Med Surg Musculoskeletal

A patient with severe rheumatoid arthritis is scheduled for a procedure called an arthrodesis. The nursing student you are precepting asks what type of procedure this is. Your response is: A. "It is a procedure where the affected joint is removed and each end of the bones found within that joint are fused together." B. "It is a procedure that involves replacing the joint with an artificial one." C. "It is a procedure where the surgeon goes in with a scope and cleans out the affected joint." D. "It is a procedure where the synovium is completely removed within the joint, which helps decrease inflammation of the joint.

A - "It is a procedure where the affected joint is removed and each end of the bones found within that joint are fused together."

A patient is ordered by the physician to take Allopurinol (Zyloprim) for treatment of gout. You've provided education to the patient about this medication. Which statement by the patient requires you to re-educate them about this medication? A. "This medication will help relieve the inflammation and pain during an acute attack." B. "It is important I have regular eye exams while taking this medication." C. "I will not take large doses of vitamin C supplements while taking this medication." D. "Allopurinol decreases the production of uric acid."

A - "This medication will help relieve the inflammation and pain during an acute attack."

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 - "This procedure will realign the knee and help decrease the amount of weight experienced on my right knee."

A nurse is caring for a client who had a below-the-knee amputation for gangrene of the right foot. The client reports sensations of burning and crushing pain in the toes of the right foot. Which of the following statements should the nurse make? A. "This type of pain usually decreases over time as the limb becomes less sensitive." B. "Try to look at the surgical wound as a reminder the limb is gone." C. "Use a cold compress intermittently to decrease these pain sensations." D. "Grief over the lost limb can sometimes cause denial that the limb is really gone."

A - "This type of pain usually decreases over time as the limb becomes less sensitive."

A client is seen in an emergency department for rotator cuff tendonitis. What is the correct immediate treatment? A. A sling for the arm. B. Muscle relaxant. C. ROM every 4 hours. D. Hot packs prn.

A - A sling for the arm.

Your patient is scheduled for a DEXA scan this morning. The patient is having heartburn and requests a PRN medication to help with relief. Which medications can the patient NOT have at this time? A. Calcium Carbonate B. Bismuth Salicylate C. Milk of Magnesia D. Famotidine

A - Calcium Carbonate

A nurse is providing discharge instructions for a client who is postoperative following inner maxillary fixation with wiring. Which of the following pieces of information should the nurse include? A. Cut the wiring if emesis occurs. B. Consume three meals daily as part of a low-protein diet. C. Swab the mouth with hydrogen peroxide if wiring produces oral irritation. D. Resume a soft diet in 3 to 5 days.

A - Cut the wiring if emesis occurs.

During an outpatient visit you are assessing the patient's understanding about the signs and symptoms associated with osteoporosis. Select all of the signs and symptoms stated by the patient that are correct: A. Dowager's Hump B. Loss of 0.5 inches in height compared to young adult height C. Swelling and warmth at the bone site D. Some patients are asymptomatic E. Fractures most commonly in the hips, wrist, and spine

A - Dowager's Hump D - Some patients are asymptomatic E - Fractures most commonly in the hips, wrist, and spine

Your patient is 2 hours post-op from a cast placement on the right leg. The patient has family in the room. Which action by the significant other requires you to re-educate the patient and family about cast care? A. Gently moving the cast with the fingertips of the hands every 2 hours to help with drying. B. Elevating the cast above heart level with pillows. C. Checking the color and temperature of the right foot. D. Using a hair dryer on the cool setting to help with drying.

A - Gently moving the cast with the fingertips of the hands every 2 hours to help with drying.

