EAQ Module 14 Quiz

Which patient statement about a bone scan for osteomyelitis indicates a need for further teaching? -"Two hours before the test, I will receive an injection of radioisotope." -"The test is noninvasive; I should not have pain during the procedure." -"Before the test, I should refrain from voiding." -"The test will take about an hour; I should remain in a supine position during the procedure."

"Before the test, I should refrain from voiding."

The nurse is caring for a patient with a fracture who has a Buck's traction boot in place. The boot helps decrease which condition?

Muscle spasms

Which position would the nurse utilize when repositioning a patient who has an increased intracranial pressure (ICP)?

Semi-Fowler's

Which structures would the nurse attribute to the composition of the body's central nervous system (CNS)? Select all that apply. -Cerebrum -Brainstem -Spinal cord -Cerebellum -Spinal nerves -Cranial nerves

-Cerebrum -Brainstem -Spinal cord -Cerebellum

Which patient statement indicates that he or she may be at risk for developing musculoskeletal problems?

"I only exercise once in a while."

Which statement by the student nurse indicates understanding of treatment for acute osteomyelitis? -"Oral antibiotics often are required for several months." -"IV antibiotics are usually required for several weeks." -"Surgery is almost always necessary to remove the dead tissue that is likely to be present." -"Drainage of the foot and instillation of antibiotics into the affected area is the usual therapy."

"IV antibiotics are usually required for several weeks."

The nurse provides education for a community group related to osteoporosis. Which statement made by a member of the group indicates the need for further education? -"People with osteoporosis should take calcium and vitamin D supplements." -"Older adults may have low bone density, which increases their risk for fractures." -"Fragility fractures are often associated with osteoporosis." -"In adults over 65 years old, hip fracture occurs more often in men than in women because of osteoporosis."

"In adults over 65 years old, hip fracture occurs more often in men than in women because of osteoporosis." ***Hip fractures due to osteoporosis actually occurs more often in women than in men

Which statement by the student nurse indicates understanding of teaching about proper body mechanics for a patient with a history of low back pain caused by a herniated lumbar disc? -"Physical therapy may help to alleviate the pain." -"I should try to get out of bed in one smooth, quick motion." -"I will never bend down below waist level to avoid additional injury." -"I should limit exercise to one to two times per week to avoid excess strain."

"Physical therapy may help to alleviate the pain."

The nurse teaches a nursing student about traction. Which statement made by the student reflects effective learning? -"Traction prevents active and passive exercise." -"Traction provides immobilization to the joint or body part." -"Traction decreases the joint space before a major joint reconstruction." -"A Buck's traction boot is a type of skeletal traction."

"Traction provides immobilization to the joint or body part."

A patient is admitted to the hospital with an open fracture. Which actions does the nurse take to prevent infection of the wound?

-Administer prophylactic antibiotics before surgery. -Administer tetanus and diphtheria prophylaxis.

A patient is suspected of having fat embolism syndrome (FES) following a traumatic femur fracture. Which assessment data gathered by the nurse supports this suspicion? Select all that apply. -Increased hematocrit -Chest pain -Mental status changes -Petechiae on the anterior chest wall -Increased partial pressure of arterial oxygen

-Chest pain -Mental status changes -Petechiae on the anterior chest wall ***FES is characterized by a classic triad of symptoms: 1. Respiratory changes 2. Mental status changes 3. Skin changes

Which questions will the nurse ask when assessing health history of a patient with severe back pain in the lumbar region? Select all that apply. -Have you been vaccinated against hepatitis? -Does your work involve lifting any heavy objects? -Have you taken any high-dose antibiotic recently? -Has this pain affected your social or professional life? -Do you consume any dietary supplements like calcium or vitamin D? -Do you require frequent change of position while you are sleeping because of the pain?

-Does your work involve lifting any heavy objects? -Has this pain affected your social or professional life? -Do you consume any dietary supplements like calcium or vitamin D? -Do you require frequent change of position while you are sleeping because of the pain?

An older adult may experience which musculoskeletal system changes? Select all that apply. -Increased bone density -Earlier fatigue with activity -Decreased basal metabolic rate -Increased risk for cartilage erosion -Increased water in discs between vertebrae

-Earlier fatigue with activity -Decreased basal metabolic rate -Increased risk for cartilage erosion

The nurse is caring for a patient with a fractured femur. Which are appropriate nursing actions? Select all that apply. -Alternating between heat and cold applications to the affected extremity -Elevating the extremity -Marking the location of pulses -Assessing for compartment syndrome -Applying ice packs to the injured area -Giving tetanus prophylaxis if there is a break in skin integrity

-Elevating the extremity -Marking the location of pulses -Assessing for compartment syndrome -Applying ice packs to the injured area -Giving tetanus prophylaxis if there is a break in skin integrity

Which instructions does the nurse give to a patient with a long leg cast to prevent edema and skin breakdown? Select all that apply. -Exercise joints above and below the cast. -Cover the cast with plastic for prolonged periods. -Remove the padding of the cast after going home. -Apply ice on the fracture site during the first 24 hours. -Elevate the leg above the heart on pillows for the first 24 hours.

