MLQ Ch 41
In chronic osteomyelitis, antibiotics are adjunctive therapy in which situation? A. Surgical debridement B. Wound irrigation C. Vitamin supplements D. Wound packing
A
Which client would the nurse identify as having the greatest risk for osteoporosis? A. A 20-year-old male athlete with repeated injuries B. A 40-year-old overweight African American woman C. A small-framed, thin 45-year-old white woman D. A 16-year-old male with a history of asthma
C
A nurse is planning discharge teaching regarding exercise for a client at risk for osteoporosis. Which exercise would the nurse be most likely to suggest? A. Yoga B. Bicycling C. Swimming D. Walking
D
The client diagnosed with osteosarcoma is scheduled for a surgical amputation. Which nursing diagnosis would be a priority for this client compared with other surgical clients? A. Disturbed body image B. Impaired physical mobility C. Risk for infection D. Inadequate nutrition
A
What food can the nurse suggest to the client at risk for osteoporosis? A. Broccoli B. Chicken C. Bananas D. Carrots
A
Which of the following is the most important nursing diagnosis for an elderly patient diagnosed with osteoporosis? A. Risk for injury related to fractures due to osteoporosis B. Deficient knowledge about osteoporosis and the treatment regimen C. Acute pain related to fracture and muscle spasm D. Risk for constipation related to immobility
A
The nurse is educating a client with low back pain on proper lifting techniques. The nurse recognizes that the education was effective when the client A. bends at the hips and tightens the abdominal muscles. B. reaches over the head with the arms fully extended. C. places the load close to the body. D. uses a narrow base of support.
C
Using proper body mechanics to lift objects is essential to prevent exacerbations of low back pain. Which of the following is the most important teaching point? A. Avoid lifting above waist level. B. Lift with the large leg muscles (quadriceps), not the back muscles. C. Limit time lifting up to reach something. D. Contract trunk muscles to stabilize the spine.
B
When describing malignant bone tumors to a group of students, which of the following would the instructor cite as the usual location? A. Wrist-hand junction B. Distal femur around the knee C. Proximal humerus D. Femur-hip area
B
The nurse is asked to explain to the client the age-related processes that contribute to bone loss and osteoporosis. What is the nurse's best response? A. Increase in calcitonin B. Increase of vitamin D C. Decrease in estrogen D. Decrease in parathyroid hormone
C
A client has been treated for migraine headaches for several months and comes to the clinic stating he is getting no better. The nurse is talking with the client and hears an audible click when the client is moving his jaw. What does the nurse suspect may be happening? A. Temporomandibular disorder B. Loose teeth C. Trigeminal neuralgia D. Dislocated jaw
A
Assessment of a client reveals signs and symptoms of Paget's disease. Which of the following would be most likely? A. Long bone bowing B. Waddling gait C. Lordosis D. Skull narrowing
A
A client has Paget's disease. An appropriate nursing diagnosis for this client is: A. Fatigue B. Risk for falls C. Risk for infection D. Delayed wound healing
B
A client with chronic osteomyelitis has undergone 6 weeks of antibiotic therapy. The wound appearance has not improved. What action would the nurse anticipate to promote healing? A. Wound packing B. Surgical debridement C. Vitamin supplements D. Wound irrigation
B
A high school student who was injured in a football game presents with knee pain with internal rotation of the foot. Which interventions are appropriate nursing actions? Select all that apply. A. Assist the client to "walk off" the pain. B. Apply ice packs to the affected knee. C. Apply a knee brace or wrap the affected knee. D. Administer morphine sulfate. E. Elevate the affected leg.
