Musculoskeletal test

A client with a fractured femur is admitted to the nursing unit. Which assessment finding requires follow up by the nurse? Select all that apply. "I cannot seem to catch my breath." "I have a pins-and-needles sensation in my toes." Dorsoplantar weak and unequal bilaterally T 101.2 degrees F; HR 110; RR 28; pulse oximetry 90% Both feet warm with capillary refill < 3 seconds

"I cannot seem to catch my breath." "I have a pins-and-needles sensation in my toes." Dorsoplantar weak and unequal bilaterally T 101.2 degrees F; HR 110; RR 28; pulse oximetry 90%

A client who has fractured the radial head asks the nurse about factors that will promote bone healing. Which statement should the nurse include when responding to the client? Select all that apply. "Immobilization of the fracture will promote healing by maximizing contact of bone fragments." "Fractured bones require a good blood supply and adequate nutrition for healing." "Weight bearing stimulates healing of the long bones of the leg, if the fracture is stabilized." "Adults heal faster than children because adult bodies are physiologically more mature." "Corticosteroids will decrease the bone and soft tissue inflammation associated with the fracture."

"Immobilization of the fracture will promote healing by maximizing contact of bone fragments." "Fractured bones require a good blood supply and adequate nutrition for healing." "Weight bearing stimulates healing of the long bones of the leg, if the fracture is stabilized."

The nurse is providing instructions to the client following application of a fiberglass cast. Which statement by the client indicates further education is needed? "Under no circumstances should I get my cast wet." "The cast should not come in contact with other plastics." "I should avoid touching the cast while it is wet." "The cast will be hot while it is drying."

"Under no circumstances should I get my cast wet."

A client has undergone a leg amputation. What teachings should the nurse offer such a client to prevent abduction deformity? Select all that apply. Advise the client to use a trochanter roll. Advise the client to adduct the stump so it presses against the other leg when the client is lying on the stomach. Advise the client to use antiembolism stockings on both legs. Advise the client to place pillows between the legs.

Advise the client to use a trochanter roll. Advise the client to adduct the stump so it presses against the other leg when the client is lying on the stomach.

A physician writes a prescription to discontinue skeletal traction on an orthopedic client. The nurse should anticipate what subsequent intervention? Application of a walking boot Application of a cast Education on how to use crutches Passive range of motion exercises

Application of a cast

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

Applying a cold pack to the injured site

A client with an arm cast reports pain. What nursing interventions should the nurse provide in order to reduce the incidence of complications? Select all that apply. Assess the fingers for color and temperature. Administer a prescribed analgesic to promote comfort and allay anxiety. Assess for a pressure sore Determine the exact site of the pain. Cut the cast with a cast saw

Assess the fingers for color and temperature. Assess for a pressure sore Determine the exact site of the pain.

A client is scheduled for a total hip replacement and the surgeon has explained the risks of blood loss associated with orthopedic surgery. The risk of blood loss is the indication for which of the following actions? Use of a cardiopulmonary bypass machine Postoperative blood salvage Prophylactic blood transfusion Autologous blood donation

Autologous blood donation

An older adult client has fallen in the home and is brought to the emergency department by ambulance with a suspected fractured hip. X-rays confirm a fracture of the left femoral neck. When planning assessments during the client's presurgical care, the nurse should be aware of the client's heightened risk of what complication?

Avascular necrosis (AVN)

A nurse is caring for an older adult client who is preparing for discharge following recovery from a total hip replacement. What outcome must be met prior to discharge? Client is able to perform ADLs independently. Client is able to perform transfers safely. Client is able to weight-bear equally on both legs. Client is able to demonstrate full ROM of the affected hip.

Client is able to perform transfers safely.

A nurse is caring for a client who is being assessed following reports of severe and persistent low back pain. The client is scheduled for diagnostic testing in the morning. Which of the following are appropriate diagnostic tests for assessing low back pain? Select all that apply. Computed tomography (CT) Angiography Magnetic resonance imaging (MRI) Ultrasound X-ray

Computed tomography (CT) Magnetic resonance imaging (MRI) Ultrasound X-ray

A client is admitted to the orthopedic unit with a fractured femur after a motorcycle accident. The client has been placed in traction until the femur can be rodded in surgery. For what early complication(s) should the nurse monitor this client? Select all that apply. Systemic infection Complex regional pain syndrome Deep vein thrombosis Compartment syndrome Fat embolism

Deep vein thrombosis Compartment syndrome Fat embolism

The health care provider is preparing to bivalve the client's cast. Which supplies should the nurse assemble? Elastic compression bandages Gauze bandages and tape Sterile saline and basin Stockinette and cotton padding

Elastic compression bandages

Which intervention would the nurse implement with the client in skeletal traction? Select all that apply. Apply 8-pound weight to the rope. Ensure the pins or wires are covered with caps. Remove foam boot and inspect skin daily. Position trapeze within the client's reach. Instruct the client on isometric exercises for immobilized extremity.

Ensure the pins or wires are covered with caps. Position trapeze within the client's reach. Instruct the client on isometric exercises for immobilized extremity.

