med surg quizzes

Postmenopausal women and the elderly need to consume approximately ____ mg of daily calcium.

1,200

A client's cast is removed. The client is worried because the skin appears mottled and is covered with a yellowish crust. What advice should the nurse give the client to address the skin problem?

Apply lotions and take warm baths or soaks.

The cornerstone of pharmacologic therapy for Paget's disease of the bone are ------------ because these medications stabilize the rapid bone turnover.

Bisphosphonates

T/F Casts made of plaster are preferred over fiberglass casts because they can dry in 15 minutes post-application.

False- fiberglass is preferred. 30 min

A patient is having low back pain. What position can the nurse suggest to relieve this discomfort?

Supine, with the knees slightly flexed and the head of the bed elevated 30 degrees- avoid a prone position

T/F? A second-degree strain occurs when a ligament is completely torn or ruptured.

false- third degree

opioid analgesic

fentanyl

A nurse advises a patient with a casted femur fracture to check for signs of a fat embolism. She tells the patient that the onset of symptoms for FES occur:

rapid-witin 12-48 hours

The anesthesiologist will use moderate (conscious) sedation during the client's surgical procedure. The circulating nurse will expect the client to:

respond verbally during procedure

Low back pain that radiates down the leg suggests the presence of nerve root involvement known as ---------

sciatica

fracture pain is:

sharp and peircing

The nurse is preparing a client to have his cast cut off after having it for 6 weeks to treat a fracture tibia. What should the nurse inform the client prior to the cast being removed?

skin may have yellowish crust but will disappear in a few days

3. The chest x-ray of a patient with fat embolism syndrome may show nothing of significance or there may be evidence of the classic --------.

snowstorm infiltrate

2. More than half of all women older than 50 years show evidence of osteopenia.

true

You are caring for a client 6 hours post surgery. You observe that the client voids urine frequently and in small amounts. You know that this most probably indicates what?

urine retention

A nurse is teaching a client with chronic bronchitis about breathing exercises. Which instruction should the nurse include in the teaching?

use diaphragmatic breathing

Which of the following may occur if a client experiences compartment syndrome in an upper extremity?

volkmanns contracture

A patient visits an orthopedic specialist because of pain that he feels beginning in his low back and radiating behind his right thigh and down below his right knee. The doctor suspects a diagnosis of sciatica. The nurse knows that the origin of the pain is between these intervertebral disks:

L4-L5 S1

4. To prevent dislocation of a hip prosthesis, a wedge pillow should be placed between the legs to prevent ------------ beyond the midline of the body.

adduction

The client who had spinal anesthesia complains of a headache. Which of the following is an inappropriate action by the nurse?

admin morphine -appropriate actions: keep HOB flat, quiet environment, hydrate patient

sometimes described as simply a "circular movement" because circumduction movements of (e.g. the arm and hand) result in the outer edge of the limb (e.g. the finger tips) tracing circles in space.

circumduction

2. A crumbling sensation (caused by the rubbing of bone fragments against each other), called ---------can be felt when gently palpating an extremity fracture

crepitus

Which of the following clinical manifestations would the nurse expect to find in a client who has had osteoporosis for several years?

decreased height

4. The patient with a clavicle fracture should be encouraged to elevate the affected arm above shoulder level after 72 hours to increase range-of-motion

false- immobilize

T/F? The nurse should recommend short periods of bed rest, in a prone position, for patients experiencing back pain resulting from a compression fracture.

false- mobilize as much as tolerated. sleep with knee flexed.

The patient in Buck's extension traction may be turned from side-to-side for back care every 4 hours.

false- will disturb the traction

a. Explain the rationale for the administration of ice for 48 hours followed by the application of heat.

heat therapy should not be used for the first 48 hours as this will have the opposite effect of cold therapy, instead apply R.I.C.E. Heat increases blood flow and relaxes muscles. Its good for easing tight muscles, but will only increase the pain and swelling in the first 48 hours after injury by accelerating metabolism -premature heat application may prolong inflammatory response (swelling)

4. Although pulmonary complications, fat emboli, thromboembolic complications, and infection are all possible complications of unstable pelvic fractures, the high mortality rate is primarily related to---------

hemorhage

When evaluating for hypovolemic shock, the nurse should be aware of which of the following clinical manifestations?

hypotension

low body temperature, shivering, chilling, and hypoxia

hypothermia

hematoma, hemorrhage, infection are all ---- post op complications.

immeadiate

Radiographic evaluation of a client's fracture reveals that a bone fragment has been driven into another bone fragment. The nurse identifies this as which type of fracture?

impacted

Syndrome is a general term that describes impaired movement of the rotator cuff of the shoulder.

impingment

A nurse suspects that a client with a recent fracture has compartment syndrome. Assessment findings may include:

inability to perform active movement, pain with passive

Which assessment finding would cause the nurse to suspect compartment syndrome in the client following a bone biopsy

increased calf diameter-bleeding into calf

is a forward rounding of the back -common in thoracic spine "C shaped" hunchback

kyphosis

age related change to musculoskeletal system

loss of bone mass

Which area of the spinal column is subject to the greatest mechanical stress and degenerative changes?

lower lumbar

3. The patient with an immobilized lower extremity (cast, splint, or brace) must be assessed for-----------nerve injury which can cause footdrop

peroneal

Which of the following would the nurse perform when assessing the ulnar nerve?

prick distal fat pad of small finger

The nurse is caring for a patient who had a total hip replacement. What lethal postoperative complication should the nurse closely monitor for?

pulmonary embolism- orthopedic patients are at increased risk post op

injury to ligament

sprain

injury when a muscle is stretched beyond its capacity

strain

2. The patient with a rotator cuff tear experiences pain and difficulty when performing activities that involve raising the arms about shoulder level.

true

3. With an open fracture, the wound should be covered with a sterile dressing and no attempt should be made to reduce the fracture.

true

5. Closed reduction is an acute care management intervention for a dislocated shoulder

true

A nurse should instruct a patient in a cast, splint, or brace to perform isometric exercises to prevent disuse syndrome.

true

Nursing assessment of the patient following the application of a body cast includes auscultation of bowel sounds every 4 to 8 hours.

true

Nursing care of a patient in skeletal traction requires inspection of the pin site at least every 8 hours for signs of inflammation and evidence of infection.

true

T/F Osteosarcoma is the most common, and most often fatal, primary malignant bone tumor

true

T/F?Over 50% of the cases of osteomyelitis are caused by Staphylococcus aureus and increasingly of the variety that is methicillin-resistant

true

When a person with a history of chronic alcoholism is admitted to the hospital for surgery, the nurse anticipates that the patient may show signs of alcohol withdrawal delirium during which time period?

up to 72 hours

5. Antibiotics are given prophylactically before total knee arthroplasty and continued for ________ hours postoperatively.

24

1. The treatment of contusions, strains, and sprains consists of intermittent application of moist or dry cold packs for up to ------ hours after injury.

72

Patients who have received corticosteroids preoperatively are at risk for which type of insufficiency?

adrenal

A client is scheduled for surgery to fuse a joint. The nurse identifies this as which of the following?

arthodensis

LOSS OF estrogen leads to a loss in bone ----

density

The nurse expects informed consent to be obtained for insertion of:

gastrostomy tube