Musculoskeletal Disorders

A client has been diagnosed with degenerative joint disease (osteoarthritis) of the left hip. Which factor in the client's history would most likely increase the joint symptoms of osteoarthritis? a long history of smoking excessive alcohol use obesity emotional stress

obesity

X-rays reveal a leg fracture in a client who was brought to the emergency department after falling on ice. After a cast is applied and allowed to dry, the nurse teaches the client how to use crutches. Which instruction should the nurse provide about climbing stairs? "Place both crutches on the first step and swing both legs upward to this step." "Place the unaffected leg on the first step, followed by the crutches and the injured leg, which should move together." "Place the crutches and injured leg on the first step, followed by the unaffected leg." "Place the injured leg and the crutch on the unaffected side on the first step; the unaffected leg and crutch on the injured side follow."

"Place the unaffected leg on the first step, followed by the crutches and the injured leg, which should move together."

A nurse is performing an admission assessment on a client admitted with a pelvic fracture. Which statement by the client requires the nurse to seek more information from a legal standpoint? "I'm so clumsy." "I'm afraid I'll lose my job because I'm going to miss so much work." "Sometimes my spouse gets so angry with me." "I'm going to need help at home after I'm discharged."

"Sometimes my spouse gets so angry with me."

The nurse is caring for a client who has been diagnosed with a strained ankle. The client asks the nurse what the difference is between a sprain and a strain. How should the nurse respond? "A strain is a milder form of injury compared to a sprain." "Sprains involve injury to the ligaments and strains to tendons or muscles." "Sprains are the results of repetitive use, while strains are from an acute injury." "A strain involves stretching of the tendons, and a sprain involves tearing of tendons."

"Sprains involve injury to the ligaments and strains to tendons or muscles."

A client who has just been diagnosed with mixed muscular dystrophy asks the nurse about the usual course of this disease. How should the nurse respond? "You should ask your physician about that." "The strength of your arms and pelvic muscles will decrease gradually, but this should cause only slight disability." "You may experience progressive deterioration in all voluntary muscles." "This form of muscular dystrophy is a relatively benign disease that progresses slowly."

"You may experience progressive deterioration in all voluntary muscles."

The nurse is caring for a client admitted for pneumonia with a history of hypertension and heart failure. The client has reported at least one fall in the last 3 months. The client may ambulate with assistance, has a saline lock in place, and has demonstrated appropriate use of the call light to request assistance. Using the Morse Fall Scale (see chart), what is this client's total score and risk level? 20, low risk 30, medium risk 40, medium risk 60, high risk

60, high risk

The nurse is teaching the client to prevent back injury. What should the nurse instruct the client to do? Pull objects rather than push them. Sleep on a soft mattress. Avoid prolonged sitting and standing. Sit in chairs with soft cushions.

Avoid prolonged sitting and standing.

A client has the leg immobilized in a long leg cast. Which finding indicates the beginning of circulatory impairment? inability to move toes cyanosis of toes sensation of cast tightness tingling of toes

tingling of toes

The nurse is planning care for a client with a femoral fracture who is in balanced suspension traction. Which nursing care can be included in the plan of care? using a fracture bedpan when the client uses the trapeze to raise the hips turning the client from side to side to give back care raising the head of the bed to 90 degrees to sit the client up giving the client a complete bed bath

using a fracture bedpan when the client uses the trapeze to raise the hips

The client with an above-the-knee amputation is to be fitted with a functioning prosthesis. The nurse has been teaching the client how to care for the residual limb. Which behavior would demonstrate that the client understands proper residual limb care? applies powder to the residual limb inspects the residual limb weekly with a mirror removes the prosthesis whenever he sits down washes and dries the residual limb daily

washes and dries the residual limb daily

A woman of African descent is admitted to the hospital after sustaining a hip fracture. The client is 5 feet, 4 inches (163 cm) tall and weighs 96 lb (44 kg). The client has five children and reports that they "just stepped forward and fell." The results of the client's bone density tests indicate they have osteoporosis. What is a risk factor for osteoporosis for this client? race weight parity balance

weight

A client is recovering from an attack of gout. Client teaching should include the need to lose weight because weight loss will reduce purine levels. weight loss will reduce inflammation. weight loss will increase uric acid levels and reduce stress on joints. weight loss will reduce uric acid levels and reduce stress on joints.

weight loss will reduce uric acid levels and reduce stress on joints.