You're explaining to a group of outpatients about the signs and symptoms that may present with osteoarthritis. Select all the signs and symptoms that may present with this condition: A. Herberden's Node B. Morning stiffness for less than 30 minutes C. Soft, tender, warm joints D. Fever E. Anemia F. Hard and bony joints G. Crepitus H. Bouchard's Node

A - Herberden's Node B - Morning stiffness for less than 30 minutes F. Hard and bony joints G. Crepitus H. Bouchard's Node

A patient with rheumatoid arthritis is experiencing sudden vision changes. Which medication found in the patient's medication list can cause retinal damage? A. Hydroxychloroquine (Plaquenil) B. Lefluomide (Arava) C. Sulfasalazine (Azulfidine) D. Methylprednisolone (Medrol)

A - Hydroxychloroquine (Plaquenil)

A nurse is collecting data from a client who is 24 hr postoperative following an above the elbow amputation. Which of the following findings should the nurse identify as the priority? A. Report of muscle spasms B. Inability to get dressed without assistance C. Report of feelings of anger D. Refusal to look at the affected limb

A - Report of muscle spasms

Because a client has bursitis, plans for nursing interventions should include? A. Rest. B. range-of-motion activities. C. A high-protein diet. D. Aggressive antibiotic therapy.

A - Rest

________________ is a form of arthritis that is an autoimmune condition that causes inflammation within the joints, specifically the synovium. A. Rheumatoid arthritis B. Osteoarthritis

A - Rheumatoid arthritis

During a home health visit you are helping a patient with gout identify foods in their pantry they should avoid eating. Select all the foods below the patient should avoid: A. Sardines B. Whole wheat bread C. Sweetbreads D. Crackers E. Craft beer F. Bananas

A - Sardines C - Sweetbreads E - Craft beer

The nurse is teaching a client with metastatic bone disease about measures to prevent hypercalcemia. It would be important for the nurse to emphasize? A. The importance of walking B. The need to restrict fluid intake to less than one liter per day C. Early recognition of tetany D. The need to have at least 5 servings of dairy products daily

A - The importance of walking

Which assessment finding found while assessing a patient with a fracture who has traction requires immediate intervention? A. The weights are freely hanging on the floor. B. Pin sites are free from drainage. C. Patient uses the overhead trapeze bar to move around in the bed. D. Patient's extremities have a capillary refill of less than 2 seconds.

A - The weights are freely hanging on the floor.

The nurse, assisting in applying a cast to a client with a broken arm, knows that? A. The wet cast should be handled with the palms of hands B. The cast should be covered until it dries C. The cast material should be dipped several times into the warm water D. The casted extremity should be placed on a cloth-covered surface

A - The wet cast should be handled with the palms of hands

A nurse is collecting data from a client who is 48 hr postoperative following open reduction and internal fixation of a fractured tibia. Which of the following findings should the nurse report to the provider? A. Toes cold to the touch B. Serous drainage from the pin sites C. Blanching of the toenail beds with pressure D. Pink tissue around the fixator insertion sites

A - Toes cold to the touch

A nurse is caring for a client who had a fiberglass cast placed on her left arm several hours ago and now reports itching under the cast. Which of the following actions should the nurse plan to take? A. Use a hair dryer on a cool setting to blow air into the cast. B. Ask the provider to bivalve the cast. C. Provide the client with a sterile cotton swab to rub the affected skin. D. Wrap the extremity with a dry heating pad.

A - Use a hair dryer on a cool setting to blow air into the cast.

A patient is prescribed Alendronate (Fosamax) at 0800 for the treatment of osteoporosis. As the nurse you know you must administer this medication: A. on an empty stomach with a full glass of water and keep the patient upright for 30 minutes. B. right after breakfast and to lay the patient flat (as tolerated) for 30 minutes. C. with food but to avoid giving this medication with dairy products. D. on an empty stomach with a full glass of juice or milk.

A - on an empty stomach with a full glass of water and keep the patient upright for 30 minutes.

Parathyroid hormone plays an important role in bone health. When the parathyroid gland secretes PTH (parathyroid hormone) it causes: A. the body to increase the calcium levels by stimulating the osteoclast activity. B. the body to decrease the calcium levels by inhibiting osteoclast activity. C. the body to increase the calcium levels by stimulating osteoblast activity. D. the body to decrease the calcium levels by inhibiting osteoblast activity.

