MSK - CHAPER 35, 36 AND 37

a patient is having repeated tears of the joint capsule in the shoulder, and the primary provider prescribes an arthrogram. which intervention will the nurse provide after the procedure is completed? (select all that apply) a. apply a compression bandage to the area b. apply heat to the area for 48 hours c. administer mild analgesic d. inform the patient that a clicking or crackling noise in the joint may persist for a couple of days. e. actively exercise the area immediately after the procedure.

a. apply a compression bandage to the area c. administer mild analgesic d. inform the patient that a clicking or crackling noise in the joint may persist for a couple of days.

a patient sustains a fracture of the arm. when will the nurse inform the patient that pendulum exercises will begin? a. as soon as tolerated, after reasonable period of immobilization b. in 2 to 3 weeks, when callus ossification prevents easy movements of bony fragments c. in about 4 to 5 weeks, after new bone is well established. d. in 2 to 3 months, after normal activities are resumed.

a. as soon as tolerated, after reasonable period of immobilization

the nurse is caring for a patient with a pelvic fracture. which nursing assessments for a pelvic fracture will be included? (select all that apply) a. checking the urine for hematuria b. palpating peripheral pulses in both lower extremities c. testing the stool for occult blood d. assessing level of consciousness e. assessing pupillary response

a. checking the urine for hematuria b. palpating peripheral pulses in both lower extremities c. testing the stool for occult blood

a patient sustains an open fracture of the left arm after an accident at the roller-skating rink. which emergency management plans will be started for this patient? (select all that apply) a. cover the are with a clean dressing if fracture is open b. immobilized the affected size. c. splint the injured limb d. have the patient demonstrate mobility of the arm e. wrap the arm in a compression mobility of the arm.

a. cover the are with a clean dressing if fracture is open b. immobilized the affected size. c. splint the injured limb

a nurse is caring for a patient who has had an amputation. which intervention will the nurse provide to a foster a positive self-image? (select all that apply) a. encouraging the patient to care for the residual limb b. allowing the expression c. encourage the patient ton have family and friends view the residual limb to decrease self-consciousness d. encouraging family and friends to refrain from visiting temporarily because this may increase the patient's embarrassments e. introducing the patient to local amputee support groups

a. encouraging the patient to care for the residual limb b. allowing the expression e. introducing the patient to local amputee support groups

the nurse is caring for a patient with bone metastasis from a primary breast cancer. the patient reports muscle weakness and nausea and is voiding large amounts frequently. cardiac arrhythmia are observed on the telemetry monitor. which does the nurse suspect based on these clinical manifestations? a. hypercalcemia b. hypocalcemia c. hypokalemia d. hyperkalemia

a. hypercalcemia

a patient has suffered a femoral shaft fracture in an industrial injury. which is an immediate nursing concern for this patient? a. hypovolemic shock b. infection c. knee and hip dislocation d. pain resulting from muscle spasm

a. hypovolemic shock

the nurse is caring for a patient who sustained an open fracture of the right femur in an automobile crash. which is the most serious complication this patient will need to be monitored for? a. infection b. muscle atrophy caused by loss of supporting bone structure c. necrosis of adjacent soft tissue caused by blood loss d. nerve damage

a. infection

a patient is diagnosed with osteomyelitis of the right leg. which signs and symptoms does the nurse identify that are associated with this diagnosis? (select all that apply) a. pain in the right leg b. erythema of the right leg c. fever d. leukopenia e. purulent drainage

a. pain in the right leg b. erythema of the right leg c. fever

the nurse is performing an assessment for a patient who may have peripheral neurovascular dysfunction. which signs does the patient present with that indicate circulation is impaired? (select all that apply) a. pale cyanotic, or mottled color b. cool temperature of the extremity c. more than 3-second capillary refill d. tenting skin turgor e. limited range of motion

a. pale cyanotic, or mottled color b. cool temperature of the extremity c. more than 3-second capillary refill

a patient comes to the clinic and informs the nurse of numbness, tingling, and burning sensation in the arm from the elbow down to the fingers. which type of symptom would this be documented as? a. paresthesia b. flaccidity c. atonia d. effusion

a. paresthesia

a patient has a fracture of the right femur sustained in a motor vehicle crash. which process of fracture healing does the nurse determine will occur with this patient? a. reactive phase, reparative phase, remodeling phase b. primary phase, secondary phase, third phase c. first intention, secondary intention, third intention d. active phase, dormant phase, restructure phase

a. reactive phase, reparative phase, remodeling phase

a patient comes back to the clinic with continued reports of back pain. which time frame does the nurse identify as "chronic pain" a. 4 weeks b. 3 months c. 6 months d. 1 year

