MDC1 exam2

The nurse recognizes that rheumatoid arthritis is characterized by:

.Ulnar deviation

The ophthalmologist tells a patient that he has increased intraocular pressure (IOP). The nurse understands that increased pressure resulting from optic nerve damage is indicated by a reading of:

21 mm Hg.

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?

Pathologic fracture

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?

Perform neuromuscular assessment every hour.

Which terms refers to the progressive hearing loss associated with aging

Presbycusis

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?

Immobilize the client's arm.

Radiographic evaluation of a client's fracture reveals that a bone fragment has been driven into another bone fragment. The nurse identifies this as which type of fracture?

Impacted

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?

Incomplete

After a person experiences a closure of the epiphyses, which statement is true?

No further increase in bone length occurs.

An unresponsive client had a plaster cast applied to the right lower leg 8 hours ago. When moving the client, the nurse notices an indentation on the posterior lower portion of the cast. What is the best action by the nurse?

Notify the physician.

An aging client is brought to the eye clinic by the son. The son states he has seen his parent holding reading materials at an increasing distance to focus properly. What age-related changes does this indicate?

Presbyopia

The client displays manifestations of compartment syndrome. What treatment will the nurse expect the client to be scheduled for?

A fasciotomy

What is the term for a rhythmic contraction of a muscle?

Clonus

Which type of fracture is one in which the skin or mucous membrane wound extends to the fractured bone?

Compound

Which assessment finding would cause the nurse to suspect compartment syndrome in the client following a bone biopsy?

Increased diameter of the calf

A client asks the nurse why his residual limb cannot be elevated on a pillow. What is the best response by the nurse?

Elevating the leg might lead to a flexion contracture."

client with arterial insufficiency undergoes below-knee amputation of the right leg. Which action should the nurse include in the postoperative care plan?

Elevating the stump for the first 24 hours

Which would be contraindicated as a component of self-care activities for the client with a cast?

Cover the cast with plastic to insulate it

Which factor inhibits fracture healing?

Local malignancy

The nurse is reviewing the medical record of a client with glaucoma. Which of the following would alert the nurse to suspect that the client was at increased risk for this disorder?

Prolonged use of corticosteroids

Which symptom is related to vertigo?

Spinning sensation

Which statement by a staff nurse on the orthopedic floor indicates the need for further staff education?

The client is receiving physical therapy twice per day, so the client doesn't need a continuous passive motion device."

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

osteomyelitis

After surgery for removal of cataract, a client is being discharged, and the nurse has completed discharge instruction. Which client statement indicates that the outcome of the teaching plan has been met?

I should avoid pulling or pushing any object that weighs more than 15 lbs."

client undergoes an arthroscopy at the outpatient clinic. After the procedure, the nurse provides discharge teaching. Which response by the client indicates the need for further teaching?

I should use my heating pad this evening to reduce some of the pain in my knee."

The nurse is obtaining a visual history from a client who has noted an increase in glare and changes in color perception. Which assessment would the nurse anticipate to confirm a definitive diagnosis?

Identification of opacities on the lens

client who has sustained a fracture reports an increase in pain and decreased function of the affected extremity. What will the nurse suspect?

Avascular necrosis

A nurse is caring for a client who's experiencing septic arthritis. This client has a history of immunosuppressive therapy and the immune system is currently depressed. Which assignment is the most appropriate for the nurse caring for this client?

.The nurse is caring for this client on the intensive care unit.

A health care provider diagnoses primary osteoporosis in a client who has lost bone mass. For which client is primary osteoporosis most common?

.elderly postmenopausal woman

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?

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

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

A patient has had a stroke and is unable to move the right upper and lower extremity. During assessment the nurse picks up the arm and it is limp and without tone. How would the nurse document this finding?

Flaccidity

Which precautions should the nurse take when a client is at risk of injury secondary to vertigo and probable imbalance?

Grasp the siderails when rising to a standing position.

A client diagnosed with a cataract comes into the clinic. What assessments should the nurse observe in this client?

Blurred or cloudy visual image

What food can the nurse suggest to the client at risk for osteoporosis?

Broccoli

A group of students is studying for a test on traction. The students demonstrate understanding of the types of traction when they identify which of the following as an example of skin traction?

Buck's

Lifestyle risk factors for osteoporosis include

lack of exposure to sunshine.

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 avoid prolonged sitting or walking."

Which would be consistent as a component of self-care activities for the client with a cast?

.Cushion rough edges of the cast with tape

A bone graft may be used for which of the following reasons? Select all that apply.

.Joint stabilization b.Defect filling Stimulation of bone healing

Which of the following presents with an onset of heel pain with the first steps of the morning?