A male client underwent a lumbar spinal fusion yesterday. Which nursing assessment should alert the nurse to the development of a possible complication? lateral rotation of the head and neck clear yellowish fluid on the dressing use of the standing position to void nonproductive cough

clear yellowish fluid on the dressing

The nurse has instructed the client about the correct positioning of the leg and hip following hip replacement surgery. Which statement indicates that the client has understood these instructions? "I may cross my legs as long as I keep my knees extended." "I should avoid bending over to tie my shoes." "I can sit in any chair that I find comfortable." "I should avoid any unnecessary walking for about 3 months after my surgery."

"I should avoid bending over to tie my shoes."

A client undergoes an arthroscopy at the outpatient clinic. After the procedure, the nurse provides discharge teaching. Which response by the client indicates the need for further teaching? "Elevating my leg will reduce swelling after the procedure." "My physician may prescribe pain pills after the procedure." "I should use my heating pad this evening to reduce some of the pain in my knee." "I may notice some bruising or swelling in my knee."

"I should use my heating pad this evening to reduce some of the pain in my knee."

A client has sustained a right tibial fracture and has just had a cast applied. Which instruction should the nurse provide concerning cast care? "Cover the cast with a blanket until the cast dries." "Keep your right leg elevated above heart level." "Use a knitting needle to scratch itches inside the cast." "A foul smell from the cast is normal."

"Keep your right leg elevated above heart level."

A client with osteoarthritis tells the nurse they are concerned that the disease will prevent them from doing their chores. Which suggestion should the nurse offer? "Do all your chores in the morning, when pain and stiffness are least pronounced." "Do all your chores after performing morning exercises to loosen up." "Pace yourself and rest frequently, especially after activities." "Do all your chores in the evening, when pain and stiffness are least pronounced."

"Pace yourself and rest frequently, especially after activities."

The client returns from surgery for a below-the-knee amputation with the residual limb covered with dressings and a woven elastic bandage. At first, the bandage was dry. Now, 30 minutes later, the nurse notices a small amount of bloody drainage. What should the nurse do first? Notify the health care provider. Mark the area of drainage. Change the dressing. Reinforce the dressing.

Mark the area of drainage.

After a person experiences a closure of the epiphyses, which statement is true? The bone grows in length but not thickness. The bone increases in thickness and is remodeled. Both bone length and thickness continue to increase. No further increase in bone length occurs.

No further increase in bone length occurs.

On the evening of surgery for a total knee replacement, a client wants to get out of bed. What should the nurse do to safely assist the client? Encourage the client to apply full weight bearing. Ask the health care provider (HCP) to prescribe a walker for the client. Place a straight-backed chair at the foot of the bed. Apply a knee immobilizer.

Apply a knee immobilizer.

A client has a fiberglass cast on the right arm which was placed after internal fixation 1 week ago. The nurse notes a warm area on the cast. What priority action should the nurse take? Apply an ice pack to the warm area of the cast. Ask the client if the cast has gotten wet recently. Elevate the casted arm above the level of the heart. Assess client's temperature and interview about pain at the site.

Assess client's temperature and interview about pain at the site.

The nurse is caring for a client with a spinal cord injury. The client is experiencing blurred vision and has a blood pressure of 204/102 mm Hg. What should the nurse do first? Position the client on the left side. Control the environment by turning the lights off and decreasing stimulation for the client. Check the client's bladder for distention. Administer pain medications.

Check the client's bladder for distention.

A client who has had an above-the-knee amputation develops a dime-sized bright red spot on the dressing after 45 minutes in the postanesthesia recovery unit. What should the nurse do first? Elevate the stump. Reinforce the dressing. Call the surgeon. Draw a mark around the site.

Draw a mark around the site.

A client with osteoarthritis asks for information concerning activity and exercise. When assisting the client, which concept should be included? The time of day when exercise is performed isn't important. Exercising in the evening before going to bed is beneficial. Exercising immediately upon awakening allows the client to participate in activities when they have the greatest amount of energy. Exercising at least 1 hour after awakening allows the client to participate in exercise after some of the morning-related stiffness has subsided.

