1110 questions bones + prep u

. A 63 year old patient has severe osteoarthritis in the right knee. The patient is scheduled for a knee osteotomy. You are providing pre-op teaching about this procedure to the patient. Which statement made by the patient is correct about this procedure?* A. "This procedure will realign the knee and help decrease the amount of weight experienced on my right knee." B. "A knee osteotomy is also called a total knee replacement." C. "A knee osteotomy is commonly performed for patients who have osteoarthritis in both knees." D. "This procedure will realign the unaffected knee and help alleviate the amount of weight experienced on the right knee."

A

A patient presents with multiple fractures and blue sclera of the eye. The same disease in infants would result in: A Death. B A, C, D. C Fractures. D Blue sclera.

B in infants, in addition to the blue sclera and the fractures, it causes death at birth or within the first year of life due to the distorted thoracic bone formation.

A client undergoes a total hip replacement. Which statement made by the client indicates to the nurse that the client requires further teaching? A)"I need to remember not to cross my legs. It's such a habit." B) "I'll need to keep several pillows between my legs at night." C)"I don't know if I'll be able to get off that low toilet seat at home by myself." D)"The occupational therapist is showing me how to use a sock puller to help me get dressed."

c

A nurse is assigned to support a patient while a cast is being applied to treat a greenstick fracture. The nurse documents that this fracture is classified as what type of fracture? a)Closed b) Compression c)Incomplete d) Stress

c

A client with arterial insufficiency undergoes below-knee amputation of the right leg. Which action should the nurse include in the postoperative care plan? a)Applying heat to the stump as the client desires b)Maintaining the client on complete bed rest c)Removing the pressure dressing after the first 8 hours d)Elevating the stump for the first 24 hours

d Stump elevation for the first 24 hours after surgery helps reduce edema and pain by increasing venous return and decreasing venous pooling at the distal portion of the extremity. Bed rest isn't indicated and could predispose the client to complications of immobility. Heat application would be inappropriate because it promotes vasodilation, which may cause hemorrhage and increase pain. The initial pressure dressing usually remains in place for 48 to 72 hours after surgery.

During a head-to-toe assessment of a patient with osteoarthritis, you note bony outgrowths on the distal interphalangeal joints. You document these findings as:* A. Bouchard's Nodes B. Heberden's Nodes C. Neurofibromatosis D. Dermatofibromas

B

Which patients below are at risk for developing osteoarthritis? Select-all-that-apply:* A. A 65 year old male with a BMI of 35. B. A 59 year old female with a history of taking long term doses of corticosteroids. C. A 55 year old male with a history of repeated right knee injuries. D. A 60 year old female with high uric acid levels.

A,C corticosteroids doesnt effect the OA risk factors are BMI equal to or greater than 30, older age, history of joint injury.

A patient with osteoarthritis is describing their signs and symptoms. Which signs and symptoms below are NOT associated with osteoarthritis? Select-all-that-apply:* A. Morning stiffness greater than 30 minutes B. Experiencing grating during joint movement C. Fever and Anemia D. Symmetrical joint involvement E. Pain and stiffness tends to be worst at the end of the day

A,C,D morning stiffness in OA is less than 30 mins. OA is not symmetrical or systemic which means it can occur only in joints and only in one side of the body. no fever or anemia

You receive your patient back from radiology. The patient had an x-ray of the hips and knees for the evaluation of possible osteoarthritis. What findings would appear on the x-ray if osteoarthritis was present? Select-all-that-apply:* A. Increased joint space B. Osteophytes C. Sclerosis of the bone D. Abnormal sites of hyaline cartilage

B,C you can only see the bones using the x-ray NOT the cartilage + you will have a decreased cartilage space NOT increased.

A patient newly diagnosed with osteoarthritis asks about the medication treatments for their condition. Which medication is NOT typically prescribed for OA?* A. NSAIDs B. Topical Creams C. Oral corticosteroids D. Acetaminophen (Tylenol)

C oral corticosteroids is not effective in OA, instead injections of corticosteroids are given in the effected joint.

Which drug reduces the incidence of fracture and increases bone mineral density, while reducing pain levels and increasing energy levels? A Risedronate. B Gentamycin. C Tramadol. D Pamidronate.

D Cyclic administration of intravenous pamidronate reduces the incidence of fracture and increases bone mineral density, while reducing pain levels and increasing energy levels.

A client comes to the Emergency Department complaining of localized pain and swelling of his lower leg. Ecchymotic areas are noted. History reveals that the client got hit in the leg with a baseball bat. Which of the following would the nurse suspect as most likely? a)Sprain b)Fracture c)Strain d) Contusion

D The client's description of blunt trauma by a baseball bat and localized pain in conjunction with swelling and ecchymosis would most likely suggest a contusion. A fracture would be manifested by pain, loss of function, deformity, swelling, and spasm. A sprain would be manifested by pain and swelling; ecchymosis may appear later. A strain is characterized by inflammation, local tenderness, and muscle spasms.

