Musculoskeletal

Réussis tes devoirs et examens dès maintenant avec Quizwiz!

Which diagnostic test would the nurse expect to be ordered for a client with lower extremity muscle weakness? Electromyograph (EMG) Biopsy Bone scan Arthrocentesis

Electromyograph (EMG)

A 35-year-old client is visiting a rheumatology group practice. The 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? Activity restrictions Dietary restrictions Loading-dose schedule Common adverse effects

Common adverse effects

A client is seen in the orthopedic clinic for complaints of severe pain in the left hip. After a series of diagnostic tests, the client is diagnosed with severe degenerative joint disease of the left hip and suggested to have the hip reconstructed. What procedure will the nurse schedule the client for? Closed reduction of the left hip. Left hip arthroplasty Left hip arthroscopy Open reduction and internal fixation of the left hip.

Left hip arthroplasty

The nurse teaches the client which intervention to avoid hip dislocation after replacement surgery? Bend forward only when seated in a chair Keep the knees together at all times Never cross the affected leg when seated Avoid placing a pillow between the legs when sleeping

Never cross the affected leg when seated

The nurse is caring for a client who had an amputation of the left leg above the knee. What position can the nurse place the client in several times per day to promote stump extension and prevent contractures? Left lateral Supine Right lateral Prone

Prone

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? Cartilage Ligament Tendon Joint

Tendon

A nurse is caring for a client placed in traction to treat a fractured femur. Which nursing intervention has the highest priority? Assessing the extremity for neurovascular integrity Keeping the ropes over the center of the pulley Keeping the client from sliding to the foot of the bed Ensuring that the weights hang free at all times

Assessing the extremity for neurovascular integrity

Which is an inaccurate principle of traction? The weights must hang freely. The client must be in good alignment in the center of the bed. The weights are not removed unless intermittent treatment is prescribed. Skeletal traction is interrupted to turn and reposition the client.

Skeletal traction is interrupted to turn and reposition the client.

A 19-year-old 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 you expect to be used? Russell traction Thomas splint Steinmann traction Buck's traction

Steinmann traction

A patient is undergoing diagnostic testing for suspected Paget's disease. What assessment finding is most consistent with this diagnosis? Altered serum sodium levels Altered serum magnesium levels Altered serum potassium levels Altered serum calcium levels

Altered serum calcium levels

Which term refers to the shaft of the long bone? Epiphysis Diaphysis Scoliosis Lordosis

Diaphysis

A client has a history of dislocations of the same joint. The nurse understands that this is most likely due to an insufficient deposit of collagen during the healing process leading to which of the following? Loss of function Reduced tensile strength Lack of mobility Allergic reaction

Reduced tensile strength

A client undergoes an invasive joint examination of the knee. The nurse would closely monitor the client for which of the following? Signs of shock Signs of depression Lack of sleep and appetite Serous drainage

Serous drainage

A client arrives in the emergency department with a suspected bone fracture of the right arm. How does the nurse expect the client to describe the pain? Similar to "muscle cramps" A dull, deep, boring ache Sore and aching Sharp and piercing

Sharp and piercing

Tendons are cordlike structures that attach muscles to the periosteum of the bone. Which is not true about tendons? One of the attachments is called the origin, and is more fixed. Tendons attach muscle to a bone in just one location. Tendons attach muscle to bone with two or more attachments. A second attachment is called the insertion, and is more movable.

Tendons attach muscle to a bone in just one location.

A client with rheumatoid arthritis comes into the clinic for a routine check-up. On assessment the nurse notes that the client appears to have lost some ability to function since the last office visit. What is the nurse's most appropriate action? Refer the client to a support group. Refer the client to social work. Arrange a family meeting in order to explore assisted living options. Arrange for the client to be assessed in her home environment.

Arrange for the client to be assessed in her home environment.

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." "CTS is a neuropathy that is characterized by bursitis and tendinitis." "CTS is a neuropathy that is characterized by flexion contracture of the fourth and fifth fingers." "CTS is a neuropathy that is characterized by pannus formation in the shoulder."

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

Which hormone inhibits bone reabsorption and increases calcium deposit in the bone? Sex hormones Growth hormone Calcitonin Vitamin D

Calcitonin

Which medication directly inhibits osteoclasts, thereby reducing bone loss and increasing BMD? Teriparatide (Forteo) Vitamin D Raloxifene (Evista) Calcitonin (Miacalcin)

Calcitonin

Which of the following inhibits bone resorption and promotes bone formation? Calcitonin Corticosteroids Parathyroid hormone Estrogen

Calcitonin

Which is an indicator of neurovascular compromise? Pain upon active stretch Diminished pain Capillary refill of more than 3 seconds Warm skin temperature

