Neuro week 8

Which discharge instructions should be given to a client after surgery for repair of a hip fracture? A. "Don't flex the hip more than 30 degrees, don't cross your legs, and get help putting on your shoes." B. "Don't flex the hip more than 60 degrees, don't cross your legs, and get help putting on your shoes." C. "Don't flex the hip more than 90 degrees, don't cross your legs, and get help putting on your shoes." D. "Don't flex the hip more than 120 degrees, don't cross your legs, and get help putting on your shoes."

"Don't flex the hip more than 90 degrees, don't cross your legs, and get help putting on your shoes."

A client with a recent fracture is suspected of having compartment syndrome. Assessment findings may include which symptom? A. Body-wide decrease in bone mass B. A growth in and around the bone tissue C. Inability to perform active movement; pain with passive movement D. Inability to perform passive movement; pain with active movement

C. Inability to perform active movement; pain with passive movement

A 20-year-old female client is complaining of severe pain in her right upper arm. If the nurse suspects domestic abuse, which X-ray finding would indicate the need for further investigation? A. Longitudinal B. Oblique C. Spiral D. Transverse

C. Spiral

A nurse is providing care for a client with a leg cast. To help prevent footdrop, which action by the nurse is the most appropriate? A. Encouraging bed rest. B. Supporting the foot with 45 degrees of flexion. C. Supporting the foot with 90 degrees of flexion. D. Placing a stocking on the foot to provide warmth.

C. Supporting the foot with 90 degrees of flexion.

A client uses a cane for assistance in walking. Which statement is true about a cane or other assistive devices? A. A walker is a better choice than a cane. B. The cane should be used on the affected side. C. The cane should be used on the unaffectedside. D. A client with osteoarthritis should be encouraged to ambulate without the cane.

C. The cane should be used on the unaffectedside.

A client who has recently been diagnosed with gout asks the nurse to explain why he needs to take colchicine. The nurse plans her response based on the understanding that colchicine: A. increases estrogen levels in the blood stream. B. decreases the risk of infection. C. decreases inflammation. D. decreases bone demineralization.

C. decreases inflammation.

A 42-year-old client recently had a total hysterectomy and bilateral oopherectomy. Which response by the client indicates that the nurse's teaching about osteoporosis has been effective? A. "My risk for osteoporosis is low because I still have my thyroid gland." B. "Osteoporosis affects only women over 65-years old." C. . "I'm still producing hormones, so I don't have to worry about osteoporosis." D. "I need to take precautions to protect myself from osteoporosis because I've had surgically-induced menopause."

D. "I need to take precautions to protect myself from osteoporosis because I've had surgically-induced menopause."

Which statement explains an open reduction of a fractured femur? A. Traction will be used. B. A cast will be applied. C. Crutches will be used after surgery. D. Some form of screw, plate, nail, or wire is usually used to maintain alignment.

D. Some form of screw, plate, nail, or wire is usually used to maintain alignment.

Which intervention would help prevent deep vein thrombosis (DVT) after hip surgery? A. Bed rest B. Egg crate mattress C. Vigorous pulmonary care D. Subcutaneous heparin and pneumatic compression boots

D. Subcutaneous heparin and pneumatic compression boots

A client is diagnosed with fat emboli. Which signs and symptoms would the nurse expect to find when assessing his client? A. Tachypnea, tachycardia, shortness of breath, paresthesia B. Paresthesia, bradypnea, bradycardia, petechial rash on chest and neck C. Bradypnea, bradycardia, shortness of breath, petechial rash on chest and neck D. Tachypnea, tachycardia, shortness of breath, petechial rash on chest and neck

D. Tachypnea, tachycardia, shortness of breath, petechial rash on chest and neck

A 21-year old male client with a fractured femur is in Russell's traction. He asks the nurse to help him with back care. Which nursing action is the most appropriate? A. Telling the client that he can't have back care while he's in traction. B. Removing the weight to give the client more slack to move. C. Supporting the weight to give the client more slack to move. D. Telling the client to use the trapeze to lift his back off the bed.

