ATI Musculoskeletal Quiz

A nurse is assessing a client who is 24 hour postop following an above the elbow amputatio. Which of the following findings should the nurse identify as the priority? A. Report of muscle spasms B. Inability to get dressed without assistance C. Report of feelings of anger D. Refusal to look at affected lim

A

A nurse is caring for a client who had a below the knee amputation for gangrene of the right foot. The client reports sensations of burning and crushing pain in the toes of the right foot. Which of the following statements should the nurse make? A. This type of pain usually decreases over time as the limb becomes less sensitive B. Try to look at the surgical wound as a rememeber the limb is gone C. Use a cold compress intermittently to decrease these pain sensations D. Grief over the lost limb can sometimes cause denial that the limb is really gone

A

A nurse is caring for a client who had a fiberglass cast placed on her left arm several hours ago and reports itching under the cast. Which of the following actions should the nurse plan to take? A. Use a hair dryer on a cool setting to blow air into the cast B. Ask the provider to bivalve the cast C.. Provide the client with a sterile cotton swab to rub the affected skin D. wrap the extremitiy with a dry heating pad

A

A nurse is assessing a client who is 48 hr postoperative following open reduction and internal fixation of a fractured tibia. Which of the following findings should the nurse report to the provider? A. Toes cold to the touch B. Serous drainage from pin sites C. Blanching of the toenail beds with pressuer D. Pink tissue around the fixator insertion sites

A The nurse should monitor for and report manifestations of compartment syndrome following internal fixation. Therefore, the nurse should contact the provider immediately if the client's toes are cold to the touch.

A nurse is providing discharge instructions for a client who is postoperative following inner maxillay fixation with wiring. Which of the following information should the nurse include? A. Cut the wiring if emesis occurs B. Consume three meals daily as part of low protein diet C. Swab the mouth with hydrogen peroxide if wiring produces oral irritation D. Resume a soft diet in 3-5 days

A. Inner maxillary fixation involves wiring of the teeth to support the fractured jaw by holding the jawbones together. The wires are left in place until the fracture is healed. To preserve the client's airway, the nurse should instruct the client to have wire cutters available to immediately cut wiring if emesis occurs. The client should return to the provider as soon as possible for re-wiring.

A nurse is caring for a client immediately following application of a plaster cast. The nurse should monitor for and report which of the following findings as an indication of compartment syndrome? A. Sensation of heat on the surface of the cast B. Paresthesias of extremity C. Pruritus of extremitiy D. Must odor noted

B

A nurse is caring for a client who is 3 days postop following total hip arthoplast. While transferring to a chair, the client cries in pain. The nurse should assess the client for which of the following manifestations of dislocation of the hip prosethsis? A. Bulging in the area over sugical incision B. Shortening of right leg C. sensation of warmth over site D. Pallor following elevation of leg

B

A nurse is caring for a client who has a pelvic fracture. The client reports sudden SOB, stabbing chest pain, and feelings of doom. The nurse should identify that the client is expierneicng which of the following complications? A. Pneumonia B. PE C. Tension pneumothorax D. TB

B Immobility following musculoskeletal trauma places the client at an increased risk for pulmonary embolus. The client might also exhibit tachycardia, chest petechiae, and have a decreased SaO2. The nurse should notify the rapid response team immediately.

A nurse is caring for a client who is in skeletal traction following a femur fracture. The nurse finds the client has slid down toward the foot of the bed and the traction weight is resting on the floor. Which of the following actions should the nurse take? A. Remove the weight temporarily to reposition the client the correct alingment in bed B. Have the client use a trapeze to pull himself up while ensuring the weight hangs freely C. Lift the rope off the pulley while the client rocks back and forth to reposition D. Lift the weight manually while another staff member moves the client up in bed

B The nurse should ensure that traction weight is hanging freely. The client can use an overhead trapeze bar to move up in bed, or the nurse can assist the client up, making sure to maintain proper alignment of the extremity.