Capillary refill of more than 3 seconds

A client experienced an open fracture to the left femur during a horse-riding accident. For which complication is this client at highest risk? Complex regional pain syndrome Depression Malunion Infection

Infection

Which term refers to a fracture in which one side of a bone is broken and the other side is bent? Oblique Avulsion Spiral Greenstick

Greenstick

Which is useful in identifying acute or chronic tears of the joint capsule or supporting ligaments of the knee, shoulder, ankle, hip, or wrist? EMG Bone densitometry Arthrography Meniscography

Arthrography

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? Loose teeth Temporomandibular disorder Dislocated jaw Trigeminal neuralgia

Temporomandibular disorder

Which term refers to an injury to ligaments and other soft tissues surrounding a joint? Sprain Subluxation Strain Dislocation

Sprain

In chronic osteomyelitis, antibiotics are adjunctive therapy in which situation? Surgical debridement Wound packing Vitamin supplements Wound irrigation

Surgical debridement

A client is admitted to the unit in traction for a fractured proximal femur and requires traction prior to surgery. What is the most appropriate type of traction to apply to a fractured proximal femur? Buck's extension traction Dunlop traction Cervical halter Russell traction

Buck's extension traction

A client with a traumatic amputation of the right lower leg is refusing to look at the leg. Which action by the nurse is most appropriate? Provide wound care without discussing the amputation. Request a referral to occupational therapy. Encourage the client to perform range-of-motion (ROM) exercises to the right leg. Provide feedback on the client's strengths and available resources.

Provide feedback on the client's strengths and available resources.

What would not be included in client and family teaching after a musculoskeletal injury? Pursue any physical activities that are comfortable. Report excessive pain or throbbing, prolonged or fresh bleeding, swelling, skin color changes, decrease in sensation, or purulent drainage. Resume work and other activities per physician's orders. Resume bathing and activity as directed by physician.

Pursue any physical activities that are comfortable

A client presents at a clinic complaining of back pain that goes all the way down the back of the leg to the foot. The nurse should document the presence of what type of pain? Tendonitis Bursitis Sciatica Radiculopathy

Sciatica

The nurse teaches the client with a high risk for osteoporosis about risk-lowering strategies, including which action? Decrease the intake of vitamin A and D Increase fiber in the diet Walk or perform weight-bearing exercises outdoors Reduce stress

Walk or perform weight-bearing exercises outdoors

A client was brought to the emergency department after a fall. The client is taken to the operating room to receive a right hip prosthesis. In the immediate postoperative period, what health education should the nurse emphasize? "Try to lie as still as possible for the first few days." "Make sure you don't bring your knees close together." "Keep your legs higher than your chest whenever you can." "Try to avoid bending your knees until next week."

"Make sure you don't bring your knees close together."

A client is receiving treatment for rheumatoid arthritis but states that he is allergic to eggs. What medication would the client not be able to receive? Anakinra (Kineret) Methotrexate (Rheumatrex) Prednisone Synvisc

Synvisc

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? "After age 40, height may show a gradual decrease as a result of spinal compression" "There may be some slight discrepancy between the measuring tools used." "The posture begins to stoop after middle age." "After menopause, the body's bone density declines, resulting in a gradual loss of height."

"After menopause, the body's bone density declines, resulting in a gradual loss of height."

Patient education for musculoskeletal conditions for the aging is based on the understanding that there is a gradual loss of bone after a peak of bone mass at age: 40 years. 30 years. 50 years. 20 years.

30 years.

A nurse is caring for a client with a diagnosis of cancer that has metastasized. What laboratory value would the nurse expect to be elevated in this client? Potassium Alkaline phosphatase Creatinine Bilirubin

Alkaline phosphatase

Which of the following diagnostic studies are done to relieve joint pain due to effusion? Arthrocentesis Electromyography (EMG) Biopsy Bone scan

Arthrocentesis

A nurse is providing discharge teaching for a client who underwent foot surgery. The nurse is collaborating with the occupational therapist and discussing the use of assistive devices. On what variables does the choice of assistive devices primarily depend? Client's occupation, motivation, and age Client's general condition, strength, and gender Client's motivation, age, and weight-bearing prescription Client's general condition, balance, and weight-bearing prescription

Client's general condition, balance, and weight-bearing prescription

A client has a cast applied to the leg for treatment of a tibia fracture and also has a wound on the leg that requires dressing changes due to drainage. For what should the nurse prepare the client? Removal of the cast Insertion of an external fixator Cutting a cast window Cutting of a bivalve cast

Cutting a cast window

The nurse suspects "compartment syndrome" for a casted extremity. What characteristic symptoms would the nurse assess that would confirm these suspicions? (Select all that apply.) 2+ peripheral pulses in the affected distal pulse Excruciating pain Capillary refill less than 3 seconds Decreased sensory function Loss of motion

