PNU 133 PrepU Passpoint Musculoskeletal Disorders

The nurse is caring for a client on the orthopedic unit. When preparing the client for discharge, which instructions should the nurse reinforce after surgical repair of a hip fracture?

"Do not flex the hip more than 90°, do not cross your legs, and get help putting on your shoes."

The nurse is reinforcing education for the parents of a child scheduled for a closed reduction of a fracture. Which statement should the nurse include?

"Fracture reduction restores alignment."

A nurse has reinforced instruction for a client to accurately measure the circumference of both calves each morning and to report any increase in circumference. Which client statement indicates that the education has been effective?

"I'll use a measuring tape to check circumference."

A client asks the nurse why he needs to apply a cold pack on a sprained ankle. Which response would be most appropriate?

"It constricts local blood vessels and decreases swelling."

Which statement by the client indicates that client education regarding osteoarthritis has been effective?

"It's a noninflammatory joint disease that causes degeneration of the joints."

A client asks a nurse to explain the difference between osteoarthritis (OA) and rheumatoid arthritis (RA). Which response is correct?

"OA is a noninflammatory joint disease. RA is characterized by inflamed, swollen joints."

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

"Pace yourself and rest frequently, especially after activities."

Which statement by a staff nurse on the orthopedic floor indicates the need for further staff education?

"The client is receiving physical therapy twice per day, so they don't need a continuous passive motion device."

A client recovering from hip replacement surgery questions the need for admission to a rehabilitation center because there are family members available at home to provide care. Which response by the nurse is best?

"The rehabilitation staff can evaluate your progress and help you recover without risking injury."

A school nurse is performing a scoliosis screening on a group of students. Which student would most commonly develop this condition?

13-year-old girl

A client who's being discharged with an arm cast wants to shower at home. The nurse demonstrates how to shower without getting the cast wet. For which reason is this important?

A wet cast will weaken or decompose.

Which of the following would the nurse identify as a neurotransmitter?

Acetylcholine

The day after a thoracotomy, a client experiencing intense incision pain has a temperature of 99° F (37.2° C); heart rate 96 beats/minute; blood pressure 136/86 mm Hg; and shallow respirations at 24 breaths/minute, with rhonchi at the bases and an oxygen saturation of 98%. Which nursing action is the priority?

Administer analgesic medications as prescribed.

A client with skeletal fracture to the right leg reports severe right leg pain. Which action should the nurse take first?

Check the client's alignment in bed.

The nurse is caring for a child with a hip spica cast which has become soiled. What is the appropriate action by the nurse?

Clean with damp cloth and dry cleanser.

A client who has been recently diagnosed with gout asks the nurse to explain why they need to take colchicine. What should the nurse base the response on?

Colchicine decreases inflammation.

A nurse on the orthopedic floor is caring for a group of clients who are in various stages of recovery after knee replacement surgery. One client is ready for discharge. How should the nurse proceed with discharge planning?

Complete the discharge instructions for the client who is being discharged, and allow time for him to ask questions.

A client who was involved in a motor vehicle accident has a fractured femur and reports severe pain. Which nursing interventions are appropriate? Select all that apply.

Determine the client's perception of pain. Ask the client about methods used previously to alleviate pain.

The nurse is making an initial visit to the home of a client who ambulates with a walker. Which finding should the nurse identify as a safety hazard when completing an assessment of the client's home?

Electrical cords are covered with a carpet.

A client with arterial insufficiency undergoes below-knee amputation of the right leg. Which action should the nurse include in the postoperative plan of care?

Elevating the stump for the first 24 hours

A client with osteoarthritis is refusing to perform independent daily care. Which approach would be most appropriate to use with this client?

Encourage the client to perform as much care as pain will allow.

A client is admitted with severe pain in the knees. Which form of arthritis is characterized by urate deposits and joint pain, usually in the feet and legs, and occurs primarily in men older than age 30?

Gouty arthritis

Which characteristic of the fascia can cause it to develop compartment syndrome?

It is unable to expand.

A client recovering from back surgery tells a nurse that she's concerned about going home. She explains that she has many stairs to navigate and household responsibilities she must perform. How can the nurse help ease this client's concerns?

Notify the charge nurse of the client's concerns, and request a team meeting to discuss the client's discharge planning.

