med surg 2 ch:46

The nurse is caring for a client who has a continuous femoral nerve blockade following a total knee arthroplasty. What nursing assessment does the nurse need to perform to ensure client safety? A. Perform focused cardiovascular and respiratory assessments. B. Check that the client can dorsiflex and plantar flex the foot on the operative leg. C. Monitor for excessive blooding and bruising during the infusion. D. Monitor vital signs frequently to detect early complications.

Ans: B. Check that the client can dorsiflex and plantar flex the foot on the operative leg.

An unlicensed assistive personnel (UAP) is assigned to care for a client who had a cemented total knee arthroplasty yesterday. Which observation by the UAP indicates a need for follow-up by the nurse? A. "The client's surgical knee is very swollen and discolored." B. "The client states that the surgical knee is very painful when moving it." C. "The client's lower leg on the surgical side is painful and red." D. "The client needs assistance with walking to the bathroom."

Answer: C. "The client's lower leg on the surgical side is painful and red."

1. The nurse is caring for a client with severe osteoarthritis. What will the nurse anticipate as the client's priority problem? A. Joint pain B. ADL dependence C. Risk for falls D. Muscle stiffness

Answer: A

A client had a left noncemented posterolateral total hip arthroplasty 2 days ago. Which statements will the nurse include in health teaching for the client? Select all that apply. A. "Practice leg exercises each day as instructed." B. "Take deep breaths and use incentive spirometry every 2 hours." C. "Be sure to cross your legs to be more comfortable in a chair." D. "Report sudden increased hip pain or rotation immediately to the nurse." E. "Stand on your right leg and pivot into the chair when getting out of bed."

Answer: A, B, D, E

Which assessment findings will the nurse expect for the client with early-stage rheumatoid arthritis? Select all that apply. A. Joint inflammation B. Subcutaneous nodules C. Severe weight loss D. Fatigue E. Thrombocytosis F. Anorexia

Answer: A, D, F

The primary health care provider prescribes daily celecoxib for a client experiencing persistent joint pain in both knees. Which health teaching will the nurse provide for the client regarding this drug for long term pain control? Select all that apply. A. "Take the prescribed drug before breakfast each day." B. "Report any sign of bleeding, including bloody or dark, tarry stool." C. "Do not take other NSAIDs while on celecoxib." D. "Report any major changes in the amount of urine you excrete each day." E. "Follow up with lab tests to assess liver function."

Answer: B, C, D

1. The nurse is assessing a client who has late-stage rheumatoid arthritis. Which assessment findings would the nurse expect for this client? Select all that apply. A. Joint inflammation B. Severe weight loss C. Bony nodules D. Joint deformities E. Sjogren's syndrome

Answer: B, D, E

1. The nurse is caring for a client who had a posterolateral total his arthroplasty yesterday. For which commonly occurring postoperative complication will the nurse monitor for this client? A. Pneumonia B. Paralytic ileus C. Wound dehiscence D. Surgical hip dislocation

Answer: D

The nurse is caring for a postoperative client with total hip arthroplasty. What actions would the nurse take to prevent venous thromboembolism (VTE) postoperatively? (Select all that apply.) A. Ambulate the client on the day of surgery. B. Keep the legs slightly abducted. C. Elevate the client's legs. D. Apply pneumatic or sequential compression devices. E. Administer anticoagulant therapy.

ans: A. Ambulate the client on the day of surgery. D. Apply pneumatic or sequential compression devices. E. Administer anticoagulant therapy.

The nurse assesses a client diagnosed with Sjögren syndrome. The nurse anticipates that the client will also have which symptom? A. Dry eyes B. Abdominal bloating after eating C. Excessive production of saliva in the mouth D. Intermittent episodes of diarrhea

ans: A. Dry eyes

The nurse recognizes that a client who has persistent pain may have difficulty with pain management after a total joint arthroplasty. What collaborative interventions are needed to help the client manage postoperative pain? (Select all that apply.) A. Identify at-risk clients preoperatively using a comprehensive assessment. B. Establish trust and explain the postoperative pain management plan. C. Consult the pain management team if needed and available. D. Use multimodal and alternative pain management modalities. E. Plan continuing pain management after discharge.

ans: A. Identify at-risk clients preoperatively using a comprehensive assessment. B. Establish trust and explain the postoperative pain management plan. C. Consult the pain management team if needed and available. D. Use multimodal and alternative pain management modalities. E. Plan continuing pain management after discharge.

