Adult Health V

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A 20 year old patient arrives in the emergency department (ED) several hours after taking 25 to 30 acetaminophen (Tylenol) tablets. Which action will the nurse plan to take? A.) Give N-acetylcysteine (Mucomyst) B.) Discuss the use of chelation therapy C.) Start oxygen using a non-rebreather mask D.) Have the patient drink large amounts of water

Teach the patient with fibromyalgia the importance of limiting intake of which foods (select all that apply): A.) Sugar B.) Alcohol C.) Caffeine D.) Red meat E.) Root vegetables

A, B, C

A 28 year old with psoriatic arthritis and back pain is receiving etanercept (Enbrel). Which finding is most important for the nurse to report to the health care provider? A.) Crackles are heard in both lung bases B.) Red, scaly patches are noted on the arms C.) Hemoglobin level is 11.1 g/dL and hematocrit is 35% D.) Patient reports continued back pain after a week of etanercept therapy

A 37 year old patient with 2 school age children who has recently been diagnosed with rheumatoid arthritis (RA) tells the nurse that home life is very stressful. Which response by the nurse is most appropriate? A.) Tell me more about situations that are causing you stress B.) You need to see a family therapist for some help with stress C.) Your family should understand the impact of your rheumatoid arthritis D.) Perhaps it would be helpful for your family to be involved in a support group

A 63 year old patient is hospitalized with polymyositis has joint pain, an erythematous facial rash, eyelid edema, and a weak, hoarse voice. The priority nursing diagnosis for the patient is: A.) Risk for aspiration related to dysphagia B.) Disturbed visual perception related to swelling C.) Acute pain related to generalized inflammation D.) Risk for impaired skin integrity related to scratching

A patient has a new order for magnetic resonance imaging (MRI) to evaluate for left femur osteomyelitis after a hip replacement surgery. Which information indicates that the nurse should consult with the health care provider before scheduling the MRI? A.) The patient has a pacemaker B.) The patient is claustrophobic C.) The patient wears a hearing aid D.) The patient is allergic to shellfish

A patient scheduled for endoscopic carpal tunnel release surgery in the morning. What should the nurse be sure to teach the patient? A.) Plan and numbness are expected to be experienced for several days to weeks B.) Immediately after surgery, the patient will no longer need assistance C.) After surgery, the dressing will be large and there will be lots of drainage D.) The patient's pain and paresthesia will no longer be present

A patient with a right lower leg fracture will be discharged home with an external fixation device in place. Which information will the nurse teach? A.) You will need to check and clean the pin insertion sites daily B.) The external fixator can be removed for your bath or shower C.) You will need to remain on bed rest until bone healing is complete D.) Prophylactic antibiotics are used until the external fixator is removed

A patient has a long-arm plaster cast applied for immobilization of a fractured left radius. Until the cast has completely dried, the nurse should: A.) Keep the left arm in dependent position B.) Avoid handling the cast using fingertips C.) Place gauze around the cast edge to pad any roughness D.) Cover the cast with a small blanket to absorb the dampness

A patient is admitted to the emergency department (ED) after falling through the ice while ice skating. Which assessment will the nurse obtain first? A.) Heart rate B.) Breath sounds C.) Body temperature D.) Level fo consciousness

Which finding in a patient with a Colles' fracture of the left wrist is most important to communicate to the health care provider? A.) Swelling is noted around the wrist B.) The patient is reporting severe pain C.) The wrist has a deformed appearance D.) Capillary refill to the fingers is prolonged

After the return of spontaneous circulation following the resuscitation of a patient who had a cardiac arrest, therapeutic hypothermia is ordered. Which action will the nurse include in the plan of care? A.) Apply external cooling device B.) Check mental status every 15 minutes C.) Avoid the use of sedative medications D.) Rewarm if temperature is <91° F (32.8° C)

An assessment finding for a 55 year old patient that alerts the nurse to the presence of osteoporosis is: A.) A measurable loss of height B.) The presence of bowed legs C.) The aversion to dairy products D.) A statement about frequent falls

An unresponsive 79 year old is admitted to the emergency department (ED) during a summer heat wave. The patient's core temperature is 105.4 F, blood pressure (BP) 88/50, and pulse 112. The nurse initially will plan to: A.) Apply wet sheets and a fan to the patient B.) Provide O2 at 6 L/min with a nasal cannula C.) Start lactated ringers solution at 1000 mL/hr D.) Give acetaminophen (Tylenol) rectal suppository

Below is the condition that a current patient is in during a Disaster Situation: - Stability of Vital Functions => Unstable - Life threat or organ threat => Obvious - How soon treated => Immediately - Expected resource intensity => High resource intensity => Staff at bedside continuously => Often mobilization of team response - Examples => Cardiac arrest => Intubated trauma patient => Overdose with bradypnea => Severe respiratory distress What ESI Score would you give the patient? A.) ESI-1 B.) ESI-2 C.) ESI-3 D.) ESI-4 E.) ESI-5

During assessment of a patient with fractures of the medial ulna and radius, the nurse finds all of these data. Which assessment finding should the nurse report to the health care provider immediately? A.) The patient reports pressure and pain B.) The cast is in place and is dry and intact C.) The skin is pink and warm to the touch D.) The patient can move all the fingers and the thumb

Following an earthquake, patients are triaged by emergency medical personnel and are transported to the emergency department (ED). Which of these patients will the nurse need to assess first? A.) A patient with a red tag B.) A patient with a blue tag C.) A patient with a yellow tag D.) A patient with a green tag

The following interventions are part of the emergency department (ED) protocol for a patient who has been admitted with multiple bee stings to the hands. Which action should the nurse take first? A.) Remove the patient's rings B.) Apply ice packs to both hands C.) Apply calamine lotion to any itching areas D.) Give diphenhydramine (Benadryl) 50 mg PO

The increased risk for falls in the older adult is most likely due to: A.) Change in balance B.) Decrease in bone mass C.) Loss of ligament elasticity D.) Erosion of articular cartilage

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

The nurse is supervising a new graduate RN caring for a patient with a fracture of the right ankle who is at risk for complications of immobility. For which action should the supervising nurse intervene? A.) Encouraging the patient to go from a lying to a standing position B.) Administering pain medication before the patient begins exercises C.) Explaining to the patient and family the purpose of the exercise program D.) Reminding the patient about the correct use of crutches

The nurse should teach the patient with ankylosing spondylitis the importance of: A.) Regular exercise and maintaining proper posture B.) Avoiding extremes in environment temperatures C.) Maintaining patient's usual physical activity during flares D.) Applying hot and cool compresses for relief of local symptoms

The nurse suggests that a patient recently diagnosed with rheumatoid arthritis (RA) plan to start each day with: A.) A warm bath followed by a short rest B.) A short routine of isometric exercises C.) Active range-of-motion (ROM) exercises D.) Stretching exercises to relieve joint stiffness

The occupational health nurse will teach the patient whose job involves many hours of typing about the need to: A.) Obtain a keyboard pad to support the wrist B.) Do stretching exercises before starting work C.) Wrap the wrists with compression bandages every morning D.) Avoid using NSAIDS for pain

The urgent care center protocol for tick bites includes the following actions. Which action will the nurse take first when caring for a patient with a tick bite? A.) Use tweezers to remove any remaining ticks B.) Check the vital signs, including temperature C.) Give doxycycline (Vibramycin) 100 mg orally D.) Obtain information about recent outdoor activities

A patient undergoes a left above-the-knee amputation with an immediate prosthetic fitting. When the patient arrives on the orthopedic unit after surgery, the nurse should: A.) Place the patient in a prone position B.) Check the surgical site for hemorrhage C.) Remove the prosthesis and wrap the site D.) Keep the residual leg elevated on a pillow

A nurse is planning discharge teaching on home safety for an older adult client who has osteoporosis. Which of the 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 for the environment D.) Walk with caution on icy surfaces E.) Maintain lighting of doorway areas

A, B, C, E

When assessing an older patient admitted to the emergency department (ED) with a broken arm and facial bruises, the nurse observes several additional bruises in various stages of healing. Which statement or question by the nurse is most appropriate? A.) Do you feel safe in your home B.) You should not return to your home C.) Would you like to see a social worker D.) I need to report my concerns to the police

When planning the response to the potential use of smallpox as an agent of terrorism, the emergency department (ED) nurse manager will plan to obtain adequate quantities of: A.) Vaccine B.) Atropine C.) Antibiotics D.) Whole blood

A patient who has experienced blunt abdominal trauma during a motor vehicle collision is complaining of increasing abdominal pain. The nurse will plan to teach the patient about the purpose of: A.) Peritoneal lavage B.) Abdominal ultrasonography C.) Nasogastric (NG) tube placement D.) Magnetic resonance imagining (MRI)

When administering medications to the patient with chronic gout, the nurse would recognize which of the following as a treatment for chronic disease? A.) Colchicine B.) Febuxostat C.) Sulfasalazine D.) Cyclosporine

Which action will the nurse take when caring for a patient with osteomalacia? A.) Teach about the use of vitamin D supplements B.) Educate about the need for weight-bearing exercise C.) Discuss the use of medications such as biphosphonates D.) Emphasize the important of sunscreen use when outside

Which finding for a patient who is taking hydroxychloroquine (Plaquenil) to treat rheumatoid arthritis is likely to be an adverse effect of the medication? A.) Blurred vision B.) Joint tenderness C.) Abdominal cramping D.) Elevated blood pressure

Which finding from a patient's right knee arthrocentesis will be of concern to the nurse? A.) Cloudy fluid B.) Scant thin fluid C.) Pale yellow fluid D.) Straw-colored fluid