D. Telling the client to use the trapeze to lift his back off the bed.

A client is diagnosed with a herniated nucleus pulposus, or herniated disk. Which statement should the nurse include in her teaching about a herniated disk? A. The disk slips out of alignment. B. The disk shatters, and fragments place pressure on nerve roots. C. The nucleus tissue itself remains centralized, and the surrounding tissue is displaced. D. The nucleus of the disk puts pressure on the annulus, causing pressure on the nerve root.

D. The nucleus of the disk puts pressure on the annulus, causing pressure on the nerve root.

A 75-year-old client with Paget's disease is undergoing tests for a suspected fracture. The nurse should expect to see which type of fracture? A. Linear B. Longitudinal C. Oblique D. Transverse

D. Transverse

Clients with osteoarthritis may be on bed rest for prolonged periods. Which nursing intervention would be appropriate for these clients? A. Encourage coughing and deep breathing, and limit fluid intake. B. Provide only passive range of motion (ROM), and decrease stimulation. C. Have the client lie as still as possible, and give adequate pain medicine. D. Turn the client every 2 hours, and encourage coughing and deep breathing

D. Turn the client every 2 hours, and encourage coughing and deep breathing.

Client education about gout includes which information? A. Good foot care will reduce complications. B. Increased dietary intake of purine is needed. C. Production of uric acid in the kidney affects joints. D. Uric acid crystals cause inflammatory destruction of the joint.

D. Uric acid crystals cause inflammatory destruction of the joint.

A client is recovering from an attack of gout. Client teaching should include the need to lose weight for which reason? A. Weight loss will decrease purine levels. B. Weight loss will decrease inflammation. C. Weight loss will increase uric acid levels and decrease stress on joints. D. Weight loss will decrease uric acid levels and decrease stress on joints.

D. Weight loss will decrease uric acid levels and decrease stress on joints.

A client is in the emergency department suspected fracture of the right hip. Which assessment findings of the right leg should the nurse expect? Select all that apply: A. The right leg is longer than the left leg. B. The right leg is shorter than the left leg. C. The right leg is abducted. D. The right leg is adducted. E. The right leg is externally rotated. F. The right leg is internally rotated.

The right leg is shorter than the left leg. The right leg is adducted. The right leg is externally rotated.

A 20-year-old client developed osteomyelitis 2 weeks after a fishhook was removed from his foot. Which rationale best explains the expected long-term antibiotic therapy needed? A. Bone has poor circulation. B. Tissue trauma requires antibiotics. C. Feet are normally more difficult to treat. D. Fishhook injuries are highly contaminated

A. Bone has poor circulation.

For a client diagnosed with Ewing's sarcoma, which test is most useful in determining the extent of metastasis? A. Bone scan B. Computed tomography (CT) scan C. Magnetic resonance imaging (MRI) D. Positron emission tomography (PET)

A. Bone scan

Dislocation of the hip includes which symptoms? A. Pain relieved with pressure B. Pain in the inguinal area, abnormal gait C. Internal rotation of the knee, abduction of the leg D. Pain in the hip, the thigh appears longer than the unaffected leg

B. Pain in the inguinal area, abnormal gait

A nurse determines a client understands the teaching regarding compartment syndrome if he reports which early symptom? A. Heat B. Paresthesia C. Skin pallor D. Swelling

B. Paresthesia

A nurse is teaching a client with degenerative joint disease, also commonly known as osteoarthritis. The teaching has been effective when the client states the following about the condition? A. "It is a noninflammatory joint disease." B. "It is an immune-mediated joint disease." C. "It is a joint inflammation after a viral infection." D. "It is a joint inflammation related to systemic infections."

A. "It is a noninflammatory joint disease."

A nurse admits a 75-year-oldwoman with a history of osteoporosis who has experienced a right wrist fracture. Which nursing diagnosis has the highest priority? A. Acute pain B. Dressing self-care deficit C. Risk fur impaired skin integrity D. Imbalanced nutrition: Less than body requirements

A. Acute pain

A client describes a foul odor from his cast. Which response or intervention would be the most appropriate? A. Assess further because this may be a sign of infection. B. Teach him proper cast care, including hygiene measures. C. This is normal, especially when a cast is in place for a few weeks. D. Assess further because this may be a sign of neurovascular compromise.

