Musculoskeletal

The nurse is reinforcing teaching provided to a patient scheduled for an arthrocentesis. Which patient statement indicates understanding of the planned procedure?

"A needle will be used to draw off some fluid from my elbow."

An older adult visiting a wellness clinic reports joint stiffness in the morning. What should the nurse respond to this patient?

"As we age, the cartilage in joints gets rough, causing stiffness."

What client statement shows understanding of proper care of a left leg plaster cast?

"I need to avoid getting the cast wet"

A client has osteoporosis. Which statement by the client requires further instruction?

"I'm glad I can still drink as much coffee as I want."

The nurse is reinforcing teaching for a patient who has severe arthritis and is having an x-ray. Which patient statement indicates teaching has been effective?

"The table is hard and cold."

The nurse is caring for a patient scheduled for an arthrography. What should the nurse explain to the patient about pain expectations during the procedure?

"There is temporary pain during dye injection."

The nurse is collecting data for a patient who is reporting pain in the right hip. Which question should the nurse ask to determine the severity of the pain?

"What number rating would you give your pain on a scale from 0 to 10?"

The nurse caring for a client after a hip arthroplasty. What would be including in teaching?

Use a raised toilet seat

The nurse reinforces teaching on prevention of osteomyelitis with a patient who has an open fracture of the right leg. Which patient statement indicates that teaching has been effective?

Wash hands prior to touching fracture area.

The nurse is collecting data for a patient who is reporting pain in the left wrist. What question should the nurse use to address the region of the pain?

Where is the pain?

The nurse is reinforcing teaching provided to a patient for carpal tunnel syndrome treatment. Which patient statement indicates a correct understanding of the teaching?

Wrist splint.

The nurse is collecting data for a patient with osteoporosis. Which serum calcium result indicates the typical changes that occur in serum calcium levels with osteoporosis?

6.5 mg/dL

The nurse is assessing capillary refill time for a patient with a fractured tibia and fibula. Which refill time should the nurse report to the physician?

7 seconds

The nurse is instructing the client on how to stand on crutches. What is the correct placement?

8 inches to the front and side of the clients toes

The nurse is caring for a patient who has had a right hip replacement. For which position is the nurse attempting to achieve when a pillow is placed between the legs during turning?

Abduction of the thighs

A client has a fractured hip. What item does the nurse use to re position the client?

Abductor pillow

The mother of a 6-year-old child is concerned that the child is not going to be tall like other family members. What should the nurse explain as influencing the growth of bone? (Select all that apply.)

Adequate intake of vitamin D Production of growth hormone Adequate intake of vitamins A and C

A patient 48 hours after surgery for a fractured femoral shaft is experiencing mental confusion, tachycardia, tachypnea, and dyspnea. The patients blood pressure is elevated and petechiae are present on the chest. After reporting the findings to the RN what should the nurse do while awaiting the physicians specific orders? (Select all that apply.)

Administer oxygen. Prepare patient for arterial blood gas tests. Prepare patient for chest x-ray or lung scan. Maintain bedrest and keep movement to a minimum. Place patient in high Fowlers position or raise the head of the bed.

The nurse is caring for a patient in traction. Which actions are appropriate when caring for this patient? (Select all that apply.)

Allow weights to hang freely in place. Use assistance to reposition the patient in bed.

A client has a sprained ankle. What should the LPN instruct him to AVOID in the next 24 hours?

Applying a heating pad

An 87-year-old female with a history of osteoarthritis reports an average generalized pain score of 4 on a 0-to-10 scale while using acetaminophen prn. Which response about this pain level should the nurse make to the patient?

Are you satisfied with this level of pain control?

A patient with a fractured pelvis and a left acetabular fracture is prescribed bedrest. When the patient asks to toilet, which measure would be appropriate?

Ask patient to lift straight up using a trapeze mounted above the bed and slide a bedpan underneath from the right side.

Which is the highest priority assessment the nurse needs to monitor after knee arthroplasty?

Calf pain

A client in skeletal traction is complaining of leg pain. What is the nurses first action?

Check the clients alignment in bed

During a health history the nurse becomes concerned that a patient is at risk for developing osteoporosis. Which modifiable risk factors did the nurse use to come to this conclusion? (Select all that apply.)

Cigarette smoking Sedentary lifestyle Low calcium intake

A client is being treated for a fat embolism, What data indicates a favorable resolution?

Clear chest xray

The nurse, who is inspecting the knee of a patient who fell and reports stiffness, hears a grating sound with knee movement. How should the nurse document this finding?

Crepitus

The nurse is reinforcing teaching for a patient who has had a total hip replacement on correct sitting positions. Which position should the nurse teach the patient to avoid?