A nurse in the ER is assessing a client who was in a motor-vehicle crash 2 days ago and sustained fractures to his tibia, ulna, and several ribs. The client is now disoriented to time and place, has a SaO2 of 87% and the nurse notes generalized petechiea on the clients skin. which of the following complications should the nurse expect? A) Hypovolemic shock (The nurse should suspect hypovolemic shock for a client who experiences hypotension following extreme fluid loss, as with uncontrolled bleeding, dehydration, or severe edema.) B) Fat embolism syndrome (The nurse should identify the triad of neurologic changes, petechial rash, and hypoxemia as findings of fat embolism syndrome. Risk factors include multiple fractures and fracture of a long bone. Male clients are also at greater risk. The manifestations occur when fat globules occlude small blood vessels.) C) Thrombophlebitis (The nurse should suspect thromboph

B) Fat embolism syndrome (The nurse should identify the triad of neurologic changes, petechial rash, and hypoxemia as findings of fat embolism syndrome. Risk factors include multiple fractures and fracture of a long bone. Male clients are also at greater risk. The manifestations occur when fat globules occlude small blood vessels.)

A nurse is caring for a client who is postop following shoulder surgery. The client has aprescription to keep the affected arm adducted. Which of the following instructios should the nurse provide the client? A. Keep your arm bent at the elbow B. Use a pillow to prop your shoulder up close to ear C. Hold your arm against the side of your body D. Position your arm with the shoulder at 90 degree

C

A nurse is caring for a client who is postop following a total knee arthroplasty and is prescribed a continous passive motion machine and PCA. The client tells the nurse, I am in so much pain.Which of the following actions should the nurse take first? A. Remind the client to push the button for the PCA device B. Discuss activites the client may use to distract from the pain C. Ask the client to describe the characterstics of the pain D. Pause the CPM machine brifly to apply a cold pack to knee

C Answering this item requires application of the nursing process priority-setting framework. The nurse can use the nursing process to plan client care and prioritize nursing actions. Each step of the nursing process builds on the previous step, beginning with assessment or data collection. Before the nurse can formulate a plan of action, implement a nursing intervention, or notify a provider of a change in the client's status, she must first collect adequate data from the client. Assessing or collecting additional data will provide the nurse with knowledge to make an appropriate decision. Therefore, the first action the nurse should take is to acquire further data by asking the client to describe the characteristics of the pain.

A nurse is performing medication reconcillation for a newly admitted client who has RA. Which of the following medications should the nurse identify as the treatment for this condition? A. Misoprostol B. Dantrolene C. Celecoxib D. Colchicine

C Celecoxib is a type of NSAID, called cyclooxygenase-2 (COX-2) inhibitors, used to relieve some of the manifestations caused by RA in adults. The nurse should identify that the medication is also prescribed for osteoarthritis, spondylitis, and painful menstruation.

A nurse is reviewing the medical record of a client who has a prescription for probenecid to treat gout. The nurse should identify that which of the following medications can interact with probenecid? A. Colchicine B. Naproxen C. Aspirin D. Prednison

C Aspirin can decreased the effectiveness of medication

A nurse is discussing the difference between RA and ostoarthritis with a newly licensed nurse. Which of the following information should the nurse include about osteoarthitis? A. Osteoarthitis is caused by autoimmune processes B. Osteoarhtitis leads to a decreased ESR C. Osteoarthisis affects other organs D. Osteoarhtis can impair a joint on asingle side of body

D

A nurse is discussing the plan of care with client who has osteomyelitis of an open wound on his heel. Which of the following information should the nurse include? A. You will need to apply a cold pack to the site three times a day B. Your provider might ask you to walk frequently to increased circulation to the area C. You will need to limit consuption of high protein foods D. Your provider might prescribe a central catheter line for long term antibiotic therapy

D

A nurse is reviewing the medical record of a female client. Which of the following findings should the nurse identify as a risk factor for osteoporosis? A. Decreased intake of phosphate containing foods B. Spending several hours in the sun daily C. Increased estrogen levels D. History of anorexia nervosa

D

A nurse in the ER is preparing to discharge a client following a grade 2 ankle sprain. Which of the following instructions should the nurse plan to give client? A. Perform passive range of motion exercises to ankle hourly B. Keep the affected extremity in a dependent position C. Wrap a loose dressing around the affected ankle D. Apply cold compresses to the extremity intermittently

D Cold minimizes swelling and erythema to the affected area. Therefore, the nurse should instruct the client to apply cold compresses for no more than 20 min at a time.

A nurse is teaching a client who has a new prescription for alendronate for treatment of osteoporosis. Which of the following statements by the client indicates understanding of the teaching? A. I will take the medication in the evening B. I will drink a full glass of milk with the medication C. I will take the medication at mealtime D. I will sit upright after taking medication

D A client taking alendronate should sit upright for 30 min after administration to prevent esophageal irritation and ulceration