A - the body to increase the calcium levels by stimulating the osteoclast activity.

You are providing a free clinic seminar to participants about gout. Which statement by a participant about the occurrence of gout is correct? A. "Gout attacks tend to awake the person out of their sleep in the middle of the night." B. "The pain felt with gout tend to be intense during the first 30 minutes." C. "It is best for a patient experiencing gout to tightly bandage the affected extremity." D. "Typically acute gout attacks are predictable and tend to occur once or twice a week."

A. "Gout attacks tend to awake the person out of their sleep in the middle of the night."

Which patient below is presenting with signs and symptoms of rheumatoid arthritis? Select all that apply: A. A 35 year old patient who has severe morning stiffness for 45 minutes. B. A 45 year old male with crepitus in the right knee. C. A 30 year old female with warm, red, soft joints on the hands and wrist. D. A 40 year old male whose x-ray imaging results showed osteophytes formation and decreased joint space in the left knee.

A. A 35 year old patient who has severe morning stiffness for 45 minutes. C. A 30 year old female with warm, red, soft joints on the hands and wrist.

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. A 65 year old male with a BMI of 35. C. A 55 year old male with a history of repeated right knee injuries.

You're caring for a patient who has experienced a fracture to the right arm that is a fractured bone that breaks through the skin. What nursing intervention will you take with this type of fracture? A. Cover the fracture with a sterile dressing. B. Place the arm below the heart level. C. Attempt bone reduction by manually readjusting the bone. D. Place a tight compression bandage over the fracture.

A. Cover the fracture with a sterile dressing.

You're developing a nursing care plan for a patient with gout present in the right foot. What specific nursing interventions will you include in this patient's plan of care? Select all that apply: A. Encourage fluid intake of 2-3 liter per day. B. Provide patient with foods high in purine with each meal daily. C. Place patient's right foot in a foot board while patient is in bed. D. Administer PRN dose of Aspirin for a pain rating greater than 5 on 1-10 scale. E. Apply alternating cold and warm compresses to right foot as tolerated by the patient daily.

A. Encourage fluid intake of 2-3 liter per day. C. Place patient's right foot in a foot board while patient is in bed. E. Apply alternating cold and warm compresses to right foot as tolerated by the patient daily.

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. Morning stiffness greater than 30 minutes C. Fever and Anemia D. Symmetrical joint involvement

A physician suspects a patient may have rheumatoid arthritis due to the patient's presenting symptoms. What diagnostic testing can be ordered to help a physician diagnose rheumatoid arthritis? Select all that apply: A. Rheumatoid factor B. Uric acid level C. Erythrocyte sedimentation D. Dexa-Scan E. X-ray imaging

A. Rheumatoid factor C. Erythrocyte sedimentation E. X-ray imaging

You are providing education to a patient, who was recently diagnosed with rheumatoid arthritis, about physical exercise. Which statement made by the patient is correct? A. "It is best I try to incorporate a moderate level of high impact exercises weekly into my routine, such as running and aerobics." B. "I will be sure to rest joints that are experiencing a flare-up, but I will try to maintain a weekly regime of range of motion exercises along with walking and riding a stationary bike." C. "It is important I perform range of motion exercises during joint flare-ups and incorporate low-impact exercises into my daily routine." D. "Physical exercise should be limited to only range of motion exercises to prevent further joint damage."

B - "I will be sure to rest joints that are experiencing a flare-up, but I will try to maintain a weekly regime of range of motion exercises along with walking and riding a stationary bike."

Which statement by a patient, who just received a cast on the right arm for a fracture, requires you to notify the physician immediately? A. "It is really itchy inside my cast!" B. "My pain is so severe that it hurts to stretch or elevate my arm." C. "I can feel my fingers and move them." D. "I've been using ice packs to reduce swelling."

B - "My pain is so severe that it hurts to stretch or elevate my arm."

