med-surg musculoskeletal

a nurse is talking with an older adult client who has an elevated risk for osteoporosis about strategies for preventing bone loss. which of the following instructions should the nurse provide a. begin a program of brisk walking b. take 800 mg of calcium per day--1200 c. drink plenty of sparkling water d. drink 8 oz of red wine each day

begin a program of brisk walking

a nurse is performing medication reconciliation for a newly admitted client who has rhematoid arthritis. which of the following medications should the nurse identify as the treatment for this condition a. misoprostol b. dantrolene--for muscle spasm c. celecoxib d. colchicine

celecoxib

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

history of anorexia nervosa because of inadequate protein intake

a nurse is caring for a client following a hip arthroplasty. the nurse places an abduction pillow on the client for which of the following purposes

to prevent dislocation of the hip during position changes or movement

a nurse is caring for a client with a hip fracture who has Buck's extension traction in place. which of the following pieces of information should the nurse give the client about this type of traction?

you will have considerably less pain with the traction in place -the traction will help decrease muscle spasms -the weight act as a pulling force to keep your leg and hip still

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

your provider might prescribe a central catheter line for long term antibiotic therapy because osteomyelitis is a chronic bone infection limit weight bearing

a nurse is caring for a client who has fractured right hip. which of the following types of traction should the nurse expect the client to have prior to hip arthroplasty surgery a. balanced skeletal traction-stabilize fractures of femur/pelvis b. pelvic belt-treat back pain c. pelvic sling-stabilize pelvic fractures d. Buck's traction

Buck's traction: is used prior to hip arthroplasty to maintain alignment and prevent muscle spasms prior to surgery

a nurse is preparing a client for a bone scan. which of the following statement indicates that the client understands the pre-procedure teaching

a special camera will scan the bones in my entire body i will have to drink a lot of water to help get the radiation out of my body i understand the radiation is harmless, and i dont have to worry about it

a nurse is caring for a client who is scheduled to undergo surgery to repair an open hip fracture. in which of the following positions should the nurse plan to place the client postoperatively

with the leg on the affected side abducted

a nurse is providing discharge teaching for a client who had a left total hip arthroplasty. which of the following client statements indicates the teaching was effective

i should not cross my legs at the ankles or knees inspect the hip incision everyday for redness, warmth

a nurse is providing preoperative teaching for a client who is scheduled for total knee arthroplasty. which of the following statements by the client indicates an understanding of the teaching a. i will wear a continuous movement machine on my knee for 24hr a day b. i should avoid taking NSAIDs 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--do it immediately

i should wear elastic stockings on both of my legs to prevent venous thromboembolism

a nurse is providing post-procedural teaching to a client who had a diagnostic knee arthroscopy. which of the following statements indicates that the client understand the nurse instruction

i will keep my leg elevated for the first day no aspirin-risk for bleeding ice for 24 hr limit activity

a nurse is teaching a client who had an amputation of the left lower leg 3 day ago which of the following statements indicates that the client understands how to care for the incision and his left upper leg

i will lie on my stomach for 30 min a few times a day

a nurse is caring for a client who is postoperative following a lumbar disk excision. which of the following interventions should the nurse include in the client's plan of care

logroll the client in bed for care procedures

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

use a hair dryer on a cool setting to blow air into the cast

a nurse is providing nutrition education to a client who has osteomalacia. the nurse should identify that this condition is caused by a deficiency in which of the following nutrients? a. fluoride b. vitamin A c. vitamin D d. phosphorus

vitamin D

a nurse is preparing a community education program about reducing the risk of osteoporosis. which of the following pieces of information should the nurse include

walking is the preferred mode of exercise to maintain strong bones.

a nurse is preparing a client for magnetic resonance imaging (MRI) of the spine. which of the following pieces of information should the nurse give the client prior to the procedure a. you can have a a mild sedative before the procedure b. you will have to lie still on your back for 15 to 20min---45-60 c. you can't have this test if you have had a cataract surgery d. your exposure to radiation will be minimal

you can have a mild sedation prior to the procedure

a nurse is determining a client's risk of developing osteoporosis. the nurse should identify which of the following as a risk factors for bone loss? a. small body frame b. hypertension c. African-American ethnicity d. low vitamin D intake e. smoking

a. small body frame d. low vitamin D intake e. smoking

a nurse in an emergency department is preparing to discharge a client following grade 11 (moderate) ankle sprain. which of the following instructions should the nurse plan to give to the client

apply cold compresses to the extremity intermittently perform passive range of motion hourly elevate the extremety apply compression dressing all to reduce swelling

a nurse is teaching a client with arthritis who is experiencing joint pain that impairs mobility. which of the following instruction should the nurse include a. engage your joints in resistance exercises b. avoid using assistive devices when walking c. perform passive exercises d. apply heat to your joint prior to exercising

apply heat to your joint prior to exercising

a nurse in an acute care clinic is talking with a client who reports that the osteoarthritis pain in her knees is increasing each day. the client wants to discuss non-pharmacological approaches to help relieve her pain. which of the following interventions should the nurse suggest a. applying warm compresses to sore joint b. decreasing the daily intake of dietary protein c. keeping joint in extension during test periods d. limiting sleep to 6-7 hr per night

applying warm compresses to sore joint

a nurse is caring for a client who is postoperative following a total knee arthroplasty and has been 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