Which finding will the nurse expect when assessing a 58 year old patient who has osteoarthritis (OA) of the knee? A.) Discomfort with joint movement B.) Heberden's and Bouchard's nodes C.) Redness and swelling of the knee joint D.) Stiffness that increases with movement

Which nursing action for a patient who has had right hip replacement surgery can the nurse delegate to experienced unlicensed assistive personnel (UAP)? A.) Reposition the patient every 1 to 2 hours B.) Assess for skin irritation on the patient's back C.) Teach the patient quadriceps-setting exercises D.) Determine the patient's pain level and tolerance

Which nursing action is correct when performing the straight-leg raising test for an ambulatory patient with back pain? A.) Raise the patient's legs to a 60-degree angle from the bed B.) Place the patient initially in the prone position on the exam table C.) Have the patient dangle both legs over the edge of the exam table D.) Instruct the patient to elevate the legs and tense the abdominal muscles

Which 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 nurse is planning care for a client who will undergo an electromyography (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 for 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, B, C, D

A patient is being discharged 4 days ago after hip replacement surgery using a posterior approach. Which patient action requires immediate intervention by the nurse? A.) The patient uses crutches with a swing-to gait B.) The patient leans over to pull shoes and socks on C.) The patient sits straight up on the edge of the bed D.) The patient bends over the skin when brushing teeth

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 diabetes mellitus 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 hr after taking pain medication before driving

A, B, C, D

Which individuals would be at high risk for lower back pain (select all that apply): A.) A 63 year old man who is a long distance truck driver B.) A 36 year old construction worker who is 6 ft 2 in and weigh 260 lbs C.) A 44 year old female chef with prior compression fracture of the spine D.) A 30 year old nurse who works on the orthopedic unit and smokes E.) A 28 year old female yoga instructor who is 5 ft 6 in and weighs 130 lbs

A, B, C, D

The nurse is working with unlicensed assistive personnel (UAP) to provide care for six patients. At the beginning of the shift, the nurse carefully tells the UAP what patient interventions and tasks he or she is expected to perform. Which "Four Cs" guide the nurse's communication with the UAP (select all that apply): A.) Clear B.) Comprehensive C.) Concise D.) Credible E.) Correct F.) Complete

A, C, E, F

A 23 year old patient with a history of muscular dystrophy is hospitalized with pneumonia. Which nursing action will be included in the plan of care? A.) Logroll the patient every 2 hours B.) Assist the patient with ambulation C.) Discuss the need for genetic testing with the patient D.) Teach the patient about the muscle biopsy procedure

A 32 year old patient who has had an open reduction and internal fixation (ORIF) of left lower leg fractures continues to complain of severe pain in the leg 15 minutes after receiving the prescribed IV morphine. Pulses are faintly palpable and the foot is cool. Which action should the nurse take next? A.) Notify the health care provider B.) Assess the incision for redness C.) Reposition the left leg on pillows D.) Check the patient's blood pressure

A 72 year old patient with kyphosis is scheduled for dual-energy x-ray absorptiometry (DXA) testing. The nurse will plan to: A.) Explain the procedure B.) Start an IV line for contrast medium injection C.) Give an oral sedative 60 to 90 minutes before the procedure D.) Screen the patient for allergies to shellfish for iodine products

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 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 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.) Expected paresthesia distal to the wound

A patient during a Mass Casualty Event has a black tag. This means the patient: A.) Is dead B.) Has a life threatening injury C.) Has a minor injury D.) Is expected to die

A patient during a Mass Casualty Event has a yellow tag. This means the patient: A.) Has a non-life threatening injury B.) Is expected to die C.) Has a life threatening injury D.) Is dead

A patient who has arthroscopic surgery of the right knee 7 days ago is admitted with a red, swollen, and hot knee. Which assessment finding by the nurse should be reported to the health care provider immediately? A.) The blood pressure is 86/50 mmHg B.) The white blood cell count is 11,500/L C.) The patient is taking ibuprofen (Motrin) D.) The patient says the knee pain is severe

A patient who underwent a right above the knee amputation 4 days ago also has a diagnosis of depression. Which order would the nurse clarify with the health care provider? A.) Give fluoxetine 40 mg once a day B.) Administer acetaminophen with codeine 1 or 2 tablets every 4 hours as needed C.) Assist the patient to the bedside chair every shift D.) Reinforce the dressing to the right residual limb as needed

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 patient with a pelvic fracture should be monitored 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 patient with a right above the knee amputation asks the nurse why he has phantom limb pain. What is the nurse's best response? A.) "Phantom limb pain is not explained or predicted by any one theory" B.) "Phantom limb pain occurs because your body thinks your leg is still present" C.) "Phantom limb pain will not interfere with your activities of daily living" D.) "Phantom limb pain is not real pain, but is remembered pain"

A patient with acute osteomyelitis of the left femur is hospitalized for regional antibiotic irrigation. Which intervention will be included in the initial plan of care? A.) Immobilization of the left leg B.) Position the left leg in flexion C.) Assisted weight-bearing ambulation D.) Quadriceps-setting exercise repetitions

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 triage nurse in a busy emergency department (ED) assesses a patient who complains of 6/10 abdominal pain and states, "I had a temperature of 104.6 F at home." The nurse's first action should be to: A.) Assess the patient's current vital signs B.) Obtain a clean-catch urine for urinalysis C.) Tell the patient that it may be several hours before being seen by the doctor D.) Ask the health care provider to order an analgesic medication for the patient

An older man arrives in triage disoriented and dyspneic. His skin is hot and dry. His wife states that he was fine earlier today. The nurse's next priority would be to: A.) Assess his vital signs B.) Obtain a brief medical history from his wife C.) Start supplemental O2 and have the ED physician see him D.) Determine the kind of insurance he has before treating him

The nurse delegates the measurement of vital signs to an experienced unlicensed assistive personnel (UAP). Osteomyelitis has been diagnosed in the patient. Which vital sign value would the nurse instruct the UAP to report immediately for this patient? A.) Temperature of 101 F B.) Blood pressure of 136/80 mmHg C.) Heart rate of 96 bpm D.) Respiratory rate of 24 breaths/min

The nurse determines that colchicine has been effective for a patient with an acute attack of gout upon finding: A.) Relief of joint pain B.) Increased urine output C.) Elevated serum urine output D.) Increased white blood cells (WBC)

The nurse evaluating effectiveness of prescribed calcitonin (Cibacalcin) and ibandronate (Boniva) for a patient with Paget's disease will consider the patient's: A.) Pain level B.) Oral intake C.) Daily weight D.) Grip strength

When receiving discharge instructions, a patient with osteoporosis makes all of these statements. Which statement indicates to the nurse that the patient needs additional teaching? A.) "I take ibuprofen every morning as soon as I get up" B.) "My daughter removed all of the throw rugs in my home" C.) "My husband helps me every afternoon with range of motion exercises" D.) "I rest in my reclining chair every day for at least an hour"

Which action will the nurse include in the plan of care for a 40 year old with newly diagnosed ankylosing spondylitis? A.) Advise the patient to sleep on the back with a flat pillow B.) Emphasize that application of heat may worsen symptoms C.) Schedule annual laboratory assessment for the HLA-B27 antigen D.) Assist patient to choose physical activities that allow the spin to flex

While performing triage in the ED, the nurse determines which patient should be seen first? A.) A patient with burns on the face and chest; BP 120/80 mm Hg, HR 92, RR 24 B.) A patient with a deformed leg indicating a fractured tibia; BP 110/60 mmHg, HR 86, RR 18 C.) A patient with type 1 diabetes in ketoacidosis; BP 100/60 mm Hg, HR 100 beats/min, RR 32 D.) A patient with a respiratory infection with a cough productive of greenish sputum; BP 128/86 mm Hg, HR 88, RR 26

When performing passive range of motion for a patient, the nurse puts the ankle join 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, B

When preparing to cool a patient who is to begin therapeutic hypothermia, which intervention will the nurse plan to do (select all that apply)? A.) Assist with endotracheal intubation B.) Insert an indwelling urinary catheter C.) Begin continuous cardiac monitoring D.) Obtain an order to restrain the patient E.) Prepare to give sympathomimetic drugs

A, B, C

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, B, C, E

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 joins 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, B, C, E

A nurse is teaching a client how to manage an external fixation device upon discharge. Which of the following statements by the client 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, B, C, E

The charge nurse assigns the nursing care of a patient who has just returned from open carpal tunnel release surgery to an experienced LPN/LVN, who will perform under the supervision of an RN. Which instructions would the RN provide for the LPN/LVN (select all that apply): A.) Check the patient's vital signs every 15 minutes in the first hour B.) Check the dressing for drainage and tightness C.) Elevate the patient's hand above the heart D.) The patient will no longer need pain medication E.) Check the neurovascular status of the fingers every hour F.) Instruct the patient to perform range of motion on the affected wrist

A, B, C, E

The nurse is preparing to teach a patient with a new diagnosis of osteoporosis about strategies to prevent falls. Which teaching points should the nurse be sure to include (select all that apply): A.) Wear a hip protector when ambulating B.) Remove throw rugs and other obstacles at home C.) Exercise to help build your strength D.) Expect a few bumps and bruises when you go home E.) Rest when you are tired F.) Avoid consuming three or more alcoholic drinks per day

A, B, C, E

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 (select all that apply): A.) Check continuous passive motion device settings B.) Palpate dorsal pedal pulses C.) Place a pillow behind the knee D.) Elevate heels off bed E.) Apply heat therapy to incision

