Muskoskeltal

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?

Cephalosporins

A client is 4 days postoperative from a tibia fracture and has a long leg cast. The nurse is conducting initial teaching for walking with crutches. What is the most important activity for the nurse to encourage the client to do prior to discharge from the hospital?

conduct exercises in bed to strengthen the upper extremities

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

The nurse is teaching a client with osteoporosis about optimal dietary choices to reduce the severity of the condition. What instruction should the nurse provide?

"Eat more dairy products such as cheese and yogurt."

A nurse is teaching a client who was recently diagnosed with carpal tunnel syndrome. Which statement should the nurse include?

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

A client asks the nurse what the difference is between osteoarthritis (OA) and rheumatoid arthritis (RA). Which response is correct?

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

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?

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

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?

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

A client recovering from lumbar surgery is fitted for a contour splint. What should the nurse explain to the client about this device?

"The splint immobilizes the body part in a functional position."

A client with a fractured leg has been instructed to ambulate without weight bearing on the affected leg. The nurse evaluates that the client is ambulating correctly if the client uses which crutch-walking gait

3 point gait

A client in the surgical intensive care unit has skeletal tongs in place to stabilize a cervical fracture. Protocol dictates that pin care should be performed each shift. When providing pin care for the client, which finding should the nurse report to the physician?

A small amount of yellow drainage at the left pin insertion site

A client who had a total hip replacement 4 days ago is worried about dislocation of the prosthesis. How should the nurse respond to the client's concern?

Activities that tend to cause adduction of the hip tend to cause dislocation, so try to avoid them."

A client is experiencing an acute exacerbation of rheumatoid arthritis. What should the nursing priority be?

Administering ordered analgesics and monitoring their effects

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?

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

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?

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

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

A client with arterial insufficiency undergoes below-knee amputation of the right leg. Which action should the nurse include in the postoperative care plan?

Elevating the stump for the first 24 hours

A client complains that they experience pain and numbness in the fingers when typing on a computer keyboard. Which action will help the nurse assess for Phalen's sign?

Having the client hold both wrists in acute flexion with the dorsal surfaces touching for 60 seconds

An older adult is admitted with a fracture of the femur. What should the nurse assess first about this client?

Mechanism of injury

After a person experiences a closure of the epiphyses, which statement is true?

No further increase in bone length occurs.

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?

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

A client with an open femoral fracture was discharged to home and reports having a fever, night sweats, chills, restlessness, and restrictive movement of the fractured leg. The nurse should interpret these findings as the client may be experiencing which complication?

Osteomyelitis

Which goal is the priority for a client with a fractured femur who is in traction?

Prevent effects of immobility while in traction

A nurse is caring for a client who underwent a total hip replacement. What should the nurse and other caregivers do to prevent dislocation of the new prosthesis?

Prevent internal rotation of the affected leg.

A client is in balanced suspension traction to maintain alignment of a fractured tibia. Which activities are safe for the client?

Raise the hips using trapeze.

Which nursing intervention is essential in caring for a client with compartment syndrome?

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

The nurse is creating a plan of care for an older adult client with osteoarthritis. Which nursing diagnosis is most appropriate?

Risk for injury related to altered mobility

A client in balanced suspension traction is transported to surgery for closed reduction and internal fixation of a fractured femur. What should the nurse do when transporting the client to the operating room?

Send the client on the bed with extra help to stabilize the traction.

The nurse enters the room to do an initial assessment on a client with a fracture of the femoral head. What would be the expected findings on the affected limb?

Shortening of the affected extremity with external rotation

Which activity should the nurse teach the client to do to strengthen the hand muscles in preparation for using crutches?

Squeezing a rubber ball

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 traction weights are resting on the floor

A client with rheumatoid arthritis has been taking large doses of aspirin to relieve joint pain. Which finding is likely?

Tinnitus

A client is scheduled for a laminectomy to repair a herniated intervertebral disk. When developing the postoperative care plan, the nurse should include which action?

Turning the client from side to side, using the logroll technique

The nurse is teaching a client about wearing a back brace after a spinal fusion. Which statement indicates the client understands how to wear the back brace?

Wear a thin t shirt under the brace

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?

Weight

The client asks the nurse what the activity limitations are while in Buck traction. What should the nurse tell the client:?

You can sit up whenever you want

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?

fat embolism

During a scoliosis screening in a college health center, a student asks the public health nurse about the consequences of untreated scoliosis. The nurse identifies one of the direct complications as

impingement on pulmonary function

Which cells are involved in bone resorption?

osteoclasts

The nurse is positioning a client who had a hip replacement. To prevent external rotation of the client's hips while lying on the back, it would be best for the nurse to place the client in which position?

trochanter rolls alongside the legs from ilium to midthigh

A client has sustained a right tibial fracture and has just had a cast applied. Which instruction should the nurse provide concerning cast care?

Keep your right leg elevated above heart level.

A client undergoes hip-pinning surgery to treat an intertrochanteric fracture of the right hip. The nurse should include which intervention in the postoperative care plan?

Keeping a pillow between the client's legs at all times

A nurse suspects that a client with a recent fracture has compartment syndrome. Assessment findings may include

inability to perform active movement and pain with passive movement.

The client sustained an open fracture of the femur from an automobile accident. The nurse should assess the client for which type of shock?

hypovolemic

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?

shorter than the leg on the unaffected side

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?

strengthens the muscles while keeping the joints stationary

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 may experience progressive deterioration in all voluntary muscles."

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?

Post menopausal women who are inactive

A male client underwent a lumbar spinal fusion yesterday. Which nursing assessment should alert the nurse to the development of a possible complication?

clear yellowish fluid on the dressing Explanation: Clear yellowish fluid on the dressing may be cerebrospinal fluid (CSF). This fluid must be tested for glucose to determine whether it is CSF. If so, the client is at great risk for an infection of the central nervous system, which has a high mortality rate. The client should be able to laterally rotate the head and neck, which is above the surgical site in the spinal column. During the nursing postoperative neuromuscular-vascular assessment of movement of the head and neck, the nurse should find results consistent with the preoperative baseline status. Using the standing position to void is normal for a male client. Coughing is the body's defense mechanism to help clear the lungs of the anesthetic agents and to ventilate the lungs in response to a sustained deep inspiration for ventilation of the lower lobes of the lungs. A frequent cough could place a strain on the incision site and should be avoided. Also, a productive cough of thick, yellow sputum would indicate the complication of a respiratory infection.