Prep U MSK

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

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

"Keep your right leg elevated above heart level."

Which hormone inhibits bone resorption and increases the deposit of calcium in the bone? -Calcitonin -Vitamin D -Growth hormone -Sex hormones

Calcitonin

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

Calcitonin

In a client with a dislocation, the nurse should initially perform neurovascular assessments a minimum of every 15 minutes until stable. Which complication does the assessments help the nurse to monitor in the client? -Compartment syndrome -Fat embolism syndrome -Carpal tunnel syndrome -Disseminated intravascular coagulation

Compartment syndrome

Which of the following deformity causes a exaggerated curvature of the lumbar spine? -Lordosis -Kyphosis -Scoliosis -Steppage gait

Lordosis

After a fracture, during which stage or phase of bone healing is devitalized tissue removed and new bone reorganized into its former structural arrangement? -Inflammation -Reparative -Revascularization -Remodeling

Remodeling

Which of the following is the final stage of fracture repair? -Cartilage calcification -Cartilage removal -Angiogenesis -Remodeling

Remodeling

A client has Paget's disease. An appropriate nursing diagnosis for this client is: -Risk for infection -Fatigue -Delayed wound healing -Risk for falls

Risk for falls

Which of the following is an appropriate priority nursing diagnosis for the client following an arthrocentesis? -Risk for infection -Deficient knowledge: procedure -Activity intolerance -Chronic pain

Risk for infection

A nurse is preparing to discharge an emergency department client who has been fitted with a sling to support her arm after a clavicle fracture. What should the nurse instruct the client to do? -Avoid moving the elbow, wrist, and fingers until bone remodeling is complete. -Elevate the arm above the shoulder three to four times daily. -Engage in active range of motion using the affected arm. -Use the arm for light activities within the range of motion.

Use the arm for light activities within the range of motion.

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

being male

Each bone is composed of cells, protein matrix, and mineral deposits. Which type of bone cell works to repair a bone fracture? -osteocytes -osteomytes -osteoclasts -osteoblasts

osteocytes

A client diagnosed with carpal tunnel syndrome (CTS) asks the nurse about numbness in the fingers and pain in the wrist. What is the best response by the nurse? -"CTS is a neuropathy that is characterized by pannus formation in the shoulder." -"CTS is a neuropathy that is characterized by flexion contracture of the fourth and fifth fingers." -"CTS is a neuropathy that is characterized by compression of the median nerve at the wrist." -"CTS is a neuropathy that is characterized by bursitis and tendinitis."

"CTS is a neuropathy that is characterized by compression of the median nerve at the wrist."

The nurse is preparing the client for computed tomography. Which information should be given by the nurse? -"Fluid will be removed from you affected joint." -"A small bit of tissue will be removed and sent to the lab." -"You must remain very still during the procedure." -"A radioisotope will be given through an IV."

"You must remain very still during the procedure."

An older adult patient had a hip replacement. When should the patient begin with assisted ambulation with a walker? -1 week -72 hours -24 hours -2 to 3 weeks

24 hours

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

3 months

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

Administering large doses of I.V. antibiotics as ordered

Which is useful in identifying acute or chronic tears of the joint capsule or supporting ligaments of the knee, shoulder, ankle, hip, or wrist? -Meniscography -Arthrography -EMG -Bone densitometry

Arthrography

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? -Arthroscopy -Open reduction -Arthroplasty -Needle aspiration

Arthroscopy

A nurse is caring for an elderly female client with osteoporosis. When teaching the client, the nurse should include information about which major complication? -Bone fracture -Negative calcium balance -Loss of estrogen -Dowager's hump

Bone fracture

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

Chlorpheniramine

The client who had a total hip replacement was discharged home and developed acute groin pain in the affected leg, shortening of the leg, and limited movement of the fractured leg. The nurse interprets these findings as indicating which complication? -Dislocation of the hip -Re-fracture of the hip -Avascular necrosis of the hip -Contracture of the hip

Dislocation of the hip

The nurse is performing a musculoskeletal assessment for a client whose right leg muscles exhibit no tone and are limp. Which descriptor should the nurse use to document this condition? -Flaccid -Atonic -Spastic -Atrophic

Flaccid

The nurse is monitoring a patient who sustained a fracture of the left hip. The nurse should be aware that which kind of shock can be a complication of this type of injury? -Neurogenic -Hypovolemic -Septic -Cardiogenic