Decreased sensory function Excruciating pain Loss of motion

The nurse is reviewing the diagnostic test findings of a client with rheumatoid arthritis. What would the nurse expect to find? Elevated erythrocyte sedimentation rate Increased red blood cell count Increased C4 complement Increased albumin levels

Elevated erythrocyte sedimentation rate

A nurse is planning the care of an older adult client with osteomalacia. What action should the nurse recommend in order to promote vitamin D synthesis? Taking thyroid supplements as prescribed Performing cardiovascular exercise while avoiding weight-bearing exercises Ensuring adequate exposure to sunlight Eating a low-purine diet

Ensuring adequate exposure to sunlight

A client has sustained a long bone fracture and the nurse is preparing the client's care plan. Which of the following should the nurse include in the care plan? Administer vitamin D and calcium supplements as prescribed. Administer corticosteroids as prescribed. Perform passive range of motion exercises as tolerated. Monitor temperature and pulses of the affected extremity.

Monitor temperature and pulses of the affected extremity.

The nurse is caring for a client with an external fixator that requires pin care twice a day. The nurse observes that there is a new purulent drainage around one of the pins. What intervention should the nurse anticipate doing? Scrubbing the drainage from around the pin site Applying iodine-based solution Apply ointment to the pin site. Obtaining a culture

Obtaining a culture

A patient comes to the clinic and informs the nurse of numbness, tingling, and a burning sensation in the arm from the elbow down to the fingers. What type of symptom would this be documented as? Flaccidity Paresthesia Effusion Atonia

Paresthesia.

A client with metastatic bone cancer sustained a left hip fracture without injury. What type of fracture does the nurse understand occurs without trauma or fall? Pathologic fracture Compound fracture Transverse fracture Impacted fracture

Pathologic fracture

What nursing intervention should the nurse prioritize to facilitate healing in a client who has suffered a hip fracture? Administer analgesics as required. Encourage internal and external rotation of the affected leg. Maintain prone positioning at all times. Place a pillow between the client's legs when turning.

Place a pillow between the client's legs when turning.

A client is seen in the office for reports of joint pain, swelling, and a low-grade fever. What blood studies does the nurse know are consistent with a positive diagnosis of rheumatoid arthritis (RA)? Select all that apply. Positive antinuclear antibody (ANA) Positive C-reactive protein (CRP) Red blood cell (RBC) count of <4.0 million/mcL Red blood cell (RBC) count of >4.0 million/uL Aspartate aminotransferase (AST) and alanine transaminase (ALT) levels of 7 units/L

Positive C-reactive protein (CRP) Positive antinuclear antibody (ANA) Red blood cell (RBC) count of <4.0 million/mcL

A client's decreased mobility has been attributed to an autoimmune reaction originating in the synovial tissue, which caused the formation of pannus. This client has been diagnosed with what health problem? Osteoporosis Systemic lupus erythematosus Polymyositis Rheumatoid arthritis (RA

Rheumatoid arthritis (RA)

Skull sutures are an example of which type of joint? Diarthrosis Amphiarthrosis Aponeuroses Synarthrosis

Synarthrosis

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

The patient has rheumatoid arthritis.

Which is not one of the general nursing measures employed when caring for the client with a fracture? assisting with ADLs administering analgesics cranial nerve assessment providing comfort measures

cranial nerve assessment

The client with a fractured left humerus reports dyspnea and chest pain. Pulse oximetry is 88%. Temperature is 100.2 degrees Fahrenheit (38.5 degrees Centigrade); heart rate is 110 beats per minute; respiratory rate is 32 breaths per minute. The nurse suspects the client is experiencing: Delayed union Complex regional pain syndrome Fat embolism syndrome Compartment syndrome

Fat embolism syndrome

A client presents at a clinic reports heel pain that impairs walking ability. The client is subsequently diagnosed with plantar fasciitis. This client's plan of care should include what intervention? Wearing open-toed shoes at all times Applying topical analgesic ointment to plantar surface each morning Gently stretching the foot and the Achilles tendon Wrapping the affected area in lamb's wool or gauze to relieve pressure

Gently stretching the foot and the Achilles tendon

A 39-year-old softball player has been brought to the ED by his teammates. The client was fielding a fly ball, fell, and injured his hip. He cannot place weight on the leg and is in significant pain. After radiographs indicate intact yet malpositioned bones, what repair would you expect the physician to perform? Analgesia and immobilization Ice and immobilization Joint manipulation and immobilization Heat and immobilization

Joint manipulation and immobilization

An instructor is describing the process of bone development. Which of the following would the instructor describe as being responsible for the process of ossification? Osteoblasts Cancellous bone Cortical bone Osteoclasts