.Plantar fasciitis

The nurse is caring for a client ordered for multiple eye screening. Following which procedure will the nurse instruct the client on a yellow coloring to the skin and urine as being normal

.Retinal Angiography

An older adult patient had a hip replacement. When should the patient begin with assisted ambulation with a walker?

24 hours

A client in the emergency department is being treated for a wrist fracture. The client asks why a splint is being applied instead of a cast. What is the best response by the nurse?

A splint is applied when more swelling is expected at the site of injury."

Which diagnostic test would the nurse expect to be ordered for a client with lower extremity muscle weakness?

A.Electromyograph (EMG)

The nurse admits a client to the emergency department who has been referred by the eye clinic. Which condition is an emergency where the nurse should refer the client for medical treatment immediately

Acute angle-closure glaucoma

Which type of glaucoma presents an ocular emergency?

Acute angle-closure glaucoma

On ocular examination, the health care provider notes severely elevated IOP, corneal edema, and a pupil that is fixed in a semi-dilated position. The nurse knows that these clinical signs are diagnostic of the type of glaucoma known as:

Acute angle-closure.

When providing discharge teaching to a client with a fractured toe, the nurse should include which instruction?

Apply ice to the fracture site.

A nurse is performing an eye examination. Which question would not be included in the examination?

Are you able to raise both eyebrows?"

A patient sustains a fracture of the arm. When does the nurse anticipate pendulum exercise should begin?

As soon as tolerated, after a reasonable period of immobilization

A client with a long arm cast continues to complain of unrelieved throbbing pain even after receiving opioid pain medication. Which is the priority action by the nurse?

Assess for complications.

A client was playing softball and dislocated four of his fingers when diving for a ball. The physician manipulated the fingers into alignment and applied a splint to maintain alignment. What type of procedure does the nurse document this as?

Closed reduction

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

A client with a recent left above-the-knee amputation states, "I can feel pain in my left toes." Which is the best response by the nurse?

Describe the pain and rate it on the pain scale."

the nurse is conducting the admission assessment for a client who is to undergo an arthrogram. What is the priority question the nurse should ask?

Do you have any allergies?"

The nurse is performing a neurovascular assessment of a client's injured extremity. Which would the nurse report?

Dusky or mottled skin color

Which nursing intervention is appropriate for a client with a closed-reduction extremity fracture?

Encourage participation in ADLs

A client with a fractured ankle is having a fiberglass cast applied. The client starts yelling, "My leg is burning, take it off." What action by the nurse is most appropriate?

Explain that the sensation being felt is normal and will not burn the client.

The nurse is providing care to a client who has been admitted to the hospital for treatment of an infection. The client is visually impaired. Which of the following would be most appropriate for the nurse to do when interacting with the client?

Face the client when speaking directly to him.

The nurse assesses subtle personality changes, restlessness, irritability, and confusion in a client who has sustained a fracture. The nurse suspects which complication?

Fat embolism syndrome

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

A client with chronic open-angle glaucoma is now presenting with eye pain and intraocular pressure of 50 mm Hg. An immediate iridotomy is scheduled. Which of the following describes the desired effects of this procedure?

Improve outflow drainage

A client is diagnosed with carpal tunnel syndrome. Which assessment findings would the nurse expect?

Inability to flex index and middle fingers

You are doing discharge teaching with a client after a stapedectomy. Why would it be important for you to advise the client to refrain from blowing the nose?

It may dislodge the prosthesis.

Which is a benefit of a continuous passive motion (CPM) device when applied after knee surgery?

It promotes healing by increasing circulation and movement of the knee joint.

A nurse is caring for a client who recently underwent a total hip replacement. What is the best action by the nurse for client care?

Limit hip flexion of the client's hip when the client sits up.

Assessment of a client reveals signs and symptoms of Paget's disease. Which of the following would be most likely?

Long bone bowing

The client presents with an exaggeration of the lumbar spine curve. How does the nurse interpret this finding?

Lordosis

A nurse conducted a history and physical for a newly admitted patient who states, "My arms are too short. I have to hold my book at a distance to read." The nurse knows that the patient is most likely experiencing:

Loss of accommodative power in the lens.

Which orthopedic surgery is done to correct and align a fracture after surgical dissection and exposure of the fracture?

Open reduction

There are four major types of ophthalmic procedures to complete a glaucoma examination. If the health care provider wants to inspect the optic nerve, the nurse would prepare the patient for:

Ophthalmoscopy.

The nurse recognizes that goal of treatment for metastatic bone cancer is to:

Promote pain relief and quality of life

The nurse is caring for a patient who had a total hip replacement. What lethal postoperative complication should the nurse closely monitor for?

Pulmonary embolism

A client has just undergone arthrography. What is the most important instruction for the nurse to include in the teaching plan?

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

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?

Right shoulder slopes downward and droops inward.

Which of the following is the most important nursing diagnosis for an elderly patient diagnosed with osteoporosis?

