prep u chapter 41

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? A. Administering large doses of oral antibiotics as ordered B. Instructing the client to ambulate twice daily C. Withholding all oral intake D. Administering large doses of I.V. antibiotics as ordered

A. Administering large doses of oral antibiotics as ordered

Which of the following positions should be avoided in severe back pain? A. Prone B. Supine C. Lateral recumbent D. Head and thorax elevated 30 degrees

A. Prone

Morton neuroma is exhibited by which clinical manifestation? A. Swelling of the third (lateral) branch of the median plantar nerve B. High arm and a fixed equinus deformity C. Diminishment of the longitudinal arch of the foot D. Inflammation of the foot-supporting fascia

A. Swelling of the third (lateral) branch of the median plantar nerve

Which is not a risk factor for osteoporosis? A. being male B. small-framed, thin White or Asian women C. being postmenopausal D. family history

A. being male

A 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? A. common adverse effects B. dietary restrictions C. activity restrictions D. loading-dose schedule

A. common adverse effects

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

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

Which classic symptom will the nurse assess for to detect the development of plantar fasciitis? A. Shortened height B. Morning heel pain C. Elevated temperature D. Shortening of affected leg

B. Morning heel pain

A client with a musculoskeletal injury is instructed to increase dietary calcium. Which statement by the nurse is appropriate? A. "You need to increase the amount of red meat in your diet." B. "You need to increase the amount of non-citrus fruits in your diet." C. "You need to increase the amount of vitamin D in your diet." D. "You need to increase the amount of phosphorus in your diet."

C. "You need to increase the amount of vitamin D in your diet."

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

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

A nurse is planning discharge instructions for the client with osteomyelitis. What instructions should the nurse include in the discharge teaching? A. "Use your continuous passive motion machine for 2 hours each day." B. "You need to perform weight-bearing exercises twice a week." C. "You need to limit the amount of protein and calcium in your diet." D. "You will receive IV antibiotics for 3 to 6 weeks."

D. "You will receive IV antibiotics for 3 to 6 weeks."

A nurse is caring for a client following foot surgery. Which nursing intervention is most important for the nurse to include in the nursing care plan? A. Examine the surgical dressing every hour. B. Administer pain medication per client request. C. Monitor vital signs every 4 hours. D. Perform neuromuscular assessment every hour.

D. Perform neuromuscular assessment every hour.

Which of the following is the most important nursing diagnosis for an elderly patient diagnosed with osteoporosis? A. Deficient knowledge about osteoporosis and the treatment regimen B. Acute pain related to fracture and muscle spasm C. Risk for constipation related to immobility D. Risk for injury related to fractures due to osteoporosis

D. Risk for injury related to fractures due to osteoporosis

A client with osteoporosis is prescribed calcitonin 100 units subcutaneously. The medication is available 200 units per ml. How many milliliters will the nurse administer to the client?

0.5

Which medication directly inhibits osteoclasts, thereby reducing bone loss and increasing bone mass density (BMD)? A. Calcitonin B. Raloxifene C. Teriparatide D. Vitamin D

A. Calcitonin

Which of the following inhibits bone resorption and promotes bone formation? A. Calcitonin B. Estrogen C. Parathyroid hormone D. Corticosteroids

A. Calcitonin

The nurse is asked to explain to the client the age-related processes that contribute to bone loss and osteoporosis. What is the nurse's best response? A. Decrease in estrogen B. Increase in calcitonin C. Decrease in parathyroid hormone D. Increase of vitamin D

A. Decrease in estrogen

Which area of the spinal column is subject to the greatest mechanical stress and degenerative changes? A. Lower lumbar B. Upper lumbar C. Thoracic D. Cervical

A. Lower lumbar

Which of the following is the most common and most fatal primary malignant bone tumor? A. Osteogenic sarcoma (osteosarcoma) B. Osteochondroma C. Enchondroma D. Rhabdomyoma

A. Osteogenic sarcoma (osteosarcoma)

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? A. Trigeminal neuralgia B. Temporomandibular disorder C. Loose teeth D. Dislocated jaw

B. Temporomandibular disorder

Which of the following presents with an onset of heel pain with the first steps of the morning? A. Plantar fasciitis B. Hallux valgus C. Morton's neuroma D. Ganglion

A. Plantar fasciitis

The nurse recognizes that goal of treatment for metastatic bone cancer is to: A. Promote pain relief and quality of life B. Reconstruct the bone with a prosthesis C. Diagnose the extent of bone damage D. Cure the diseased bone and cartilage

A. Promote pain relief and quality of life

Which common problem of the upper extremity results from entrapment of the median nerve at the wrist? A. Ganglion B. Carpal tunnel syndrome C. Dupuytren contracture D. Impingement syndrome

B. Carpal tunnel syndrome

A nurse is caring for a client with eczema. Which medication would be prescribed when an allergy is a factor causing the skin disorder? A. Dexamethasone B. Chlorpheniramine C. Dicloxacillin D. Bupivacaine

B. Chlorpheniramine

Which group is at the greatest risk for osteoporosis? A. Men B. European American women C. Asian American women D. African American women

B. European American women

A nurse notices a client lying on the floor at the bottom of the stairs. The client is alert and oriented and denies pain other than in the arm, which is swollen and appears deformed. After calling for help, what should the nurse do? A. Place the client in a sitting position. B. Immobilize the client's arm. C. Help the client walk to the nearest nurses' station. D. Raise the client's arm above the heart.