Identify which patient below is at MOST risk for developing gout: A. A 56 year old male who reports consuming foods low in purines. B. A 45 year old male with a BMI of 40 who reports taking hydrochlorothiazide and aspirin. C. A 39 year old female hospitalized with bulimia that has a BMI of 24. D. A 27 year old female with ulcerative colitis.

B - A 45 year old male with a BMI of 40 who reports taking hydrochlorothiazide and aspirin.

.A 58 year old female is experiencing a flare-up with rheumatoid arthritis. While assisting the patient with her morning routine, the patient verbalizes a pain rating of 7 on 1-10 scale in the right and left wrist along with severe stiffness. You note the wrist joints to be red, warm, and swollen. What nonpharmalogical nursing interventions can you provide to this patient to help alleviate pain and stiffness? Select-all-that-apply: A. Exercise the affected joints B. Assist the patient with a warm shower or bath C. Perform deep massage therapy to the wrist joints D. Assist the patient with applying wrist splints

B - Assist the patient with a warm shower or bath D - Assist the patient with applying wrist splints

This a fractured bone that breaks through the skin. A. Closed Fracture B. Compound Fracture C. Greenstick Fracture D. Transverse Fracture

B - Compound Fracture

During the first 24 hours after an above-the-knee amputation for vascular disease, nursing priority for stump care would be: A. Inspecting for redness and pressure points. B. Elevating to reduce edema. C. Initiating fitting for prosthesis. D. Cleansing with soap and water.

B - Elevating to reduce edema.

A nurse in the emergency department is assessing a client who was in a motor-vehicle crash 2 days ago and sustained fractures to his tibia, ulna, and several ribs. The client is now disoriented to time and place, has a SaO2 of 87%, and the nurse notes generalized petechiae on the client's skin. Which of the following complications should the nurse suspect? A. Hypovolemic shock B. Fat embolism syndrome C. Thrombophlebitis D. Avascular bone necrosis

B - Fat embolism syndrome

A nurse is caring for a client who is in skeletal traction following a femur fracture. The nurse finds the client has slid down toward the foot of the bed and the traction weight is resting on the floor. Which of the following actions should the nurse take? A. Remove the weight temporarily to reposition the client to the correct alignment in bed. B. Have the client use a trapeze to pull himself up while ensuring the weight hangs freely. C. Lift the rope off the pulley while the client rocks back and forth to reposition. D. Lift the weight manually while another staff member moves the client up in bed.

B - Have the client use a trapeze to pull himself up while ensuring the weight hangs freely.

You're providing care to a patient with severe rheumatoid arthritis. While performing the head-to-toe nursing assessment, you note the patient's overall skin color to be pale and the patient looks exhausted. You ask the patient how she is feeling, and she says "I'm so tired. I can't even get out of this bed without getting short of breath." Which finding on the patient's morning lab work may confirm a complication that can be experienced with rheumatoid arthritis? A. Potassium 3.2 mEq/L B. Hemoglobin 7 g/dL C. Sodium 135 mEq/L D. WBC count 6,500

B - Hemoglobin 7 g/dL

Disease-modifying antirheumatic drugs (DMARDS) are used to treat rheumatoid arthritis. Select-all-the drugs below that are DMARDS: A. Dexamethasone (Decadron) B. Hydroxychloroquine (Plaquenil) C. Teriparatide (Forteo) D. Calcitonin E. Leflunomide (Arava) F. Methotrexate (Trexall)

B - Hydroxychloroquine (Plaquenil) E - Leflunomide (Arava) F - Methotrexate (Trexall)

A 85 year old patient has an accidental fall while going to the bathroom without assistance. It appears the patient has sustained a bone fracture to the left leg. The leg's shape is deformed and the patient is unable to move it. The patient is alert and oriented but in pain. What will you do FIRST after confirming the patient is safe and stable? A. Apply an ice pack covered with a towel to the site. B. Immobilize the fracture with a splint. C. Administer pain medication. D. Elevate the extremity above heart level.

B - Immobilize the fracture with a splint.