Osteoblasts

A client who has had an amputation is being cared for by a multidisciplinary rehabilitation team. What is the primary goal of this multidisciplinary team? Ensure that the client's health care is holistic Maximize the efficiency of care Promote the client's highest possible level of function Facilitate the client's adjustment to a new body image

Promote the client's highest possible level of function

Which of the following musculoskeletal injuries is manifested by acromioclavicular joint pain? Acute compartment syndrome Heterotopic ossification Rotator cuff tears Epicondylitis

Rotator cuff tears

The nurse is preparing to assess Phalen's sign. Which of the following would the nurse identify as indicative of a positive indicator for this sign? Percussion of the median nerve causes tingling and numbness. Wrist flexion for 30 seconds causes pain and numbness. Electrical stimulation shows a delay in motor responses. Shaking hands causes a reduction in the pain.

Wrist flexion for 30 seconds causes pain and numbness.

During the physical assessment of a client with a musculoskeletal disorder, which techniques would enable the nurse to determine the client's ability to exhibit fine motor skills? instructing the client to walk in a straight line asking the client to grasp objects palpating the client's muscles and joints instructing the client to stretch and flex muscles

asking the client to grasp objects

A nurse is assigned to support a patient while a cast is being applied to treat a greenstick fracture. The nurse documents that this fracture is classified as what type of fracture? Incomplete Stress Closed Compression

Incomplete

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 Imbalanced Fluid Volume Risk for Aspiration Risk for Falls Risk for Impaired Skin Integrity

Risk for impaired skin integrity

Which is not a guideline for avoiding hip dislocation after replacement surgery. The hip may be flexed to put on clothing such as pants, stockings, socks, or shoes. Never cross the legs when seated. Keep the knees apart at all times. Put a pillow between the legs when sleeping.

The hip may be flexed to put on clothing such as pants, stockings, socks, or shoes.

A nurse is planning the care of a client who has undergone orthopedic surgery. What main goal should guide the nurse's choice of interventions? Improving the client's level of function Helping the client come to terms with limitations Administering medications safely Improving the client's adherence to treatment

Improving the client's level of function

A client has come to the orthopedic clinic for a follow-up appointment 6 weeks after fracturing his ankle. Diagnostic imaging reveals that bone union is not taking place. What factor may have contributed to this complication? Inadequate immobilization Bleeding at the injury site Inadequate vitamin D intake Venous thromboembolism (VTE)

Inadequate immobilization

A client has severe osteoarthritis in the left hip and is having surgery to replace both articular surfaces of the hip. What type of surgical procedure will the nurse prepare the client for? Hemiarthroplasty Osteotomy Total arthroplasty Arthrodesis

Total arthroplasty

What is the term for a lateral curving of the spine? Lordosis Diaphysis Epiphysis Scoliosis

Scoliosis

A nurse is preparing to discharge a client from the emergency department after receiving treatment for an ankle sprain. While providing discharge education, the nurse should encourage what action? Maintain the ankle in a dependent position. Apply heat for the first 24 to 48 hours after the injury. Keep an elastic compression bandage on the ankle. Exercise hourly by performing rotation exercises of the ankle.

Keep an elastic compression bandage on the ankle.

A nurse is admitting a client to the unit who presented with a lower extremity fracture. What signs and symptoms would suggest to the nurse that the client may have a peroneal nerve injury? Pallor to the dorsal surface of the foot Visible cyanosis in the toes Inadequate capillary refill to the toes Numbness and burning of the foot

Numbness and burning of the foot

A client has a fracture that is being treated with open rigid compression plate fixation devices. What teaching will the nurse reinforce to the client about how the progress of bone healing will be monitored? The bone will heal on its own without intervention. The plate will be removed to determine if the bone is growing back. An arthroscopy will be performed. Serial x-rays will be taken.

Serial x-rays will be taken.

The emergency room nurse is reporting the location of a fracture to the client's primary care physician. When stating the location of the fracture on the long shaft of the femur, the nurse would be most correct to state which terminology locating the fractured site? The fracture is on the diaphysis. The fracture is on the tuberosity. The fracture is ventrally located. The fracture is on the epiphyses.

The fracture is on the diaphysis

A client had a total left hip arthroplasty. What clinical manifestation would indicate to the nurse that the prosthesis is dislocated? The client has discomfort when moving in bed. The left leg is internally rotated. There are diminished peripheral pulses on the affected extremity. The leg length is the same as the right leg.

The left leg is internally rotated.

A client with a fractured femur is in balanced suspension traction. The client needs to be repositioned toward the head of the bed. During repositioning, what should the nurse do? Maintain consistent traction tension while repositioning. Release the weights and replace them immediately after positioning. Place slight additional tension on the traction cords. Reposition the bed instead of repositioning the client.

Maintain consistent traction tension while repositioning.