Risk for injury related to fractures due to osteoporosis

A client arrives in the emergency department with a suspected bone fracture of the right arm. How does the nurse expect the client to describe the pain?

Sharp and piercing

Which device is designed specifically to initially support and immobilize a body part in a desired position until swelling subsides?

Splint

A patient is having low back pain. What position can the nurse suggest to relieve this discomfort?

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

In chronic osteomyelitis, antibiotics are adjunctive therapy in which situation?

Surgical debridement

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?

Surgical debridement

Which is not a guideline for avoiding hip dislocation after replacement surgery.

The hip may be flexed to put on clothing such as pants, stockings, socks, or shoes.

A client had a total left hip arthroplasty. What clinical manifestation would indicate to the nurse that the prosthesis is dislocated?

The left leg is internally rotated.

The nurse assesses soft subcutaneous nodules along the line of the tendons in a patient's hand and wrist. What does this finding indicate to the nurse?

The patient has rheumatoid arthritis.

A patient visits a clinic for an eye examination. He describes his visual changes and mentions a specific diagnostic clinical sign of glaucoma. What is that clinical sign?

The presence of halos around lights

A nurse is teaching a client about preventing osteoporosis. Which teaching point is correct?

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

The nurse is preparing a client to have his cast cut off after having it for 6 weeks to treat a fractured tibia. What should the nurse inform the client prior to the cast being removed?

The skin may be covered with a yellowish crust that will shed in a few days.

To straighten the ear canal in an adult for examination, the nurse practitioner would grasp the auricle and pull it:

Up and backward.

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?

Vitamin D-fortified milk

The nurse teaches the client with a high risk for osteoporosis about risk-lowering strategies, including which action?

Walk or perform weight-bearing exercises outdoors

A nurse is planning discharge teaching regarding exercise for a client at risk for osteoporosis. Which exercise would the nurse be most likely to suggest?

Walking

The older client asks the nurse how best to maintain strong bones. What is the nurse's best response?

Weight-bearing exercises can strengthen bones."

The nurse is checking the traction apparatus for a client in skin traction. Which finding would require the nurse to intervene?

Weights hanging and touching the floor

A 52-year-old comes to the clinic for a follow-up examination after being diagnosed with glaucoma. The client states, "I'm hoping that I don't have to use these drops for very long." Which response by the nurse would be most appropriate?

You'll need to use the drops for the rest of your life to control the glaucoma."

The nurse is demonstrating how to perform punctal occlusion. Which activities does the nurse perform?

a.Applies gentle pressure bilaterally on the bridge of the nose to the inner canthus of each eye

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

A nurse is caring for a client who has had an amputation. What interventions can the nurse provide to foster a positive self-image? (Select all that apply.)

a.Encouraging the client to care for the residual limb b.Allowing the client to express griefe.Introducing the client to local amputee support groups

Which of the following are associated with compartment syndrome? Select all that apply.

a.Trauma from accidents b.Surgeryc.Castsd.Tight bandages e.Crushing injuries

Which instruction should the nurse include when teaching the client following hip replacement surgery? (Select all that apply.)

b."Place pillows between your legs when you lay on your side." c."Avoid bending forward when sitting in a chair."d."Use a raised toilet seat and high-seated chair."

Which is not a risk factor for osteoporosis?

being male

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?

common adverse effects

The nurse is evaluating a client's peripheral neurovascular status. Which would the nurse report to the health care provider as a circulatory indicator of peripheral neurovascular dysfunction?

cool skin

A client has just been diagnosed with early glaucoma. During a teaching session, the nurse should:

demonstrate eyedrop instillation.

A client is examined due to recent vision changes and is diagnosed with myopia. What is the cause of this client's vision change?

elongated eyeballs

A client has noticed recently having clearer vision at a distance than up close. What is the term used to describe this client's visual condition?

hyperopia

A client complains of vertigo. The nurse anticipates that the client may have a problem with which portion of the ear?

inner ear

The client with chronic open-angle glaucoma is receiving timolol (Timoptic) eye drops. Which evaluation finding would indicate to the nurse the treatment is working?

intraocular pressure 15 mm Hg

A client is exhibiting diminished range of motion, loss of flexibility, stiffness, and loss of height. The history and physical findings are associated with age-related changes of which area?

joint

The nurse is screening children for scoliosis. What nursing assessment finding is indicative of scoliosis?

lateral curvature of the spine

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

places the load close to the body.

The nurse realizes that a client understands how to correctly instill ophthalmic medications when the client:

pulls the tissue near the cheek downward to instill medication.

Which client would the nurse identify as having the greatest risk for osteoporosis?

small-framed, thin 45-year-old white woman

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."