A nurse is caring for a teenager immediately following surgical correction of severe scoliosis. Which interventions should the nurse expect to be part of the care plan? Select all that apply. A. Assess bowel sounds daily. B. Monitor urinary catheter output. C. Assist child to the chair once per shift. D. Administer pain medication around the clock.

B - Monitor urinary catheter output. D - Administer pain medication around the clock.

A client has undergone a lumbar laminectomy and has just returned to the nursing unit. It is essential for the nurse to perform which of the following activities during this period? A. Vital signs checks every half-hour B. Neurovascular checks C. Assessment of bladder function D. Early ambulation

B - Neurovascular checks

Select all the risk factors for developing osteoarthritis: A. Malnutrition B. Obesity C. Manual labor jobs D. Premature birth E. Older age F. Diabetes

B - Obesity C - Manual labor jobs E - Older age

Your patient has arthritis that affects the weight-bearing joints such as the hands, knees, hips, and spine. This type of arthritis is most likely: A. Rheumatoid arthritis B. Osteoarthritis

B - Osteoarthritis

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 - Osteophytes C - Sclerosis of the bone

Select all the signs and symptoms that will present in compartment syndrome? A. Capillary refill less than 2 seconds B. Pallor C. Pain relief with medication D. Feeling of tingling in the extremity E. Affected extremity feels cooler to the touch than the unaffected extremity

B - Pallor D - Feeling of tingling in the extremity E - Affected extremity feels cooler to the touch than the unaffected extremity

A nurse is caring for a client immediately following application of a plaster cast. The nurse should monitor for and report which of the following findings as an indication of compartment syndrome? A. Sensation of heat on the surface of the cast B. Paresthesias of the extremity C. Pruritus of the extremity D. Musty odor noted from cast materials

B - Paresthesias of the extremity

The nurse prepares a client for a bone scan. What priority assessment should the nurse perform for this client? A. Current vital signs B. Presence of intravenous (IV) access C. History of claustrophobia D. Presence of metallic implants such as a pacemaker or aneurysm clips

B - Presence of intravenous (IV) access

A nurse is caring for a client who has a pelvic fracture. The client reports sudden shortness of breath, stabbing chest pain, and anxiety. The nurse should notify the charge nurse that the client is experiencing which of the following complications? A. Pneumonia B. Pulmonary embolus C. Tension pneumothorax D. Tuberculosis

B - Pulmonary embolus

____________ affects the joints in a symmetrical fashion. A. Osteoarthritis B. Rheumatoid arthritis

B - Rheumatoid arthritis

Which statement is FALSE concerning rheumatoid arthritis? A. Rheumatoid arthritis most commonly affects the fingers and wrist. B. Rheumatoid arthritis is different from osteoarthritis in that it doesn't affect other systems of the body. C. Rheumatoid arthritis can occur at any age (20-60 year old most commonly). D. Ankylosis can occur in severe cases of rheumatoid arthritis.

B - Rheumatoid arthritis is different from osteoarthritis in that it doesn't affect other systems of the body.

A nurse is caring for a client who is 3 days postoperative following a right total hip arthroplasty. While transferring to a chair, the client cries out in pain. The nurse should assess the client for which of the following manifestations of dislocation of the hip prosthesis? A. Bulging in the area over the surgical incision B. Shortening of the right leg C. Sensation of warmth over the surgical incision D. Pallor following elevation of the right leg

B - Shortening of the right leg

Upon a client's admission for extracapsular fracture of the left femur, how should a nurse expect the extremity to appear? A. Internally rotated. B. Shorter than the other leg. C. To have footdrop. D. Blanched over the fracture site.

B - Shorter than the other leg.