b. 3 months

a patient had an above-the-knee amputation of the left leg related to complications from peripheral vascular disease (PVD). the nurse enters the patient's room and observes the dressing and bed covers saturated with blood. which is the first action by the nurse? a. notify the health care provider b. apply a tourniquet c. use skin clips to close the wound d. reinforce the dressing

b. apply a tourniquet

a patient fell in a hole in the yard, causing an ankle injury. the ankle is edematous and painful to palpation. how long will the nurse inform the patient that the acute inflammatory stage will last? a. less than 24 hours b. between 24 and 48 hours c. about 72 hours d. at least 1 week

b. between 24 and 48 hours

a patient has been diagnosed with esteomalacia. which common symptoms does the nurse recognized with the diagnosis? a. bone fracture and kyphosis b. bone pain and tenderness c. muscle weakness and spasms d. softened and compressed vertebrae

b. bone pain and tenderness

the nurse is caring for a pregnant patient with pregnancy-induced hypertension. when assessing the reflexes in the ankle, the nurse observes rhythmic contractions of the muscle when dorsiflexing the foot. what would the nurse document this finding as? a. positive Babinski reflex b. clonus c. hypertrophyhy d. ankle reflex

b. clonus

a patient comes to the clinic reporting low back pain radiating down the left leg. after diagnostic studies rule out any pathology, the health care provider prescribes a serotonin-norepinephrine reuptake inhibitor (SNRI). which medication does the nurse educate the patient about? a. amitriptyline b. duloxetine c. gabapentin d. cyclobenzaprine

b. duloxetine

a patient had a stroke and is unable to move the right upper and lower extremities. during assessment, the nurse picks up the arm and finds it limp and without tone. how will the nurse document this finding? a. rigidity b. flaccidity c. atonic d. tetanic

b. flaccidity

while riding a bicycle on a narrow road, a patient was hit from behind and thrown into a ditch, sustaining a pelvic fracture. which complications does the nurse monitor for that are common with pelvic fracture? a. paresthesia and ischemia b. hemorrhage and shock c. paralytic ileus and a lacerated urethra d. thrombophlebitis and infection

b. hemorrhage and shock

the nurse is monitoring a patient who sustained an open fracture of the left hip. which type of shock will the nurse identify may occur with this type of injury? a. cardiogenic b. hypovolimic c. neurogenic d. septicemic

b. hypovolimic

a patient has a fracture treated with open rigid compression plate fixation devices. how will the progress of bone healing be monitored? a. remove the plate and determine if the bone is growing back b. perform serial x-rays c. perform an arthroscopy d. the bone will on its own without intervention

b. perform serial x-rays

the hospice nurse is assigned to care for a patient with metastatic bone cancer who wants to remain at home. which is the therapeutic goal in the care of this patient? a. prevent the patient from having to go to the hospital for care b. relieve pain and discomfort while promoting quality of life. c. increase the activity level of the patient to prevent complications related to immobility. d. ensure that the family accepts the patient's imminent death.

b. relieve pain and discomfort while promoting quality of life.

a patient reports experiencing low back pain. which position will the nurse suggest to relieve the discomfort? a. high fowler to allow for maximum hip flexion b. supine, with the knees slightly flexed and the head of the bed is elevated to 30 degrees c. prone, with pillow under the shoulders d. supine, with the bed flat and a firm mattress in place

b. supine, with the knees slightly flexed and the head of the bed is elevated to 30 degrees

the nurse educated a patient with low back pain about techniques to relieve the discomfort and prevent further complications. which statement by the patient demonstrates an understanding of the education the nurse provided? a. "I will lie prone with my legs slightly elevated b. "I will bend at the waist when I am lifting objects from the floor" c. "I will avoid prolonged sitting or walking" d. instead of turning around to grasp an object. I will twist at the waist"

c. "I will avoid prolonged sitting or walking"

a patient tells the nurse "i was working out and lifting weights and now that i have stopped, i am flabby and my muscles have gone!" which is the best response by the nurse? a. "while you are lifting weights, endorphins are released, creating increase in muscle mass, but if the muscles are not used, they will atrophy" b. "the muscle mass has decreased from the lack of calcium in the cells" c. "your muscles were in a state of hypertrophy from the weight lifting but it will persist only if the exercise is continued" d. "once you stop exercising, the contraction of the muscle does not regain its strength"

c. "your muscles were in a state of hypertrophy from the weight lifting but it will persist only if the exercise is continued"

a patient diagnosed with carpal tunnel syndrome (CTS) asks the nurse about numbness in the fingers and pain in the wrist. in responding to the patient, how would the nurse best describe CTS? a. CTS is a neuropathy that is characterized by bursitis and tendonitis b. CTS is a neuropathy that that is characterized by flexion contracture of the fourth and fifth fingers c. CTS is a neuropathy that is characterized by compression of the median nerve at the wrist d. CTS is a neuropathy that is characterized by pannus formation in the shoulders.