Hypovolemic

The client returns to the nursing unit following an open reduction with internal fixation of the right hip. Nursing assessment findings include temperature 100.8 degrees Fahrenheit, heart rate 112 beats per minute, respiratory rate 28 breaths per minute, and blood pressure 86/58. There is no urine in the Foley catheter collection bag. The nurse interprets these findings as indicating which complication? -Osteomyelitis -Urinary retention -Atelectasis -Hypovolemic shock

Hypovolemic shock

Which of the following is the most common site of joint effusion? -Elbow -Shoulder -Knee -Hip

Knee

The nurse is performing an assessment on an older adult patient and observes the patient has an increased forward curvature of the thoracic spine. What does the nurse understand this common finding is known as? -Scoliosis -Lordosis -Osteoporosis -Kyphosis

Kyphosis

Which cells are involved in bone resorption? -Osteocytes -Chondrocytes -Osteoclasts -Osteoblasts

Osteoclasts

A nurse is caring for a client who is recovering in the hospital following orthopedic surgery. The nurse is performing frequent assessments for signs and symptoms of infection in the knowledge that the client faces a high risk of what infectious complication? -Septic arthritis -Sepsis -Osteomyelitis -Cellulitis

Osteomyelitis

Which nursing instruction is most important to stress when teaching on calcium intake? -Maintain diary sources of calcium intake. -Provide age-related calcium intake recommendations. -Eat green, leafy vegetables. -Drink calcium- and vitamin D-fortified orange juice.

Provide age-related calcium intake recommendations.

A client has a fracture that is being treated with open rigid compression plate fixation devices. What teaching will the nurse reinforce to the client about how the progress of bone healing will be monitored? -The plate will be removed to determine if the bone is growing back. -The bone will heal on its own without intervention. -An arthroscopy will be performed. -Serial x-rays will be taken.

Serial x-rays will be taken.

A client undergoes an invasive joint examination of the knee. What will the nurse closely monitor the client for? -Lack of sleep and appetite -Signs of depression -Serous drainage -Signs of shock

Serous drainage

Which laboratory study indicates the rate of bone turnover? -Serum calcium -Urine calcium -Serum phosphorous -Serum osteocalcin

Serum osteocalcin

The health care team is caring for a client with osteomalacia. It has been determined that the osteomalacia is caused by malabsorption. What treatment should the nurse anticipate? -Colony-stimulating factors and calcitonin -Supplemental potassium and pancreatic enzymes -Supplemental calcium and increased doses of vitamin D -Exogenous parathyroid hormone and multivitamins

Supplemental calcium and increased doses of vitamin D

Skull sutures are an example of which type of joint? -Diarthrosis -Aponeuroses -Synarthrosis -Amphiarthrosis

Synarthrosis

A client experiences a musculoskeletal injury that involves the structure that connects a muscle to the bone. The nurse understands that this injury involves which structure? -Tendon -Ligament -Cartilage -Joint

Tendon

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

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

A client visits the health care provider for a routine checkup. The history reveals that the client was diagnosed with a spinal curvature. Which region of the spine should the nurse assess for complications? -Sacral -Thoracic -Lumbar -Cervical

Thoracic

When teaching a client how to prevent low back pain as a result of lifting, the nurse should instruct the client to -use a narrow base of support. -bend the knees and loosen the abdominal muscles. -place the load away from the body. -avoid overreaching.

avoid overreaching

When the client who has experienced trauma to an extremity reports severe burning pain, vasomotor changes, and muscles spasms in the injured extremity, the nurse recognizes that the client is likely demonstrating signs of -heterotrophic ossification. -complex regional pain syndrome. -avascular necrosis of bone. -a reaction to an internal fixation device.

complex regional pain syndrome.

Which is not one of the general nursing measures employed when caring for the client with a fracture? -administering analgesics -cranial nerve assessment -providing comfort measures -assisting with ADLs

cranial nerve assessment

A client who has fallen and injured a hip cannot place weight on the leg and is in significant pain. After radiographs indicate intact but malpositioned bones, what would the physician diagnose? -dislocation -sprain -fracture -strain

dislocation

The nurse is teaching a client about osteoporosis. What diagnostic test will the nurse include with the client teaching? -arthrocentesis -arthroscopy -bone biopsy -dual-energy x-ray absorptiometry

dual-energy x-ray absorptiometry

A client has come to the clinic with foot pain. The physician has described the client's condition as a flexion deformity of the proximal interphalangeal joint. What is the name of this disorder? -Heberden nodes -mallet toe -hallux valgus (bunion) -hammer toe

hammer toe

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? -"I will bend at the waist when I am lifting objects from the floor." -"Instead of turning around to grasp an object, I will twist at the waist." -"I will lie prone with my legs slightly elevated." -"I will avoid prolonged sitting or walking."