B, C, E
During a routine physical examination of a client, the nurse observes a flexion deformity of the proximal interphalangeal (PIP) joint of two toes on the right foot. How would the nurse document this finding? A. Hammer toe B. Bunion C. Mallet toe D. Hallux valgus
A
A nurse is caring for an elderly female client with osteoporosis. When teaching the client, the nurse should include information about which major complication? A. Loss of estrogen B. Bone fracture C. Negative calcium balance D. Dowager's hump
B
The nurse is caring for a client with a hip fracture. The physician orders the client to start taking a bisphosphonate. Which medication would the nurse document as given? A. Raloxifene B. Alendronate C. Denosumab D. Teriparatide
B
A nurse is caring for a client who's experiencing septic arthritis. This client has a history of immunosuppressive therapy and the immune system is currently depressed. Which assignment is the most appropriate for the nurse caring for this client? A. The nurse caring for this client is also caring for four other immunosuppressed clients on the medical floor. B. The nurse caring for this client is also caring for two other immunosuppressed clients on the medical intensive care unit. C. The nurse is caring for this client on the intensive care unit. D. The nurse caring for this client is also caring for four clients receiving chemotherapy for cancer treatment on the oncology floor.
C
A client has experienced increasing pain and progressing inflammation of the hands and feet. The rheumatologist has prescribed NSAID use to treat the condition. What client education is most important for the nurse to address with the use of these medications? A. common adverse effects B. dietary restrictions C. loading-dose schedule D. activity restrictions
A
Which medication directly inhibits osteoclasts, thereby reducing bone loss and increasing bone mass density (BMD)? A. Raloxifene B. Calcitonin C. Teriparatide D. Vitamin D
B
Which term refers to a flexion deformity caused by a slowly progressive contracture of the palmar fascia? A. Hammertoe B. Dupuytren's contracture C. Hallux valgus D. Callus
B
A client is diagnosed with carpal tunnel syndrome. Which assessment findings would the nurse expect? A. Pain radiating down the dorsal surface of the forearm B. A decrease in grasp strength C. Inability to flex index and middle fingers D. Tenderness in the affected wrist
C
A client with suspected osteomalacia has a fractured tibia and fibula. What test would give a definitive diagnosis of osteomalacia? A. Increased and decreased areas of bone metabolism B. Demineralization of the bone C. A bone biopsy D. Elevated levels of alkaline phosphatase
C
The nurse is assisting a client with removing shoes prior to an examination and observes that the client has a flexion deformity of several toes on both feet of the proximal interphalangeal (PIP) joints. What can the nurse encourage the client to do? A. Have surgery to fix them. B. Do active range of motion on the toes. C. Wear properly fitting shoes. D. Bind the toes so that they will straighten.
C
A patient is diagnosed with osteogenic sarcoma. What laboratory studies should the nurse monitor for the presence of elevation? A. Magnesium level B. Troponin levels C. Potassium level D. Alkaline phosphatase
D
Health education for a woman over age 50 includes providing information about the importance of adequate amounts of calcium and vitamin D to prevent osteoporosis. Select the daily dosage of calcium and vitamin D that the nurse should recommend. A. 1,800 mg; 1,600 IU B. 1,400 mg; 1,200 IU C. 1,600 mg; 1,400 IU D. 1,200 mg; 1,000 IU
D
What clinical manifestation would the nurse expect to find in a client who has had osteoporosis for several years? A. Bone spurs B. Diarrhea C. Increased heel pain D. Decreased height
D
Which of the following inhibits bone resorption and promotes bone formation? A. Corticosteroids B. Estrogen C. Parathyroid hormone D. Calcitonin
D
A nurse is caring for a client following foot surgery. Which nursing intervention is mostimportant for the nurse to include in the nursing care plan? A. Monitor vital signs every 4 hours. B. Administer pain medication per client request. C. Perform neuromuscular assessment every hour. D. Examine the surgical dressing every hour.