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 - Water aerobics C - Weight Lifting E - Walking

You are assessing the diagnostic testing results for a patient that has rheumatoid arthritis. What result is NOT an indicator of this disease? A. Elevated erythrocyte sedimentation B. X-ray imaging showing osteophyte formation C. Positive c-reactive protein D. Positive rheumatoid factor

B - X-ray imaging showing osteophyte formation

A patient is post-op from surgery. The patient has a history of gout. While performing a head-to-toe assessment, you assess the patient for signs and symptoms of gout. As the nurse, you know that gout tends to start at what site? A. Elbow B. Big toe C. Thumb or index finger D. Knees

B. Big toe

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. Heberden's Nodes

A nurse is caring for a client who is postoperative following shoulder surgery. The client has a prescription to keep the affected arm adducted. Which of the following instructions should the nurse provide the client? A. "Keep your arm bent at the elbow." B. "Use a pillow to prop your shoulder up close to your ear." C. "Hold your arm against the side of your body." D. "Position your arm with the shoulder at a 90-degree angle."

C - "Hold your arm against the side of your body."

A nurse is reinforcing preoperative teaching with a client who is scheduled for total knee arthroplasty. Which of the following statements by the client should the nurse identify as understanding the teaching? A. "I will wear a continuous movement machine on my knee for 24 hours a day." B. "I should avoid taking NSAID medications for pain after surgery." C. "I should wear elastic stockings on both of my legs." D. "I will begin exercising my legs the day after surgery."

C - "I should wear elastic stockings on both of my legs."

During a routine health check-up visit a patient states, "I've been experiencing severe pain and stiffness in my joints lately." As the nurse, you will ask the patient what questions to assess for other possible signs and symptoms of rheumatoid arthritis? Select-all-that-apply: A. "Does the pain and stiffness tend to be the worst before bedtime?" B. "Are you experiencing fatigue and fever as well?" C. "Is your pain and stiffness symmetrical on the body?" D. "Is your pain and stiffness aggravated by extreme temperature changes?"

C - "Is your pain and stiffness symmetrical on the body?"

Which patient below is NOT at risk for osteoporosis? A. A 50 year old female whose last menstrual period was 7 years ago. B. A 45 year old male patient who has been taking glucocorticoids for the last 6 months. C. A 30 year old male who drinks alcohol occasionally and has a BMI of 28. D. A 35 year old female who has a history of seizures and takes Dilantin regularly.

C - A 30 year old male who drinks alcohol occasionally and has a BMI of 28.

A client is admitted following a motor vehicle accident where his left thigh was crushed beneath the vehicle. The nurse must assess for which of the following complications? A. Hypokalemia B. Hypotension C. Acute renal failure D. Fat emboli syndrome

C - Acute renal failure

A nurse is caring for a client who is postoperative following a total knee arthroplasty and is prescribed a continuous passive motion (CPM) machine and PCA. The client tells the nurse, "I am in so much pain." Which of the following actions should the nurse take first? A. Remind the client to push the button for the PCA device. B. Discuss activities the client may use to distract from the pain. C. Ask the client to describe the characteristics of the pain. D. Pause the CPM machine briefly to apply a cold pack to the client's knee.

C - Ask the client to describe the characteristics of the pain.

A nurse is reviewing the medical record of a client who has a prescription for probenecid to treat gout. The nurse should identify that which of the following medications can interact with probenecid? A. Colchicine B. Naproxen C. Aspirin D. Prednisone

C - Aspirin

A nurse is performing medication reconciliation for a newly admitted client who has rheumatoid arthritis (RA). Which of the following medications should the nurse identify as the treatment for this condition? A. Misoprostol B. Dantrolene C. Celecoxib D. Colchicine

C - Celecoxib

During the 1000 medication pass, your patient reports to you that he is having muscle pain and tingling in his fingers and toes. You note that the patient also has a grayish color to his lips. You immediately notify the doctor. In addition, you would hold which medication that is scheduled to be administered at 1000? A. Ibuprofen B. Prednisone C. Colchicine D. Aspirin

C - Colchicine

The client is being evaluated for osteoporosis. Which diagnostic test is the most accurate when diagnosing osteoporosis? A. Serum alkaline phosphatase. B. X-ray of the femur. C. Dual-energy x-ray absorptiometry (DEXA). D. Serum bone Gla-protein test.