A nurse is caring for an elderly female client with osteoporosis. When teaching the client, the nurse should include information about which major complication? Dowager's hump Loss of estrogen Bone fracture Negative calcium balance

Bone fracture

A client is experiencing symptoms that are suspected to be related to systemic lupus erythematosus. What cutaneous symptom occurs in about 50% of clients affected by this disease? Butterfly-shaped rash on the face over the bridge of the nose and cheeks Fluid-filled vesicles clustered on the cheeks, chin, and forehead Diffuse purplish lesions on the trunk Pustules scattered on the chest and back

Butterfly-shaped rash on the face over the bridge of the nose and cheeks

A 78-year-old client is in the emergency department following involvement in a motor-vehicle collision. Radiographs indicate a fractured humerus; the client is awaiting the casting of her upper extremity and admission to the orthopedic unit. What is the primary treatment for musculoskeletal trauma? Immobilization Enhancing complications External rotation Surgical repair

Immobilization

The nurse is performing an assessment on an older adult patient and observes the patient has an increased forward curvature of the thoracic spine. What does the nurse understand this common finding is known as? Lordosis Scoliosis Osteoporosis Kyphosis

Kyphosis

A client had a dislocated shoulder, and when healing, the client had insufficient deposits of collagen during the repair stage. What complication is the nurse aware can occur from this lack of collagen? Carpal tunnel syndrome Volkmann's contracture Recurrent dislocations Compartment syndrome

Recurrent dislocations

Which nursing intervention is essential in caring for a client with compartment syndrome? Wrapping the affected extremity with a compression dressing to help decrease the swelling Keeping the affected extremity below the level of the heart Starting an I.V. line in the affected extremity in anticipation of venogram studies Removing all external sources of pressure, such as clothing and jewelry

Removing all external sources of pressure, such as clothing and jewelry

A client with rheumatoid arthritis comes to the clinic reporting pain in the joint of his right great toe and is eventually diagnosed with gout. When planning teaching for this client, what management technique should the nurse emphasize? Restrict weight-bearing on right foot. Take OTC calcium supplements consistently. Ensure fluid intake of at least 4 L per day. Restrict consumption of foods high in purines.

Restrict consumption of foods high in purines.

A 91-year-old client is slated for orthopedic surgery and the nurse is integrated gerontologic considerations into the client's plan of care. What intervention is most justified in the care of this client? Use of a Foley catheter until discharge Use of a pressure-relieving mattress Total parenteral nutrition (TPN) Administration of prophylactic antibiotics

Use of a pressure-relieving mattress

A nurse is working with a client with rheumatic disease who is being treated with salicylate therapy. What statement would indicate that the client is experiencing adverse effects of this drug? "I feel so foggy in the mornings and it takes me so long to wake up." "I have this ringing in my ears that just won't go away." "When I eat a meal that's high in fat, I get really nauseous." "I seem to have lost my appetite, which is unusual for me."

"I have this ringing in my ears that just won't go away."

The client scheduled for a Syme amputation is concerned about the ability to eventually stand on the amputated extremity. How should the nurse best respond to the client's concern? "You likely will not be able to use this extremity but you will receive teaching on use of a wheelchair." "You will eventually be able to withstand full weight-bearing after the amputation." "You will be fitted for a prosthesis which may or may not allow you to walk." "You will have minimal weight-bearing on this extremity but you'll be taught how to use an assistive device."

"You will eventually be able to withstand full weight-bearing after the amputation."

A 78-year-old client is in the emergency department following a motor-vehicle collision. Radiographs indicate a fractured humerus; the client is awaiting the casting of her upper extremity and admission to the orthopedic unit. Other than her bone, what other physical structures could be affected by this injury? Blood vessels Nerves All options are correct Muscles

All options are correct

A client has a compound fracture of the right femur. Due to the nature of the fracture, open reduction will be used to align the femur. What other rationale requires the use of open reduction? Fracture involves several, small pieces of bone. Wound débridement is necessary. Fracture causes wide bone separation. All options are correct.

All options are correct

A client is admitted with acute osteomyelitis that developed after an open fracture of the right femur. When planning this client's care, the nurse should anticipate which measure? Instructing the client to ambulate twice daily Withholding all oral intake Administering large doses of oral antibiotics as ordered Administering large doses of I.V. antibiotics as ordered

Administering large doses of I.V. antibiotics as ordered

A client is experiencing muscle weakness in the upper extremities. The client raises an arm above the head but then loses the ability to maintain the position. Muscular dystrophy is suspected. Which diagnostic test would evaluate muscle weakness or deterioration? A serum calcium test An arthroscopy An electromyography A magnetic resonance imaging (MRI)

An electromyography

A nurse is caring for a client with Paget disease and is reviewing the client's most recent laboratory values. Which of the following values is most characteristic of Paget disease? An elevated serum alkaline phosphatase level and a normal serum calcium level An elevated level of parathyroid hormone and low calcitonin levels A low serum alkaline phosphatase level and a low serum calcium level An elevated calcitonin level and low levels of parathyroid hormone

An elevated serum alkaline phosphatase level and a normal serum calcium level

A client has undergone arthroscopy. After the procedure, the site where the arthroscope was inserted is covered with a bulky dressing. The client's entire leg is also elevated without flexing the knee. What is the appropriate nursing intervention required in caring for a client who has undergone arthroscopy? Assist with performing ROM exercises. Apply a cold pack at the insertion site. Apply warm compresses to the insertion site. Provide a gentle massage.