A nurse is caring for a client who sustained a gunshot wound to the leg during a jewelry store robbery. The client is in police custody and receiving treatment in the emergency department. A member of the media asks the nurse about the client's condition. How should the nurse respond?

Notify the nursing supervisor so she can obtain a formal statement from the physician about the client's condition for the media.

A 69-year-old client asks the nurse what the difference is between osteoarthritis (OA) and rheumatoid arthritis (RA). Which response is correct?

OA is a noninflammatory joint disease. RA is characterized by inflamed, swollen joints.

Which nursing intervention is essential in caring for a client with compartment syndrome?

Removing all external sources of pressure, such as clothing and jewelry

A nurse is caring for a confused client with a fractured hip who is trying to get out of bed. Which action should the nurse take first?

Reorient the client to the surroundings.

Which nursing diagnosis is most appropriate for an elderly client with osteoarthritis?

Risk for injury related to altered mobility

On a visit to the family physician, a client reports painful swelling on the lateral side of the great toe, at the metatarsophalangeal joint. After determining that the swelling is a bunion, the physician injects an intra-articular corticosteroid. The client asks the nurse what causes bunions. Which answer is correct?

Some bunions are congenital; others are caused by wearing shoes that are too short or narrow.

The nurse is instructing unlicensed assistive personnel (UAP) on the proper care of a client in Buck's extension traction following a fracture of his left fibula. Which observation indicates that the education was effective?

The weights are allowed to hang freely over the end of the bed.

A client is admitted with acute osteomyelitis that developed after an open fracture of the right femur. When planning this client's care, the nurse should anticipate which measure?

administering large doses of I.V. antibiotics as ordered

A client with long-standing rheumatoid arthritis has frequent reports of joint pain. The plan of care should be based on the understanding that chronic pain is most effectively relieved when analgesics are administered in which way?

at regularly scheduled intervals

A young child sustains a dislocated hip as well as a subcapital fracture. Which complication is of greatest concern?

avascular necrosis

Which information is the priority to include in the discharge plan for a client leaving the hospital in a leg cast?

cast care, neurovascular checks, and hygiene measures

A child in skeletal traction for a fracture of the right femur reports new and constant left calf pain. Also, the nurse notes that the child's left calf is 1 inch larger than the right and that he has nonpitting edema below the left knee. The nurse knows these signs are most consistent with which condition?

deep vein thrombosis (DVT)

A client has developed compartment syndrome from full thickness burns on both arms. What treatment will the nurse prepare the client for?

fasciotomy

A client is diagnosed with a long bone fracture. What potential complication related to this form of fracture should the nurse carefully monitor?

fat emboli

A client sustained a femur fracture while skiing. After the client undergoes surgery to stabilize the fracture, what does the nurse determine will assist with healing of this fracture?

formation of new bone tissue

A nurse is gathering data to determine fall risk for a client. What information is most important for the nurse collect? Select all that apply.

functional level muscular strength gait and balance visual acuity

When gathering data for a 2-year-old child with a history of muscular dystrophy, the nurse observes that the child's legs appear to be held together and the knees are touching. The nurse suspects contraction of which muscles?

hip adductors

During a scoliosis screening in a college heath center, a student asks the public health nurse about the consequences of untreated scoliosis. The nurse would be accurate by identifying one of the direct complications as:

impingement on pulmonary function.

Which strategy does the nurse reinforce education regarding, that would be the first choice in attempting to maximize function in a child with muscular dystrophy?

long leg braces

An older adult client is seen in the clinic with reports of right hip pain that worsens after activity, decreased range of motion (ROM) of the right hip, and difficulty getting up after sitting for long periods. The nurse hears crepitus in the right hip upon movement and determines that these symptoms are associated with which condition?

osteoarthritis

A client is reporting severe pain in the right upper arm. Which x-ray finding would indicate to the nurse that further investigation is required?

spiral fracture

Which activity in a child with muscular dystrophy should a nurse anticipate difficulty with first?

standing

A client with a fractured femur is in Russell's traction and asks the nurse to help with back care. Which nursing action is most appropriate?

telling the client to use the trapeze to lift his back off the bed

A client is 2 weeks post op from knee replacement surgery and has been on warfarin therapy. The client's most recent INR blood level was 5.6. What should the nurse prepare to administer to the client?

vitamin K