Exercising at least 1 hour after awakening allows the client to participate in exercise after some of the morning-related stiffness has subsided.

The nurse is going to lunch and is conducting a "hand-off of care" to the charge nurse. Which information should the nurse communicate to the charge nurse during the hand-off of care communication? Tell the charge nurse that the nurse is going to lunch. Verify that the charge nurse has assigned someone else to take care of the client. Give the charge nurse information about what care should be given while the nurse is at lunch. Remind the charge nurse about the client's history and current medications.

Give the charge nurse information about what care should be given while the nurse is at lunch.

What should the nurse do to protect a client's skin under a back brace? Place padding as necessary for a snug fit. Have the client wear a close-fitting thin cotton shirt under the back brace. Lubricate the areas where the client's back brace will contact skin surfaces. Apply powder to the areas where the client's back brace will contact skin surfaces.

Have the client wear a close-fitting thin cotton shirt under the back brace.

To reduce the incidence of complications in a client in traction, which intervention should be included in the care plan? Remove the weights during linen changes. Increase calorie intake. Reduce fluid intake. Increase fiber intake.

Increase fiber intake.

The nurse is evaluating the outcome of therapy for a client with osteoarthritis. Which finding indicates the goals of therapy have been met? Joint degeneration has been arrested. The client is able to self-administer gold compound safely. The client feels better than on hospital admission. Joint range of motion has improved.

Joint range of motion has improved.

The nurse is developing a teaching plan with a client with osteoporosis. Which information should be included in the plan? Select all that apply. Maintain a diet with adequate amounts of vitamin D. Choose calcium-rich foods. Use alcohol in moderation. Swim to maintain bone mass. Avoid high-fat foods.

Maintain a diet with adequate amounts of vitamin D. Choose calcium-rich foods. Use alcohol in moderation.

A client with a broken ulna reports having pain in the casted arm that is unrelieved by pain medication. The nurse assesses the arm and notes that the fingers are swollen and difficult to separate. After reviewing the health care provider's prescriptions, what should the nurse do first? Administer morphine 2 mg intravenously. Apply an ice bag to the fingers to relieve pain. Elevate the arm on two pillows, and reassess in 30 minutes. Notify the health care provider (HCP) about the swelling and pain.

Notify the health care provider (HCP) about the swelling and pain.

The nurse has positioned a client in balanced skeletal traction. What should the nurse do to ensure the traction is effective? Observe that the traction weights hang freely from the bed at all times. Increase the traction weight gradually as the client's tolerance increases. Apply and remove the traction weights at regular intervals throughout the day. Remove the weights briefly as necessary to reposition the client in bed.

Observe that the traction weights hang freely from the bed at all times.

A client is brought to the emergency department after injuring their right arm in a bicycle accident. The orthopedic surgeon tells the nurse that the client has a greenstick fracture of the arm. What does this mean? The fracture line extends through the entire bone substance. The fracture results from an underlying bone disorder. Bone fragments are separated at the fracture line. One side of the bone is broken and the other side is bent.

One side of the bone is broken and the other side is bent.

Which goal is the priority for a client with a fractured femur who is in traction? Prevent effects of immobility while in traction. Develop skills to cope with prolonged immobility. Choose appropriate diversional activities during the prolonged recover. Adapt to inactivity from the impaired mobility.

Prevent effects of immobility while in traction.

A client is in balanced suspension traction to maintain alignment of a fractured tibia. Which activity is safe for the client? Eat while lying flat. Raise the hips using a trapeze. Rotate from side to side. Flex and extend the ankle on the affected side.

Raise the hips using a trapeze.

A middle-age female client has been diagnosed with rheumatoid arthritis. When conducting a health assessment, the nurse notes that the client has bilateral inflamed finger joints with pain, warmth, and limited motion. Although they have pain, the client says they are most concerned about their ability to care for their children and home because of their fatigue. Based on these data, which would be the priority for planning care for this client? managing the pain caused by the inflammation in the fingers establishing a positive body image caring for their children resting to relieve fatigue

caring for their children

The school nurse is planning an educational session to prevent injuries in children with juvenile arthritis. Which information should the nurse include in the teaching? Encourage participation in group sports to enhance growth and development of muscles and bones. Reduce unnecessary activity and walking by homeschooling the child with the disorder. Encourage the child with the disorder to run and play as able to expend energy and strengthen muscles. Schedule the completion of daily range-of-motion exercises to support joint mobility.