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

a patient sustains an open fracture with extensive soft tissue damage. the nurse identifies this fracture is classified as which grade? a. I b. II c. III d. IV

c. III

a patient is diagnosed with osteogenic sacroma which laboratory studies will the nurse monitor for the presence of elevation? a. magnesium level b. potassium level c. alkaline phosphatase d. troponin levels

c. alkaline phosphatase

a patient tells the health care provider about shoulder pain that is present even without any strenuous movement. the health care provider identifies a sac filled with synovial fluid. which condition will the nurse educate the patient about? a. a fracture of the clavicle b. osteoarthritis of the shoulder c. chronic bursitis d. ankylosing spondylitis

c. chronic bursitis

the nurse is assessing the feet of a patient and observes an overgrowth of the horny layer of the epidermis. which condition will the nurse educate the patient about? a. bunion b. clawfoot c. corn d. hammer toe

c. corn

a patient shows the nurse a round, form, module on the wrist. the pain is described as aching, with some weakness of the fingers. which treatment does the nurse assist with? (select all that apply) a. educate the patient on the use of gabapentin b. active range-of-motion exercises c. corticosteroid injections d. surgical excision e. aspiration of the cyst

c. corticosteroid injections d. surgical excision e. aspiration of the cyst

a patient was climbing a ladder, slipped on a rung, and fell on the right side of the chest. x-ray studies reveal three rib fractures, and the patient reports pain with inspiration. which is the priority intervention in the treatment of this patient a. chest strapping b. mechanical ventilation c. coughing and deep breathing with pillow splitting c. thoracentesis

c. coughing and deep breathing with pillow splitting

the nurse is educating the patient with low back pain about the proper way to lift objects. which muscle will the nurse encourage the patient to maximize? a. gastrocnemius b. latissmus dorsi c. quadriceps d. rectus abdominis

c. quadriceps

the nurse assesses soft subcutaneous nodules along the line of the tendons in a patient's hand and wrist. which does this finding indicate to the nurse? a. the patient has osteoarthritis b. the patient has lupus erythematosus c. the patient has rheumatoid arthritis d. the patient has neurofibromatosis

c. the patient has rheumatoid arthritis

after a bone density test, an older adult female patient tells the nurse "i don't understand why i have osteoporosis because i eat well and take my calcium." which is the best response by the nurse? a. "everyone gets osteoporosis and there is nothing you can do to prevent it" b. "men lose more bone mass that women but women still lose more" c. "in order to prevent bone loss, you will have to take hormones" d. "the loss is from withdrawal of estrogen and a decrease in activity levels"

d. "the loss is from withdrawal of estrogen and a decrease in activity levels"

the nurse is caring for a patient after arthroscopic surgery for a rotator cuff tear. the nurse informs the patient that full activity can usually resume after what period of time? a. 3 to 4 weeks b. 8 weeks c. 3 to 4 months d. 6 to 12 months

d. 6 to 12 months

a patient is scheduled for a procedure that will allow the primary provider to visualize the knee joint in order to diagnosed the patient's pain. which procedure will the nurse prepare the patient for? a. arthrocentesis b. bone scan c. electromyography d. arthroscopy

d. arthroscopy

a patient is sustained an open fracture of the femur 25 hours ago. while assessing the patient the nurse observes the patient is having difficulty breathing, and oxygen saturation decreases to 88% from a previous 99%. which complications of the fracture is the patient experiencing? a. spontaneous pneumothorax b. cardiac tamponade c. pneumonia d. fat emboli

d. fat emboli

the nurse is performing an assessment on an older adult patient and observes the patient has an increased forward curvature of the thoracic spine. which does the nurse identify this common finding as? a. lordosis b. scoliosis c. osteoporosis d. kyphosis

d. kyphosis

a patient had hand surgery to correct a dupuytren contracture. which nursing intervention is a priority postoperatively? a. changing the dressing b. applying a cook-up splint and immobilization c. having the patient exercise fingers to avoid fracture contractures d. performing hourly neurovascular assessments for the first 24 hours.

d. performing hourly neurovascular assessments for the first 24 hours.

a patient stepped in an acorn while walking barefoot in the backyard and developed an infection progressing to osteomyelitis. which microorganism does the nurse identify is most often the cause of the development of osteomyelitis? a proteus b. pseudomonas c. salmonella d. staphylococcus aerus

d. staphylococcus aureus

a patient falls while skiing and sustains an supracondylar fracture of the humerus. which serious complication of this injury should the nurse monitor for? a. hemarthrosis b. paresthesia c. malunion d. volkmarin ischemic contracture

d. volkmarin ischemic contracture