A, B, D

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, B, D, E

The emergency department nurse receives a call about a patient with a traumatic finger amputation. What instructions does the nurse provide to the patient's wife (select all that apply): A.) Wrap the completely severed finger in dry sterile gauze (if available) or a clean cloth B.) Put the finger in a watertight, sealed plastic bag C.) Place the bag directly on ide D.) Elevate the affected extremity above the patient's heart E.) Examine the amputation site and apply direct pressure with layers of dry gauze F.) After performing these steps, call 911 and check the patient for breathing

A, B, D, E

During assessment of the patient with fibromyalgia, the nurse would expect the patient to report to which of the following (select all that apply): A.) Sleep disturbances B.) Multiple tender points C.) Cardiac palpitations and dizziness D.) Multi joint pain with inflammation and swelling E.) Widespread bilateral, burning musculoskeletal pain

A, B, E

In which order will the nurse implement these collaborative interventions prescribed for a patient being admitted who has acute osteomyelitis with a temperature of 101.2 F? A.) Obtain blood cultures from two sites B.) Send to radiology for computed tomography (CT) scan of right leg C.) Administer gentamicin (Garamycin) 60 mg IV D.) Administer acetaminophen (Tylenol) now and every 4 hours PRN for fever

A, C, D, B

A nurse is assessing a client who had an external fixation device applied 2 hr 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 sec 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, C, D, E

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.) A 30 year old client who jogs 3 miles daily C.) A 45 year old client who takes phenytoin for seizures D.) A 65 year old client who has a sedentary lifestyle E.) A 70 year old client who has smoked for 50 years

A, C, D, E

A nurse is planning care for a client who is postoperative 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, C, D, E

The nurse is preparing a discussion of musculoskeletal health maintenance for a group of older adults. Which key points would the nurse be sure to include (select all that apply): A.) Be aware of and consume foods rich in calcium and vitamin D B.) Wear hats and long sleeves to avoid sun exposure C.) Consider exercise with low impact to avoid risk for injury D.) If you smoke, consider a smoking cessation program E.) Excessive alcohol intake can interfere with vitamins and nutrients for bone growth F.) Weight-bearing activities decrease the risk for osteoporosis

A, C, D, E, F

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 with 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, C, E

The nurse is caring for a patient who had a dual-energy x-ray absorption (DEXA) scan and is now prescribed calcium with vitamin D twice a day. The patient asks the nurse the purpose of the drug. What is the nurse's best response (select all that apply): A.) "When your calcium and vitamin D levels are low, your risk for osteoporosis and osteomalacia increases" B.) "When your vitamin D level is high, your bones release calcium to keep your blood calcium level in the normal range" C.) "When your blood calcium is low, calcium is released from your bones increasing your risk for fractures" D.) "When blood calcium is normal, long bones are formed increasing a person's height" E.) "The extra calcium and vitamin D will help protect your bones from damage such as fractures" F.) "You can also get extra vitamin D by increasing your intake of beef and pork sources"

A, C, E

A nurse is assessing a client who has osteoarthritis of the knees and fingers. Which of the following manifestations should the nurse expect to fine (select all that apply): A.) Heberden's nodes B.) Swelling of all joints C.) Small body frame D.) Enlarged joint size E.) Limp when walking

A, D, E

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 client E.) Perform isometric exercises

A, D, E

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 further problems with low back pain (select all that apply): A.) Engage in regular exercise including walking B.) Sit for up to 10 hr 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, D, E

What are effective interventions to decrease absorption or increase elimination of an ingested poison (select all that apply): A.) Hemodialysis B.) Milk dilution C.) Eye irrigation D.) Gastric lavage E.) Activated charcoal

A, D, E

Which actions will the nurse include in the plan of care when caring for a patient with metastatic bone cancer of the left femur (select all that apply): A.) Monitor serum calcium level B.) Teach about the need for strict bed rest C.) Avoid use of sustained release opioids for pain D.) Support the left leg when repositioning the patient E.) Support family as they discuss the prognosis of patient

A, D, E

A 22 year old tennis player has an arthroscopic repair of a rotator cuff injury performed in same-day surgery. When the nurse plans postoperative teaching for the patient, which information will be included? A.) You will not be able to serve a tennis ball again B.) You will work with a physical therapist tomorrow C.) The doctor will use the drop-arm test to determine the success of surgery D.) Leave the shoulder immobilizer on the first 4 days to minimize pain

A 31 year old woman who is taking methotrexate (Rheumatrex) to treat rheumatoid arthritis. Which information from the patient's health history is important for the nurse to report to the health care provider about the methotrexate? A.) The patient had a history of infectious mononucleosis as a teenager B.) The patient is trying to get pregnant before her disease becomes more severe C.) The patient has a family history of age-related macular degeneration of the retina D.) The patient has been using large doses of vitamins and health foods to treat the RA

A 39-year-old patient whose work involves frequent lifting has a history of chronic back pain. After the nurse has taught the patient about correct body mechanics, which patient statement indicates that the teaching has been effective? A.) I will keep my back straight to lift anything higher than my waist B.) I will begin doing exercises to strengthen the muscles of my back C.) I can try to sleep with my hips and knees extended to prevent back strain D.) I can tell my boss that I need to change to a job where I can work at a desk

A 40 year old African American patient has scleroderma manifested by CREST (calcinosis, Raynaud's phenomenon, esophageal dysfunction, sclerodactyly, and telangiectasia) syndrome. Which action will the nurse include in the plan of care? A.) Avoid use of capsaicin cream on hands B.) Keep environment warm and draft free C.) Obtain capillary blood glucose before meals D.) Assist to bathroom every 2 hours while awake

A 42 year old male patient complains of shoulder pain when the nurse moves his arm behind the back. Which question should the nurse ask? A.) Are you able to feed yourself without difficulty? B.) Do you have difficulty when you are putting on a shirt? C.) Are you able to sleep through the night without waking? D.) Do you ever have trouble lowering yourself to the toilet?

A 46 year old male patient with dermatomyositis is receiving long term prednisone (Deltasone) therapy. Which assessment finding by the nurse is most important to report to the health care provider? A.) The blood glucose is 112 mg/dL B.) The patient has painful hematuria C.) Acne is noted on the patient's face D.) The patient has an increased appetite

A 50 year old patient is being discharged after a week of IV antibiotic therapy for acute osteomyelitis in the right leg. Which information will be included in the discharge teaching? A.) How to apply warm packs to the leg to reduce pain B.) How to monitor and care for the long-term IV catheter C.) The need for daily aerobic exercise to help maintain muscle strength D.) The reason for taking oral antibiotics for 7 to 10 days after discharge

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

A nurse is caring for a client who injured her lower back during a fall and described 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 the use of pillows B.) Semi-Fowler's with a pillow under the knees C.) High-Fowler's with the knees flat on the bed D.) Supine with the head flat

A nurse is preparing a plan of care to prevent a client from developing flexion contractions following a below the knee amputation 24 hr 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 hr after surgery B.) Position the client prone several times each day C.) Wrap the stump in a figure eight pattern D.) Encourage sitting in a chair during the day

A nurse is providing care for a client who had a vertebroplasty 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 1 hr D.) Ambulate the client within the first hour postprocedure

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 of chicken D.) White rice

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 discussion? 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 hr during the day

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.) This tumor is related to the melanoma I had 3 years ago D.) I'm glad hey can take out the cancer with such a small scar

A patient during a Mass Casualty Event has a green tag. This means the patient: A.) Is expected to die B.) Has a minor injury C.) Is dead D.) Has a life threatening injury

A patient during a Mass Casualty Event has a red tag. This means the patient: A.) Is dead B.) Has a life threatening injury C.) Is expected to die D.) Has a minor injury

A patient has a core temperature of 90 F. The most appropriate priate rewarming technique would be: A.) Passive rewarming with warm blankets B.) Active internal rewarming using warmed IV fluids C.) Passive rewarming using air-filled warming blankets D.) Active external rewarming by submerging in a warm bath

A patient is scheduled for an electromyogram (EMG). 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

A patient who has had an open reduction and internal fixation (ORIF) of a hip fracture tells the nurse that he is ready to get out of bed for the first time. Which action should the nurse take? A.) Use a mechanical life to transfer the patient from the bed to the chair B.) Check the postoperative orders for the patient's weight bearing status C.) Avoid administration of pain medications before getting the patient up D.) Delegate the transfer of the patient to nursing assistive personnel (NAP)

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 the 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

A patient who is to have no weight bearing on the left leg is learning to walk using crutches. Which observation by the nurse indicates that the patient can safely ambulate independently? A.) The patient moves the right crutch with the right leg and then the left crutch with the left leg B.) The patient advances the left leg and both crutches together and then advances the right leg C.) The patient uses the bedside chair in balance as needed when ambulating in the room D.) The patient keeps the padded area of the crutch firmly in the axillary area when ambulating

A patient who is unconscious after a fall from a ladder is transported to the emergency department by emergency medical personnel. During the primary survey of the patient, the nurse should: A.) Obtain a complete set of vital signs B.) Obtain a Glasgow Coma Scale score C.) Ask about chronic medical conditions D.) Attach a cardiac electrocardiogram monitor

A patient with a complex pelvic fracture form a motor vehicle crash is on bed rest. Which nursing assessment finding is important to report to the health care provider? A.) The patient states that the pelvis feels unstable B.) Abdomen is distended and bowel sounds are absent C.) There are ecchymoses across the abdomen and hips D.) The patient complains of pelvic pain with palpation

A patient with a fractured femur. Which finding would the nurse instruct the unlicensed assistive personnel (UAP) to report immediately? A.) The patient reports pain B.) The patient appears confused C.) The patient's blood pressure is 136/88 mmHg D.) The patient voided using the bedpan