A client with a right leg fracture is returning to the orthopedist to have the cast removed. During cast removal, it is important for the nurse to assure:

the client that he or she won't be cut.

The nurse is assigned to care for a client who has had an open reduction and internal fixation of a fractured right femur 2 days ago. The nurse is listening to the client's lungs and, when moving the gown, observes petechial hemorrhages on the skin of the chest. What is the first action by the nurse?

.Call the physician to inform them of the findings.

A patient sustains an open fracture of the left arm after an accident at the roller skating rink. What does emergency management of this fracture involve? (Select all that apply.)

.Covering the area with a clean dressing if the fracture is open b.Immobilizing the affected sitec.Splinting the injured limb

A client is reporting pain following orthopedic surgery. Which intervention will help relieve pain?

A.Elevate the affected extremity and use cold applications.

A client has had surgical repair of a hip injury after joint manipulation was unsuccessful. After surgery, the nurse implements measures to prevent complications. Which complications is the nurse seeking to prevent? Select all that apply.

A.skin breakdown B.wound infection C.pneumonia

Which statement describes paresthesia?

Abnormal sensations

Which of the following factors would the nurse need to keep in mind about the focus of the initial history when assessing a new client with a musculoskeletal problem?

Any chronic disorder or recent injury

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 a cold pack at the insertion site.

A client is transported to the emergency department for a femur fracture following a motor vehicle crash. What action by the nurse is the highest priority?

Assess vital signs and level of consciousness.

A nurse is caring for a client placed in traction to treat a fractured femur. Which nursing intervention has the highest priority?

Assessing the extremity for neurovascular integrity

A client who is undergoing skeletal traction reports pressure on bony areas. Which action would be most appropriate to provide comfort for the client?

Changing the client's position within prescribed limits.

Which of the following is the role of the nurse toward a patient who is to undergo eye examinations and tests?

Ensuring that the patient receives eye care to preserve his or her eye function and prevent further visual loss

A nurse is teaching a client who was recently diagnosed with carpal tunnel syndrome. Which statement should the nurse include?

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

After a car accident, a client is admitted to an acute care facility with multiple traumatic injuries, including a fractured pelvis. For 24 to 48 hours after the accident, the nurse must monitor the client closely for which potential complication of a fractured pelvis?

Fat embolism

The nurse is monitoring a patient who sustained an open fracture of the left hip. What type of shock should the nurse be aware can occur with this type of injury?

Hypovolemic

The nurse is providing instructions to the client who is being prepared for skeletal traction. Which statement by the client indicates teaching was effective?

Metal pins will go through my skin to the bone."

A client is scheduled to undergo an electromyography. When performed, what will this test evaluate?

Muscle weakness

Assessment of visual acuity reveals that the client has blurred vision when looking at distant objects but no difficulty seeing near objects. The nurse documents this as which of the following?

Myopia

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?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?

Osteomyelitis

Which is a hallmark sign of compartment syndrome?

Pain

A client's left leg is in skeletal traction with a Thomas leg splint and Pearson attachment. Which intervention should the nurse include in this client's care plan?

Teach the client how to prevent problems caused by immobility.

Which statement is accurate regarding care of a plaster cast?

The cast can be dented while it is damp.

The nurse is giving a visual field examination to a 55-year-old male client. The client asks what this test is for. What would be the nurse's best answer?

This test measures peripheral vision and detects gaps in the visual field."

A client accidentally splashes chemicals into one eye. The nurse knows that eye irrigation with plain tap water should begin immediately and continue for 15 to 20 minutes. What is the primary purpose of this first aid treatment?

To prevent vision loss

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?

Total arthroplasty

The nurse is preparing the client for computed tomography. Which information should be given by the nurse?

You must remain very still during the procedure."

A nurse is planning discharge instructions for the client with osteomyelitis. What instructions should the nurse include in the discharge teaching?

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

A nurse is obtaining a history from a new client with glaucoma. The client indicates having read about the diagnosis and understanding that this type of glaucoma is due to the degeneration and obstruction of the trabecular meshwork, whose original function is to absorb the aqueous humor. The loss of absorption will lead to an increased resistance, and thus a chronic, painless buildup of pressure in the eye. Which type of glaucoma has the client described?

open angle

Which action would be most important postoperatively for a client who has had a knee or hip replacement?

Assisting in early ambulation.

The nurse is providing care to a client following a knee arthroscopy. What would the nurse expect to include in the client's plan of care?

Administering the prescribed analgesic.

A client's fracture was reduced by surgically exposing the bone and realigning it. What type of treatment does the nurse identity this as?

Open reduction

After surgery to treat a hip fracture, a client returns from the postanesthesia care unit to the medical-surgical unit. Postoperatively, how should the nurse position the client?

With the leg on the affected side abducted

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?

Administering large doses of I.V. antibiotics as ordered