Schedule the completion of daily range-of-motion exercises to support joint mobility.

The nurse is caring for a client with acute osteomyelitis in the right tibia. Which action is best when repositioning the client's leg? Hold the leg by the ankle when repositioning to avoid touching the tibia. Have the client move the leg by themself to decrease pain. Support the leg above and below the affected area when positioning. Apply warm, moist compresses to the leg before repositioning.

Support the leg above and below the affected area when positioning.

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? Apply the traction straps snugly. Assess the client's level of consciousness. Remove the traction at least every 8 hours. Teach the client how to prevent problems caused by immobility.

Teach the client how to prevent problems caused by immobility.

Unlicensed assistive personnel (UAP) are helping a client who had knee surgery 2 days ago get into bed. As the nurse makes rounds, which information requires the nurse to intervene? The call light is pinned to the head of the bed in the client's reach. The night light is dimmed, giving low-level lighting to the room. There is a clear path to the bathroom. The side rails on the head and foot of the bed are in the up position.

The side rails on the head and foot of the bed are in the up position.

The nurse is caring for a client with a fractured fibula who has skeletal traction and skeletal pins. What would the nurse instruct the unlicensed assistive personnel (UAP) to report immediately? The client is reporting pain and muscle spasm. The traction weights are resting on the floor. The client wants to change position. There is a small amount of clear fluid at the pin sites.

The traction weights are resting on the floor.

A pediatric client has just had a plaster cast placed on their lower left leg. Which action should the nurse take to provide safe cast care? Petal the cast as soon as it is put on. Keep the child in the same position for 24 hours until the cast is dry. Use only the palms of the hand when handling the cast. Notify the health care provider (HCP) if the client feels heat.

Use only the palms of the hand when handling the cast.

When the client who has had a hip replacement is lying on the side, the nurse should place pillows or an abductor splint between the legs to prevent: flexion of the knees. abduction of the thighs. adduction of the hip joint. hyperextension of the knees.

adduction of the hip joint.

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? administering large doses of oral antibiotics as ordered instructing the client to ambulate twice daily withholding all oral intake administering large doses of I.V. antibiotics as ordered

administering large doses of I.V. antibiotics as ordered

A nurse is teaching a client with a long leg cast how to use crutches properly while descending a staircase. The nurse should tell the client to transfer body weight to the unaffected leg, and then advance both legs. advance the unaffected leg. advance the affected leg. advance both crutches.

advance both crutches.

What is the most important assessment for the nurse to make when assessing peripheral pulses on a client who is post limb fracture? strong contractility and rate of only the unaffected limb color of the skin and rhythm above the affected fracture site amplitude and symmetry of both extremities local temperature and visible pulsations

amplitude and symmetry of both extremities

A client diagnosed with arthritis doesn't want to take medications. Physical therapy and occupational therapy have been consulted for nonpharmacologic measures to control pain. What might physical and occupational therapy include in the care plan to help control this client's pain? acupuncture an exercise routine that includes range-of-motion (ROM) exercises heat therapy and nonsteroidal anti-inflammatory medications (NSAIDs) cold therapy

an exercise routine that includes range-of-motion (ROM) exercises

A nurse is caring for a client who had hip pinning surgery 6 hours ago to treat intertrochanteric fracture of the right hip. What assessment finding requires further investigation by the nurse? capillary refill of the right lower extremity of 2-3 seconds pitting edema of the right hip 100 milliliters of red drainage in the closed drainage system client anxious and confused

client anxious and confused

A child is to receive intravenous (IV) antibiotics for osteomyelitis. Before the initial dose of antibiotics can be given, the nurse confirms that a blood sample for which test has been drawn? creatinine culture hemoglobin white blood cell count

culture

A client comes to the emergency department reporting pain in the right leg. When obtaining the history, the nurse learns that the client has a history of obesity and hypertension. Based on this information the nurse anticipates the client having which musculoskeletal disorder? degenerative joint disease muscular dystrophy scoliosis Paget's disease