The nurse is providing care for a client who has had a below-the-knee amputation. The nurse enters the client's room and finds the client resting in bed with the residual limb supported on a pillow. What is the nurse's most appropriate action? Inform the surgeon of this finding. Explain the risks of flexion contracture to the client. Transfer the client to a sitting position. Encourage the client to perform active ROM exercises with the residual limb.

Explain the risks of flexion contracture to the client.

A client has just begun been receiving skeletal traction and the nurse is aware that muscles in the client's affected limb are spastic. How does this change in muscle tone affect the client's traction prescription? Traction must temporarily be aligned in a slightly different direction. Extra weight is needed initially to keep the limb in proper alignment. A lighter weight should be initially used. Weight will temporarily alternate between heavier and lighter weights.

Extra weight is needed initially to keep the limb in proper alignment.

A nurse is caring for a client after stabilization of a radial fracture. Which actions by the nurse would be appropriate for the client following arm casting? Select all that apply. Elevate the arm on a plastic-covered pillow Protect the cast by covering with a sheet Handle the cast with the palms of hands Circulate room air with a portable fan Petal and smooth the edges of the cast

Handle the cast with the palms of hands Circulate room air with a portable fan Petal and smooth the edges of the cast

Which statements describe open reduction of a fracture? Select all that apply. It is performed in the operating room. The bone is surgically exposed and realigned. The client usually receives general or spinal anesthetic. The bone is restored to its normal position by external manipulation.

It is performed in the operating room. The bone is surgically exposed and realigned. The client usually receives general or spinal anesthetic.

A client is having traction applied to a fractured left lower extremity prior to surgery. What outcomes does the nurse expect from the application of the traction for the client? Select all that apply. Surgery will not be required. Muscle spasms will be relieved. The bones of the left leg will be aligned. Immobilization of the left leg will be maintained. Less pain medication will be required.

Muscle spasms will be relieved. The bones of the left leg will be aligned. Immobilization of the left leg will be maintained.

A client with a short arm cast is suspected to have compartment syndrome. What actions should the nurse include in the plan of care? Select all that apply. Elevate the arm above the heart. Prepare to remove the cast. Provide support to the injured extremity. Assess neurovascular status every 8 hours. Apply ice to extremity.

Prepare to remove the cast. Provide support to the injured extremity.

A client has had a brace prescribed to facilitate recovery from a knee injury. What are the potential therapeutic benefits of a brace? Select all that apply. Preventing additional injury Immobilizing prior to surgery Providing support Controlling movement Promoting bone remodeling

Preventing additional injury Providing support Controlling movement

A client diagnosed with osteoporosis is being discharged home. Which priority education should the nurse should provide? Remove all small rugs from the home Participate in weight-bearing exercises Classify medications Increase calcium and vitamin D in the diet

Remove all small rugs from the home

With fractures of the femoral neck, the leg is

Shortened, adducted, and externally rotated

A provider asks the nurse to teach a client with low back pain how to sit in order to minimize pressure on the spine. Which teaching points would the nurse include? Select all that apply. Sit in a straight-backed chair with arm rests. Use a firm pillow placed behind the thoracic vertebrae to straighten the small of the back. Avoid hip extension. Place feet flat on the floor. Sit with the buttocks "tucked under."

Sit in a straight-backed chair with arm rests. Avoid hip extension. Place feet flat on the floor. Sit with the buttocks "tucked under."

The nurse is caring for the client with chronic osteomyelitis of the jaw with a draining wound. Which client goal is a priority for the client? Select all that apply. The client will experience a tolerable level of pain. The client will demonstrate wound care. The client will maintain adequate nutritional intake. The client will remain free from injury. The client will maintain effective airway clearance.

The client will experience a tolerable level of pain. The client will demonstrate wound care. The client will maintain adequate nutritional intake.

A client arrives in the emergency room complaining of severe pain in her left hip after falling out of the bed. What indication upon assessment does the nurse recognize as a dislocated left hip? Select all that apply. The left leg is shorter than the right. Limited range of motion of the left hip. The skin over the left hip is warm. The skin of the lower left leg is pale. The client is able to bend the knee but not move toes.

The left leg is shorter than the right. Limited range of motion of the left hip. The skin of the lower left leg is pale.

Which of the following are associated with compartment syndrome? Select all that apply. Trauma from accidents Surgery Casts Tight bandages Crushing injuries

Trauma from accidents Surgery Casts Tight bandages Crushing injuries

total hip arthroplasty is scheduled for a client wiht DJD of the left femoral head. following surgery it is most important for the nurse to place the client's left leg is which position abducted with toes pointing upward elevated on pillows elevated with the ankle abducted adducted with ankle joint hyperextended

abducted with toes pointing upward

Which is one of the most common causes of death in clients diagnosed with fat emboli syndrome?

