Mobility

The nurse is providing instructions to the client who is being prepared for skeletal traction. Which statement by the client indicates teaching was effective?

"Metal pins will go through my skin to the bone."

A client is being prepared for a total hip arthroplasty, and the nurse is providing relevant education. The client is concerned about being on bed rest for several days after the surgery. The nurse should explain what expectation for activity following hip replacement?

"The physical therapist will likely help you get up using a walker the day after your surgery."

Which is an inappropriate use of traction?

Decrease space between opposing structures

Which term refers to a flexion deformity caused by a slowly progressive contracture of the palmar fascia?

Dupuytren's contracture

The nurse is assisting the client with multiple myeloma to ambulate. What is the most important nursing intervention to help prevent fractures in the client?

Promote safety.

The nurse has developed an evidence-based plan of care for a patient requiring rehabilitation after a total hip replacement. Ultimately, who should approve the plan of care?

The patient

A client in the emergency department is being treated for a wrist fracture. The client asks why a splint is being applied instead of a cast. What is the best response by the nurse?

"A splint is applied when more swelling is expected at the site of injury."

Which instruction should the nurse include when teaching the client following hip replacement surgery? (Select all that apply.)

"Avoid bending forward when sitting in a chair." "Place pillows between your legs when you lay on your side." "Use a raised toilet seat and high-seated chair."

A client diagnosed with carpal tunnel syndrome (CTS) asks the nurse about numbness in the fingers and pain in the wrist. What is the best response by the nurse?

"CTS is a neuropathy that is characterized by compression of the median nerve at the wrist."

A client undergoes a total hip replacement. Which statement made by the client indicates to the nurse that the client requires further teaching?

"I don't know if I'll be able to get off that low toilet seat at home by myself."

The nurse is admitting a client who is to undergo an open reduction with internal fixation for a fractured femur. About which comment by the client should the nurse be most concerned?

"I was worried I would have an incision and scar."

A client has sustained a right tibial fracture and has just had a cast applied. Which instruction should the nurse provide in client cast care?

"Keep your right leg elevated above heart level."

The nurse is assisting a patient with peripheral arterial disease to ambulate in the hallway. What should the nurse include in the education of the patient during ambulation?

"Walk to the point of pain, rest until the pain subsides, then resume ambulation."

An older adult with rheumatoid arthritis says exercise was not effective. Which response will the nurse make to learn the reason for the failure of this treatment approach?

"What types of exercise were you doing?"

The nurse is collaborating with the health care provider on a plan of care for a 54-year-old male client with osteomyelitis of the left femur secondary to uncontrolled type 1 diabetes.

*Perform neurovascular checks of lower extremities every 8 hours. *Administer IV antibiotic based on culture and sensitivity report. *Administer ibuprofen 400 mg orally three times daily, as needed for pain. *Make referral to dietitian to discuss nutrition for healing and blood glucose control. *Provide education on self-blood glucose monitoring and insulin administration.

An older adult patient had a hip replacement. When should the patient begin with assisted ambulation with a walker?

24 hours

The client displays manifestations of compartment syndrome. What treatment will the nurse expect the client to be scheduled for?

A fasciotomy

Which term refers to fixation or immobility of a joint?

Ankylosis

A nurse is caring for a client who is in skeletal traction. To prevent the complication of skin breakdown in a client with skeletal traction, what action should be included in the plan of care?

Assess the pin insertion site every 8 hours.

An elderly client is hospitalized for induction of chemotherapy to treat leukemia. The client reports fatigue to the nurse. What nursing intervention would best address the client's fatigue?

Assist the client to sit in a chair for meals.

The nurse is providing care for a client who had a biliopancreatic diversion with duodenal switch 2 days ago. How should the nurse best address the client's risk for postoperative venous thromboembolism?

Assist the client with ambulating as early and often as possible

Which of the following is the first-line medication that would be used to treat and prevent osteoporosis?

Bisphosphonates

Which hormone inhibits bone resorption and increases the deposit of calcium in the bone?