degenerative joint disease

The nurse is planning an educational program about the prevention of osteoporosis for a group of women. Which preventive measure should the nurse include in the teaching plan? increasing daily intake of protein ingesting 2000 mg of calcium supplements daily sunbathing for 1 hour a day during the summer months encouraging weight-bearing exercise on a regular basis

encouraging weight-bearing exercise on a regular basis

A male client comes to the clinic with complaints of pain in his great toe. The client reports that the pain is worse at night. Assessment reveals tophi. The nurse suspects the client has osteoarthritis. gouty arthritis. rheumatoid arthritis. reactive arthritis.

gouty arthritis.

The nurse is teaching the client how to use crutches. The nurse should instruct the client to bear weight primarily on which part of the body? axillae elbows upper arms hands

hands

After surgery and insertion of a total hip prosthesis, a client develops severe sudden pain and an inability to move the extremity. What do these findings indicate? The client: is developing an infection. is bleeding in the operative site. has a joint dislocation. has glue seepage into soft tissue.

has a joint dislocation.

A nurse suspects that a client with a recent fracture has compartment syndrome. Assessment findings may include body-wide decrease in bone mass. a growth in and around the bone tissue. inability to perform active movement and pain with passive movement. inability to perform passive movement and pain with active movement.

inability to perform active movement and pain with passive movement.

The nurse is preparing a primary prevention program to reduce the incidence of osteoporosis in a population. For which risk factors will the nurse screen to identify the subgroup of the population who is at greatest risk for developing osteoporosis? women who are diagnosed as hypothyroid older men and women who are active smokers postmenopausal women who are overweight postmenopausal women who are inactive

postmenopausal women who are inactive

A female client is at risk for developing osteoporosis. Which action will reduce the client's risk? living a sedentary lifestyle to reduce the incidence of injury stopping estrogen therapy taking a 300-mg calcium supplement to meet dietary guidelines initiating weight-bearing exercise routines

initiating weight-bearing exercise routines

A female client is at risk for developing osteoporosis. Which action will reduce the client's risk? living a sedentary lifestyle to reduce the incidence of injury stopping estrogen therapy taking a 300-mg calcium supplement to meet dietary guidelines initiating weight-bearing exercise routines

initiating weight-bearing exercise routines

Which findings best correlate with a diagnosis of osteoarthritis? joint stiffness that decreases with activity erythema and edema over the affected joint anorexia and weight loss fever and malaise

joint stiffness that decreases with activity

The nurse is completing the history and physical examination of a client diagnosed with osteoarthritis. The nurse should obtain information about which condition? anemia osteoporosis weight loss local joint pain

local joint pain

The nurse is assessing a client who reports having a back injury. What should the nurse ask the client about first? family history of back problems previous hospitalizations personal history of illness mechanism of injury

mechanism of injury

When assessing an older adult as a candidate for crutch walking, the nurse should take into account that for some elderly people, crutch walking is an impractical goal primarily because of decreased: visual acuity. reaction time. motor coordination. level of comprehension.

motor coordination.

A diet plan is developed for a client with gouty arthritis. The nurse should advise the client to limit his intake of organ meats. citrus fruits. green vegetables. fresh fish.

organ meats.

Which cells are involved in bone resorption? chondrocytes osteoblasts osteoclasts osteocytes

osteoclasts

Elderly clients who fall are most at risk for which injuries? wrist fractures humerus fractures pelvic fractures cervical spine fractures

pelvic fractures

A client in a double-hip spica cast is constipated. The surgeon cuts a window into the front of the cast. Which outcome is intended? The window in the cast will allow: the nurse to palpate the superior mesenteric artery. the surgeon to manipulate the fracture site. the nurse to reposition the client. relief from pressure due to abdominal distention.

relief from pressure due to abdominal distention.