A client is experiencing pain, joint instability, and difficulty walking due to an injury to the knee ligaments. The injury was judged not to require surgery. Which intervention would not be included in this client's care? a)traction b) joint immobilization c)ice and NSAIDs d)limited weight bearing

a

Which factor inhibits fracture healing? a)Local malignancy b)Vitamin D c)Exercise d)Maximum bone fragment contact

a

A client has been diagnosed with a muscle strain. What does the physician mean with the term "strain"? a) injury resulting from a blow or blunt trauma b)stretched or pulled beyond its capacity c) injuries to ligaments surrounding a joint d)subluxation of a joint

b

A client with a traumatic amputation of the right lower leg is refusing to look at the leg. Which action by the nurse is most appropriate? a)Encourage the client to perform range-of-motion (ROM) exercises to the right leg. b) Provide feedback on the client's strengths and available resources. c)Provide wound care without discussing the amputation. d)Request a referral to occupational therapy.

b

A client with metastatic bone cancer sustained a left hip fracture without injury. What type of fracture does the nurse understand occurs without trauma or fall? a)Impacted fracture b)Pathologic fracture c)Transverse fracture d)Compound fracture

b

A client who suffers an injury in a local high school hockey game presents with left shoulder pain. The client cannot move the left arm, and the left shoulder is lower than the right shoulder. The nurse recognizes the client most likely has a: a)Clavicle fracture b)Dislocated shoulder c)Dislocated elbow d)Cervical injury

b Clinical manifestations of a dislocated shoulder include pain, lack of motion, feeling of an empty shoulder socket, and uneven posture.

Which general nursing measure is used for a client with a fracture reduction? a)Examine the abdomen for enlarged liver or spleen b)Encourage participation in ADLs c)Assist with intake of immune-enhancing tube feeding formulas d) Promote intake of omega-3 fatty acids

b General nursing measures for a client with a fracture reduction include administering analgesics, providing comfort measures, encouraging participation in ADLs, promoting physical mobility, preventing infection, maintaining skin integrity, and preparing the client for self-care.

The nurse is teaching the parents of a newborn with osteogenesis imperfecta. The nurse should tell the parents: A That the baby will need daily calcium supplements. B To lift the baby by the buttocks when diapering. C That the condition is a temporary one. D That only the bones are affected by the disease.

b to prevent fractures instead of lifting the child by the ankles.

The nurse is caring for a client who was involved in an automobile accident and sustained multiple trauma. The client has a Volkmann's contracture to the right hand. What objective data does the nurse document related to this finding? a)Clawlike deformity of the right hand without ability to extend fingers b)Extension of the fingers of the right hand c)Nodules on the knuckles of the third and fourth finger d)Dislocation of the fingers

A

The nurses 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? a)Do not flex the hip more than 90 degrees. b)Do not flex the hip more than 60 degrees. c)Do not flex the hip more than 120 degrees. d)Do not flex the hip more than 30 degrees.

A

What bone disorder is caused by an autosomal dominant defect in the synthesis of collagen type 1? A Osteogenesis imperfecta. B Achondroplasia. C Osteopetrosis. D Osteomyelitis.

A osteogenesis imperfecta is mainly caused because of defect in collagen type 1 production.

The home health nurse is visiting an 18-year-old with osteogenesis imperfecta. Which information obtained on the visit would cause the most concern? The client: A Likes to play football. B Drinks several carbonated drinks per day. C Has two sisters with sickle cell trait. D Is taking acetaminophen to control pain

A playing football is not encouraged in this condition and will cause fractures.

A patient with osteoarthritis has finished their first physical therapy session. As the nurse you want to evaluate the patient's understanding of the type of exercises they should be performing regularly at home as self-management. Select all the appropriate types of exercise stated by the patient:* A. Jogging B. Water aerobics C. Weight Lifting D. Tennis E. Walking

B,C,E no running, jumping

A nurse advises a patient with a casted femur fracture to check for signs of a fat embolism. She tells the patient that the onset of symptoms for FES occur: a)About 4 weeks after the bone fragments solidify. b) 1 to 2 weeks after the fracture is set. c)Within 12 to 48 hours. d)Immediately after the fracture heals, when activity begins.

c

Two days after surgery to amputate his left lower leg, a client states that he has pain in the missing extremity. Which action by the nurse is most appropriate? a)Initiate a consult with a psychologist. b)Contact the physician. c)Administer medication, as ordered, for the reported discomfort. d)Do nothing because it isn't possible to have pain in a missing limb.

c

Which nursing intervention is appropriate for minimizing muscle spasms in the client with a hip fracture? a)Assist the client with use of a trapeze. b) Apply a soft compression dressing. c) Maintain Buck's traction. d)Maintain the internal fixator.

c

A patient had an above-the-knee amputation of the left leg related to complications from PVD. The nurse enters the patient's room and observes the dressing and bed covers saturated with blood. What is the first action by the nurse? a)Use skin clips to close the wound. b)Notify the physician. c)Apply a tourniquet. d)Reinforce the dressing.

c Following an amputation, immediate postoperative bleeding may develop slowly or may take the form of massive hemorrhage resulting from a loosened suture. A large tourniquet should be in plain sight at the patient's bedside so that if severe bleeding occurs, it can be applied to the residual limb to control the hemorrhage. The nurse immediately notifies the surgeon in the event of excessive bleeding.