A patient with gout has a new prescription for losartan (Cozaar) to control the condition. The nurse will plan to monitor: A.) Blood glucose B.) Blood pressure C.) Erythrocyte count D.) Lymphocyte count

A patient with left knee pain is diagnosed with bursitis. The nurse will explain that bursitis is an inflammation of: A.) The synovial membrane that lines the joint B.) A small, fluid-filled sac found at some joints C.) The fibrocartilage that acts as a shock absorber in the knee joint D.) Any connective tissue that is found supporting the joints of the body

A patient with rheumatoid arthritis (RA) complains to the clinic nurse about having chronically dry eyes. Which action by the nurse is most appropriate? A.) Teach the patient about adverse effects of the RA medications B.) Suggest that the patient use over-the-counter (OTC) artificial tears C.) Reassure the patient that dry eyes are a common problem with RA D.) Ask the health care provider about discontinuing methotrexate (Rheumatrex)

A young man arrives in the emergency department with ankle swelling and severe pain after twisting his ankle playing basketball. Which of these prescribed collaborative interventions will the nurse implement first? A.) Take the patient to have x-rays B.) Wrap the ankle and apply an ice pack C.) Administer naproxen (Naprosyn) 500 mg PO D.) Give acetaminophen with codeine (Tylenol #3)

After being hospitalized for 3 days with a right femur fracture, a 32-year-old patient suddenly develops shortness of breath and tachypnea. The patient tells the nurse, "I feel like I am going to die!" Which action should the nurse take first? A.) Stay with the patient and offer reassurance B.) Administer the prescribed PRN oxygen at 4 L/min C.) Check the patient's legs for swelling or tenderness D.) Notify the health care provider about the symptoms

After the nurse has finished teaching a 68 year old patient with osteoarthritis (OA) of the right hip about how to manage the OA, which patient statement indicates a need for more teaching? A.) "I can take glucosamine to help decrease my knee pain." B.) "I will take 1 g of acetaminophen (Tylenol) every 4 hours." C.) "I will take a shower in the morning to help relieve stiffness." D.) "I can use a cane to decrease the pressure and pain in my hip."

After the nurse has taught a 28-year-old with fibromyalgia, which statement by the patient indicates a good understanding of effective self-management? A.) "I am going to join a soccer team to get more exercise." B.) "I will need to stop drinking so much coffee and soda." C.) "I will call the doctor every time my symptoms get worse." D.) "I should avoid using over-the-counter medications for pain."

Before assisting a patient with ambulation 2 days after a total hip replacement, which action is most important for the nurse to take? A.) Observe the status of the incisional drain device B.) Administer the ordered oral opioid pain medication C.) Instruct the patient about the benefits of ambulation D.) Change the hip dressing and document the wound appearance

Below is the condition that a current patient is in during a Disaster Situation: - Stability of Vital Functions => Threatened - Life threat or organ threat => Likely but not always obvious - How soon treated => Within 10 min - Expected resource intensity => High resource intensity => Multiple, often complex diagnostic studies => Frequent consultation => Continuous monitoring - Examples => Chest pain probably resulting from ischemia => Multiple trauma unless unresponsive What ESI score would you give the patient? A.) ESI-1 B.) ESI-2 C.) ESI-3 D.) ESI-4 E.) ESI-5

During the primary assessment of a victim of a motor vehicle collision, the nurse determines that the patient is breathing and has an unobstructed airway. Which action should the nurse take next? A.) Palpate extremities for bilateral pulses B.) Observe the patient's respiratory efforts C.) Check the patient's level of consciousness D.) Examine the patient for any external bleeding

Following laminectomy with a spinal fusion to treat a herniated disc, a patient reports numbness and tingling of the right lower leg. The first action that the nurse should take is to: A.) Report the patient's complaint to the surgeon B.) Check the chart for preoperative assessment data C.) Check the vital signs for indications of hemorrhage D.) Turn the patient to the side to relieve pressure on the right leg

Gastric lavage and administration of activated charcoal are ordered for an unconscious patient who has been admitted to the emergency department (ED) after ingesting 30 lorazepam (Ativan) tablets. Which action should the nurse plan to do first? A.) Insert a large bore orogastric tube B.) Assist with intubation of the patient C.) Prepare a 60 mL syringe with saline D.) Give first dose of activated charcoal

In assessing the joints of a patient with osteoarthritis, the nurse understands that Bouchard's nodes: A.) Are often swollen, red and tender 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

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.) The patient is unable to move the lower extremities C.) The patient is nauseated and has not voided in 4 hours D.) The patient complains of pain at the bone graft donor site

The charge nurse is assigning the nursing care of a patient who has a left below the knee amputation 1 day ago to an experienced LPN/LVN, who will function under an RN's supervision. What will the RN tell the LPN/LVN is the major focus for the patient's care today? A.) To attain pain control over phantom pain B.) To monitor for signs of sufficient tissue perfusion C.) To assist the patient to ambulate as soon as possible D.) To elevate the residual limb when the patient is supine

The day after a having a right below-the-knee amputation, a patient complains of pain in the right foot. Which action is best for the nurse to take? A.) Explain the reasons for the phantom limb pain B.) Administer prescribed analgesics to relieve the pain C.) Loosen the compression bandage to decrease incisional pressure D.) Inform the patient that this phantom pain will diminish over time

The emergency department (ED) nurse should question which health care provider order when providing care for an older adult with a fracture of the left ulna? A.) Get x-rays of left forearm B.) Give meperidine IM for pain C.) Monitor vital signs every hour D.) Elevate left arm on pillows

The health care provider has prescribed the following collaborative interventions for a patient who is taking azathioprine (Imuran) for systemic lupus erythematosus. Which order will the nurse question? A.) Draw anti-DNA blood titer B.) Administer varicella vaccine C.) Naproxen (Aleve) 200 mg BID D.) Famotidine (Pepcid) 20 mg daily

The nurse determines that additional instruction is needed when a patient diagnosed with scleroderma says which of the following? A.) Paraffin baths can be used to help my hands B.) I should lie down for an hour after each meal C.) Lotions will help if I rub them in for a long time D.) I should perform range of motion exercises daily

The nurse instructs a patient who has osteosarcoma of the tibia about the scheduled above the knee amputation. Which statement by a patient indicates that additional patient teaching is needed? A.) I will need to participate in physical therapy after surgery B.) I did not have this bone cancer until my leg broke a week ago C.) I wish that I did not have to have chemotherapy after this surgery D.) I can use the patient controlled analgesia (PCA) to control postoperative pain

The nurse is preparing a patient who had carpal tunnel release surgery for discharge. Which information is important to provide for this patient? A.) The surgical procedure is a cure for carpal tunnel syndrome (CTS) B.) Do not lift any heavy objects C.) Frequent doses of pain medication will no longer be necessary D.) The health care provider should be notified immediately if there is any pain or discomfort

The nurse notes crackling sounds and a grating sensation with palpation of an older patient's elbow. How will this finding be documented? A.) Torticollis B.) Crepitation C.) Subluxation D.) Epicondylitis

The nurse will instruct the patient with a fractured left radius that the cast will need to remain in place: A.) For several months B.) For at least 3 weeks C.) Until swelling of the wrist has resolved D.) Until x-rays show complete bony union

The nurse's assessment reveals all of these data when a patient with Paget disease is admitted to the acute care unit. Which finding should the nurse notify the health care provider about first? A.) There is a bowing of both legs, and the knees are asymmetrical B.) The base of the skull is invaginated (platybasia) C.) The patient is only 5 feet tall and weighs 120 lbs D.) The skull is soft, thick and larger than normal

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

When administering alendronate (Fosamax) to a patient with osteoporosis, the nurse will: A.) Ask about any leg cramps or hot flashes B.) Assist the patient to sit up at the bedside C.) Be sure that the patient has recently eaten D.) Administer the ordered calcium carbonate

When assessing a Tinels sign in a patient with possible right-sided carpal tunnel syndrome, the nurse will ask the patient about: A.) Weakness in the right little finger B.) Tingling in the right elbow and forearm C.) Burning in the right elbow and forearm D.) Tremor when gripping with the right hand

When caring for a patient who is using Bucks traction after a hip fracture, which action can the nurse delegate to unlicensed assistive personnel (UAP)? A.) Monitor the skin under the traction boot for redness B.) Ensure that the weight for the traction is off the floor C.) Check for intact sensation and movement in the affected leg D.) Offer reassurance that hip and leg pain are normal after hip fracture

When doing discharge teaching for a patient who has had a repair of a fractured mandible, the nurse will include information about: A.) When and how to cut the immobilizing wires B.) Self-administration of nasogastric tube feedings C.) The use of sterile technique for dressing changes D.) The importance of including high-fiber foods in the diet

Which action can the nurse delegate to unlicensed assistive personnel (UAP) who are working in the orthopedic clinic? A.) Grade leg muscle strength for a patient with back pain B.) Obtain blood sample for uric acid from a patient with gout C.) Perform straight-leg-raise testing for a patient with sciatica D.) Check for knee joint crepitation before arthroscopic surgery

Which action should the nurse take before administering gentamicin (Garamycin to a patient who has acute osteomyelitis? A.) Ask the patient about any nausea B.) Review the patient's creatinine level C.) Obtain the patient's oral temperature D.) Change the prescribed wet to dry dressing

Which action will the nurse include in the plan of care for a 33 year old patient with a new diagnosis of rheumatoid arthritis? A.) Instruct the patient to purchase a soft mattress B.) Suggest that the patient take a nap in the afternoon C.) Teach the patient to use lukewarm water when bathing D.) Suggest exercise with light weights several times daily