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 interacts with probenecid a. colchicine b. naproxen c. aspirin d. prednisone

aspirin

a nurse is caring for a client who is 72 hr postoperative following an above-the-knee amputation. which of the following actions should the nurse take

assist the client into a prone position every 4 hr for 20-30min. avoid elevating the limb for 72hr reapply bandage every 4-6hr in a distal to proximal direction

a nurse in the emergency department is caring for a client who reports pain in her left leg following a motor-vehicle crash. the client's left leg has bruising, swelling, and displacement of the bones. which of the following actions should the nurse take first a. obtain an xray of the injured leg b. apply ice packs to the affected area c. check neurovascular status distal to the injury d. elevate the affected leg on 2 pillows

check neurovascular status distal to the injury

a nurse is assessing a client who has a fractured left femur and is in skeletal traction. which of the following findings should the nurse report to the provider a. ecchymosis of the thigh b. serous drainage at the pin site c. chest petechiae d. muscle spasm in the left leg

chest petechiae

a nurse is assessing 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. client report muscle spasms b. inability to get dressed without assistance c. client report of feelings of anger d. refusal to look at the affected limb

client report of muscle spasms

a nurse is preparing an in-service presentation about the basics of bone injuries. which of the following types of fractures results when a client bone breaks into multiple pieces a. avulsion b. comminuted c. compression d. spiral

comminuted

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 occur b. consume 3 meal 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--1-4wks

cut the wiring if emesis occur

a nurse is assessing a female client who report severe joint pain. the nurse should identify that which of the following factors places the client at risk for gout a. perimenopaause b. migraine headaches c. diuretic use d. irritable bowel syndrome

diuretic use

a nurse is caring for a client who has a fractured hip and was placed in Buck's traction 4hr ago. which of the following actions should the nurse take

encourage the client to perform dorsiflexion of the affected extremity every 2 hr

a nurse is teaching a group of client at a senior center about the risk factors of osteoporosis. which of the following statements should the nurse include in the teaching

extended periods of immobility increase your risk of osteoporosis and prolong use of corticosteroid

a nurse in the emergency department is assessing a client who has in a motor vehicle crash 2 days ago and sustained fractures of his tibia, ulna, and several ribs. the client is now disoriented to time and place and has a SAO2 of 87%. 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

fat embolism syndrome

a nurse is caring for a client who has osteoporosis and a new prescription for calcium supplements. which of the following foods should the nurse recommend to promote calcium absorption a. fortified milk--vit D b. ripe bananas c. steamed broccoli d. green leafy vegetables

fortified milk

a nurse preparing an in-service presentation about the basics of bone injuries. which of the following types of fractures is especially common in children a. impacted-force of injury drives one fragment of bone into another b. depressed-force of injury drives the bone fragment inward c. compound-sharp edge of the bone breaks through the skin d. greenstick

greenstick-incomplete break in the bone

a nurse is assessing a client who has osteoarthritis. the client's medical record indicates the presence of hebenden's nodes. which of the following findings should the nurse expect? a. inflamed, fluid-filled sacs over the joints b. clubbing of the fingernails c. flexion contracture of the fingers d. hard lumps over the joint of the fingers

hard lumps over the joint of the finger

a nurse is caring for a client who is in skeletal traction following a femur fracture. on entering, the nurse finds that the client has slid towards the foot of the bed, and the traction weight is resting on the floor. which of the following actions should the nurse take

have the client use a trapeze to pull himself up while ensuring the weight hangs freely

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 share with the client

hold your arm against the side of your body

a home health nurse is performing an assessment on a client who is 1 week postoperative following a total knee replacement. which of the following statements by the client indicates an understanding of the teaching

i plan to use a walker to help me get around do not place a pillow under the knee

a nurse is teaching a client who is in bed rest about preventing complications. which of the following client statements indicates an understanding of the teaching

i should cough and deep-breath every hour range of motion exercise 3-4 times per day ankle pump exercise 1-2hr

a nurse is teaching a client who has a cast on his left arm to treat a forearm fracture. which of the following statements indicates that the client understands the teaching.

i will call the doctors office if my fingers get colder on the arm with the cast

a nurse is providing teaching about disease management to a client who has rheumatoid arthritis. which of the following responses by the client indicates understanding of the teaching?