"I will avoid prolonged sitting or walking."

A nurse is educating a client diagnosed with osteomalacia. Which statement by the nurse is appropriate? -"You will need to avoid foods high in phosphorus and vitamin D." -"You will need to decrease the amount of dairy products you consume." -"You may need to be evaluated for an underlying cause, such as renal failure." -"You will need to engage in vigorous exercise three times a week for 30 minutes."

"You may need to be evaluated for an underlying cause, such as renal failure."

A patient tells the nurse, "I was working out and lifting weights and now that I have stopped, I am flabby and my muscles have gone!" What is the best response by the nurse? -"Once you stop exercising, the contraction of the muscle does not regain its strength." -"The muscle mass has decreased from the lack of calcium in the cells." "-Your muscles were in a state of hypertrophy from the weight lifting but it will persist only if the exercise is continued." -"While you are lifting weights, endorphins are released, creating increase in muscle mass, but if the muscles are not used they will atrophy."

"Your muscles were in a state of hypertrophy from the weight lifting but it will persist only if the exercise is continued."

The client displays manifestations of compartment syndrome. What treatment will the nurse expect the client to be scheduled for? -A total hip replacement -An open reduction -A total knee replacement -A fasciotomy

A fasciotomy

A patient is diagnosed with osteogenic sarcoma. What laboratory studies should the nurse monitor for the presence of elevation? -Troponin levels -Magnesium level -Alkaline phosphatase -Potassium level

Alkaline phosphatase

A client is experiencing muscle weakness in the upper extremities. The client raises an arm above the head but then loses the ability to maintain the position. Muscular dystrophy is suspected. Which diagnostic test would evaluate muscle weakness or deterioration? -An electromyography -An arthroscopy -A serum calcium test -A magnetic resonance imaging (MRI)

An electromyography

When providing discharge teaching to a client with a fractured toe, the nurse should include which instruction? -Apply heat to the fracture site. -Perform ankle dorsiflexion three times per day. -Apply ice to the fracture site. -Use crutches for 1 week.

Apply ice to the fracture site.

A client has had an electromyography. What is an appropriate nursing intervention following this diagnostic procedure? -Apply warm compresses. -Monitor the client for infection. -Monitor the client for anaphylaxis. -Apply a compression dressing.

Apply warm compresses

A nurse is caring for a client placed in traction to treat a fractured femur. Which nursing intervention has the highest priority? -Ensuring that the weights hang free at all times -Keeping the client from sliding to the foot of the bed -Assessing the extremity for neurovascular integrity -Keeping the ropes over the center of the pulley

Assessing the extremity for neurovascular integrity

Which is an indicator of neurovascular compromise? -Diminished pain -Pain upon active stretch -Capillary refill of more than 3 seconds -Warm skin temperature

Capillary refill of more than 3 seconds

Which common problem of the upper extremity results from entrapment of the median nerve at the wrist? -Dupuytren contracture -Ganglion -Carpal tunnel syndrome -Impingement syndrome

Carpal tunnel syndrome

The nurse is caring for a pregnant patient with pregnancy-induced hypertension. When assessing the reflexes in the ankle, the nurse observes rhythmic contractions of the muscle when dorsiflexing the foot. What would the nurse document this finding as? -Hypertrophy -Positive Babinski reflex -Ankle reflex -Clonus

Clonus

An x-ray demonstrates a fracture in which a bone has splintered into several pieces. Which type of fracture is this? -Comminuted -Depressed -Compound -Impacted

Comminuted

In a client with a dislocation, the nurse should initially perform neurovascular assessments a minimum of every 15 minutes until stable. Which complication does the assessments help the nurse to monitor? -Ganglion cysts -Carpal tunnel syndrome -Gastrointestinal bleeding -Compartment syndrome

Compartment syndrome

Choose the correct statement about the endosteum, a significant component of the skeletal system: -Contains blood vessels and lymphatics -Facilitates bone growth -Covers the marrow cavity of long bones -Supports the attachment of tendons to bones

