Ch. 64- Musculoskeletal System

4. stay with the victim and encourage him or her to remain still

The nurse witnessed a vehicle hit a pedestrian. The victim is dazed and tries to get up. A leg appears fractured. Which intervention should the nurse take? 1. try to reduce the fracture manually 2. assist the victim to get up and walk to the sidewalk 3. leave the victim for a few moments to call an ambulance 4. stay with the victim and encourage him or her to remain still

2. injury to the brachial plexus nerves

A client being measured for crutches asks the nurse why the crutches cannot rest up underneath the arm for extra support. The nurse responds knowing that which would most likely result from this improper crutch measurement? 1. A fall and further injury 2. injury to the brachial plexus nerves 3. skin breakdown in the area of the axilla 4. impaired range of motion while the client ambulates

3. impaired tissue perfusion

A client has sustained a closed fracture and has just had a cast applied to the affected arm. The client is complaining of intense pain. The nurse elevates the limb, applies an ice bag, and administers an analgesic, with little relief. Which problem may be causing this pain? 1. infection under the cast 2. the anxiety of the client 3. impaired tissue perfusion 4. the recent occurrence of the fracture

1. "I need to avoid getting the cast wet"

A client is being discharged to home after application of a plaster leg cast. Which statement indicates that the client understands proper care of the cast? 1. "I need to avoid getting the cast wet" 2. "I need to cover the casted leg with warm blankets" 3. "I need to use my fingertips to lift and move my leg" 4. "I need to use something like a padded coat hanger end to scratch under the cast if it itches"

1. Temperature of 101.6 F orally

A client is caring for a client who has had spinal fusion, with insertion of hardware. The nurse would be most concerned with which assessment findings? 1. Temperature of 101.6 F orally 2. Complaints of discomfort during repositioning 3. Old bloody drainage outlined on a surgical dressing 4. Discomfort during coughing and deep-breathing exercises

3. bending or lifting

A client is complaining of low back pain that radiates down the left posterior thigh. The nurse should ask the client if the pain is worsened or aggravated by which factor? 1. bed rest 2. ibuprofen 3. bending or lifting 4. application of heat

4. Provides comfort by reducing muscle spasms, provides fracture immobilization, and involves pulleys and wheels

A client with a hip fracture asks the nurse about Buck's (extension) traction that is being applied before surgery and what is involved. The nurse should provide which information to the client? 1. Allows bony healing to begin before surgery and involves pins and screws 2. Provides rigid immobilization of the fracture site and involves pulleys and wheels 3. Lengthens the fractured leg to prevent severing of blood vessels and involves pins and screws 4. Provides comfort by reducing muscle spasms, provides fracture immobilization, and involves pulleys and wheels

4. separation of the wound edges

A client with diabetes mellitus has had a right below-knee amputation. Given the client's history of diabetes mellitus, which complication is the client at most risk for after surgery? 1. hemorrhage 2. edema of the residual limb 3. slight redness of the incision 4. separation of the wound edges

3. thick, yellow drainage from the pin sites

The nurse is evaluating a client in skeletal traction. When evaluating the pin sites, the nurse would be most concerned with which finding? 1. redness around the pin sites 2. pain on palpation at the pin sites 3. thick, yellow drainage from the pin sites 4. clear, watery drainage from the pin sites

3. Rewrap the residual limb with an elastic compression bandage

The nurse is caring for a client who had an above-knee amputation 2 days ago. The residual limb was wrapped with an elastic compression bandage, which has come off. Which immediate action should the nurse take? 1. Apply ice to the site 2. Call the HCP 3. Rewrap the residual limb with an elastic compression bandage 4. Apply a dry, sterile dressing and elevate the residual limb on 1 pillow

2. Uric acid level of 9.0 mg/dL

The nurse is caring for a client with a diagnosis of gout. Which lab value would the nurse expect to note in the client? 1. Ca+ level of 9.0 mg/dL 2. Uric acid level of 9.0 mg/dL 3. K+ level of 4.1 mEq/L 4. Phosphorus level of 3.1 mg/dL

4. A sedentary 65-year old woman who smokes cigarettes

The nurse is conducting health screening for osteoporosis. Which client is at greatest risk for developing this disorder? 1. A 25-year old woman who runs 2. A 36-year old man who has asthma 3. A 70-year old man who consumes excess alcohol 4. A sedentary 65-year old woman who smokes cigarettes

2. numbness and tingling in the fingers

The nurse has conducted teaching with a client in an arm cast about the S/S of compartment syndrome. The nurse determines that the client understands the information if the client states that he or she should report which early symptom of compartment syndrome? 1. cold, bluish-colored fingers 2. numbness and tingling in the fingers 3. pain that increases when the arm is dependent 4. pain that is out of proportion to the severity of the fracture

4. "I need to report a fever or swelling to my HCP"

The nurse has given instructions to a client returning home after knee arthroscopy. Which statement by the client indicates that the instructions are understood? 1. "I can resume regular exercise tomorrow" 2. "I cannot eat food for the remainder of the day" 3. "I need to stay off the leg entirely for the rest of the day" 4. "I need to report a fever or swelling to my HCP"

1. "I should not use someone else's crutches" 2. "I need to remove any scatter rugs at home" 4. "I need to have spare crutches and tips available"

The nurse has given the client instructions about crutch safety. Which statement indicates that the client understands the instructions? Select all that apply: 1. "I should not use someone else's crutches" 2. "I need to remove any scatter rugs at home" 3. "I can use crutch tips even when they are wet" 4. "I need to have spare crutches and tips available" 5. "When I am using the crutches, my arms need to be completely straight"

4. elevated on pillows continuously for 24-48 hours

The nurse is admitting a client with multiple trauma injuries to the nursing unit. The client has a leg fracture and had a plaster cast applied. Which position would be best for the casted leg? 1. elevated for 3 hours, then flat for 1 hour 2. flat for 3 hours, then elevated for 1 hour 3. flat for 12 hours, then elevated for 12 hours 4. elevated on pillows continuously for 24-48 hours

3. presence of a "hot spot" on the cast

The nurse is assessing the casted extremity of a client. Which sign is indicative of infection? 1. dependent edema 2. diminished distal pulse 3. presence of a "hot spot" on the cast 4. coolness and paleness of extremity

1. clear mentation

The nurse is caring for a client being treated for fat embolus after multiple fractures. Which data would the nurse evaluate as the most favorable indication of resolution of the fat embolus? 1. clear mentation 2. minimal dyspnea 3. O2 saturation of 85% 4. Arterial O2 level of 78 mmHg

1. keep the cast clean and dry 2. allow the cast 24-72 hours to dry 3. keep the cast and extremity elevated

Which cast care instructions should the nurse provide to a client who just had a plaster cast applied to the right forearm? Select all that apply: 1. keep the cast clean and dry 2. allow the cast 24-72 hours to dry 3. keep the cast and extremity elevated 4. expect tingling and numbness in the extremity 5. use a hair dryer set on warm to hot in the extremity 6. use a soft, padded object that will fit under the cast to scratch the skin under the cast