C
Morton neuroma is exhibited by which clinical manifestation? A. Diminishment of the longitudinal arch of the foot B. High arm and a fixed equinus deformity C. Inflammation of the foot-supporting fascia D. Swelling of the third (lateral) branch of the median plantar nerve
D
A client with Paget's disease comes to the hospital and reports difficulty urinating. The emergency department health care provider consults urology. What should the nurse suspect is the most likely cause of the client's urination problem? A. Renal calculi B. Dehydration C. Benign prostatic hyperplasia D. Urinary tract infection (UTI)
A
A home care nurse assesses for disease complications in a client with bone cancer. Which laboratory value may indicate the presence of a disease complication? A. Calcium level of 11.6 mg/dl B. Sodium level of 110 mEq/L C. Magnesium level of 0.9 mg/dl D. Potassium level of 6.3 mEq/L
A
A nurse is performing discharge teaching for an elderly client with osteoporosis. Which instruction about a calcium supplement should the nurse include? A. Take the supplement on an empty stomach with a full glass of water. B. Take the supplement with meals or with orange juice. C. Remain in an upright position 30 minutes after taking the supplement. D. Take weekly on the same day and at the same time.
B
The nurse is preparing a client for a surgical procedure that will allow visualization of the extent of joint damage of the knee for a client with rheumatoid arthritis and also obtain a sample of synovial fluid. What procedure will the nurse prepare the client for? A. Open reduction B. Arthroscopy C. Needle aspiration D. Arthroplasty
B
A nurse is teaching a client about preventing osteoporosis. Which teaching point is correct? A. Obtaining the recommended daily allowance of calcium requires taking a calcium supplement. B. To prevent fractures, the client should avoid strenuous exercise. C. The recommended daily allowance of calcium may be found in a wide variety of foods. D. Obtaining an X-ray of the bones every 3 years is recommended to detect bone loss.
C
A nurse is teaching a client who was recently diagnosed with carpal tunnel syndrome. Which statement should the nurse include? A. "Surgery is the only sure way to manage this condition." B. "Using arm splints will prevent hyperflexion of the wrist." C. "Ergonomic changes can be incorporated into your workday to reduce stress on your wrist." D. "This condition is associated with various sports."
C
In which deformity does the great toe deviate laterally? A. Hallux valgus B. Plantar fasciitis C. Pes cavus D. Hammertoe
A
While the nurse is performing a physical assessment, the client reports numbness, tingling, and pain when the nurse percusses lightly over the median nerve. What should this assessment indicate to the nurse? A. Carpal tunnel syndrome B. Impingement syndrome C. Dupuytren's contracture D. Morton's neuroma
A
A nurse is caring for a client with eczema. Which medication would be prescribed when an allergy is a factor causing the skin disorder? A. Chlorpheniramine B. Bupivacaine C. Dexamethasone D. Dicloxacillin
A
A nurse is planning discharge instructions for the client with osteomyelitis. What instructions should the nurse include in the discharge teaching? A. "You will receive IV antibiotics for 3 to 6 weeks." B. "Use your continuous passive motion machine for 2 hours each day." C. "You need to perform weight-bearing exercises twice a week." D. "You need to limit the amount of protein and calcium in your diet."
A
A patient is having low back pain. What position can the nurse suggest to relieve this discomfort? A. Supine, with the knees slightly flexed and the head of the bed elevated 30 degrees B. High-Fowler's to allow for maximum hip flexion C. Supine, with the bed flat and a firm mattress in place D. Prone, with a pillow under the shoulders
A
During a routine physical examination on an older female client, a nurse notes that the client is 5 feet, 3/8 inches (1.6 m) tall. The client states, "How is that possible? I was always 5 feet and 1/2? (1.7 m) tall." Which statement is the best response by the nurse? A. "The posture begins to stoop after middle age." B. "After age 40, height may show a gradual decrease as a result of spinal compression" C. "There may be some slight discrepancy between the measuring tools used." D. "After menopause, the body's bone density declines, resulting in a gradual loss of height."
D
The hospice nurse is assigned to care for a patient with metastatic bone cancer who wants to remain at home. What is the therapeutic goal in the care of this patient? A. Prevent the patient from having to go to the hospital for care. B. Ensure that the family accepts the patient's imminent death. C. Increase the activity level of the patient to prevent complications related to immobility. D. Relieve pain and discomfort while promoting quality of life.
D