A. Assess further because this may be a sign of infection.

A client was prescribed an anti-inflammatory drug for osteoarthritis 5 days ago. He says the pain has decreased some but not completely. Which nursing intervention would be the most appropriate? A. Continue the present dose and offer other pain relief measures. B. Notify the physician and suggest increasing the dose. C. Notify the physician and suggest stopping the medication. D. Notify the physician and suggest adding another medication

A. Continue the present dose and offer other pain relief measures.

Which symptom would lead the nurse to suspect a fat embolus in a client who has a fracture of his left femur? A. Dyspnea B. Sudden headache C. Muscle spasm in the left thigh D. Numbness in the left leg

A. Dyspnea

A client is taking salicylates for osteoarthritis. The presence of which of the following indicates that further assessment is needed? A. Hearing loss B. Increased pain in joints C. Decreased calcium absorption D. Increased bone demineralization

A. Hearing loss

A nurse is performing an admission assessment on a client with osteoarthritis. Which finding should she expect to note? A. Joint pain after exercise relieved by rest B. Symmetrical swelling of the joints of both hands C. Morning stiffness lasting longer than 30 minutes D. Fever

A. Joint pain after exercise relieved by rest

Which condition or actions can cause primary osteoarthritis? A. Overuse of joints, aging, obesity B. Obesity, diabetes mellitus, aging C. Congenital abnormality, aging, overuse of joints D. Diabetes mellitus, congenital abnormality, aging

A. Overuse of joints, aging, obesity

The nurse is instructing a nursing assistant on the proper car of a client in Buck's extension traction following a fracture of his left fibula. Which observation indicates that the teaching was effective?

A. The weights are allowed to hang freely over the end of the bed.

A client has developed compartment syndrome following application of a cast to a fractured tibia. Which of the following responses is the most accurate for prompt action in treating compartment syndrome? A. Decrease the level of pain. B. Prevent tissue death, which can occur within 2 to 4 hours. C. Prevent further complications. D. Decrease the swelling in the extremity.

B. Prevent tissue death, which can occur within 2 to 4 hours.

Nursing interventions to treat a musculoskeletal injury may include cold or heat therapy. Cold therapy is ordered for which reason? A. Promotes analgesia and circulation B. Numbs the nerves and dilates the vessels C. Promotes circulation and reduces muscle spasms D. Causes local vasoconstriction and prevents edema or muscle spasm

D. Causes local vasoconstriction and prevents edema or muscle spasm

Which nursing intervention is appropriate for a client in traction? A. Add and remove weights as the client wants. B. Make sure the knots in the rope catch on the pulley. C. Assess the pin sites every shift and as needed. D. Give range of motion (ROM) to all joints, including those immediately proximal and distal to the fracture, every shift.

Assess the pin sites every shift and as needed.

The nurse is teaching a client about the cause of osteoporosis. Which statement by the nurse would be the most accurate in stating the primary cause? A. Alcoholism B. Hormonal imbalance C. Malnutrition D. Osteogenesis imperfecta

B. Hormonal imbalance

After surgical repair of a hip, which position is best for a client's legs and hips? A. Prone B. Abduction C. Adduction D. Subluxated

B. Abduction

Which areas should be included in a neurovascular assessment?

B. Capillary refill, movement, pulses, warmth

Which serious complication is most frequently seen "With long hone fractures? A. Bone emboli B. Fat emboli C. Platelet emboli D. Serous emboli

B. Fat emboli

A client complains that he experiences pain and numbness in his fingers when he types on a computer keyboard. Which action will help the nurse assess for Phalen's sign? A. Having the client hold both hands above his head with his arms straight for 30 seconds B. Having the client hold both wrists in acute flexion with the dorsal surfaces touching for 60 seconds C. Tapping gently over the median nerve in the wrist D. Having the client extend his wrists while the nurse provides resistance

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

A client has just returned from the post anesthesia care unit after undergoing internal fixation of a left femoral neck fracture. The nurse should place the client in which position? A. On his left side with his right knee bent B. On his back with two pillows between his legs C. On his right side with his left knee bent D. Sitting at a 90-degree angle

B. On his back with two pillows between his legs

Which instruction should a nurse include in her preoperative teaching for a client scheduled for closed spine surgery? A. "There is a greater associated risk with closed spine surgery." B. "Intense physical therapy is needed after the procedure." C. "An endoscope is used to perform the surgery." D. "Recovery time is twice as long as with open spine surgery."