Apply a cold pack at the insertion site.

What is the priority intervention for a client who has been admitted repeatedly with attacks of gout? Insert a Foley catheter Place client on bed rest Assess diet and activity at home Increase fluids

Assess diet and activity at home

A client tells the nurse that he has pain and numbness to his thumb, first finger, and second finger of the right hand. The nurse discovers that the client is employed as an auto mechanic, and that the pain is increased while working. This may indicate that the client could possibly have what health problem? Carpel tunnel syndrome Dupuytren contracture Tendonitis Impingement syndrome

Carpal tunnel syndrome

A client arriving at the emergency department is diagnosed with a dislocation. Assessment would most likely reveal which of the following? Select all that apply. Swelling Complaint of a popping sound Area warm to touch Protrusion in the area of the dislocation Pain

Complaint of a popping sound Swelling Pain

Which general nursing measure is used for a client with a fracture reduction? Examine the abdomen for enlarged liver or spleen Promote intake of omega-3 fatty acids Encourage participation in ADLs Assist with intake of immune-enhancing tube feeding formulas

Encourage participation in ADLs

A client is diagnosed with a fracture of a diarthrosis joint. What is an example of this type of joint? Elbow Skull Fifth thoracic vertebrae Symphysis pubis

Elbow

A client is reporting pain following orthopedic surgery. Which intervention will help relieve pain? Breathe deeply and cough every 2 hours until ambulation is possible. Apply antiembolism stockings as indicated. Elevate the affected extremity and use cold applications. Do ROM exercises as indicated.

Elevate the affected extremity and use cold applications.

A client with polymyositis is experiencing challenges with activities of daily living as a result of proximal muscle weakness. What is the most appropriate nursing action? Administer skeletal muscle relaxants as prescribed Facilitate referrals to occupational and physical therapy Initiate a program of passive range of motion exercises Encourage a progressive program of weight-bearing exercise

Facilitate referrals to occupational and physical therapy

A patient has had a stroke and is unable to move the right upper and lower extremity. During assessment the nurse picks up the arm and it is limp and without tone. How would the nurse document this finding? Rigidity Flaccidity Tetanic Atonic

Flaccidity

Radiographic evaluation of a client's fracture reveals that a bone fragment has been driven into another bone fragment. The nurse identifies this as which type of fracture? Comminuted Impacted Compression Greenstick

Impacted

When assessing a client's peripheral nerve function, the nurse uses an instrument to prick the fat pad at the top of the client's small finger. This action will assess what nerve? Tibial Ulnar Radial Median

Ulnar

A client has Paget's disease. An appropriate nursing diagnosis for this client is: Fatigue Delayed wound healing Risk for infection Risk for falls

Risk for falls

A 45-year-old softball player arrives at the emergency department following his injury while sliding into a base during a game. After his examination and radiographs, the physician diagnoses muscle strain and prescribes appropriate treatment. What does the physician mean with the term "strain"? Stretched or pulled beyond capacity Injuries to ligaments surrounding a joint Subluxation of a joint Injury resulting from a blow or blunt trauma

Stretched or pulled beyond capacity

An adult is swinging a small child by the arms, and the child screams and grabs his left arm. It is determined in the emergency department that the radial head is partially dislocated. What is this partially dislocated radial head documented as? Compartment syndrome Subluxation Sprain Volkmann's contracture

Subluxation

A nurse practitioner assesses a patient's movement in his left hand after a cast is removed. The nurse asks the patient to turn his wrist so the palm of his hand is facing up. This movement is known as: Pronation. Extension. Supination. Eversion.

Supination.

A variety of complications can occur after a leg amputation. Which is not a possibility in the immediate postoperative period? hematoma osteomyelitis hemorrhage infection

osteomyelitis

The human body has 206 bones, which are classified into four categories. Which types of bones are located in the forearm? short bones flat bones irregular bones long bones

long bones

Nursing care for the client with fibromyalgia should be guided by the assumption that patients with fibromyalgia will eventually lose their ability to walk. may feel as if their symptoms are not taken seriously. rarely respond to treatment. all have the same type of symptoms.

may feel as if their symptoms are not taken seriously.