Crossing legs

Decribe three point crutch walking for a client with a LEFT leg cast.

Crutches and the left leg, then advance the right leg

A patient with a casted, fractured left leg asks why the leg has to be elevated. What should the nurse respond to this patient?

Decreases swelling.

The nurse is collecting data for a patients health history as part of the musculoskeletal system assessment. What should the nurse include when collecting this data? (Select all that apply.)

Diet history Occupation and activities Risk factors for musculoskeletal problems Family history of musculoskeletal problems

The nurse is collecting data for a patient who is reporting pain in the left knee. What question should the nurse ask to address radiation of the pain?

Does the pain move?

The nurse is caring for a patient who has a newly casted, fractured wrist. Data collection reveals slightly puffy fingers with good capillary refill. What should the nurse do now to prevent complications?

Elevate the cast on pillows.

A client has a new application of a plaster cast. What would help prevent compartment syndrome?

Elevate the limb and apply ice to the affected leg

The daughter of an older female patient with osteoporosis asks what she can do to prevent the development of the disorder as she ages. What should the nurse suggest to the daughter?

Engage in weight-bearing exercises.

The nurse is assisting in the development of an educational seminar on prevention of osteoporosis for a group of community members. Which actions should the nurse suggest be included in this presentation? (Select all that apply.)

Ensure an adequate intake of calcium each day Participate in weight-bearing exercise every day Wear well-supporting nonskid shoes at all times Consider participating in resistance exercise training

The nurse is monitoring a patient with a casted left tibial fracture and a contusion of the thigh. The patient reports increasing pain in the left foot that has not been relieved by morphine injections. What should the nurse do?

Ensure physician is immediately notified.

What is the LPN highest priority after a client had skeletal traction applied and pin insertion?

Ensure that the weights on the traction hang freely

The nurse observes a petechial rash and respiratory distress in a patient recovering from a fractured femur. What should these findings suggest to the nurse?

Fat embolism

The nurse is contributing to the plan of care for a patient recovering from total hip replacement. Which exercises should the nurse recommend to help prevent deep vein thrombosis (DVT) formation? (Select all that apply.)

Foot circles Heel pumping Quadriceps setting Straight leg raises (SLRs)

A patient with a 36-hour-old fractured femur is in traction and is prescribed morphine 10 mg every 3 hours as needed. The patient received a dose 3 hours ago and is now reporting a pain level of 8. The patient is stable. Which action should the nurse take?

Give pain medication as ordered.

A patient recovering from a biopsy of the right femur had pain medication 1 hour ago. Which symptom should the nurse report and closely monitor in this patient? (Select all that apply.)

Hematoma formation Pain reported as 7 on a 0-to-10 scale

The nurse is caring for a client with osteoporosis. Which one is not a risk factor?

High calcium diet

A patient is completing instructions about complications that can occur from osteoporosis. Which complication should the patient state as evidence that teaching has been effective?

Hip fracture.

The nurse sees a neighbor fall and fracture a leg. What should the nurse do first for the neighbor?

Immobilize the affected limb using minimal movement.

A nurse see's a client fall and suspects a leg fracture. What action is priority?

Immobilizing the leg before moving the client

A patient is experiencing a tendon that is torn from a moveable bone. What should the nurse observe when collecting data on the patients musculoskeletal system?

Inability to move the joint

The nurse is reviewing data collected during the health history for a patient with osteoporosis. What should the nurse identify as a risk factor for osteoporosis development?

Increased caffeine intake

A client with rib fractures needs a CXR (chest xray). How does the nurse describe this procedure?

It is necessary to remove jewelry and any other metal.

The nurse is reinforcing teaching provided to a patient recovering from right total hip replacement. Which patient statement indicates a correct understanding of the teaching?

Keep legs apart.

A client has a RIGHT leg skeletal traction. What area is at high risk for breakdown/pressure?

LEFT heel

The nurse is admitting an 88-year-old woman to an extended care facility. Which findings should the nurse consider as normal age-related changes of the patients musculoskeletal system? (Select all that apply.)

Limb weakness S-shaped curve to back. Mild pain experiencing in the hands during the morning hours

A patient is diagnosed with osteomyelitis of the right lower leg. What should the nurse expect to be prescribed for this patients care?

Long-term antibiotic therapy

A patient asks the difference between osteoarthritis and rheumatoid arthritis. What manifestations should the nurse explain are characteristic of rheumatoid arthritis? (Select all that apply.)

Low-grade fever Autoimmune disease Early morning stiffness Involvement of other major organs

The nurse is contributing to the plan of care for a patient who has a right fractured femur. What intervention should the nurse include in the plan of care to prevent fat emboli?

Maintain immobilization of the right leg.