Calcitonin

The nurse is observing a client using a cane to ambulate. Which of the following would require the nurse to intervene?

Client moves the arm and leg on the same side together at the same time.

Two days after application of a cast to treat a fractured femur, the client reports severe, deep, and constant pain in the leg. What will the nurse suspect?

Compartment syndrome.

Which would be consistent as a component of self-care activities for the client with a cast?

Cushion rough edges of the cast with tape

The nurse in an orthopedic clinic is caring for a new client. What sign or symptom would lead a nurse to suspect that a client has a rotator cuff tear?

Difficulty lying on affected side

The health care provider is preparing to bivalve the client's cast. Which supplies should the nurse assemble?

Elastic compression bandages

A nurse is caring for a female client following a motor vehicle accident resulting in paraplegia. The client is ready for discharge to home with her husband, who states, "I'm scared to carry her because I'm afraid I'll either hurt my back or drop her." What information will the nurse give the husband during discharge teaching?

Ergonomic principles and body mechanics

A client is experiencing muscle weakness and an ataxic gait. The client has a diagnosis of multiple sclerosis (MS). Based on these symptoms, the nurse formulates "Impaired physical mobility" as one of the nursing diagnoses applicable to the client. What nursing intervention should be most appropriate to address the nursing diagnosis?

Help the client perform range-of-motion (ROM) exercises every 8 hours.

Which intervention should the nurse implement with the client who has undergone a hip replacement?

Instruct the client to avoid internal rotation of the leg.

Which of the following is the most common site of joint effusion?

Knee

The client presents with an exaggeration of the lumbar spine curve. How does the nurse interpret this finding?

Lordosis

An older adult client experienced a fall and required treatment for a fractured hip on the orthopedic unit. Which of the following are contributory factors to the incidence of falls and fractured hips among the older adult population? Select all that apply.

Loss of visual acuity Slowed reflexes Muscle weakness Adverse medication effects

The diagnosis of multiple sclerosis is based on which test?

Magnetic resonance imaging (MRI)

Which of the following is considered a central nervous system (CNS) disorder?

Multiple sclerosis

During a home visit, the nurse notes that a client with polymyositis has difficulty combing the hair and putting on socks and shoes. Which referrals will the nurse recommend for this client? Select all that apply.

Physical therapy Occupational therapy

The nurse is attempting to ambulate a client who underwent shoulder surgery earlier in the day, but the client is refusing to do so. What action by the nurse is most appropriate?

Reinforce the importance of early mobility in preventing complications.

A nurse is developing a plan of care for an 85-year-old woman who is bedridden following a stroke. Which of the following would the nurse be least likely to include in the plan of care for this patient to reduce her risk for pressure ulcers?

Repositioning the patient about once a shift

The nurse in collaboration with the rehabilitation team is working with a patient on performing therapeutic exercises. Which of the following would the nurse expect to encourage to increase the patient's muscle power?

Resistive exercises

A patient with amyotrophic lateral sclerosis (ALS) asks if the nurse has heard of a drug that will prolong the patient's life. The nurse knows that there is a medication that may prolong the life by 3 to 6 months. To which medication is the patient referring?

Riluzole

A nurse is planning the care of a client who will require a prolonged course of skeletal traction. When planning this client's care, the nurse should prioritize interventions related to what risk nursing diagnosis?

Risk for Impaired Skin Integrity

Which of the following musculoskeletal injuries is manifested by acromioclavicular joint pain?

Rotator cuff tears

An older adult client has a diagnosis of rheumatoid arthritis (RA) and has been achieving only modest relief with the use of nonsteroidal anti-inflammatory drugs (NSAIDs). When creating this client's plan of care, which nursing diagnosis would most likely be appropriate?

Self-care deficit related to fatigue and joint stiffness

In which position would a client undergoing a lumbar puncture be placed?

Side-lying, knees to chest

Which device is designed specifically to initially support and immobilize a body part in a desired position until swelling subsides?

Splint

The nurse is assessing the client for scoliosis. What will the nurse have the client do to perform the assessment?

Stand behind the client and ask the client to bend forward at the waist.