A client has had surgical repair of a hip injury after joint manipulation was unsuccessful. After surgery, the nurse implements measures to prevent complications. Which complications is the nurse seeking to prevent? Select all that apply. diarrhea pneumonia skin breakdown wound infection

skin breakdown wound infection pneumonia

An example of a flat bone is the sternum. metacarpals. vertebra. femur.

sternum.

A client with a lengthy history of degenerative joint disease is being seen by an orthopedic surgeon. What joints are most commonly replaced? Select all that apply. shoulder hip knee finger

hip knee

A client with a right tibial fracture is being discharged home after having a cast applied. What instruction should the nurse provide in relationship to the client's cast care? "Keep your right leg elevated above heart level." "A foul smell from the cast is normal after the first few days." "Use a clean object to scratch itches inside the cast." "Cover the cast with a blanket until the cast dries."

"Keep your right leg elevated above heart level."

A client is undergoing diagnostic testing to determine the etiology of recent joint pain. The client asks the nurse about the difference between osteoarthritis (OA) and rheumatoid arthritis (RA). What is the best response by the nurse? "OA and RA are very similar. OA affects the smaller joints such as the fingers, and RA affects the larger, weight-bearing joints like the knees." "OA originates with an infection. RA is a result of your body's cells attacking one another." "OA is associated with impaired immune function; RA is a consequence of physical damage." "OA is considered a noninflammatory joint disease. RA is characterized by inflamed, swollen joints."

"OA is considered a noninflammatory joint disease. RA is characterized by inflamed, swollen joints."

A client with SLE asks the nurse why she has to come to the office so often for "check-ups." What would be the nurse's best response? "Taking care of you in the best way involves monitoring your disease activity and how well the prescribed treatment is working." "Taking care of you in the best way involves seeing you face to face." "Taking care of you in the best way involves drawing blood work every month." "Taking care of you in the best way involves making sure you are taking your medication the way it is prescribed."

"Taking care of you in the best way involves monitoring your disease activity and how well the prescribed treatment is working."

An older adult client slipped on an area rug at home and fractured the left hip. The client is unable to have surgery immediately and is having severe pain. What interventions should the nurse provide for the patient to minimize energy loss in response to pain? Avoid administering too much medication because the client is older. Give pain medication to the client after providing care. Administer prescribed analgesics around-the-clock. Administer prescribed pain medication only when the client requests it.

Administer prescribed analgesics around-the-clock.

A group of students is reviewing information about cast composition in preparation for a discussion on the advantages and disadvantages of each. The students demonstrate understanding of the topic when they cite which of the following as an advantage of a plaster cast? Longer lasting More breathable Better molding to the client Quicker drying

Better molding to the client

A client has suffered a muscle strain and is reporting pain at 6 on a 10-point scale. The nurse should recommend what action? Performing passive ROM exercises Applying a heating pad to the affected muscle Taking an opioid analgesic as prescribed Applying a cold pack to the injured site

Applying a cold pack to the injured site

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? Arthroplasty Needle aspiration Arthroscopy Open reduction

Arthroscopy

A patient sustains a fracture of the arm. When does the nurse anticipate pendulum exercise should begin? In 2 to 3 weeks, when callus ossification prevents easy movements of bony fragments As soon as tolerated, after a reasonable period of immobilization In 2 to 3 months, after normal activities are resumed In about 4 to 5 weeks, after new bone is well established

As soon as tolerated, after a reasonable period of immobilization

An emergency department client is diagnosed with a hip dislocation. The client's family is relieved that the client has not suffered a hip fracture, but the nurse explains that this is still considered to be a medical emergency. What is the rationale for the nurse's statement? The client's pain will increase until the joint is realigned. Avascular necrosis may develop at the site if it is not promptly resolved. The longer the joint is displaced, the more difficult it is to get it back in place. Dislocation can become permanent if the process of bone remodeling begins.

Avascular necrosis may develop at the site if it is not promptly resolved.

A patient has stepped in a hole in the yard, causing an ankle injury. The ankle is edematous and painful to palpation. How long should the nurse inform the patient that the acute inflammatory stage will last? Less than 24 hours About 72 hours Between 24 and 48 hours At least 1 week

Between 24 and 48 hours

A clinic nurse is caring for a client with a history of osteoporosis. What diagnostic test will best allow the care team to assess the client's risk of fracture? Arthrography Bone densitometry Arthroscopy Bone scan

Bone densitometry

A nurse is performing a musculoskeletal assessment of a client with arthritis. During passive range-of-motion exercises, the nurse hears an audible grating sound. The nurse should document the presence of what assessment finding? Effusion Clonus Fasciculations Crepitus

Crepitus

What clinical manifestation would the nurse expect to find in a client who has had osteoporosis for several years? Diarrhea Decreased height Bone spurs Increased heel pain

Decreased height

A client has been diagnosed with temporomandibular disorder and has not been able to eat. What suggestion can the nurse make to modify the diet so that the client will be able to eat? Have the client placed on a liquid diet. Have the client's food pureed. Give the client clear liquids as well as intravenous fluids. Have the client eat soft rather than coarse food.