-Exercise joints above and below the cast. -Apply ice on the fracture site during the first 24 hours. -Elevate the leg above the heart on pillows for the first 24 hours.

Which interventions will the nurse include to prepare a patient for a CT scan of the knee joint? Select all that apply. -Ensure that the knee is shaved completely. -Administer local anesthesia and obtain a blood sample. -Inform the patient that procedure typically causes sharp pain. -Inform the patient of the importance of remaining still during the procedure. -If a contrast medium is being used, verify that patient does not have shellfish allergy.

-Inform the patient of the importance of remaining still during the procedure. -If a contrast medium is being used, verify that patient does not have shellfish allergy.

Which discharge instructions does the nurse give to a patient with a cast? Select all that apply. -Use talcum powder under the cast as needed. -Keep the extremity elevated as much as possible. -Take pain medications only when the pain is unbearable. -Report a fever or a foul odor coming from beneath the cast. -Report itching under the cast because it could indicate an infection. -Keep the extremity in a dependent position as much as possible.

-Keep the extremity elevated as much as possible. -Report a fever or a foul odor coming from beneath the cast.

The nurse is caring for a patient with skeletal traction for an extremity fracture and takes which actions to maintain the traction? Select all that apply. -Keep the weights off the floor. -Elevate the end of the bed as needed. -Ensure that the weights are secured to the pulleys. -Confirm that the forces are pulling in the same direction. -Make sure that the traction ranges from 5 to 45 pounds (2.3 to 20.4 kg). -Apply the traction intermittently.

-Keep the weights off the floor. -Elevate the end of the bed as needed. -Make sure that the traction ranges from 5 to 45 pounds (2.3 to 20.4 kg).

A patient with a hip fracture has been treated with insertion of a prosthesis. Which findings indicate dislocation of the prosthesis? Select all that apply. -Limb shortening -Edema of the limb -A lump in the buttock -Weak pulse in the limb -External rotation of the limb

-Limb shortening -A lump in the buttock -External rotation of the limb

Which musculoskeletal assessment findings are normal? Select all that apply. -Muscle strength 5/5 -No spinal curvature -No muscle atrophy or asymmetry -No joint swelling, deformity, or crepitation -Full range of motion of all joints without pain or laxity -No tenderness on palpation of spine, joints, or muscles

-Muscle strength 5/5 -No muscle atrophy or asymmetry -No joint swelling, deformity, or crepitation -Full range of motion of all joints without pain or laxity -No tenderness on palpation of spine, joints, or muscles

When planning the care for a patient with an increased intracranial pressure (ICP), which interventions would the nurse integrate to provide the most comfort? Select all that apply. -Provide the patient a quiet and calm environment. -Minimize procedures that potentially produce agitation. -Facilitate an increased number of family visits to the patient. -Encourage the patient's family to increase patient interactions. -Observe the patient for signs of agitation or irritation and intervene.

-Provide the patient a quiet and calm environment. -Minimize procedures that potentially produce agitation. -Observe the patient for signs of agitation or irritation and intervene.

When performing a fall-risk assessment on an older patient, the nurse would identify which nervous system changes as normal, though they place the patient at a higher risk for falls? Select all that apply. -Sensory deficit -Memory deficit -Motor-function deficit -Cranial and spinal nerves -Reticular activation system -Central nervous system changes

-Sensory deficit -Motor-function deficit -Central nervous system changes

A patient with spinal cord injury is suspected of having venous thromboembolism (VTE). Low-molecular-weight heparin is prescribed. Before initiating the drug, the nurse performs which assessments? Select all that apply. -Gastroenteritis -Signs of infection -Signs of any internal bleeding -Any history of recent surgeries -Signs of any respiratory distress

-Signs of any internal bleeding -Any history of recent surgeries

The nurse has applied Buck's traction to a patient who has sustained a fractured femur. Which are the main purposes of this type of traction? Select all that apply. -To reduce muscle spasms -To reduce the risk for a fat embolism -To repair the fracture without surgery -To immobilize and stabilize the fracture -To reduce the amount of analgesics required -To allow the nursing staff to care for the patient more easily

-To reduce muscle spasms -To immobilize and stabilize the fracture

During the discharge of an older adult patient who has had a history of repeated falls at home, which instructions does the nurse give to the patient to prevent falls?

-Use a walker or cane -Exercise fingers and toes -Avoid walking on uneven surfaces

A patient is admitted to the orthopedic surgical unit for a fracture of the left tibia. Which instructions does the nurse give concerning the prevention of venous thromboembolism (VTE)? Select all that apply. -Wear compression gradient stockings. -Dorsiflex and plantar flex the ankle of the left leg against resistance. -Perform range-of-motion (ROM) exercises on the right leg. -Increase the intake of calcium. -Take vitamin D supplements.