i will have handrails installed in my bathroom -take hot showers -move around -balance activity with rest 1-2 nap

a nurse is teaching a client who has a new prescription for alendronate for the treatment of osteoporosis. which of the following statements by the client indicates an understanding of the teaching a. i will take the medication in the evening--morning b. i will drink a full glass of milk with the medication-- cause hypocalcemia and reduce absorption c. i will take the medication at mealtime--30 min b4 food d. i will sit upright after taking the medication

i will sit upright for 30min after taking the medication

a nurse is preparing a client who is postoperative following total hip arthroplasty for discharge. which of the following statements indicates that the client understands the instructions

i will use a Reacher to help me pick up anything i drop on the floor clean with soap and water every day perform straight leg raise

a nurse is preparing a client for discharge who is postoperative following a conventional lumbar disk excision. which of the following statements indicates that the client understands the nurse instructions a. i should have no problem climbing stairs when i get home b. i will wait about 3 weeks before i return to my usual activities c. i will use my heating pad if i feel any muscle spasms in my back d. i can go back to driving in about 2 weeks

i will use my heating pad if i feel any muscle spasms in my back

a nurse is providing teaching for a client following a below-the-knee amputation. which of the following pieces of information should the nurse include in the teaching? a. instruct the client to lie prone while in bed b. ensure the client sleeps on a soft mattress c. pull up the residual limb while in bed d. keep the residual limb exposed to air

instruct the client to lie prone while in bed

a nurse is assessing a client who has several risk factors for osteoporosis. which of the following findings indicates that the client require futher evaluation for this disorder a. leg cramps with exercise b. stress incontinence c. abdominal distention d. lower back pain

lower back pain

a nurse is caring for a client who has chronic phantom limb pain following an above knee amputation. which of the following medication prescription should the nurse verify with provider a. meperidine b. amitriptyline c. gabapentin d. propranolol

meperidine-residual limb pain

a nurse is caring for a client who is wearing a halo fixator. which of the following interventions should the nurse implement?

monitor the client's vitals every 4 hrs monitor the client pin sites for loosening check the client skin to ensure the jacket is not applying pressure

a nurse is preparing to care for a client who is in balanced skeletal traction to stabilize a femur fracture. which of the following actions should the nurse include in the client plan of care

offering the client a diet high in fluid and fiber inspect pin site every 8-12hr

a nurse is discussing the difference between rheumatoid arthritis (RA) and osteoarthritis with a newly licensed nurse. which of the following should the nurse include about osteoarthritis note: rheumatoid arthritis is an autoimmune disease that leads to a decreased erythrocyte sedimentation rate -rheumatoid affects other organ system

osteoarthritis can impair a joint on a single side of the body

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 an an indication of compartment syndrome a. sensation of heat on the surface of the cast b. parenthesias of the extremity c. pruritus of the extremity d. musty odor noted from cast materials.

parenthesias of the extremity

a nurse is caring for a client who has a depressed skull fracture of the bone that makes up larger part of the upper and side wall of the cranium. the fracture is located on which of the following bone a. sphenoid--part of face b. occipital--back of scull c. parietal d. frontal--front of skull

parietal bones form the larger part of the upper and side

a nurse is teaching a client who has osteoporosis. which of the following instructions should the nurse include in the teaching a. reduce dietary protein intake b. apply ice to painful areas c. increase calcium intake to 900 mg per day d. perform weight-bearing exercise

perform weight-bearing exercise

a nurse is planning care for a client following a total hip arthroplasty. which of the following interventions should the nurse include in the plan a. position the client with her legs adducted b. internally rotate the client's affected hip c. place a pillow between the client's legs d. instruct the client to avoid flexing her hip more than 95-avoid more than 90 degrees to avoid hip dislocation

place a pillow between the client's legs

the nurse is caring for a client who has a pelvic fracture. the client report sudden shortness of breath, stabbing chest pain, and feelings of doom. this client is experiencing which of the following complications a. pneumonia b. pulmonary embolus c. tension pneumothorax d. tuberculosis

pulmonary embolus

a nurse is providing discharge teaching to a client who has osteoarthritis. which of the following instruction should the nurse include a. rest frequently after periods of activity b. perform your exercise only on days that you feel good c. perform your exercises after applying cold packs to your joints d. place a large pillow under your knees when lying down

rest frequently after periods of activity

a nurse is caring for a client who is 3 days postoperative following a below-the-knee amputation. which of the following actions should the nurse take

rewrap the residual limb with bandage 3 times per day

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. a sensation of warmth over the surgical incision d. pallor following the elevation of the right leg

shortening of the right leg

a nurse is assessing a client's skeletal system. the nurse should be in which of the following positions to screen the client for scoliosis

standing behind the client, who is bent over at waist

a nurse is preparing a client who is scheduled to have an arthroscopy the following day. which of the following statements indicates the pre-procedure teaching.

the doctor will be able to see if i have signs of rheumatoid arthritis

a nurse is preparing a client for an electromyogram (EMG). which of the following statements indicates that the client understands the pre-procedure teaching

this test will help my doctor know if my nerves are working correctly

a nurse is caring for a client who had a below-the-knee amputation for gangrene of the right foot. the client report sensations of burning and crushing pain in the toes of the absent right foot. which of the following statement should the nurse make

this type of pain usually decreases over time as the limb becomes less sensitive

a nurse is assessing 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 that are cold to touch b. serous drainage from the pin sites c. blanching of the toenail bed with pressure d. pink tissue around the fixator insertion sites

toes that are cold to touch