A client presents at the emergency department with a compound fracture of the right femur. Skeletal traction is applied to align the bones. What type of traction would be used?

Steinmann traction

A client with respiratory complications of multiple sclerosis (MS) is admitted to the medical-surgical unit. Which equipment is most important for the nurse to keep at the client's bedside?

Suction machine with catheters

A client's left leg is in skeletal traction with a Thomas leg splint and Pearson attachment. Which intervention should the nurse include in this client's care plan?

Teach the client how to prevent problems caused by immobility.

A client experiences a musculoskeletal injury that involves the structure that connects a muscle to the bone. The nurse understands that this injury involves which structure?

Tendon

A client is diagnosed with a first-degree strain of the left ankle related to running 5 miles daily. How would the nurse differentiate the first-degree strain from other strains and sprains?

The client has some edema of the left ankle with muscle spasms but is able to walk without assistive devices.

You are caring for a client who needs to ambulate. What considerations should be included when planning the postoperative ambulatory activities for the older adult?

Tolerance

The nurse is helping to set up Buck's traction on an orthopedic client. How often should the nurse assess circulation to the affected leg?

Within 30 minutes, then every 1 to 2 hours

The nurse is admitting an older adult to a skilled nursing facility. What assessment parameters will the nurse expect to find with the musculoskeletal assessment? Select all that apply.

decreased range of motion decreased endurance joint stiffness

The nurse is gathering a health history for a client with osteoarthritis. What clinical manifestation will the nurse expect to find?

early morning stiffness

Arthrodesis is:

fusion of a joint (most often the wrist or knee) for stabilization and pain relief.

Osteoarthritis is known as a disease that

is the most common and frequently disabling of joint disorders.

A client has an exaggerated convex curvature of the thoracic spine. What is this condition called?

kyphosis

A nurse is caring for an elderly female client with osteoporosis. When teaching the client, the nurse should include information about which major complication?

Bone fracture

Which of the following is an example of a gliding joint?

Carpal bones in the wrist

The nurse is assessing a client with a musculoskeletal system condition. Which statement indicates to the nurse that the client is experiencing bone pain?

"The pain feels deep in my legs and keeps me awake at night."

A client is admitted to the emergency room after being hit by a car while riding a bicycle. The client sustained a fracture of the left femur, and the bone is protruding through the skin. What type of fracture does the nurse recognize requires emergency intervention?

Compound

A client has a plaster cast applied to the left leg. Which comment by the client following the procedure should the nurse address first?

"My toes are stiff."

A client is undergoing rehabilitation following a stroke that left him with severe motor and sensory deficits. The client has been unable to ambulate since his accident, but has recently achieved the goals of sitting and standing balance. What is the client now able to use?

Parallel bars

A 55-year-old patient arrives at the operating room. The nurse is reviewing the medical record and notes that the patient has a history of osteoporosis in her lower back and hips. The patient is scheduled to receive epidural anesthesia. Which of the following nursing diagnoses would be a priority for this patient?

Risk for perioperative positioning injury related to operative position

Which device is designed specifically to support and immobilize a body part in a desired position?

splint

An example of a flat bone is the

sternum

The nurse is teaching a client with osteoarthritis about the disease. What is the most important client focus for disease management?

strategies for remaining active

A client with chronic kidney disease reports generalized bone pain and tenderness. Which assessment finding would alert the nurse to an increased potential for the development of spontaneous bone fractures?

Hyperphosphatemia

A nursing instructor is preparing a class on pressure ulcers. Which of the following would the instructor most likely include as a possible risk factor? Select all that apply.

Immobility Increased moisture Anemia

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

Increased diameter of the calf

A client with degenerative joint disease asks the nurse for suggestions to avoid unusual stress on the joints. Which suggestion would be most appropriate?

Maintain good posture.

The nurse is working with a client with systemic lupus erythematosus (SLE). What are the immune abnormalities characterized by SLE? Select all that apply.

autoantibodies immune complexes damage inflammation abnormal innate and adaptive immune responses susceptibility