MS EXAM 4 ATI BOOK, MEDSURG EXAM 4 TXTBK

A patient with osteoporosis shows an understanding of appropriate self-care when they state

"I should remove trip hazards such as throw rugs in my house to make it safer."

A nurse is teaching a client who has systemic lupus erythematosus (SLE) about self care. Which of the following statements by the client indicates an understanding of teaching?

"I should use a mild hair shampoo"

A patient with history of colon cancer is diagnosed with rib fractures, and the HCP orders a bone scan. The nurse determines the patient understands teaching about the purpose of the procedure when they state

"The bone scan will see if my colon cancer may have spread."

A nurse is teaching a client who has a new diagnosis of rheumatoid arthritis. Which of the following statements should the nurse include in the teaching?

"You can experience morning stiffness when you get out of bed"

Assessment findings that the nurse would expect in a patient with rheumatoid arthritis who has articular involvement include (select all that apply)

- metatarsal head dislocation in feet -morning stiffness lasting 60 minutes or more

A patient with osteoarthritis is scheduled for total hip arthroplasty. The nurse explains the purpose of this procedure is to (select all that apply)

- replace the joint. -improve or maintain ROM

A nurse is performing health screenings at a health fair. Which of the following clients have a risk factor of osteoporosis? (SATA)

-40 yr old client who has been taking prednisone for 4 months -45 yr old client who takes phenytoin for seizures -65 yr old client who has a sedentary lifestyle -70 ye old client who has smoked for 50 years

Which persons are at high risk for chronic low back pain? (select all that apply)

-A 63-year-old man who is a long-distance truck driver -A 30-year-old nurse who works on an orthopedic unit and smokes -A 55-year-old construction worker who is 6 ft, 2 in and weighs 250 lb -A 44-year-old female chef with prior compression fracture of the spine

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? (SATA)

-Apply heat to joints to alleviate pain -Reduce the amount of exercise done on days with increased pain -Active range of motion is more effective than passive

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 to the client to prevent future problems with low back pain? (SATA)

-Engage in regular exercise including walking -Create a smoking cessation plan -Wear low heeled shoes

A nurse is caring for a client who has rheumatoid arthritis. Which of the following laboratory tests are used to diagnose this disease? (SATA)

-Erythrocyte sedimentation rate (ESR) -Antinuclear antibody (ANA) titer -WBC count

A nurse is assessing a client who has osteoarthritis of the knees and fingers. Which of the following manifestations should the nurse expect to find? (SATA)

-Herberden's nodes -Enlarged joint size -Limp when walking

A nurse is teaching a client how to manage an external fixation device upon discharge. Which of the following statements by the client indicates understanding? (SATA)

-I will clean the pins more often if drainage from the pins increases -I will use a separate cotton swab for each pin -I will report loosening of the pins to my doctor -I will report increased redness at the pin sites

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? (SATA)

-Intense pain when the client's left foot is passively moved -Hard, swollen muscle in the client's left leg -Burning and tingling of the client's left foot

A patient with acute osteomyelitis is being discharged on antibiotic therapy. What would the nurse include in the teaching plan? (select all that apply)

-It is important to finish all the antibiotics even if you feel better. -You will need to schedule periodic through bone scans and ESR testing. -Signs such as fever and night sweats may be present but are usually not severe. -Contact the HCP if signs of infection such as pain and swelling at the site occur.

A nurse is admitting an adult client who has suspected osteoporosis. Which of the following findings are risk factors for osteoporosis? (SATA)

-Loss in height of 2 inches -BMI of 18 -Kyphotic curve at upper thoracic spine -History of lactose intolerance

A nurse is reviewing the plan of care for a client who has systemic lupus erythematosus (SLE). The client reports fatigue, joint tenderness, swelling, and difficulty urinating. Which of the following laboratory findings should the nurse anticipate?