acute respiratory distress syndrome

an older adult client is diagnosed with a fractured femur. the nurse recognizes which observation is an early sign of fat embolism? chest pain and dyspnea increased respirations pulse and temp altered mental status petechiae

altered mental status

A client comes to the clinic 2 days after sustaining a sprain to the left ankle. What intervention can the nurse encourage the client to perform that will help improve circulation? Active range-of-motion exercises Take nonsteroidal anti-inflammatory drugs Applying cold compresses Applying heat

apply heat

Emergency medical technicians transport a client to the emergency department and inform the nurse that the client fell from a two-story building. The comatose client has a large contusion on the left side of the chest, a hematoma in the left parietal area, and a compound fracture of the left femur. The client was intubated and is maintaining an arterial oxygen saturation of 92% by pulse oximeter with a manual-resuscitation bag. Which intervention by the nurse has the highest priority?

assessing the left leg

A client has low back pain and the healthcare provider needs to rule out the presence of a tumor. Which diagnostic procedure would the nurse anticipate to be ordered for the client? Bone scan Computed tomography Magnetic resonance imaging Electromyogram

bone scan

The client is admitted to the hospital with a diagnosis of left femoral neck fracture. Which treatment modality would the nurse expect the health care provider to order?

buck's traction

Which assessment findings would the nurse expect to find in the client with osteomyelitis? Column A wbc 6,000 esr 12 ca 7.2 phosphorous 5.3 alkaline phosphatase 125 Column B wbc 12,000 esr 32 ca 9.2 phosphorus 3.1 alkaline phosphatase 88 Column C wbc 15000 esr 9 ca 11.2 phosphorus 3.0 alkaline phosphatase 96 Column D wbc 9,000 esr 45 ca 5.3 phosphorus 4.8 alkaline phosphatase 45

column B

A client with a tibia fracture was placed in an external fixator 24 hours ago. The nurse is completing pin care and notices redness at the pin site and a small amount of serous drainage. What action by the nurse is appropriate?

document the findings

the nurse in the outpatient clinic instructs a client receiving probenecid. it is most important for the nurse to make which statement drink 6-8 glasses of water a day take the med on an empty stomach you may take aspirin for minor pain you are permitted to drink wine with dinner

drink 6-8 levels of water each day

the nurse provides care for a client with a newly applied plaster cast to the lower extremity. the nurse takes which action? elevates the leg on pillows and leaves the cast open to air sets up a fan to blow on the cast and maintains the client in supine position rests the casted leg on the mattress and avoids handling it until it has dried covers the cast lightly with a sheet until completely dry

elevates the leg on pilloes and leaves the cast open to air

an older adult client has an open reduction and internal fixation of the left femoral head after a fracture. which action by the nurse is best offer the client a clear liquid diet keep the client turned to the non operative side instruct the client to exercise the arms encourage the client to cough and deep breathe every 2 hours

encourage the client to cough and deep breathe every 2 hours

The nurse assesses subtle personality changes, restlessness, irritability, and confusion in a client who has sustained a fracture. The nurse suspects which complication?

fat embolism syndrome

the nurse makes a home health care visit to a client with a fractured right femur the nurse assesses the client's ability to safely use crutches the nurse intervenes if which observation is made

g

A client has a cast that extends from below the elbow to the palmar crease and is secured around the base of the thumb. The thumb is also casted. The nurse identifies this as which type of cast? Short arm cast Gauntlet cast Body cast Spica cast

gauntlet cast

the nurse prepares a client for a total hip replacement which client information will likely postpone surgery

hemoglobin 15 reports burning on urination reports periodic heartburn platelet count 250,000

What areas of the body may be examined when bone densitometry is done? Select all that apply. hip spine wrist knee

hip spine wrist

the nurse teaches a client diagnosed with a fractured left femur that is ina. cast the client asks how to keep the muscles of the legs strong during the time the cast is on the left leg which response by the nurse is best it is import to perform active ROM every day with your left leg perform left leg lifts with a 2lb weight attached to your ankle ill teach you how to do isometric exercises with your left leg

ill teach you how to do isometric exercises with your left leg

Lifestyle risk factors for osteoporosis include lack of aerobic exercise a low-protein, high-fat diet an estrogen deficiency or menopause lack of exposure to sunshine

lack of exposure to sunshine.

aspirin is prescribed for a client the nurse administers this medication with which liquid? milk orange juice diet soda small amount of water

milk-- gi upset

Which of the following describes failure of the ends of a fractured bone to unite in normal alignment?

nonunion

the nurse assesses a client diagnosed with osteoarthritis the nurse expects to observe which signs/symptoms? joint pain and stiffness after a stressful event fever rash and nodules over bony prominences swollen reddened painful joint with limitation of motion pain with activity and stiffness of the joints after periods of rest

pain with activity and stiffness of the joints after periods of rest

A 75-year-old client had surgery for a left hip fracture yesterday. When completing the plan of care, the nurse should include assessment for which complications? Select all that apply. Pneumonia Necrosis of the humerus Skin breakdown Sepsis Delirium

pneumonia Skin breakdown Sepsis Delirium

Which is one of the most common causes of death in clients diagnosed with fat emboli syndrome? a. myocardial infarction b. stroke c. acute respiratory distress syndrome d. pulmonary embolism

pulmonary embolism

A client who was injured while playing basketball reports an extremely painful elbow, which is very edematous. What type of injury has the client experienced? sprain strain contusion All options are correct.

sprain