Covers the marrow cavity of long bones

A client has a cast applied to the leg for treatment of a tibia fracture and also has a wound on the leg that requires dressing changes due to drainage. For what should the nurse prepare the client? -Removal of the cast -Cutting a cast window -Insertion of an external fixator -Cutting of a bivalve cast

Cutting a cast window

Which term refers to a flexion deformity caused by a slowly progressive contracture of the palmar fascia? -Hallux valgus -Hammertoe -Dupuytren's contracture -Callus

Dupuytren's contracture

The primary nursing intervention that will control swelling while treating a musculoskeletal injury is: -Elevate the affected area. -Apply an elastic compression bandage. -Apply cold (moist or dry). -Immobilize the injured area.

Elevate the affected area.

The client with a fractured left humerus reports dyspnea and chest pain. Pulse oximetry is 88%. Temperature is 100.2 degrees Fahrenheit (38.5 degrees Centigrade); heart rate is 110 beats per minute; respiratory rate is 32 breaths per minute. The nurse suspects the client is experiencing: -Delayed union -Compartment syndrome -Fat embolism syndrome -Complex regional pain syndrome

Fat embolism syndrome

During a routine physical examination of a client, the nurse observes a flexion deformity of the proximal interphalangeal (PIP) joint of two toes on the right foot. How would the nurse document this finding -Hallux valgus -Hammer toe -Mallet toe -Bunion

Hammer toe

A healthcare provider asks a nurse to test a client for Tinel's sign to diagnose carpal tunnel syndrome. What should the nurse do to perform this assessment? -Have the client stretch the fingers around a ball and squeeze with force. -Have the client pronate the hand while the nurse palpates the radial nerve. -Have the client make a fist and open the hand against resistance. -Have the client hold the palm of the hand up while the nurse percusses over the median nerve.

Have the client hold the palm of the hand up while the nurse percusses over the median nerve.

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 term refers to muscle tension being unchanged with muscle shortening and joint motion? -Contracture -Fasciculation -Isotonic contraction -Isometric contraction

Isotonic contraction

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

Long bone bowing

Which area of the spinal column is subject to the greatest mechanical stress and degenerative changes? -Lower lumbar -Cervical -Upper lumbar -Thoracic

Lower lumbar

A client scheduled to undergo an electromyography asks the nurse what this test will evaluate. What is the correct response from the nurse? -Metastatic bone lesions -Bone density -Muscle composition -Muscle weakness

Muscle weakness

Which of the following describes failure of the ends of a fractured bone to unite in normal alignment? -Nonunion -Delayed union -Malunion -Subluxation

Nonunion

The nurse is caring for a client with an external fixator that requires pin care twice a day. The nurse observes that there is a new purulent drainage around one of the pins. What intervention should the nurse anticipate doing? -Obtaining a culture -Apply ointment to the pin site. -Scrubbing the drainage from around the pin site -Applying iodine-based solution

Obtaining a culture

A nurse is caring for a client with an undiagnosed bone disease. When instructing on the normal process to maintain bone tissue, which process transforms osteoblasts into mature bone cells? -Remodeling -Resorption -Ossification and calcification -Epiphyses and diaphysis formation

Ossification and calcification

A client presents to the emergency department with fever, chills, restlessness, and limited movement of a fractured jaw. What complication should the nurse interpret as the findings? -Avascular necrosis -Osteomyelitis -Compartment syndrome -Fat embolism

Osteomyelitis

Which nursing intervention is essential in caring for a client with compartment syndrome? -Starting an I.V. line in the affected extremity in anticipation of venogram studies -Wrapping the affected extremity with a compression dressing to help decrease the swelling -Removing all external sources of pressure, such as clothing and jewelry -Keeping the affected extremity below the level of the heart

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

Which of the following musculoskeletal injuries is manifested by acromioclavicular joint pain? -Acute compartment syndrome -Heterotopic ossification -Epicondylitis -Rotator cuff tears

Rotator cuff tears

A client is having a cast applied for a fractured leg that extends from below the knee to the base of the toes. The foot is flexed at a right angle in a neutral position. What type of cast is the client having applied? -Walking cast -Hip spica cast -Short leg cast -Long leg cast

Short leg cast

An elderly client's hip joint is immobilized prior to surgery to correct a femoral head fracture. What is the nurse's priority assessment? -The client's complaints of pain -The presence of internal or external rotation -The presence of leg shortening -Signs of neurovascular compromise

Signs of neurovascular compromise

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? -"Some bunions are congenital; others are caused by wearing shoes that are too short or narrow." -"Bunions are caused by a metabolic condition called gout." -"Bunions are congenital and can't be prevented." -"Bunions may result from wearing shoes that are too big, causing friction when the shoes slip back and forth."