-Wear compression gradient stockings. -Dorsiflex and plantar flex the ankle of the left leg against resistance. -Perform range-of-motion (ROM) exercises on the right leg.

Which time will the nurse plan to send a patient for a bone scan if the radioisotope was given at 9:00 a.m.?

11:00 a.m.

Which branch of the neurologic system is responsible for BP changes in an older adult patient?

Autonomic nervous system (ANS)

A patient with a leg fracture is scheduled for a fasciotomy. Which complication is identified as having caused the need for this type of surgery?

Compartment syndrome

A patient with a long leg cast reports pain in the toes. The nurse discovers that the toes are pale and cool to the touch with intact pulses and minimal neuropathy. The findings indicate that the patient may be experiencing which complication?

Compartment syndrome

The nurse is assessing a patient who has a traumatic leg injury. Which intervention is the most important in the initial assessment? -Assess the patient's pain level. -Realign the extremity into the appropriate position. -Check for full or partial loss of feeling and sensation. -Determine the extremity's color and temperature in the area of the injury.

Determine the extremity's color and temperature in the area of the injury. ***This is priority to determine any venous or arterial insufficiency

Which term describes flexion of the ankle and toes toward the shin?

Dorsiflexion

Which laboratory finding indicates significant inflammation in the patient with cellulitis and osteomyelitis? -Red blood cell count 4.5 -Blood urea nitrogen (BUN) 24 -White blood cell count 9500/mm 3 -Erythrocyte sedimentation rate (ESR) 88

Erythrocyte sedimentation rate (ESR) 88 ***ESR indicates inflammation and is usually elevated in patients with osteomyelitis

The nurse plans care for a patient who has a fractured femur. During the 24 to 48 hours after the fracture, the nurse monitors the patient for the development of which complication?

Fat embolism syndrome

Increased intracranial pressure due to increased cerebrospinal fluid pressure can result in

Herniation of the brainstem

Which type of fracture is most common in adults greater than 65 years of age?

Hip fractures

When planning care for a patient with a C5 spinal cord injury, which nursing diagnosis has the highest priority?

Ineffective airway clearance caused by high cervical spinal cord injury

Which information will the nurse include when teaching a patient about a bone scan procedure?

It is important to drink increased fluids after the procedure. ***This helps excrete any remaining radioisotope

A patient with osteomyelitis may present with which assessment finding?

Limited range of motion of the extremity due to localized pain

Which immobilization device is best for a patient with an unstable wrist fracture?

Long arm cast ***These are commonly used for stable forearm or elbow fractures, and unstable wrist fractures

During a lumbar puncture, which area of the spine can the health care provider obtain cerebrospinal fluid (CSF)?

Lumbar vertebrae ***Specifically, a large subarachnoid space in the third and fourth lumbar vertebrae is used to obtain CSF

The nurse assists with prehospital care of a patient with a suspected C7 spinal cord injury. Which is the most important nursing intervention during this acute stage of care?

Maintaining a patent airway

Which nursing intervention is the priority for a patient hospitalized with osteomyelitis who has a prescription for bed rest with bathroom privileges, with the affected foot elevated on two pillows? -Ambulate the patient to the bathroom every two hours. -Ask the patient about preferred activities to relieve boredom. -Perform frequent position changes and range-of-motion (ROM) exercises. -Allow the patient to dangle legs at the bedside every two to four hours.

Perform frequent position changes and range-of-motion (ROM) exercises. ***Patient is at risk for atelectasis of the lungs and for contractures because of prescribed bed rest

Which technique will the nurse use to turn a patient in the postoperative phase of spinal surgery?

Place a pillow between the patient's legs and turn the body as a unit. ***This helps keep the spine in good alignment & reduces pain/discomfort following spinal surgery

Which term describes flexion of the ankle and toes toward the surface of the foot?

Plantar flexion

Which intervention may be included for a patient with musculoskeletal issues who complains of fatigue and difficulty sleeping?

Provide pillows and blankets for comfort.

The nurse reviews the medical record of a patient with poikilothermia. The nurse identifies that which history finding likely caused this condition?

Spinal cord injury ***SCI can result in the body's inability to maintain body temperature

Which division of the nervous system would the nurse recognize as activating the "fight-or-flight" response in a frightened patient reporting chest pain after a fire broke out in the home?

Sympathetic nervous system

The nurse suspects that a patient is experiencing fat embolism syndrome (FES) after sustaining a femur fracture based on which assessment findings?

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

A patient with a fracture of the femur has the extremity in skeletal traction and is encouraged to use an overhead trapeze apparatus. Which is the primary purpose of the overhead trapeze?

To facilitate safe, independent movement while the patient is in bed