Which action will the nurse take first when a patient is seen in the outpatient clinic with neck pain? A.) Provide information about therapeutic neck exercises B.) Ask about numbness or tingling of the hands and arms C.) Suggest that the patient alternate the use of heat and cold to the neck and to treat pain D.) Teach about the use of NSAIDS such as ibuprofen (Advil)

Which action will the nurse take in order to evaluate the effectiveness of Bucks traction for a 62 year old patient who has an intracapsular fracture of the right femur? A.) Check peripheral pulses B.) Ask about hip pain level C.) Assess for hip contractures D.) Monitor for hip dislocation

Which assessment finding about a patient who has been using naproxen (Naprosyn) for 6 weeks to treat osteoarthritis is most important for the nurse to report to the health care provider? A.) The patient has gained 3 pounds B.) The patient has dark colored stools C.) The patient's pain has become more severe D.) The patient is using capsaicin cream (Zostrix)

Which assessment information obtained by the nurse indicates that a patient with an exacerbation of rheumatoid arthritis (RA) is experiencing a side effect of prednisone (Deltasone)? A.) The patient has joint pain and stiffness B.) The patient's blood glucose is 165 mg/dL C.) The patient has experienced a recent 5 pound weight loss D.) The patient's erythrocyte sedimentation rate (ESR) has increased

Which information in a 67 year old woman's health history will alert the nurse to the need for a more focused assessment of the musculoskeletal system? A.) The patient sprained her ankle at age 13 B.) The patient's mother became shorter with aging C.) The patient takes ibuprofen (Advil) for occasional headaches D.) The patient's father died of complications of miliary tuberculosis

Which information obtained by the nurse about a 29 year old patient with a lumbar vertebral compression fracture is most important to report to the health care provider? A.) Patient refuses to be turned due to back pain B.) Patient has been incontinent of urine and stool C.) Patient reports lumbar area tenderness to palpation D.) Patient frequently uses oral corticosteroids to treat asthma

Which information will the nurse include when preparing teaching materials for patients with exacerbations of rheumatoid arthritis? A.) Affected joins should not be exercised when pain is present B.) Application of cold packs before exercise may decrease joint pain C.) Exercises should be performed passively by someone other than the patient D.) Walking may substitute for range-of-motion (ROM) exercises on some days

Which information will the nurse include when teaching a 38 year old male patient with newly diagnosed ankylosing spondylitis (AS) about the management of the condition? A.) Exercise by taking long walks B.) Do daily deep breathing exercises C.) Sleep on the side with hips flexed D.) Take frequent naps during the day

Which nursing action can the registered nurse (RN) delegate to unlicensed assistive personnel (UAP) who are assisting with the care of a patient with scleroderma? A.) Monitor for difficulty in breathing B.) Document the patient's oral intake C.) Check finger strength and movement D.) Apply capsaicin (Zostrix) cream to hands

Which nursing intervention would be included in the plan of care after a patient with a right femur fracture has a hip spica cast applied? A.) Avoid placing the patient in prone position B.) Ask the patient about abdominal discomfort C.) Discuss remaining on bed rest for several weeks D.) Use a cast support bar to reposition the patient

Which result for a 30-year-old patient with systemic lupus erythematosus (SLE) is most important for the nurse to communicate to the health care provider? A.) Decreased C-reactive protein (CRP) B.) Elevated blood urea nitrogen (BUN) C.) Positive antinuclear antibodies (ANA) D.) Positive lupus erythematosus cell prep

Which statement by a 62 year old patient who has had an above-the-knee amputation indicates that the nurse's discharge teaching has been effective? A.) I should elevate my residual limb on a pillow 2 or 3 times a day B.) I should lay flat on my abdomen for 30 minutes 3 or 4 times a day C.) I should change the limb sock when it becomes soiled or each week

Which statement by the patient with systemic lupus erythematosus (SLE) indicates that the patient has understood the nurse's teaching about the condition? A.) I will exercise even if I am tired B.) I will use sunscreen when I am outside C.) I should take birth control pills to keep from getting pregnant D.) I should avoid aspirin or NSAIDs

You are working in the triage area of an ED, and the following four clients approach the triage desk at the same time. List the order in which you will assess these clients. A.) Ambulatory, dazed 25 y/o man with a bandaged head wound B.) Irritable infant with a fever, petechiae, and nuchal rigidity C.) 35 y/o jogger with a twisted ankle who has a pedal pulse and no deformity D.) 50 y/o old woman with moderate abdominal pain and occasional vomiting

B, A, D, C

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 and IV antibiotics are not effective in most cases of bone infections 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, C

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 in C.) Body mass index (BMI) of 21 D.) Kyphotic curve at upper thoracic spine E.) History of lactose intolerance

B, C, D, E

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, C, D, E

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, C, E

The nurse is caring for a postoperative patient with a hip replacement. Which patient care actions can be delegated to the experienced unlicensed assistive personnel (UAP) (select all that apply): A.) Inspect heels and other bony prominences every 8 hours B.) Turn and reposition the patient every 2 hours C.) Assure that the patient's heels are elevated off the bed D.) Assess the patient's calf and regions for redness and swelling E.) Check vital signs and oxygen saturation via pulse oximetry F.) Assess for pain and administer pain medication

B, C, E

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, D

A nurse is educating clients at a health fair about dual energy x-ray absorptiometry (DXA) 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 the device scans C.) The scan detects osteoarthritis D.) Bone pain can indicate a need for a scan E.) At age 40 years, you should have a baseline scan

B, D, E

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, E

A 19-year-old patient hospitalized with a fever and red, hot, and painful knees is suspected of having septic arthritis. Information obtained during the nursing history that indicates a risk factor for septic arthritis is that the patient: A.) Had several knee injuries as a teenager B.) Recently returned from South America C.) Is sexually active with multiple partners D.) Has a parent who has rheumatoid arthritis

A 22 year old patient who experienced a near drowning accident in a local pool, but now is awake and breathing spontaneously, is admitted for observation. Which assessment will be most important for the nurse to take during the observation period? A.) Auscultate heart sounds B.) Palpate peripheral pulses C.) Auscultate breath sounds D.) Check pupil reaction to light

A 28 year old patient who has deep human bite wounds on the left hand is being treated in the urgent care center. Which action will the nurse plan to take? A.) Prepare to administer rabies immune globulin (BayRab) B.) Assist the health care provider with suturing of the bite wounds C.) Teach the patient the reason for the use of prophylactic antibiotics D.) Keep the wounds dry until the health care provider can assess them

A 29 year old patient reporting painful urination and knee pain is diagnosed with reactive arthritis. The nurse will plan to teach the patient about the need for several months of therapy with: A.) Anakinra (Kineret) B.) Etanercept (Enbrel) C.) Doxycycline (Vibramycin) D.) Methotrexate (Rheumatrex)

A 42 year old patient is admitted to the emergency department with a left femur fracture. Which information obtained by the nurse is more important to report to the health care provider? A.) Ecchymosis of the left thigh B.) Complaints of severe thigh pain C.) Slow capillary refill of the left food D.) Outward pointing toes on the left foot

A 67 year old patient is receiving IV antibiotics at home to treat chronic osteomyelitis of the left femur. The nurse chooses a nursing diagnosis of ineffective health maintenance when the nurse finds that the patient: A.) Is frustrated with the length of treatment required B.) Takes and records the oral temperature twice a day C.) Is unable to plantar flex the foot on the affected side D.) Uses crutches to avoid weight bearing on the affected leg

A high school teacher with ulnar drift caused by rheumatoid arthritis (RA) is scheduled for a left hand arthroplasty. Which patient statement to the nurse indicates a realistic expectation for the surgery? A.) "This procedure will correct the deformities in my fingers." B.) "I will not have to do as many hand exercises after the surgery." C.) "I will be able to use my fingers with more flexibility to grasp things." D.) "My fingers will appear more normal in size and shape after this surgery."

A new clinic patient with joint swelling and pain is being tested for systemic lupus erythematosus. Which test will provide the most specific findings for the nurse to review? A.) Rheumatoid factor (RF) B.) Antinuclear antibody (ANA) C.) Anti-Smith antibody (Anti-Sm) D.) Lupus erythematosus (LE) cell prep

A nurse who works on the orthopedic unit has just received the change-of-shift report. Which patient should the nurse assess first? A.) Patient who reports foot pain after hammertoe surgery B.) Patient with low back pain and a positive straight leg raise test C.) Patient who has not voided 10 hours after having a laminectomy D.) Patient with osteomyelitis who has a temperature of 100.5 F

A patient arrived at the emergency department after tripping over a rug and falling at home. Which finding is most important for the nurse to communicate to the health care provider? A.) There is bruising at the shoulder area B.) The patient reports arm and shoulder pain C.) The right arm appears shorter than the left D.) There is decreased shoulder range of motion

A patient who arrives at the emergency department experiencing severe left knee pain is diagnosed with a patellar dislocation. The initial patient teaching by the nurse will focus on the need for: A.) A knee immobilizer B.) Gentle knee flexion C.) Monitored anesthesia care D.) Physical activity restrictions

A patient who slipped and fell in the shower at home has a proximal humerus fracture immobilized with a left-sided long-arm cast and a sling. Which nursing intervention will be included in the plan of care? A.) Use surgical net dressing to hang the arm from an IV pole B.) Immobilize the fingers of the left hand with gauze dressings C.) Assess the left axilla and change absorbent dressings as needed D.) Assist the patient in passive range of motion (ROM) for the right arm

A patient with a fractured fibula is receiving skeletal traction and has skeletal pins in place. What would the nurse instruct the unlicensed assistive personnel (UAP) to report immediately? A.) The patient wants to change position in bed B.) There is a small amount of clear fluid at the pin sites C.) The traction weights are resting on the floor D.) The patient reports pain and muscle spasm