-Postive ANA titer -2+ urine protein -Elevated BUN

A nurse is working in an outpatient clinic is assessing a client who has rheumatoid arthritis (RA). The client reports increased joint tenderness and swelling. Which of the following findings should the nurse expect? (SATA)

-Recent influenza -Decreased range of motion -Pain at rest

A nurse is planning discharge teaching on home safety for an adult client who has osteoporosis. Which of the following information should the nurse include in the teaching? (SATA)

-Remove throw rugs in walkways -Use prescribed assistive devices -Remove clutter from the environment -Maintain lighting of doorway areas

Teach the patient with fibromyalgia the importance of limiting intake of which foods? (select all that apply)

-Sugar -Alcohol -Caffeine

A nurse is discussing gout with a client who is concerned about developing the disorder. Which of the following findings should the nurse identify as risk factors for this disease? (SATA)

-diuretic use -obesity -cardiovascular disease

A patient who ran his first marathon had heel pain that would not resolve and was diagnosed with calcaneus stress fracture. The nurse will teach the patient to (select all that apply)

-rest and refrain from running. -wear a shoe heel pad when ambulating. -apply ice to the heel and take NSAIDs as directed by HCP.

A nurse is assessing a client who has a new diagnosis of systemic lupus erythematosus (SLE). Which of the following findings should the nurse expect?

Alopecia

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 embolus?

Altered mental status

A nurse is completing discharge teaching to a client who has a wound debridement for osteomyelitis. Which of the following information should the nurse include?

Antibiotic therapy should continue for 3 months

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?

Buck's traction

Which drug would the nurse prepare to administer to the patient with acute gout?

Colchicine

Which drug would the nurse plan to administer to the patient with Sjögren syndrome with the goal of improving symptoms of dry eyes?

Cyclosporine (Restasis)

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?

Kale

A nurse is caring for a client who has systemic lupus erythematosus (SLE) and is experiencing an episode of Raynaud's phenomenon. Which of the following findings should the nurse anticipate?

Pallor of toes with cold exposure

A nurse is providing care for a client who has a vertebroplasty of the thoracic spine. Which of the following actions should the nurse take?

Place the client in a supine position

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?

Put on gloves before applying the cream to other parts of the body

A nurse is caring for a client who received a lower back injury during a fall and describes sharp pain in the back and down the left leg. In which of the following positions should the nurse place the client to decrease pain?

Semi-Fowler's with a pillow under the knees

When caring for a patient after lumbar spinal surgery, the nurse would immediately report which finding to the HCP?

The patient has loss of sensation to the perineum, buttocks, inner thighs, and back of the legs.

A patient is scheduled for total ankle replacement. The nurse should tell the patient that after surgery he should avoid

bearing weight on the affected leg for 6 weeks.

The nurse would monitor a patient with a pelvic fracture for

changes in urine output.

The nurse suspects a neurovascular problem based on assessment of

decreased sensation distal to the fracture site.

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

formation of callus.

The nurse teaches the patient with an above-the-knee amputation that the residual limb should not be routinely elevated because this position promotes

hip flexion contracture.

In assessing the joints of a patient with osteoarthritis, the nurse understands that Heberden nodes

indicate osteophyte formation at the DIP joints.

The nurse provides counseling to a family of a patient with Duchenne muscular dystrophy with the knowledge that

only males can pass the gene to their offspring.

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

other nonsurgical methods cannot achieve adequate alignment.

A patient with a stable, closed humeral fracture has a temporary splint with bulky padding applied with an elastic bandage. The nurse suspects early compartment syndrome when the patient has

pain when passively extending the fingers.

The nurse should teach the patient with ankylosing spondylitis the importance of

regularly exercising and maintaining proper posture.

In teaching a patient with systemic lupus erythematosus about the disorder, the nurse knows the pathophysiology includes

the production of a variety of autoantibodies directed against components of the cell nucleus.

The nurse in urgent care suspects an ankle sprain when a patient describes

twisting his ankle while running bases during a baseball game.