A client is admitted to the hospital with a diagnosis of a right hip fracture. The client has right hip pain and cannot move the right leg. The nurse should further assess the right leg to determine if the leg is in which position? rotated internally held in a flexed position adducted shorter than the leg on the unaffected side

shorter than the leg on the unaffected side

Which activity should the nurse teach the client to do to strengthen the hand muscles in preparation for using crutches? combing the hair squeezing a rubber ball flexing and extending the wrists pushing the hands into the mattress while raising the body in bed

squeezing a rubber ball

The nurse is caring for an older adult who has hip pain related to rheumatoid arthritis. The client is practicing appropriate self-care activities when the client chooses to sit in which type of chair? recliner chair with arms to support wrists and hands couch with soft cushions to support thighs straight-back chair with elevated seat curved-back rocking chair

straight-back chair with elevated seat

The nurse is teaching the client with rheumatoid arthritis to perform isometric exercises to strengthen the leg muscles after having a hip replacement. Which is the expected benefit of isometric exercise? does not require specialized equipment strengthens the muscles while keeping the joints stationary involve clients in their own care and thus improves morale prevents joint stiffness

strengthens the muscles while keeping the joints stationary

After a laminectomy, the client states, "The doctor said that I can do anything I want to." Which activity that the client intends to do indicates the need for further teaching? drying the dishes sitting outside on firm cushions making the bed by walking from one side of the bed to the other sweeping the front porch

sweeping the front porch

During a routine physical examination on a 75-year-old 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 inches (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." "After menopause, the body's bone density declines, resulting in a gradual loss of height." "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."

A client is treated in the emergency department for acute muscle strain in the left leg caused by trying a new exercise. During discharge preparation, the nurse should provide which instruction? "Apply ice packs for the first 12 to 18 hours." "Apply heat packs for the first 24 to 48 hours." "Apply ice packs for the first 24 to 48 hours, then apply heat packs." "Apply heat packs for the first 24 hours, then apply ice packs for the next 48 hours."

"Apply ice packs for the first 24 to 48 hours, then apply heat packs."

A client is diagnosed with rheumatoid arthritis and is ordered oral indomethacin. What should the nurse include in the client's teaching concerning the administration of indomethacin? Select all that apply. "Take the drug with a glass of water only." "It is OK to continue to consume alcohol at dinner." "Avoid any hazardous activity until you know how you react to this drug." "Tell your health care provider immediately about changes in your hearing." "Do not use aspirin while taking this drug."

"Avoid any hazardous activity until you know how you react to this drug." "Tell your health care provider immediately about changes in your hearing." "Do not use aspirin while taking this drug."

A nurse is teaching a client who was recently diagnosed with carpal tunnel syndrome. Which statement should the nurse include? "This condition is associated with various sports." "Surgery is the only sure way to manage this condition." "Using arm splints will prevent hyperflexion of the wrist." "Ergonomic changes can be incorporated into your workday to reduce stress on your wrist."

"Ergonomic changes can be incorporated into your workday to reduce stress on your wrist."

A client with an amputation is learning how to apply a prosthetic limb. Which statement(s) made by the client indicates an increased risk for skin impairment? Select all that apply. "I can clean and inspect the skin of my amputated leg weekly." "I will make sure the padding is all placed in the front of the stump." "I can wear a cotton garment with seams over the stump." 'I will make sure the device is supportive but not too snug." "I don't like wearing the prosthesis, but it helps me to walk."

"I can clean and inspect the skin of my amputated leg weekly." "I will make sure the padding is all placed in the front of the stump." "I can wear a cotton garment with seams over the stump."

A client is brought to the emergency department with a painful swollen ankle. What is the nurse's most appropriate action? Apply a warm compress. Elevate the ankle. Assess range of motion. Administer I.V. morphine sulfate as needed.

Elevate the ankle.

A client is being discharged following an open reduction and internal fixation of the left ankle and is to wear a non-weight-bearing cast for 2 weeks. What should the nurse teach the client to do when using crutches? Use a four-point gait. Maintain two to three finger widths between the axillary fold and underarm piece grip. Keep the leg dependent when sitting. Maintain balance by supporting the body's weight on the axillae.

Maintain two to three finger widths between the axillary fold and underarm piece grip.