A patient with an acute attack of gout in the right great toe has a new prescription for probenecid (Benemid). Which information about the patient's home routine indicates a need for teaching regarding gout management? A.) The patient sleeps about 8 to 10 hours every night B.) The patient usually eats beef once or twice a week C.) The patient takes on aspirin a day to prevent angina D.) The patient usually drinks about 3 quarts of water daily

A patient with hypotension and an elevated temperature after working outside on a hot day is treated in the emergency department (ED). The nurse determines that discharge teaching has been effective when the patient makes which statement? A.) "I will take salt tablets when I work outdoors in the summer" B.) "I should take acetaminophen (Tylenol) if I start to feel too warm" C.) "I should drink sports drinks when working outside in hot weather" D.) "I will move to a cool environment if I notice that I am feeling confused"

A patient with rheumatoid arthritis being seen in the clinic has rheumatoid nodules on the elbows. Which action will the nurse take? A.) Draw blood for rheumatoid factor analysis B.) Teach the patient about injections for the nodules C.) Assess the nodules for skin breakdown or infection D.) Discuss the need for surgical removal of the nodules

A pedestrian who was hit by a car is admitted to the emergency department with possible right lower leg fractures. The initial action by the nurse should be to: A.) Elevate the right leg B.) Splint the lower leg C.) Check the pedal pulses D.) Verify tetanus immunizations

After completing the health history, the nurse assessing the musculoskeletal system will begin by: A.) Having the patient move the extremities against resistance B.) Feeling for the presence of crepitus during joint movement C.) Observing the patient's body build and muscle configuration D.) Checking active and passive range of motion for the extremities

After the health care provider has recommended amputation for a patient who has nonhealing ischemic foot ulcers, the patient tells the nurse that he would rather die than have an amputation. Which response by the nurse is best? A.) "You are upset, but you may lose the foot anyway." B.) "Many people are able to function with a foot prosthesis." C.) "Tell me what you know about your options for treatment." D.) "If you do not want an amputation, you do not have to have it."

After the nurse receives change of shift report, which patient should be assessed first? A.) A 42 year old patient with carpal tunnel syndrome who reports pain B.) A 64 year old patient with osteoporosis awaiting discharge C.) A 28 year old patient with a fracture who reports that the cast is tight D.) A 56 year old patient with a left leg amputation who reports phantom pain

An appropriate nursing intervention for a patient who has acute low back pain and muscle spasms is to teach the patient to: A.) Keep both feet flat on the floor when prolonged standing is required B.) Twist gently from side to side to maintain range of motion in the spine C.) Keep the head elevated slightly and flex the knees when resting in bed D.) Avoid the use of cold packs because they will exacerbate the muscle spasms

An older woman arrives in the ED complaining of severe pain in her right shoulder. The nurse notes that her clothes are soiled with urine and feces. She tells the nurse that she lives with her son and that she "fell." She is tearful and asks you if she can be admitted. What possibility should the nurse consider? A.) Dementia B.) Possible cancer C.) Family violence D.) Orthostatic hypotension

Anakinra (Kineret) is prescribed for a 49-year-old patient who has rheumatoid arthritis (RA). When teaching the patient about this drug, the nurse will include information about: A.) Avoiding concurrently taking aspirin B.) Symptoms of gastrointestinal (GI) bleeding C.) Self-administration of subcutaneous injections D.) Taking the medication with at least 8 oz of fluid

Below is the condition that a current patient is in during a Disaster Situation: - Stability of Vital Functions => Stable - Life threat or organ threat => Unlikely but possible - How soon treated => Up to 1 hour - Expected resource intensity => Medium to high resource intensity => Multiple diagnostic studies( Multiple laboratory studies, x-rays, etc.) => Brief observations => Complex procedures( IV fluids, medications, etc.) - Examples => Abdominal pain => Gynecologic disorders unless in severe distress => Hip fracture in older patient What ESI score would you give the patient? A.) ESI-1 B.) ESI-2 C.) ESI-3 D.) ESI-4 C.) ESI-5

Family members are in the patient's room when the patient has a cardiac arrest and the staff start resuscitation measures. Which action should the nurse take next? A.) Keep the family in the room and assign a staff member to explain the care given and answer questions B.) Ask the family to wait outside the patient's room with a designated staff member to provide emotional support C.) Ask the family members about whether they would prefer to remain in the patient's room or wait outside the room D.) Tell the family members that patients are comforted by having family members present during resuscitation efforts

Following a motorcycle accident, a 58-year-old patient arrives in the emergency department with massive left lower leg swelling. Which action will the nurse take first? A.) Elevate the leg on 2 pillows B.) Apply a compression bandage C.) Check leg pulses and sensation D.) Place ice packs on the lower leg

In teaching a patient with Sjören's Syndrome about drug therapy for this disorder, the nurse should include instruction on use of which drug? A.) Pregabalin (Lyrica) B.) Etanercept (Enbrel) C.) Cyclosporine (Restasis) D.) Cyclobenzaprine (Flexeril)

The bone cells that function in the resorption of bone tissue are called: A.) Osteoids B.) Osteocytes C.) Osteoclasts D.) Osteoblasts

The charge nurse observed an LPN/LVN assigned to provide all of these interventions for a patient with Paget disease. Which action requires that the charge nurse intervene? A.) Administering 600 mg of ibuprofen to the patient B.) Encouraging the patient to perform exercises recommended by a physical therapist C.) Applying ice and gentle massage to the patient's lower extremities D.) Reminding the patient to drink milk and eat cottage cheese

The nurse is caring for a patient with carpal tunnel syndrome (CTS) who has been admitted for surgery. Which intervention should be delegated to the unlicensed assistive personnel (UAP)? A.) Initiating placement of a splint for immobilization during the day B.) Assessing the patient's wrist and hand for discoloration and brittle nails C.) Assisting the patient with daily self-care measures such as bathing and eating D.) Testing the patient for painful tingling in four digits of the hand

The nurse is planning care for a patient with hypertension and gout who has a red and painful right great toe. Which nursing action will be included in the plan of care? A.) Gently palpate the toe to assess swelling B.) Use pillows to keep the right foot elevated C.) Use a footboard to hold bedding away from the toe D.) Teach patient to avoid use of acetaminophen (Tylenol)

The nurse is providing care for a patient with a rotator cuff tear. What treatment does the nurse expect the health care provider will prescribe first for this patient? A.) Arthroscopic repair of the rotator cuff tear B.) Elimination of movements in the affected shoulder C.) Conservative therapies such as NSAIDS and physical therapy D.) Pendulum exercises that start slow and progress over 2 weeks

The nurse is teaching an older person about risks for fractures and osteoporosis. Which diagnostic test should the nurse teach about when the goal is to establish the patient's bone strength and determine if osteoporosis is present? A.) Computed tomography (CT) scan B.) Magnetic resonance imaging (MRI) scan C.) Dual energy x-ray absorptiometry (DXA or DEXA) scan D.) Joint x-rays

The nurse notices a circular lesion with a red border and clear center on the arm of an 18-year-old summer camp counselor who is in the camp clinic complaining of chills and muscle aches. Which action should the nurse take next? A.) Palpate the abdomen B.) Auscultate the heart sounds C.) Ask the patient about recent outdoor activities D.) Question the patient about immunization history

The nurse observes the unlicensed assistive personnel (UAP) performing all of these interventions for a patient with carpal tunnel syndrome (CTS). Which action requires that the nurse intervene immediately? A.) Arranging the patient's lunch tray and cutting his meat B.) Providing warm water and assisting the patient with his bath C.) Replacing the patient's splint in hyperextension position D.) Reminding the patient not to lift very heavy objects

The nurse should reposition the patient who has just had a laminectomy and discectomy by: A.) Instructing the patient to move the legs before turning the rest of the body B.) Having the patient turn by grasping the side rails and pulling the shoulders over C.) Placing the pillow between the patient's legs and turning the entire body as a unit D.) Turning the patient's head and shoulders first, followed by the hips, legs and feet

The nurse suspects a neurovascular problem based on assessment of: A.) Exaggerated strength with movement B.) Increase redness and heat below the injury C.) Decreased sensation distal to the fracture site D.) Purulent drainage at the site of an open fracture

The nurse will anticipate the need to teach a 57 year old patient who has osteoarthritis (OA) about which medication? A.) Adalimumab (Humira) B.) Prednisone (Deltasone) C.) Capsaicin cream (Zostrix) D.) Sulfasalazine (Azulfidine)

The second day after admission with a fractured pelvis, a 64-year-old patient suddenly develops confusion. Which action should the nurse take first? A.) Take the blood pressure B.) Assess patient orientation C.) Check the oxygen saturation D.) Observe for facial asymmetry

When a patient arrives in the emergency department with a facial fracture, which action will the nurse take first? A.) Assess for nasal bleeding and pain B.) Apply ice to the face to reduce swelling C.) Use a cervical collar to stabilize the spine D.) Check the patient's alertness and orientation

When giving home care instructions to a patient who has multiple forearm fractures and a long-arm cast on the right arm, which information should the nurse include? A.) Keep the hand immobile to prevent soft tissue swelling B.) Keep the right shoulder elevated on a pillow or cushion C.) Avoid the use of nonsteroidal anti-inflammatory drugs (NSAIDs) for the first 48 hours after the injury D.) Call the health care provider for increased swelling or numbness

When teaching seniors at a community recreation center, which information will the nurse include about ways to prevent fractures? A.) Tack down scatter rugs in the home B.) Most falls happen outside the home C.) Buy shoes that provide good support and are comfortable to wear D.) Range-of-motion exercises should be taught by a physical therapist

When the nurse brings medications to a patient with rheumatoid arthritis, the patient refuses the prescribed methotrexate (Rheumatrex). The patient tells the nurse, "My arthritis isn't that bad yet. The side effects of methotrexate are worse than the arthritis." The most appropriate response by the nurse is: A.) "You have the right to refuse to take the methotrexate." B.) "Methotrexate is less expensive than some of the newer drugs." C.) "It is important to start methotrexate early to decrease the extent of joint damage." D.) "Methotrexate is effective and has fewer side effects than some of the other drugs."