B. Immobilize the client's arm.

A patient is having low back pain. What position can the nurse suggest to relieve this discomfort? A. High-Fowler's to allow for maximum hip flexion B. Supine, with the knees slightly flexed and the head of the bed elevated 30 degrees C. Prone, with a pillow under the shoulders D. Supine, with the bed flat and a firm mattress in place

B. Supine, with the knees slightly flexed and the head of the bed elevated 30 degrees

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? A. Open reduction B. Needle aspiration C. Arthroplasty D. Arthroscopy

D. Arthroscopy

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

D. Decreased height

A client visits an orthopedic specialist because of pain beginning in the low back and radiating behind the right thigh and down below the right knee. The doctor suspects a diagnosis of sciatica. The nurse knows that the origin of the pain is between which intervertebral disks? A. C3, C4, and L1 B. L1, L2, and L4 C. L2, L3, and L5 D. L4, L5, and S1

D. L4, L5, and S1

A client is diagnosed with osteomyelitis. This is most commonly caused by which of the following? A. Proteus vulgaris B. Pseudomonas aeruginosa C. Escherichia coli D. Staphylococcus aureus

D. Staphylococcus aureus

A client with chronic osteomyelitis has undergone 6 weeks of antibiotic therapy. The wound appearance has not improved. What action would the nurse anticipate to promote healing? A. Wound packing B. Wound irrigation C. Vitamin supplements D. Surgical debridement

D. Surgical debridement

A nurse is caring for a client with bone metastasis from a primary breast cancer. The client reports muscle weakness and nausea and is voiding large amounts frequently. The telemetry monitor is observed showing premature ventricular contractions. What should the nurse suspect based on the clinical manifestations? A. Hypercalcemia B. Hypocalcemia C. Hypokalemia D. Hyperkalemia

A. Hypercalcemia

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

B. Walk or perform weight-bearing exercises outdoors

The nurse is educating a client with low back pain on proper lifting techniques. The nurse recognizes that the education was effective when the client A. reaches over the head with the arms fully extended. B. places the load close to the body. C. uses a narrow base of support. D. bends at the hips and tightens the abdominal muscles.

B. places the load close to the body.

The nurse has educated a patient with low back pain about techniques to relieve the back pain and prevent further complications. What statement by the patient shows understanding of the education the nurse provided? A. "I will lie prone with my legs slightly elevated." B. "I will bend at the waist when I am lifting objects from the floor." C. "I will avoid prolonged sitting or walking." D. "Instead of turning around to grasp an object, I will twist at the waist."

C. "I will avoid prolonged sitting or walking."

Assessment of a client reveals signs and symptoms of Paget's disease. Which of the following would be most likely? A. Skull narrowing B. Lordosis C. Long bone bowing D. Upright gait

C. Long bone bowing

A client comes back to the clinic with a continued complaint of back pain. What time frame does the nurse understand constitutes "chronic pain"? A. 4 weeks B. 3 months C. 6 months D. 1 year

B. 3 months

Which aspect should a nurse include in the teaching plan for a client with osteomalacia? A. Avoid dairy products B. Include calcium, phosphorus, and vitamin D supplements C. Avoid green, leafy vegetables D. Avoid any activity or exercise

B. Include calcium, phosphorus, and vitamin D supplements

On a visit to the family health care provider, a client is diagnosed with a bunion on the lateral side of the great toe at the metatarsophalangeal joint. Which statement should the nurse include in the teaching session? A. "Bunions are congenital and can't be prevented." B. "Bunions may result from wearing shoes that are too big, causing friction when the shoes slip back and forth." C. "Some bunions are congenital; others are caused by wearing shoes that are too short or narrow." D. "Bunions are caused by a metabolic condition called gout."

C. "Some bunions are congenital; others are caused by wearing shoes that are too short or narrow."

Which client would the nurse identify as having the greatest risk for osteoporosis? A. A 40-year-old overweight African American woman B. A 16-year-old male with a history of asthma C. A small-framed, thin 45-year-old white woman D. A 20-year-old male athlete with repeated injuries

C. A small-framed, thin 45-year-old white woman

While the nurse is performing a physical assessment, the client reports numbness, tingling, and pain when the nurse percusses lightly over the median nerve. What should this assessment indicate to the nurse? A. Morton's neuroma B. Dupuytren's contracture C. Carpal tunnel syndrome D. Impingement syndrome

C. Carpal tunnel syndrome

The nurse is educating the patient with low back pain about the proper way to lift objects. What muscle should the nurse encourage the patient to maximize? A. Gastrocnemius B. Latissimus dorsi C. Quadriceps D. Rectus abdominis

C. Quadriceps

A nurse is teaching a client about preventing osteoporosis. Which teaching point is correct? A. Obtaining an X-ray of the bones every 3 years is recommended to detect bone loss. B. To prevent fractures, the client should avoid strenuous exercise. C. The recommended daily allowance of calcium may be found in a wide variety of foods. D. Obtaining the recommended daily allowance of calcium requires taking a calcium supplement.

C. The recommended daily allowance of calcium may be found in a wide variety of foods.

Primary prevention of osteoporosis includes: A. placing items within the client's reach. B. installing grab bars in the bathroom to prevent falls. C. optimal calcium intake and estrogen replacement therapy. D. using a professional alert system in the home in case a client falls when she's alone.

C. optimal calcium intake and estrogen replacement therapy.