The nurse is admitting a client with a fractured tibia. Which area should the nurse assess first? area proximal to the fracture actual fracture site area distal to the fracture opposite extremity for baseline comparison

area distal to the fracture

A clinical nurse specialist developed clinical pathways for common orthopedic conditions. In which way should the interdisciplinary team use these pathways? as guidelines to ensure continuity of care as a step-by-step care plan for clients as a way to accurately document care as a staff education tool about optimal care

as guidelines to ensure continuity of care

After total hip replacement, a client is receiving epidural analgesia to relieve pain. Which action is a nursing priority for this client? changing the catheter site dressing every shift assessing capillary refill time assessing for sensation in the legs keeping the client flat in bed

assessing for sensation in the legs

A client diagnosed with rheumatoid arthritis reports that pain and stiffness are worse when arising in the morning. What interventions can the nurse suggest to assist the client in decreasing the pain? Select all that apply. energy conservation techniques splint the joints in the same position around the clock opioids for pain adaptive equipment hot bath to alleviate stiffness

energy conservation techniques adaptive equipment hot bath to alleviate stiffness

Before planning care for a group of clients with mobility issues, the nurse wants to ensure best practices are incorporated into the plan. Which source should the nurse access to ensure safe quality care is provided? evidence-based research designated outcome criteria organizational policies pertinent assessment data

evidence-based research

After a car accident, a client is admitted to an acute care facility with multiple traumatic injuries, including a fractured pelvis. For 24 to 48 hours after the accident, the nurse must monitor the client closely for which potential complication of a fractured pelvis? compartment syndrome fat embolism infection Volkmann's ischemic contracture

fat embolism

A client seeks care for lower back pain of 2 weeks duration. Which assessment finding suggests a herniated intervertebral disk? pain radiating down the posterior thigh back pain when the knees are flexed atrophy of the lower leg muscles Homans' sign

pain radiating down the posterior thigh

A client has a leg immobilized in traction. Which observation by the nurse indicates that the client understands actions to take to prevent muscle atrophy? The client: adducts the affected leg every 2 hours. rolls the affected leg away from the body's midline twice per day. performs isometric exercises to the affected extremity three times per day. asks the nurse to add a 5-lb (2.3-kg) weight to the traction for 30 minutes a day.

performs isometric exercises to the affected extremity three times per day.

The nurse is assisting a client who has had a spinal fusion apply a back brace. In which order of priority from first to last should the nurse assist the client applying the brace? All options must be used. Assist the client to log roll and rise to a sitting position. Verify the prescriptions for the settings for the brace. Have the client in a side-lying position. Ask the client to stand with their arms held away from their body.

Verify the prescriptions for the settings for the brace. Have the client in a side-lying position. Assist the client to log roll and rise to a sitting position. Ask the client to stand with their arms held away from their body.

What are important nursing priorities on the first postoperative day for a client who has had an open reduction and internal fixation (ORIF) after a right hip fracture? supporting the leg to maintain adduction, ensuring adequate pain control, and maintaining bed rest assessing the neurovascular status in the right leg, providing pain control, encouraging position changes, and early ambulation assessing for skin integrity, enhancing nutritional status, and encouraging position changes while maintaining bed rest reorienting frequently to prevent confusion and disorientation, restricting analgesics, and encouraging pursed-lip breathing

assessing the neurovascular status in the right leg, providing pain control, encouraging position changes, and early ambulation

A nurse monitors a client receiving enoxaparin 30 mg subcutaneously BID after hip replacement surgery. Which adverse reaction is the client most likely to experience? anaphylactic shock hypersensitivity bronchospasm bleeding

bleeding

A client is admitted with a possible diagnosis of osteomyelitis. Based on the documentation, which laboratory result is the priority for the nurse to report to the physician? rheumatoid factor blood culture alkaline phosphatase ESR

blood culture

A client with acute osteomyelitis is to receive parenteral penicillin for 4 to 6 weeks. Before administering the first dose, the nurse asks the client about known drug allergies. An allergy to which antibiotic or antibiotic class necessitates cautious use of penicillin? tetracyclines aminoglycosides erythromycin cephalosporins

cephalosporins

Passive range-of-motion (ROM) exercises for the legs and assisted ROM exercises for the arms are part of the care regimen for a client with a spinal cord injury. Which observation by the nurse would indicate a successful outcome of this treatment? free, easy movement of the joints absence of paralytic foot drop external rotation of the hips at rest absence of tissue ischemia over bony prominences

free, easy movement of the joints