C - Dual-energy x-ray absorptiometry (DEXA).

The nurse assesses which of the following clinical manifestations in a client with osteomyelitis? Select all that apply: A. Petechial B. Cool extremities C. Fever D. Night sweats E. Restlessness F. Nausea

C - Fever D - Night sweats E - Restlessness F - Nausea

A client has been hospitalized after an automobile accident. A full leg cast was applied in the emergency room. The MOST important reason for the nurse to elevate the casted leg is to ? A. Decrease irritation to the skin B. Promote the client's comfort C. Improve venous return D. Reduce the drying time

C - Improve venous return

This is a fracture that is slanted across the bone shaft. A. Transverse Fracture B. Spiral Fracture C. Oblique Fracture D. Compound Fracture

C - Oblique Fracture

Bones play an important role in the body. Which of the following in NOT a function performed by the bones? A. Provide protection and support for the organs. B. Give the body shape. C. Secrete the hormone calcitonin and store blood cells. D. Store calcium and phosphorus.

C - Secrete the hormone calcitonin and store blood cells.

A client has bilateral knee pain from osteoarthritis. In addition to taking the prescribed NSAID, the nurse should instruct the client to A. Keep legs elevated when sitting B. Rest the knees as much as possible to decrease inflammation C. Start a regular exercise program D. Avoid foods high in citrus acid

C - Start a regular exercise program

Identify the correct sequence in how rheumatoid arthritis develops: A. Development of pannus, synovitis, ankylosis B. Anklyosis, development of pannus, synovitis C. Synovitis, development of pannus, anklyosis D. Synovitis, anklyosis, development of pannus

C - Synovitis, development of pannus, anklyosis

During discharge teaching to a patient at risk for developing osteoporosis, you discuss the types of exercise the patient should perform. Which type of exercise is not the best to perform to prevent osteoporosis? A. Tennis B. Weight-lifting C. Walking D. Hiking

C - Walking

Gout is a type of arthritis that occurs due to the accumulation of ____________ in the blood that causes needle-like crystals to form around the joints. A. purines B. creatinine C. uric acid D. amino acids

C - uric acid

A patient is newly diagnosed with osteoarthritis. Which medication below is NOT ordered to treat this condition? A. NSAIDs B. Intra-articular corticosteroids C. DMARDs D. Glucosamine

C. DMARDs

A patient sustained a fracture to the femur. The patient has suddenly become confused, restless, and has a respiratory rate of 30 breaths per minute. Based on the location of fracture and the presenting symptoms, this patient may be experiencing what type of complication? A. Compartment Syndrome B. Osteomyelitis C. Fat embolism D. Hypovolemia

C. Fat embolism

A patient is taking Calcitonin for osteoporosis. The patient should be monitored for? A. Hyperkalemia B. Hypokalemia C. Hypocalcemia D. Hypercalcemia

C. Hypocalcemia

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

A nurse is teaching a client who has a new prescription for alendronate for treatment of osteoporosis. Which of the following statements by the client indicates understanding of the teaching? A. "I will take the medication in the evening." B. "I will drink a full glass of milk with the medication." C. "I will take the medication at mealtime." D. "I will sit upright after taking the medication."

D - "I will sit upright after taking the medication."

A nurse is discussing the difference between rheumatoid arthritis (RA) and osteoarthritis with a newly licensed nurse. Which of the following information should the nurse include about osteoarthritis? A. "Osteoarthritis is caused by autoimmune processes." B. "Osteoarthritis leads to a decreased erythrocyte sedimentation rate." C. "Osteoarthritis affects other organ systems." D. "Osteoarthritis can impair a joint on a single side of the body."

D - "Osteoarthritis can impair a joint on a single side of the body."

