What topic should the nurse emphasize in the teaching session? A. Using crutches efficiently B. Exercising joints above and below the cast, as prescribed C. Removing the cast correctly at the end of the treatment period D. Reporting signs of impaired circulation

D. Reporting signs of impaired circulation

A client is brought to the emergency department by a softball team member who states the client and another player ran into each other, and the client is having severe pain in the right shoulder. What symptoms of a fractured clavicle does the nurse recognize? A. Client complains of tingling and numbness in the right shoulder. B. Right shoulder is elevated above the left. C. Client complains of pain in the unaffected shoulder. D. Right shoulder slopes downward and droops inward.

D. Right shoulder slopes downward and droops inward.

The nurse suspects that a client with an arm cast has developed a pressure ulcer. Where should the nurse assess for the presence of the ulcer? A. Lateral malleolus B. Olecranon C. Radial styloid D. Ulna styloid

D. Ulna styloid