Have the client eat soft rather than coarse food.

Which factor inhibits fracture healing? Increased vitamin D and calcium in the diet Immobilization of the fracture Age of 35 years History of diabetes

History of diabetes

A client is being discharged from the hospital after being diagnosed with and treated for systemic lupus erythematosus (SLE). What would the nurse not say when teaching the client and family information about managing the disease? If you have problems with a medication, you may stop it until your next physician visit. Avoid sunlight and ultraviolet radiation. Pace activities. Maintain a well-balanced diet and increase fluid intake to raise energy levels and promote tissue healing.

If you have problems with a medication, you may stop it until your next physician visit.

A nurse is caring for a client who has suffered a hip fracture and who will require an extended hospital stay. The nurse should ensure that the client does what action to prevent common complications associated with a hip fracture? Increase fluid intake and perform prescribed foot exercises. Use supplementary oxygen when transferring or mobilizing. Remain on bed rest for 14 days or until instructed by the orthopedic surgeon. Avoid requesting analgesia unless pain becomes unbearable.

Increase fluid intake and perform prescribed foot exercises.

A nurse is performing the health history and physical assessment of a client who has a diagnosis of rheumatoid arthritis (RA). What assessment finding is most consistent with the clinical presentation of RA? Signs of systemic infection Joint stiffness, especially in the morning Visible atrophy of the knee and shoulder joints Cool joints with decreased range of motion

Joint stiffness, especially in the morning

After a traumatic back injury, a client requires skeletal traction. Which intervention takes priority? Monitoring the client for skin breakdown Maintaining traction continuously to ensure its effectiveness Restricting the client's fluid and fiber intake to reduce the movement required for bedpan use Supporting the traction weights with a chair or table to prevent accidental slippage

Maintaining traction continuously to ensure its effectiveness

During the assessment of a client scheduled for orthopedic surgery, the nurse discovers that the client was previously treated for the disorder. In such a case, what additional data need to be collected? Details of the medical team that handled the previous treatment Measures taken to minimize postoperative wound infection Occurrence of complications or problems during treatment Perception of the client about the previous treatment

Occurrence of complications or problems during treatment

A patient is diagnosed with osteomyelitis of the right leg. What signs and symptoms does the nurse recognize that are associated with this diagnosis? (Select all that apply.) Purulent drainage Fever Erythema Leukopenia Pain

Pain Erythema Fever

A client is taking ibuprofen for the treatment of osteoarthritis. What education will the nurse give the client about the medication? Take the medication on an empty stomach in order to increase effectiveness. Take the medication with food to avoid stomach upset. Since the medication is able to be obtained over the counter, it has few side effects. Inform the health care provider if there is ringing in the ears.

Take the medication with food to avoid stomach upset.

Which statement is accurate regarding care of a plaster cast? The cast can be dented while it is damp. The cast must be covered with a blanket to keep it moist during the first 24 hours. The cast will dry in about 12 hours. A dry plaster cast is dull and gray.

The cast can be dented while it is damp.

A client was seen in the clinic for musculoskeletal pain, fatigue, mood disorders, and sleep disturbances. The physician has diagnosed fibromyalgia. What would not be a part of teaching plan for this condition? applications of ice regular exercise and stress reduction encouraging the client to eat a healthy diet avoiding caffeine and alcohol

applications of ice

A client is being treated for hyperuricemia. Part of the treatment strategy is for the client to avoid contributing factors whenever possible. Which activities might bring on an acute attack? frequently ingesting salicylates eating organ meats and sardines frequently drinking coffee high carbohydrate intake

eating organ meats and sardines

Arthrodesis is: total reconstruction or replacement of a joint (most often the knee or hip) with an artificial joint to restore function and relieve pain. cutting and removal of a wedge of bone (most often the tibia or femur) to change the bone's alignment, thereby improving function and relieving pain. fusion of a joint (most often the wrist or knee) for stabilization and pain relief. replacement of one of the articular surfaces in a joint, such as the femoral head but not the acetabulum.

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


Ensembles d'études connexes

Business Management 1 Objective 3.00

View Set

Management of Patients with Structural, Infectious Inflammatory Cardiac Disorders (Chapter 28)

View Set

Patho Ch. 8 Disorders of fluid & electrolyte & acid base balance

View Set

Ch. 36 - Patients with Special Challenges

View Set

Organizational Dynamics Lesson Three Quiz answers

View Set