A nurse is discussing the plan of care with a client who has osteomyelitis of an open wound on his heel. Which of the following information should nurse include? A. "You will need to apply a cold pack to the site three times a day." B. "Your provider might ask you to walk frequently to increase circulation to the area." C. "You will need to limit consumption of high-protein foods." D. "Your provider might prescribe a central catheter line for long-term antibiotic therapy."

D - "Your provider might prescribe a central catheter line for long-term antibiotic therapy."

A nurse in an urgent care clinic is reinforcing teaching with a client following a Grade 2 (moderate) ankle sprain. Which of the following instructions should the nurse plan to include? A. Perform passive range-of-motion exercises of the ankle hourly. B. Keep the affected extremity in a dependent position. C. Wrap a loose dressing around the affected ankle. D. Apply cold compresses to the extremity intermittently.

D - Apply cold compresses to the extremity intermittently.

During a head-to-toe assessment of a patient with arthritis, you note bony outgrowths on the proximal interphalangeal joint. These outgrowths are known as __________ and occur in ______________. A. Heberden's Node, osteoarthritis B. Bouchard's Node, rheumatoid arthritis C. Heberden's Node, rheumatoid arthritis D. Bouchard's Node, osteoarthritis

D - Bouchard's Node, osteoarthritis

The fractured bone is broken into many fragments (3 or more). A. Open Fracture B. Greenstick Fracture C. Oblique Fracture D. Comminuted Fracture

D - Comminuted Fracture

A client fractured his femur yesterday. Monitoring for which potential complication must be included by the nurse in the client's plan of care? A. Chronic pain B. Disturbed body image C. Crush injury D. Fat emboli syndrome

D - Fat emboli syndrome

A nurse is reviewing the medical record of a female client. Which of the following findings should the nurse identify as a risk factor for osteoporosis? A. Decreased intake of phosphate-containing foods B. Spending several hours in the sun daily C. Increased estrogen levels D. History of anorexia nervosa

D - History of anorexia nervosa

The client is diagnosed with osteoarthritis. Which sign/symptom should the nurse expect the client to exhibit? A. Severe bone deformity. B. Waddling gait. C. Swan-neck fingers. D. Joint stiffness.

D - Joint stiffness.

________ are found within the spongy bone and are responsible for building up the bone matrix. While ________, which are also found in the spongy bone, breakdown the bone matrix. A. Osteocytes, osteoclasts B. Osteoclasts, osteoblasts C. Osteocytes, osteoblasts D. Osteoblasts, osteoclasts

D - Osteoblasts, osteoclasts

What is a late sign of compartment syndrome? A. Paralysis B. Pain C. Parethesia D. Pulselessness

D - Pulselessness

You're caring for a patient who has a health history of severe osteoporosis. On assessment you note the patient has severe kyphosis of the upper back. Which nursing diagnosis takes priority for this patient's care? A. Risk for skin breakdown B. Knowledge deficient regarding disease process C. Limited mobility D. Risk for falls

D - Risk for falls

A complication of Buck's extension traction would be noted by a nurse if: A. Dorsiflexion developed in the affected foot. B. Redness and purulent drainage appeared at the pin site. C. Skin over the fracture site was flushed. D. Toes of affected leg became dusky in color.

D - Toes of affected leg became dusky in color.

It is important a patient with gout avoid medications that can increase uric acid levels. Which medication below is NOT known to increase uric acid levels? A. Aspirin B. Niacin C. Cyclosporine D. Tylenol

D - Tylenol

A 75 year old male is admitted for chronic renal failure. You note that the patient has white/yellowish nodules on the helix of the ear and fingers. The patient reports they are not painful. As you document your nursing assessment findings, you will document this finding as? A. Nodosa B. Keloid C. Dermoid D. Tophi

D. Tophi

Osteoarthritis develops due to the deterioration of the synovium within the joint that can lead to complete bone fusion. True False

False

True or False: Osteoporosis is a disease process that results in the thinning of the matrix of pore-like structures within the compact bone. True False

False

True or False: Rheumatoid arthritis tends to affect women more than men and people who are over the age of 60. True False

False