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

A client reports pain in the right knee, stating, "My knee got twisted when I was going down the stairs." The client was diagnosed with an injury to the ligaments and tendons of the right knee. Which terminology, documented by the nurse, best reflects the injury? -Strain -Sprain -Subluxation -Dislocation

Sprain

A client is brought to the emergency department after being struck with a baseball bat on the upper arm while diving for a pitched ball. Diagnostic tests reveal that the humerus is not broken but that the client has suffered another type of injury. What type of injury would the physician likely diagnose? -subluxation -sprain -contusion -strain

contusion

A client who has injured a hip in a fall cannot place weight on the leg and is in significant pain. After radiographs indicate intact yet malpositioned bones, what repair would the physician perform? -analgesia and immobilization -ice and immobilization -joint manipulation and immobilization -heat and immobilization

joint manipulation and immobilization

The nurse is conducting a medication reconciliation with a client admitted with a fracture. What medication predisposes a client for a risk for fractures? -digoxin -furosemide -metoprolol -prednisone

prednisone

Red bone marrow produces which of the following? Select all that apply. -Red blood cells (RBCs) -Estrogen -Platelets -White blood cells (WBCs) -Corticosteroids

-Red blood cells (RBCs) -Platelets -White blood cells (WBCs)

A patient had a total hip replacement. What recommended leg position should the nurse ensure is maintained to prevent prosthesis dislocation? -Flexion -Adduction -Internal rotation -Abduction

Abduction

Which statement describes paresthesia? -Absence of muscle movement suggesting nerve damage -Abnormal sensations -Absence of muscle tone -Involuntary twitch of muscle fibers

Abnormal sensations

A client has undergone arthroscopy. After the procedure, the site where the arthroscope was inserted is covered with a bulky dressing. The client's entire leg is also elevated without flexing the knee. What is the appropriate nursing intervention required in caring for a client who has undergone arthroscopy? -Apply warm compresses to the insertion site. -Provide a gentle massage. -Apply a cold pack at the insertion site. -Assist with performing ROM exercises.

Apply a cold pack at the insertion site.

If a dislocation is not treated promptly, tissue death due to anoxia can occur. This would be documented as which of the following? -Subluxation -Heterotopic ossification -Osteomyelitis -Avascular necrosis (AVN)

Avascular necrosis (AVN)

When an infection is bloodborne, the manifestations include which symptom? -Chills -Bradycardia -Hyperactivity -Hypothermia

Chills

A client is admitted to the emergency room after being hit by a car while riding a bicycle. The client sustained a fracture of the left femur, and the bone is protruding through the skin. What type of fracture does the nurse recognize requires emergency intervention? -Spiral -Oblique -Compound -Greenstick

Compound

Which is a circulatory indicator of peripheral neurovascular dysfunction? -Paralysis -Paresthesia -Cool skin -Weakness

Cool skin

The nurse is assessing the muscle tone of a client with cerebral palsy. Which description does the nurse determine to be an expected assessment of this client's muscle tone? -Hypertonic -Flaccid -Atonic -Atrophied

Hypertonic

A client who was in a motor vehicle crash is diagnosed with a stable T7 spinal fracture with no neurologic deficits. Which nursing intervention should the nurse implement? -Sit the client upright in a padded chair for meals. -Withhold opioid pain medication to prevent ileus. -Maintain bed rest with the head of the bed at 20 degrees. -Maintain NPO (nothing by mouth) status for surgical repair.

Maintain bed rest with the head of the bed at 20 degrees.

An instructor is describing the process of bone development. Which of the following would the instructor describe as being responsible for the process of ossification? -Cortical bone -Cancellous bone -Osteoblasts -Osteoclasts

Osteoblasts

A nurse is caring for an older woman with a hip fracture. What are appropriate risk factors for the nurse to consider related to the client's hip fracture? Select all that apply. -Presence of anemia -History of diverticulitis -Female gender -Muscular agility -Osteoporosis

Presence of anemia Female gender Osteoporosis

A client has just undergone arthrography. What is the most important instruction for the nurse to include in the teaching plan? -Gently massage joints with any crackling or clicking joint noises. -Avoid sunlight or harsh, dry climate. -Avoid intake of dairy products. -Report joint crackling or clicking noises occurring after the second day.