Which action with the urgent care nurse take when caring for a patient who has possible knee meniscus injury? A.) Encourage bed rest for 24 to 48 hours B.) Avoid palpation or movement of the knee C.) Apply a knee immobilizer to the affected leg D.) Administer intravenous narcotics for pain relief

Which discharge instruction will the emergency department nurse include for a patient with a sprained ankle? A.) Keep the ankle loosely wrapped with gauze B.) Apply a heating pad to reduce muscle spasms C.) Use pillows to elevate the ankle above the heart D.) Gently move the ankle through the range of motion

Which information obtained during the nurse's assessment of a 30 year old patient's nutritional-metabolic pattern may indicate the risk for musculoskeletal problems? A.) The patient takes a multivitamin daily B.) The patient dislikes fruits and vegetables C.) The patient is 5 ft 2 in and weighs 180 lb D.) The patient prefers whole milk to nonfat milk

Which information will the nurse include when teaching a patient with newly diagnosed chronic fatigue syndrome about self management? A.) Avoid use of over the counter antihistamines or decongestants B.) A low residue, low fiber diet will reduce any abdominal distension C.) A gradual increase in your daily exercise may help decrease fatigue D.) Chronic fatigue syndrome usually progresses as patient's become older

Which laboratory data is important to communicate to the health care provider for a patient who is taking methotrexate (Rheumatrex) to treat rheumatoid arthritis? A.) The blood glucose is 90 mg/dL B.) The rheumatoid factor is positive C.) The white blood cell (WBC) count is 1500/L D.) The erythrocyte sedimentation rate is elevated

Which laboratory result will the nurse monitor to determine whether prednisone (Deltasone) has been effective for a 30 year old patient with an acute exacerbation of rheumatoid arthritis? A.) Blood glucose test B.) Liver function tests C.) C-reactive protein level D.) Serum electrolyte levels

Which medication information will the nurse identify as a concern for a patient's musculoskeletal status? A.) The patient takes a daily multivitamin and calcium supplement B.) The patient takes hormone therapy (HT) to prevent "hot flashes." C.) The patient has severe asthma and requires frequent therapy with oral corticosteroids D.) The patient has migraine headaches treated with nonsteroidal antiinflammatory drugs (NSAIDs)

Which nursing action included in the care of a patient after laminectomy can the nurse delegate to experienced unlicensed assistive personnel (UAP)? A.) Check ability to plantar and dorsiflex the foot B.) Determine the patient's readiness to ambulate C.) Log roll the patient from side to side every 2 hours D.) Ask about pain control with the patient-controlled analgesia (PCA)

Which patient seen by the nurse in the outpatient clinic is most likely to require teaching about ways to reduce risk for osteoarthritis (OA)? A.) A 38 year old male who plays on a summer softball team B.) A 56 year old man who is a member of a construction crew C.) A 56 year old woman who works on an automotive assembly line D.) A 49 year old woman who is newly diagnosed with diabetes mellitus

Which statement by the patient indicates a good understanding of the nurse's teaching about a new short-arm plaster cast? A.) I can get the cast wet as long as I dry it right away with a hair dryer B.) I should avoid moving my fingers and elbow until the cast is removed C.) I will apply an ice pack to the cast over the fracture site off and on for 24 hours D.) I can use a cotton-tipped applicator to rub lotion on any dry areas under the cast

While obtaining subjective assessment data related to the 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

The following four patients arrive in the emergency department (ED) after a motor vehicle collision. In which order should the nurse assess them? A.) A 74-year-old with palpitations and chest pain B.) A 43-year-old complaining of 7/10 abdominal pain C.) A 21-year-old with multiple fractures of the face and jaw D.) A 37-year-old with a misaligned left leg with intact pulses

C, A, B, D

Emergency and ambulatory care nurses are among the first healthcare workers to encounter victims of a bioterroist attack. List in order of priority the actions that should be taken by ED staff in the event of a biochemical incident: A.) Report to the public health department or CDC per protocol B.) Decontaminate the affected individuals in a separate area C.) Protect the environment for the safety of personnel and non-affected clients D.) Don personal protective equipment E.) Perform triage according to protocol

C, D, B, E, A

In which order will the nurse take these actions when caring for a patient in the emergency department with a right leg fracture after a motor vehicle accident? A.) Obtain x-rays B.) Check pedal pulses C.) Assess lung sounds D.) Take blood pressure E.) Apply splint to the leg F.) Administer tetanus prophylaxis

C, D, B, E, A, F

The emergency department (ED) nurse is initiating therapeutic hypothermia in a patient who has been resuscitated after a cardiac arrest. Which actions in the hypothermia protocol can be delegated to an experienced licensed practical/vocational nurse (LPN/LVN) (select all that apply): Å.) Continuously monitor heart rhythm B.) Check neurologic status every 2 hours C.) Place cooling blankets above and below patient D.) Give acetaminophen (TYlenol) 650 mg per nasogastric tube E.) Insert rectal temperature probe and attach to cooling blanket control panel

C, D, E

Which information will the nurse include when teaching a patient with acute low back pain (select all that apply): A.) Sleep in a prone position with the legs extended B.) Keep the knees straight leaning forward to pick up C.) Avoid activities that require twistign of the back or prolonged sitting D.) Symptoms of acute low back pain frequently improve in a few weeks E.) Ibuprofen (Motrin, Advil) or acetaminophen (Tylenol) can be used to relieve pain

C, D, E

A 19-year-old is brought to the emergency department (ED) with multiple lacerations and tissue avulsion of the left hand. When asked about tetanus immunization, the patient denies having any previous vaccinations. The nurse will anticipate giving: A.) Tetanus immunoglobulin (TIG) only B.) TIG and tetanus-diphtheria toxoid (Td) C.) tetanus-diphtheria toxoid and pertussis vaccine (Tdap) only D.) TIG and tetanus-diphtheria toxoid and pertussis vaccine (Tdap)

A 25 year old female patient with systemic lupus erythematosus (SLE) who has a facial rash and alopecia tells the nurse, "I never leave my house because I hate the way I look." An appropriate nursing diagnosis for the patient is: A.) Activity intolerance related to fatigue and inactivity B.) Impaired social interaction related to lack of social skills C.) Impaired skin integrity related to itching and skin sloughing D.) Social isolation related to embarassment about the effects of SLE

A 48 year old patient with a comminuted fracture of the left femur has Bucks traction in place while waiting for surgery. To assess for pressure areas on the patients back and sacral area and to provide skin care, the nurse should: A.) Loosen the traction and help the patient turn onto the unaffected side B.) Place a pillow between the patient's legs and turn gently to each side C.) Turn the patient partially to each side with the assistance of another nurse D.) Have the patient lift the buttocks by bending and pushing with the right leg

A 54 year old patient arrives in the emergency department (ED) after exposure to powdered lime at work. Which action should the nurse take first? A.) Obtain the patient's vital signs B.) Obtain a baseline complete blood count C.) Decontaminate the patient by showering with water D.) Brush off any visible powder on the skin and clothing

A 54 year old woman who recently reached menopause and has a family history of osteoporosis is diagnosed with osteopenia following densitometry testing. In teaching the woman about her osteoporosis, the nurse explains that: A.) Estrogen replacement therapy must be started to prevent rapid progression to osteoporosis B.) Continuous, low-dose corticosteroid treatment is effective in stopping the course of osteoporosis C.) With a family history of osteoporosis, there is no way to prevent or slow gradual bone resorption D.) Calcium loss from bones can be slowed by increasing calcium intake and weight-bearing exercise

A 71 year old patient who takes multiple medications develops acute gouty arthritis. The nurse will consult with the health care provider before giving the prescribed dose of: A.) Sertraline (Zoloft) B.) Famotidine (Pepcid) C.) Oxycodone (Roxicodone) D.) Hydrochlorothiazide (HydroDIURIL)

A chemical explosion occurs at an nearly industrial site. The first responders report that victims are being decontaminated at the scene and approximately 125 wormers will need medical evaluation and care. The nurse receiving this report should know that this will first require activation of: A.) A code blue alert B.) A disaster medical assistance team C.) The local police and fire departments D.) The hospital's emergency response plan

A factory line worker has repetitive strain syndrome in the left elbow. The nurse will plan to teach the patient about: A.) Surgical options B.) Elbow injections C.) Wearing a left wrist splint D.) Modifying arm movements

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.) Remove the initial pressure dressing B.) Encourage use of cold therapy C.) Question whether the pain is real D.) Administer an antiepileptic 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 years B.) History of cancer C.) Previous joint replacement D.) Bronchitis 2 weeks ago

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 procedure begins" B.) "You will be inside a tube-like structure during the procedure" C.) "You will need to take radioactive precautions with your urine for 24 hours after the procedure" D.) "You will have to urinate just before the procedure"

A patient during a Mass Casualty Event has a blue tag. This means the patient: A.) Has a minor injury B.) Is dead C.) Has a life threatening injury D.) Is expected to die

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 on the affected ankle D.) Bearing weight on the affected leg for 6 weeks