A patient with diabetes mellitus is scheduled for an arthroscopy of the right knee at 0800. What should be included in nursing preoperative care for this patient? (Select all that apply.)

Maintaining NPO (nothing by mouth) status Obtaining blood glucose Witnessing signature on surgical consent

A client underwent a fasciotomy for compartment syndrome. What wound care will be ordered?

Moist sterile saline dressing

The nurse is caring for a patient who had a bone biopsy on the right leg. Which activity should the nurse implement?

Monitor site of biopsy for bleeding.

The client is using a cane for left sided weakness. What action should the nurse correct?

Moves the cane when the right leg is moved

A patient recovering from a bone biopsy of the left leg has pain unrelieved by morphine 5 mg intramuscularly given 1.5 hours ago. The morphine is prescribed for every 3 hours. What should the nurse do?

Notify charge nurse

A patient who has a displaced mid-shaft fracture of the left femur and is in balanced suspension skeletal traction with 35 pounds of weights is experiencing calf pain with right foot dorsiflexion. Which action should the nurse take?

Notify the RN.

The nurse checks a patients casted right leg resting upon a pillow and finds that the cast appears too tight. What should the nurse do?

Notify the RN.

A client has a newly casted arm for a fracture. What is an EARLY sign of compartment syndrome?

Numbness and tingling in the fingers

The nurse is contributing to the plan of care for a patient with Pagets disease. Which outcome should the nurse identify as being appropriate for this patient?

Pain is relieved at a satisfactory level.

The nurse is caring for a patient who had a closed reduction of the ulna with a cast applied. Later the patient reports left arm pain. What should the nurse do first?

Perform neurovascular check on fingers.

A patient has an open reduction of a radial fracture and is casted. Several hours after the operation, the patient reports a throbbing pain in the arm. What nursing action is essential for the nurse to take?

Perform neurovascular checks.

The nurse is collecting data from a patient suspected of developing a fat embolus from a fracture of the right femur. Which manifestations should the nurse expect? (Select all that apply.)

Petechiae Tachycardia Mental confusion

A client with fractures develops dyspnea, tachycardia, and confusion. What is the initial action?

Place the client in a fowlers position

Which intervention is contraindicated following a bone biopsy of the left arm?

Place the left arm in a dependent position for 24 hours

The nurse is checking a clients casted extremity. What sign is indicative of an infection?

Presence of a "hot spot" on the cast

The nurse is contributing to the plan of care for a patient who is scheduled for a below-the-knee amputation. What nursing diagnosis should be recommended for the preoperative plan of care?

anxiety

A patient was an unrestrained passenger in a motor vehicle accident and hit the windshield. The patients leg was also fractured. Which areas should be included in a patients neurovascular checks? (Select all that apply.)

Pulses Sensation Movement

What pin site finding would be of most concern to the nurse?

Purulent drainage

A client with a hip fracture is in Buck's traction. What is the primary function?

Reduces muscle spasm and provides fracture immobilization

The nurse is contributing to the plan of care for a patient who has a fractured hip and is placed in Bucks (boot) traction while awaiting surgery. What is the desired outcome for placing the patient in Bucks traction?

Relieve patient pain.

A patient in the ambulatory clinic is diagnosed with a muscle strain. What actions should the nurse instruct the patient to do to treat this injury? (Select all that apply.)

Rest the limb. Elevate the limb. Apply ice to the area. Wrap with an elastic bandage.

A client had surgery for carpal tunnel syndrome. Which should be AVOIDED by the client?

Start pronation and supination exercises 24 hours post op

The nurse is caring for a patient 1 hour after a diagnostic arthroscopy of the right knee. Which activity should the nurse implement?

Straight-leg raises

The nurse is reinforcing teaching on positioning for a patient after a right total knee replacement. Which patient statement indicates a correct understanding of the teaching?

Supine with pillow under right knee.

The nurse finds a 2-day postoperative patient who had a right total hip replacement lying supine with crossed legs. What data should the nurse collect on this patient?

The right leg for shortening

The nurse is contributing to the plan of care for a patient who has an upper extremity amputation. Why should the nurse keep in mind that this type of amputation can be more debilitating than a lower extremity amputation when planning care?

The upper extremity is more specialized.

The nurse is reinforcing teaching provided to a patient who is postmenopausal, has lost 2 inches of height, and has osteoporosis. Which patient statement indicates correct understanding of the purpose of calcium supplements?

To decrease bone loss

A patient with a neurological illness has lost the function of opposing muscle antagonists. What should the nurse expect to assess in this patient?

inability to maintain balance

A patient is diagnosed with fractured thoracic vertebrae from a motor vehicle crash. Which other structure should the nurse suspect may have been damaged during this accident?

ribs