Report joint crackling or clicking noises occurring after the second day.

Six weeks after an above-the-knee amputation (AKA), a client returns to the outpatient office for a routine postoperative checkup. During the nurse's assessment, the client reports symptoms of phantom pain. What should the nurse tell the client to do to reduce the discomfort of the phantom pain? -Apply intermittent hot compresses to the area of the amputation. -Elevate the level of the amputation site. -Take opioid analgesics as prescribed. -Avoid activity until the pain subsides.

Take opioid analgesics as prescribed.

A client is diagnosed with a first-degree strain of the left ankle related to running 5 miles daily. How would the nurse differentiate the first-degree strain from other strains and sprains? -The client has some edema of the left ankle with muscle spasms but is able to walk without assistive devices. -The client complains of pain when the joint is moved and has mild edema. The client is unable to bear weight on the left ankle and has a large ecchymotic area. -The client has ecchymosis, edema, and has no function of the left foot and ankle.

The client has some edema of the left ankle with muscle spasms but is able to walk without assistive devices.

A client has a fractured femur and is being seen in the emergency department. The nurse assessing the area notices there is a grating sound that is suspected to be bone ends moving over one another. This sound is called: -spasm. -false motion. -deformity. -crepitus.

crepitus

A variety of complications can occur after a leg amputation. Which is not a possibility in the immediate postoperative period? -infection -hematoma -osteomyelitis -hemorrhage

osteomyelitis

A client is having repeated tears of the joint capsule in the shoulder, and the health care provider orders an arthrogram. What intervention should the nurse provide after the procedure is completed? Select all that apply. -Apply heat to the area for 48 hours. -Inform the client that a clicking or crackling noise in the joint may persist for a couple of days. -Apply a compression bandage to the area. -Administer a mild analgesic. -Actively exercise the area immediately after the procedure.

-Inform the client that a clicking or crackling noise in the joint may persist for a couple of days. -Apply a compression bandage to the area. -Administer a mild analgesic.

A nurse is performing discharge teaching for an elderly client with osteoporosis. Which instruction about a calcium supplement should the nurse include? -Take the supplement on an empty stomach with a full glass of water. -Take the supplement with meals or with orange juice. -Remain in an upright position 30 minutes after taking the supplement. -Take weekly on the same day and at the same time.

Take the supplement with meals or with orange juice.

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

Increase fiber intake.

Which nursing intervention is appropriate for a client with a closed-reduction extremity fracture? -Use frequent dependent positioning to prevent edema -Promote intake of omega-3 fatty acids -Encourage participation in ADLs -Administer prescribed enema to prevent constipation

Encourage participation in ADLs

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. -Cut the cast with a cast saw -Assess for a pressure sore -Determine the exact site of the pain. -Administer a prescribed analgesic to promote comfort and allay anxiety. -Assess the fingers for color and temperature.

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

A client with diabetes punctured the foot with a sharp object. Within a week, the client developed osteomyelitis of the foot. The client was admitted for IV antibiotic therapy. How long does the nurse anticipate the client will receive IV antibiotics? -3 months -7 to 10 days -6 months -At least 4 weeks

At least 4 weeks

The nurse caring for a client, who has been treated for a hip fracture, instructs the client not to cross their legs and to have someone assist with tying their shoes. Which additional instruction should the nurse provide to client? -Do not flex the hip more than 60 degrees. -Do not flex the hip more than 30 degrees. -Do not flex the hip more than 120 degrees. -Do not flex the hip more than 90 degrees.

Do not flex the hip more than 90 degrees.

A client is being treated for a fractured hip and the nurse is aware of the need to implement interventions to prevent muscle wasting and other complications of immobility. What intervention best addresses the client's need for exercise? -Performing gentle leg lifts with both legs -Encouraging frequent use of the over-bed trapeze -Performing massage to stimulate circulation -Encouraging the client to logroll side to side once per hour

Encouraging frequent use of the over-bed trapeze

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

The nurse is assisting with the application of a cast. What will the nurse expect to be done first? -Cleaning the skin surface. -Applying strips of the cast material evenly. -Arranging for an x-ray to check bone alignment. -Covering the skin with a stockinette.

