Week 12

A patient with osteoporosis shows an understanding of appropriate self-care when they state a. "I should remove trip hazards such as throw rugs in my house to make it safer." b. "I am not using the cane my HCP recommended. I don't want to look that old!" c. "I can continue to go downhill skiing as long as I'm careful and don't ever fall." d. "I need to take up running to help strengthen my bones. Walking is just not enough."

a. "I should remove trip hazards such as throw rugs in my house to make it safer."

Which persons are at high risk for chronic low back pain? (select all that apply) a. A 63-year-old man who is a long-distance truck driver b. A 30-year-old nurse who works on an orthopedic unit and smokes c. A 55-year-old construction worker who is 6 ft, 2 in and weighs 250 lb d. A 44-year-old female chef with prior compression fracture of the spine e. A 28-year-old female yoga instructor who is 5 ft, 6 in and weighs 130 lb

a. A 63-year-old man who is a long-distance truck driver b. A 30-year-old nurse who works on an orthopedic unit and smokes c. A 55-year-old construction worker who is 6 ft, 2 in and weighs 250 lb

Which drug would the nurse prepare to administer to the patient with acute gout? a. Colchicine b. Allopurinol c. Sulfasalazine d. Cyclosporine

a. Colchicine

The nurse obtained a health history of a patient with a fracture. Which problem, if reported by the patient, would most concern the nurse? a. Diabetes b. Hypertension c. Chronic bronchitis d. Nephrotic syndrome

a. Diabetes

A patient with acute osteomyelitis is being discharged on antibiotic therapy. What would the nurse include in the teaching plan? (select all that apply) a. It is important to finish all the antibiotics even if you feel better. b. You will need to schedule periodic through bone scans and ESR testing. c. If the infection comes back, you must contact the HCP to schedule surgery. d. Signs such as fever and night sweats may be present but are usually not severe. e. Contact the HCP if signs of infection such as pain and swelling at the site occur.

a. It is important to finish all the antibiotics even if you feel better. b. You will need to schedule periodic through bone scans and ESR testing. d. Signs such as fever and night sweats may be present but are usually not severe. e. Contact the HCP if signs of infection such as pain and swelling at the site occur.

Teach the patient with fibromyalgia the importance of limiting intake of which foods? (select all that apply) a. Sugar b. Gluten c. Alcohol d. Caffeine e. Red meat

a. Sugar c. Alcohol d. Caffeine

The increased risk for falls in the older adult is likely due to (select all that apply) a. changes in balance. b. decrease in bone mass. c. loss of ligament elasticity. d. erosion of articular cartilage. e. decrease in muscle mass and strength.

a. changes in balance. b. decrease in bone mass. c. loss of ligament elasticity. e. decrease in muscle mass and strength.

The nurse would monitor a patient with a pelvic fracture for a. changes in urine output. b. petechiae on the abdomen. c. a palpable lump in the buttock. d. sudden increase in blood pressure.

a. changes in urine output.

A patient with a torn ligament in the knee asks what the ligament does. The nurse would respond that ligaments a. connect bone to bone. b. provide strength to muscle. c. lubricate joints with synovial fluid. d. relieve friction between moving parts.

a. connect bone to bone.

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

a. flexion and extension. c. pronation and supination.

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.

The nurse teaches 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 for wound dehiscence.

a. hip flexion contracture.

A patient with history of colon cancer is diagnosed with rib fractures, and the HCP orders a bone scan. The nurse determines the patient understands teaching about the purpose of the procedure when they state a. "The bone scan will cure my rib fractures." b. "The bone scan will see if my colon cancer may have spread." c. "My colon cancer was cured so I really don't think this is necessary." d. "The results of the bone scan will only just confirm that I have a rib fracture."

b. "The bone scan will see if my colon cancer may have spread."

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

b. indicate osteophyte formation at the DIP joints.

Assessment findings that the nurse would expect in a patient with rheumatoid arthritis who has articular involvement 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 should teach the patient with ankylosing spondylitis the importance of a. avoiding extremes in environmental temperatures. b. regularly exercising and maintaining proper posture. c. maintaining the patient's usual physical activity during flares. d. applying hot and cool compresses for relief of local symptoms.

b. regularly exercising and maintaining proper posture.

A patient with osteoarthritis is scheduled for 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. d. improve or maintain ROM.

A patient who ran his first marathon had heel pain that would not resolve and was diagnosed with calcaneus stress fracture. The nurse will teach the patient to (select all that apply) a. resume running in 1 week. b. rest and refrain from running. c. wear a shoe heel pad when ambulating. d. walk barefoot to decrease pressure on the heel. e. apply ice to the heel and take NSAIDs as directed by HCP.

b. rest and refrain from running. c. wear a shoe heel pad when ambulating. e. apply ice to the heel and take NSAIDs as directed by HCP.

An abnormal assessment finding of the musculoskeletal system is a. equal leg length bilaterally. b. ulnar deviation and subluxation. c. full range of motion in all joints. d. muscle strength of 5/5 in all muscles.

b. ulnar deviation and subluxation.

Which drug would the nurse plan to administer to the patient with Sjögren syndrome with the goal of improving symptoms of dry eyes? a. Etanercept (Enbrel) b. Pilocarpine (Salagen) c. Cyclosporine (Restasis) d. Cyclobenzaprine (Flexeril)

c. Cyclosporine (Restasis)

A patient is scheduled for a bone scan. 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.

c. administration of a radioisotope before the procedure.

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. d. purulent drainage at the site of an open fracture.

c. decreased sensation distal to the fracture site.

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

c. other nonsurgical methods cannot achieve adequate alignment.

When caring for a patient after lumbar spinal surgery, the nurse would immediately report which finding to the HCP? a. The patient reports mild low back pain. b. The patient has a single episode of emesis. c. The patient is nauseated and has not voided in 4 hours. d. The patient has loss of sensation to the perineum, buttocks, inner thighs, and back of the legs.

d. The patient has loss of sensation to the perineum, buttocks, inner thighs, and back of the legs.

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

d. active movement against gravity but not against resistance.

A patient is scheduled for 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.

d. bearing weight on the affected leg for 6 weeks.

The nurse provides counseling to a family of a patient with Duchenne muscular dystrophy with the knowledge that a. patients are usually female. b. all daughters of a carrier will be carriers. c. genetic testing can help determine treatment. d. only males can pass the gene to their offspring.

d. only males can pass the gene to their offspring.

The bone cells that function in the formation of new bone tissue after a patient sustains a fracture are called a. osteoids. b. osteocytes. c. osteoclasts. d. osteoblasts.

d. osteoblasts.

A patient with a stable, closed humeral fracture has a temporary splint with bulky padding applied with an elastic bandage. The nurse suspects early compartment syndrome when the patient has 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.

In teaching a patient with systemic lupus erythematosus about the disorder, the nurse knows the pathophysiology 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 skin layer. c. immunologic dysfunction leading to chronic inflammation in the cartilage and muscles. d. the production of a variety of autoantibodies directed against components of the cell nucleus.

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

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

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