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 is unable to tolerate prolonged immobilization B.) The patient cannot tolerate the surgery for a closed reduction C.) A temporary cast would be too unstable to provide normal mobility D.) Adequate alignment cannot be obtained by other nonsurgical methods

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.) Increased 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

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 principals 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

After change-of-shift report, which patient should the nurse assess first? A.) Patient with a Colles fracture who has right wrist swelling and deformity B.) Patient with a intracapsular left hip fracture whose leg is externally rotated C.) Patient with a repaired mandibular fracture who is complaining of facial pain D.) Patient with right femoral shaft fracture whose thigh is swollen and ecchymotic

After the nurse assesses a 78 year old who uses naproxen (Aleve) daily for hand and knee osteoarthritis management, which information is most important to report to the health care provider? A.) Knee crepitation is noted with normal knee range of motion B.) Patient reports embarrassment about having Heberden's nodes C.) Patient's knee pain while golfing has increased over the last year D.) Laboratory results indicate blood urea nitrogen (BUN) is elevated

Assessment of a male patient during the primary survey indicates delayed capillary refill of the extremities. He cannot explain the events before admission to the ED. Which action should the nurse take immediately? A.) Apply leads to the patient's chest to initiate ECG monitoring. B.) Insert one or two large-bore IV catheters to start IV fluid resuscitation. C.) Continue the primary survey to complete a brief neurologic examination. D.) Initiate pulse oximetry by placing a monitoring device on the patient's index finger.

Below is the condition that a current patient is in during a Disaster Situation: - Stability of Vital Functions => Stable - Life threat or organ threat => No - How soon treated => Could be delayed - Expected resource intensity => Low resource intensity => One simple diagnostic study(X-ray) and Simple procedure (Sutures) - Examples => Closed extremity trauma => Simple laceration => Cystitis What ESI score would you give the patient? A.) ESI-1 B.) ESI-2 C.) ESI-3 D.) ESI-4 E.) ESI-5

During morning care, a patient with a below the knee amputation asks the unlicensed assistive personnel (UAP) about protheses. How will the nurse instruct the UAP to respond? A.) "You should get a prosthesis so that you can walk again" B.) "Wait and ask your doctor that question the next time he comes in" C.) "It's too soon to be worrying about getting a prosthesis" D.) "I'll ask the nurse to come in and discuss this with you"

During the primary survey of a patient with severe leg trauma, the nurse observes that the patient's left pedal pulse is absent and the leg is swollen. Which action will the nurse take next? A.) Send blood to the lab for a complete blood count B.) Assess further for a cause of the decreased circulation C.) Finish the airway, breathing, circulation, disability survery D.) Start normal saline fluid infusion with a large-bore IV line

In teaching a patient with SLE about the disorder, the nurse knows that 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 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

The RN is mentoring a student nurse who is caring for a patient with carpal tunnel syndrome of the right hand with neurovascular check ordered every 2 hours. For which action by the student nurse must the RN interevene? A.) Student nurse checks the patient's radial pulse every 2 hours B.) Student nurse checks for sensation in the patient's right hand C.) Student nurse assesses color, temperature and pain in right wrist and hand D.) Student nurse instructs the patient to avoid movement because of the pain

The charge nurse is making assignments for the day shift. Which patient should be assigned to the nurse who was floated from the postanesthesia care unit (PACU) for the day? A.) A 35 year old patient with osteomyelitis who needs teaching before hyperbaric oxygen therapy B.) A 62 year old patient with osteomalacia who is being discharged to a long term care facility C.) A 68 year old with osteoporosis given a new orthotic device whose knowledge of its use must be assessed D.) A 72 year old patient with Paget disease who has just returned from surgery for total knee replacement

The day after a 60-year-old patient has an open reduction and internal fixation (ORIF) for an open, displaced tibial fracture, the priority nursing diagnosis is: A.) Activity intolerance related to deconditioning B.) Risk for constipation related to prolonged bed rest C.) Risk for impaired skin integrity related to immobility D.) Risk for infection related to disruption of skin integrity

The emergency department (ED) triage nurse is assessing four victims involved in a motor vehicle collision. Which patient has the highest priority for treatment? A.) A patient with no pedal pulses B.) A patient with an open femur fracture C.) A patient with bleeding facial lacerations D.) A patient with paradoxic chest movements

The home health nurse is doing a follow up visit to a 41 year old patient with recently diagnosed rheumatoid arthritis (RA). Which assessment made by the nurse indicates that more patient teaching is needed? A.) The patient takes a 2-hour nap each day B.) The patient has been taking 16 aspirins daily C.) The patient sits on a stool while preparing meals D.) The patient sleeps with two pillows under the head

The nurse finds that a patient can flex the arms when no resistance is applied but is unable to flex when the nurse applies light resistance. The nurse should document the patient's muscle strength as level: A.) 0 B.) 1 C.) 2 D.) 3

The nurse is caring for a patient who is to be discharged from the hospital 5 days after insertion of a femoral head prosthesis using a posterior approach. Which statement by the patient indicates a need for additional instruction? A.) I should not cross my legs while sitting B.) I will use a toilet elevator on the toilet seat C.) I will have someone else put on my shoes and socks D.) I can sleep in any position that is comfortable for me

The nurse is caring for a patient with osteoporosis who is at increased risk for falls. Which intervention should the nurse delegate to the unlicensed assistive personnel (UAP)? A.) Identifying environmental factors that increase risk for falls B.) Monitoring gait, balance and fatigue level with ambulation C.) Collaborating with the physical therapist to provide the patient with a walker D.) Assisting the patient with ambulation to the bathroom and in the halls

The nurse is preparing a patient for magnetic resonance imaging (MRI). Which action can the nurse delegate to the experienced unlicensed assistive personnel (UAP)? A.) Teach the patient what to expect during the test B.) Instruct the patient to remove metal objects including zippers C.) Witness that the patient has signed the consent form D.) Check and record preprocedure vital signs

The nurse suspects an ankle sprain when a patient at an urgent care center 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 gamr

The nurse teaching a support group of women with rheumatoid arthritis (RA) about how to manage activities of daily living suggests that they: A.) Stand rather than sit when performing household and yard chores B.) Strengthen small hand muscles by wringing sponges or washcloths C.) Protect the knee joints by sleeping with a small pillow under the knees D.) Avoid activities that require repetitive use of the same muscles and joints

The nurse who notes that a 59-year-old female patient has lost 1 inch in height over the past 2 years will plan to teach the patient about: A.) Discography studies B.) Myelographic testing C.) Magnetic resonance imaging (MRI) D.) Dual-energy x-ray absorptiometry (DXA)

The nurse will determine that more teaching is needed if a patient with discomfort from a bunion says, "I will A.) Give away my high-heeled shoes." B.) Take ibuprofen (Motrin) if I need it." C.) Use the bunion pad to cushion the area." D.) Only wear sandals, no closed-toe shoes."

To prevent muscle atrophy, the nurse teaches the patient with a leg immobilized in traction to perform (select all that apply): A.) Flexion contractions B.) Tetanic contractions C.) Isotonic contractions D.) Isometric contractions E.) Extension contractions

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

When rewarming a patient who arrived in the emergency department (ED) with a temperature of 87 F, which assessment indicates that the nurse should discontinue the rewarming? A.) A patient begins to shiver B.) The BP decreases to 86/42 mmHg C.) The patient develops atrial fibrillation D.) The core temperature is 94 F

Which action will the nurse include in the plan of care for a patient who has had a total right knee arthroplasty? A.) Avoid extension of the right knee beyond 120 degrees B.) Use a compression bandage to keep the right knee flexed C.) Teach about the need to avoid weight bearing for 4 weeks D.) Start progressive knee exercises to obtain 90-degree flexion

Which assessment finding for a patient who has had a surgical reduction of an open fracture of the right radius is most important to report to the health care provider? A.) Serous wound drainage B.) Right arm muscle spasms C.) Right arm pain with movement D.) Temperature 101.4 F

Which finding is of the highest priority when the nurse is planning care for a 77 year old patient seen in the outpatient clinic? A.) Symmetric joint swelling of fingers B.) Decreased right knee range of motion C.) Report of left hip aching when jogging D.) History of recent loss of balance and fall

Which menu choice by the patient with osteoporosis indicates that the nurse's teaching about appropriate diet has been effective? A.) Pancakes with syrup and bacon B.) Whole wheat toast and fresh fruit C.) Egg white omelet and a half grapefruit D.) Oatmeal with skim milk and fruit yogurt

Below is the condition that a current patient is in during a Disaster Situation: - Stability of Vital Functions => Stable - Life threat or organ threat => No - How soon treated => Could be delayed - Expected resource intensity => Low resource intensity => Examination only - Examples => Cold symptoms => Minor burn recheck => Prescription refill What ESI score would you give the patient? A.) ESI-1 B.) ESI-2 C.) ESI-3 D.) ESI-4 E.) ESI-5

You are working in a small rural community hospital. There is a fire in a local church, and six injured clients have arrived at the hospital. Many others are expected to arrive soon, and other hospitals are 5 hours away. Using disaster triage principles, place the following six clients in the order in which they should receive medical attention: A.) 52 y/o man in full cardiac arrest who has been receiving CPR continuously for the past 60 minutes B.) Firefighter who is showing combative behavior and has respiratory stridor C.) 60y/o woman with full-thickness burns to the hands and forearms D.) Teenager with a crushed leg that is very swollen who is anxious and has tachycardia E.) 3 y/o child with respiratory distress and burns over more than 70% of the anterior body F.) 12 y/o with wheezing and very labored respirations unrelieved by an asthma inhaler

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