Cleaning the skin surface.

Which type of fracture involves a break through only part of the cross-section of the bone? -Open -Comminuted -Oblique -Incomplete

Incomplete

A group of students is reviewing information about cast composition in preparation for a discussion on the advantages and disadvantages of each. The students demonstrate understanding of the topic when they cite which of the following as an advantage of a plaster cast? -Longer lasting -Better molding to the client -More breathable -Quicker drying

Better molding to the client

A nurse is caring for a client who is in skeletal traction. To prevent the complication of skin breakdown in a client with skeletal traction, what action should be included in the plan of care? -Encourage the client to push up with the elbows when repositioning. -Encourage the client to perform isometric exercises once a shift. -Assess the pin insertion site every 8 hours. -Apply occlusive dressings to the pin sites.

Assess the pin insertion site every 8 hours.

The nurse is assessing the feet of a patient and observes an overgrowth of the horny layer of the epidermis. What does the nurse recognize this condition as? -Hammer Toe -Corn -Bunion -Clawfoot

Corn

A client was climbing a ladder, slipped on a rung, and fell on the right side of the chest. X-ray studies reveal three rib fractures, and the client reports pain with inspiration. What is the anticipated treatment for this client? -Coughing and deep breathing with pillow splinting -Mechanical ventilation -Chest strapping -Thoracentesis

Coughing and deep breathing with pillow splinting

Which would be contraindicated as a component of self-care activities for the client with a cast? -Elevate the casted extremity to heart level frequently -Do not attempt to scratch the skin under a cast -Cover the cast with plastic to insulate it -Cushioning rough edges of the cast with tape

Cover the cast with plastic to insulate it

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? -Increase of vitamin D -Decrease in estrogen -Increase in calcitonin -Decrease in parathyroid hormone

Decrease in estrogen

Which group is at the greatest risk for osteoporosis? -African American women -Asian American women -European American women -Men

European American women

The client with osteoarthritis is seen in the clinic. Which assessment finding indicates the client is having difficulty implementing self-care? -Has a weight gain of 5 pounds -Reports decreased joint pain -Shows increased joint flexibility -Reports ability to perform ADLs

Has a weight gain of 5 pounds

A patient in pelvic traction needs circulatory status assessed. How should the nurse assess for a positive Homans' sign? -Have the patient plantar flex both feet while the nurse performs the blanch test on all of the patient's toes. -Have the patient squeeze the nurse's hands with his or her hands to evaluate any difference in strength. -Have the patient extend both hands while the nurse compares the volume of both radial pulses. -Have the patient extend each leg and dorsiflex each foot to determine if pain or tenderness is present in the lower leg.

Have the patient extend each leg and dorsiflex each foot to determine if pain or tenderness is present in the lower leg.

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? -Hypocalcemia -Hypokalemia -Hyperkalemia -Hypercalcemia

Hypercalcemia

A nurse is caring for a client who has suffered a hip fracture and who will require an extended hospital stay. The nurse should ensure that the client does what action to prevent common complications associated with a hip fracture? -Avoid requesting analgesia unless pain becomes unbearable. -Use supplementary oxygen when transferring or mobilizing. -Increase fluid intake and perform prescribed foot exercises. -Remain on bed rest for 14 days or until instructed by the orthopedic surgeon.

Increase fluid intake and perform prescribed foot exercises.

After a traumatic back injury, a client requires skeletal traction. Which intervention takes priority? -Restricting the client's fluid and fiber intake to reduce the movement required for bedpan use -Supporting the traction weights with a chair or table to prevent accidental slippage -Maintaining traction continuously to ensure its effectiveness -Monitoring the client for skin breakdown

Maintaining traction continuously to ensure its effectiveness

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. -Use measures other than turning to prevent pressure ulcers. -Keep the affected leg in a position of adduction. -Keep the hip flexed by placing pillows under the client's knee.

Prevent internal rotation of the affected leg.

A client is brought to the emergency department by a softball team member who states the client and another player ran into each other, and the client is having severe pain in the right shoulder. What symptoms of a fractured clavicle does the nurse recognize? -Client complains of pain in the unaffected shoulder. -Client complains of tingling and numbness in the right shoulder. -Right shoulder slopes downward and droops inward. -Right shoulder is elevated above the left.

Right shoulder slopes downward and droops inward.

