Med Surg; Neuro/Muscular Questions
A nurse is developing a plan of care for a client who is scheduled for cerebral angiography. Which of the following statements by the client should the nurse report to the provider? (select all that apply): A. "I think I might be pregnant" B. "I take warfarin." C. "I take antihypertensive medication" D. "I am allergic to shrimp" E. "I ate a light breakfast this morning."
A. "I think I might be pregnant" B. "I take warfarin." D. "I am allergic to shrimp" E. "I ate a light breakfast this morning."
When a client experiences visual manifestations before having a migraine headache or a seizure this manifestation is known as what? A. An aura B. A TIA C. Nystagmus D. Increased ICP
A. An aura
The nurse has documented a patient diagnosed with a head injury as having a glasgow coma scale of 7. This score is generally interpreted as which of the following? A. Coma B. Least responsive C. Most responsive D. Minimally responsive
A. Coma
Which cranial nerves are assessed when the nurse has the patient move the eyes throughout the six cardinal fields? A. Ill,IV,VI B. II,V,VII C. VII,IX,X D. IX,X,XII
A. Ill,IV,VI
A client has undergone an external fixation. Which of the following is the most important nursing action to be taken for such a client? A. Perform pin care. B. PIan the client's diet. C. Monitor the clients urine output. D. Monitor the client's blood pressure.
A. Perform pin care.
A client with asthma as well as a musculoskeletal disorder is prescribed calcium carbonate as treatment for the musculoskeletal disorder. What advice, related to the intake of calcium carbonate, should the nurse give to the client? A. Take other drugs 1 to 2 hours after taking calcium carbonate. B. Avoid performing strenuous activity for 1 to 2 hours after taking calcium carbonate. C. Take calcium carbonate before bedtime. D. Ingest calcium carbonate with plenty of milk.
A. Take other drugs 1 to 2 hours after taking calcium carbonate.
Which of the following is the most important nursing action that may help clients who undergo a knee or hip replacement? A. Provide crutches to the client. B. Assist in early ambulation. C. Use a continuous passive motion (CPM) machine. D. Encourage expressions of anxiety or depression.
B. Assist in early ambulation.
As part of a start of shift nursing assessment, the nurse is documenting a patients neurological status according to the glasgow coma scale (GCS). What responses will the nurse assess to determine the patients GCS score? (select all that apply): A. Best judgment B. Best eye opening C. Best motor response D. Best sensory response E. Best verbal response
B. Best eye opening C. Best motor response E. Best verbal response
A patient is just admitted to the hospital following a spinal cord injury at the level of T4. A priority of nursing care for the patient is monitoring for: A. Return of reflexes B. Bradycardia with hypoxemia C. Effects of sensory deprivation E. Fluctuations in body temperature
B. Bradycardia with hypoxemia
A client who is undergoing skeletal traction complains of pressure on bony areas. Which of the following nursing actions would comfort the client? A. Assist with range-of-motion and isometric exercises. B. Change the client's position within prescribed limits. C. Administer prescribed analgesics. D. Apply warm compresses.
B. Change the client's position within prescribed limits.
A young adult is hospitalized after an accident that resulted in a complete transection of the spinal cord at the level of C7. The nurse informs the patient that after rehabilitation, the level of function that is most likely to occur is the ability to: A. Breathe with respiratory support B. Drive a vehicle with hand controls C. Ambulate with long-leg braces and crutches D. Use a powered device to handle eating utensils.
B. Drive a vehicle with hand controls
A patient has suffered a spinal cord injury after a driving accident. When first brought to the emergency room, the patient is suffereing from spinal shock. Which symptoms best describe this condition? A. Decreased venous return & skin breakdown in the extremities B. Flaccid paralysis & anesthesia in the lower extremities C. Back pain, muscle spasms, and difficulty walking D. Hypotension, headache and blurred vision
B. Flaccid paralysis & anesthesia in the lower extremities
The nurse is caring for a comatose client. Which method may the nurse use to assess the motor response? A. Observing the reaction of pupils to light B. Observing the clients response to painful stimulus. C. Using the Romberg test D. Assessing the clients sensitivity to temperature.
B. Observing the clients response to painful stimulus.
A client undergoes an invasive joint examination of the knee. Which of the following signs or symptoms should the nurse closely monitor for in the client? A. Lack of sleep and appetite B. Serous drainage C. Signs of depression D. Signs of shock
B. Serous drainage
How would the nurse identify rheumatoid nodules in a client with rheumatoid arthritis,. A. The nodules usually are tender and red. B. The nodules usually are nontender and movable. C. The nodules usually are red and movable. D. The nodules are minuscule and occur over non bony areas.