The nurse is teaching a client preparing to have a total knee replacement about interventions to help prevent surgical infection. What interventions would the nurse include in this teaching? (Select all that apply.) A. Showering the night before and the morning of surgery with chlorhexidine B. Sleeping on clean linen wearing clean nightwear C. Avoiding sleeping with pets in the client's bed D. Giving antibiotics before and after surgery for at least 3 days E. Using nasal mupirocin for at least a week before surgery

ans: A. Showering the night before and the morning of surgery with chlorhexidine B. Sleeping on clean linen wearing clean nightwear C. Avoiding sleeping with pets in the client's bed E. Using nasal mupirocin for at least a week before surgery

The nurse is caring for an older, alert adult client diagnosed with osteoarthritis. Which client statement indicates to the nurse that the client is using effective coping strategies? A. "I do not know how long my wife will be able to take care of me at home." B. "The bus is coming to pick me up from the senior center three times a week so I can play cards." C. "I am helping with the dishes and laundry, but I hurt so badly when I am doing it." D. "I do not know how much longer my neighbor can continue to help clean my house."

ans: B. "The bus is coming to pick me up from the senior center three times a week so I can play cards."

The nurse is planning health teaching for a client starting hydroxychloroquine for rheumatoid arthritis. What instruction would the nurse include in the teaching? A. "Keep this medication in the refrigerator at all times." B. "Expect nausea and vomiting for the first week after starting the drug." C. "Be aware that the drug may cause secondary types of cancer." D. "Have eye examinations every 6 months while on the drug."

ans: D. "Have eye examinations every 6 months while on the drug."

The nurse is preparing to give apixaban for a client who recently had a total knee arthroplasty. What does the nurse recognize as the advantage of this drug over other anticoagulants? A. The client is not at risk for bleeding or bruising. B. The client does not need to wear sequential compression devices. C. The client only needs to take the drug while in the hospital. D. The client does not need to have labs drawn for PT or INR.

ans: D. The client does not need to have labs drawn for PT or INR.

The nurse is caring for a client with osteoarthritis who reports severe pain in both knees. What nonpharmacologic intervention is the most appropriate for the nurse to recommend for this client? A. Hot compresses or moist heating pad. B. Ice packs used every 3 to 4 hours during the day. C. Glucosamine and chondroitin combination. D. Massage and hypnosis.

ans: A. Hot compresses or moist heating pad.

The nurse is caring for a client with osteoarthritis (OA) in the left knee. What factor does the nurse suspect is the most likely cause of this client's OA? A. Trauma to the joint B. Aging C. Familial history D. Osteoporosis

ans: A. Trauma to the joint

The nurse is assessing an older client who has bony nodules on finger joints (Heberden and Bouchard nodes). What priority question would the nurse want to ask as part of the client interview? A. "When did your bony nodules develop?" B. "Are you able to independently perform ADLs?" C. "Are your bony nodules painful or tender?" D. "How do you feel about having these bony nodules?"

ans: B. "Are you able to independently perform ADLs?"

The nurse has provided health teaching for a female client starting on methotrexate (MTX) for early rheumatoid arthritis. What statement by the client indicates a need for further teaching? A. "I will try to avoid crowds because I could easily get an infection." B. "I can drink alcohol in small amounts at night to help me relax." C. "I will start folic acid supplements whichh can help decrease side effects." D. "I will use strict birth control while I am taking this drug."

ans: B. "I can drink alcohol in small amounts at night to help me relax."

A client was recently diagnosed with osteoarthritis and asks the nurse which over-the-counter drug would be the best to take? What would the nurse's recommendation be? A. Ibuprofen B. Acetaminophen C. Gabapentin D. Tramadol

ans: B. Acetaminophen

The nurse is preparing a client for a total hip arthroplasty today. What IV antibiotic would the nurse likely administer if the client has no drug allergies? A. Vancomycin B. Clindamycin C. Cefazolin D. Penicillin

ans: C. Cefazolin

The nurse is caring for a client with an inflamed, reddened, and severely painful first metatarsal joint. With what type of arthritis are these signs and symptoms associated? A. Rheumatoid arthritis B. Infectious arthritis C. Gouty arthritis D. Osteoarthritis

ans: C. Gouty arthritis

The nurse is developing a health teaching plan for a client diagnosed with osteoarthritis (OA). The nurse includes which instruction in the teaching plan? A. Begin a jogging or running program. B. Take up knitting to slow down joint degeneration. C. Eat at least 2 yogurts every day. D. Wear supportive shoes at all times.

ans: D. Wear supportive shoes at all times.