A client has severe osteoarthritis in the left hip and is having surgery to replace both articular surfaces of the hip. What type of surgical procedure will the nurse prepare the client for? -Arthrodesis -Osteotomy -Total arthroplasty -Hemiarthroplasty

Total arthroplasty

A client with a musculoskeletal injury is instructed to alter the diet. The objective of altering the diet is to facilitate the absorption of calcium from food and supplements. Considering the food intake objective, which food item should the nurse encourage the client to include in the diet? -Bananas -Green vegetables -Vitamin D-fortified milk -Red meat

Vitamin D-fortified milk

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

Walk or perform weight-bearing exercises outdoors

The nurse working in the emergency department receives a call from the x-ray department communicating that the client the nurse is caring for has a fracture in the shaft of the tibia. The nurse tells the physician that the client's fracture is in the -scoliosis. -epiphysis. -diaphysis. -lordosis.

diaphysis.

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. -Delirium -Necrosis of the humerus -Skin breakdown -Pneumonia -Sepsis

Delirium Skin breakdown Pneumonia Sepsis

A client has just undergone a leg amputation. What will the nurse closely monitor the client for during the immediate postoperative period? -Chronic osteomyelitis -Unexplainable burning pain (causalgia) -Hematoma -Neuroma

Hematoma

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? -L1, L2, and L4 -L4, L5, and S1 -L2, L3, and L5 -C3, C4, and L1

L4, L5, and S1

Which term refers to a disease of a nerve root? -Involucrum -Contracture -Sequestrum -Radiculopathy

Radiculopathy

A nurse is giving instructions to a client who's going home with a leg cast. Which teaching point is most critical? -Using crutches properly -Reporting signs of impaired circulation -Avoiding walking on a leg cast without the health care provider's permission -Exercising joints above and below the cast, as ordered

Reporting signs of impaired circulation

A nurse is caring for a client who has sustained ligament and a meniscal injury to the knee. Which action would be most appropriate to allow the client to progress without causing further injury? -Apply heat to the affected area every night. -Assist with a gradual introduction of activity. -Administer nonsteroidal anti-inflammatory drugs (NSAIDs) regularly. -Apply a cold pack to the affected area every night.

Assist with a gradual introduction of activity.

A nurse is preparing to discharge a client from the emergency department after receiving treatment for an ankle sprain. While providing discharge education, the nurse should encourage what action? -Keep an elastic compression bandage on the ankle. -Exercise hourly by performing rotation exercises of the ankle. -Apply heat for the first 24 to 48 hours after the injury. -Maintain the ankle in a dependent position.

Keep an elastic compression bandage on the ankle.

Hypercalcemia is a dangerous complication of bone cancer. Therefore, nursing assessment includes evaluation of symptoms that require immediate treatment. Which of the following are signs/symptoms that are indictors of an elevated serum calcium? Select all that apply. -Muscle weakness -Lack of muscle coordination -Anorexia and constipation -Prolonged ST segment -Shortened QT interval -Tachycardia

Muscle weakness Anorexia and constipation Shortened QT interval Tachycardia

Which of the following is the only selective estrogen receptor modulator approved for osteoporosis in post menopausal women? -Forteo -Denosumab -Fosamax -Raloxifene

Raloxifene

A client with Paget's disease comes to the hospital and reports difficulty urinating. The emergency department health care provider consults urology. What should the nurse suspect is the most likely cause of the client's urination problem? -Benign prostatic hyperplasia -Dehydration -Urinary tract infection (UTI) -Renal calculi

Renal calculi

The orthopedic surgeon has prescribed balanced skeletal traction for a client. What advantage is conferred by balanced traction? -Balanced traction can be applied at night and removed during the day. -Balanced traction allows for greater client movement and independence than other forms of traction. -Balanced traction is portable and may accompany the client's movements. -Balanced traction facilitates bone remodeling in as little as 6 days.

Balanced traction allows for greater client movement and independence than other forms of traction.

A patient has stepped in a hole in the yard, causing an ankle injury. The ankle is edematous and painful to palpation. How long should the nurse inform the patient that the acute inflammatory stage will last? -Less than 24 hours -Between 24 and 48 hours -At least 1 week -About 72 hours

Between 24 and 48 hours -At least 1 week

Pulselessness, a very late sign of compartment syndrome, may signify -Nerve involvement -Venous congestion -Lack of distal tissue perfusion -Diminished arterial perfusion

Lack of distal tissue perfusion