C. "An endoscope is used to perform the surgery."

A client has been treated with IV antibiotics for osteomyelitis. The treatment has not been effective. Which intervention would be the most appropriate for this client? A. Bone grafts B. Hyperbaric oxygen therapy C. Amputation of the extremity D. Debridement of necrotic tissue

D. Debridement of necrotic tissue

A client is being discharged from the emergency department after cast application for a tibial fracture. A serious complication of this injury is identified with the nursing diagnosis Impaired gas exchange: Fat embolus related to long bone fracture. Based on this diagnosis, which instruction should the nurse provide? A. "Cough and deep breathe at least every 2 hours." B. "Keep the leg elevated and apply ice for the first 24 to 48 hours." C. "Call the physician at once if you experience apprehensiveness, shortness of breath, fever, or palpitations." D. "Restrict your fluid intake to 1 L per day."

C. "Call the physician at once if you experience apprehensiveness, shortness of breath, fever, or palpitations."

The nurse is assessing a client with a diagnosis of osteoarthritis. Which of the following signs would the nurse most likely assess? A. Elevated sedimentation rate B. Multiple subcutaneous nodules C. Asymmetrical joint involvement (osteo ) D. Signs and symptoms of inflammation, such as heat, fever, and malaise rhemutoid

C. Asymmetrical joint involvement (osteo )

A client with skeletal traction to his right leg complains of severe right leg pain. Which action should the nurse take first? A. Perform pin care. B. Remove the weights from the traction. ( never remove the weights ) C. Check the client's alignment in bed. D. Call the physician.

C. Check the client's alignment in bed.

Treatment of compartment syndrome includes which measure? A. Amputation B. Casting C. Fasciotomy D. Observation; no treatment necessary

C. Fasciotomy

A nurse is caring for a client with a femoral shaft fracture. Which serious complication is seen with this condition? A. Constipation B. Decreased urine output C. Hemorrhage D. Pain

C. Hemorrhage

A high-protein diet is ordered for a client recovering from a fracture. High protein is ordered for which reason? A. Protein promotes gluconeogenesis. B. Protein has anti-inflammatory properties. C. Protein promotes cell growth and bone union. D. Protein decrease pain medication requirements.

C. Protein promotes cell growth and bone union.

Which instruction would be considered primary prevention of injury from osteoarthritis? A. "Stay on bed rest." B. "Avoid physical activity." C. "Perform only repetitive tasks." D. "Warn up before exercise and avoid repetitive tasks"

D. "Warn up before exercise and avoid repetitive tasks."

Elevating a limb with a cast will prevent swelling. Which action best describes how this is done? A. Place the limb with the cast close to the body. B. Place the limb with the cast at the level of the heart. C. Place the limb with the cast below the level of the heart. D. Place the limb with the cast above the level of the heart

D. Place the limb with the cast above the level of the heart.

Which symptoms are considered signs of a fracture? A. Tingling, coolness, loss of pulses B. Loss of sensation, redness, coolness C. Coolness, redness, new site of pain D. Redness, warmth, pain at the site of injury

D. Redness, warmth, pain at the site of injury

The nurse is assessing a client's response to skeletal traction applied to the lower extremity. Which finding would be considered normal? A. Coolness and pallor below the fracture level B. Erythema and swelling immediately around the pin insertion site C. Moderate to severe muscle spasms around the fracture area D. Serous drainage and crust formation at the pin insertion site

D. Serous drainage and crust formation at the pin insertion site