B. The nodules usually are nontender and movable.
The nurse has to conduct the physical assessment of a client with a traumatic injury. The physical assessment should begin with the collection of which of the following data? A. The age of the client B. The vital signs of the client C. The nature of the injury D. The level of sensation of the injured part
B. The vital signs of the client
A client who is immobilized after an orthopedic surgery is at risk for the pooling of his or her secretions. Which of the following nursing actions will help minimize the risk? A. Encourage the client to sneeze hard. B. Turn the client at least every 2 hours. C. Administer analgesics as prescribed. D. Elevate the affected extremity and use cold applications.
B. Turn the client at least every 2 hours.
Which interventions are contraindicated in the care of a client in a halo vest? (Select all that apply): A. Removing the vest for daily hygiene and bathing B. Using the vests struts to help pull the client up in bed C. Turning the client every 2 hours D. Providing pin care as per unit protocol E. Inspecting the pins for security
B. Using the vests struts to help pull the client up in bed
Which of the following clients is at greatest risk for osteoporosis and needs to be educated about the condition by the nurse? A. An overweight African-American woman approaching menopause B. A teenaged male with asthma C. A small-framed, thin white woman approaching menopause D. A young male athlete who plays contact sports and is constantly injured
C. A small-framed, thin white woman approaching menopause
Which of the following factors influences the focus of the initial history when assessing a new client with a musculoskeletal problem? A. Client's age B. Client's lifestyle C. Any chronic disorder or recent injury D. Duration and location of discomfort or pain
C. Any chronic disorder or recent injury
A client's cast is removed. The client is worried because the skin appears mottled and is covered with a yellowish crust. What advice should the nurse give the client to address the skin problem? A. Consult a skin specialist. B. Scrub the area vigorously to remove the crust. C. Apply lotions and take warm baths or soaks. D. Avoid harsh sunlight.
C. Apply lotions and take warm baths or soaks.
A thrombus may cause which of the following conditions? A. Cluster headache B. Autonomic dysreflexia C. CVA D. Multiple sclerosis
C. CVA
What advice should the nurse give to a client recovering from a fractured hip to facilitate calcium absorption from food and supplements? A. Increase intake of amino acids. B. Increase intake of vitamin B6. C. Increase intake of vitamin D. D. Increase intake of dairy products.
C. Increase intake of vitamin D.
The nurse is required to care for a client with a musculoskeletal injury who underwent a surgical incision. Which of the following nursing actions would help prevent the back flow of the drainage into the incision? A. Block the incision with sterilized gauze. B. Block the incision with a temporary cast. C. Keep the wound drainage system below the level of the incision. D. Keep the wound drainage system above the level of the incision.
C. Keep the wound drainage system below the level of the incision.
Which of the following advice should the nurse provide to a client with gout? A. Limit fluid intake. B. Limit protein-rich foods. C. Limit purine-rich foods. D. Limit carbohydrates.
C. Limit purine-rich foods.
During assessment of a patient with a spinal cord injury at the level of T2 at the rehabilitation center, which of the following findings would concern the nurse the most? A. A heart rate of 92 B. A reddened area over the patients coccyx C. Marked perspiration on the patients face and arms D. A light inspiratory wheeze on auscultation of the lungs
C. Marked perspiration on the patients face and arms
Which of the following is an important teaching point for a client who has undergone arthography? A. Avoid sunlight or harsh, dry climate. B. Avoid intake of dairy products. C. Report crackling or clicking noises in the joint if they occur beyond the second day. D. Treat crackling or clicking noises in the joint by gently massaging the joints.
C. Report crackling or clicking noises in the joint if they occur beyond the second day.
A client with a traumatic injury is administered a prescribed narcotic analgesic for pain relief. For which of the following signs and symptoms should the nurse closely monitor? A. Allergic reactions B. Hypotension C. Respiratory depression D. Joint inflammation
C. Respiratory depression
A male client, an ace professional tennis player, sprains his right ankle during a tennis match. The client is immediately rushed to the nurse, who provides him with first-aid care. Which of the following immediate combination of treatments should the nurse provide to the client? A. Heat, compression, analgesics, and exercise B. Rest, heat, compression, and elevation C. Rest, ice, compression, and elevation D. Exercise, ice, compression, and elevation
C. Rest, ice, compression, and elevation
A client is scheduled for a joint replacement surgery. Which of the following actions should a nurse take at this stage? A. Ensure adequate fluid intake before the surgery. B. Withhold intake of solid food before the surgery. C. Withhold administration of aspirin before the surgery. D. Ensure adequate sleep before the surgery.
C. Withhold administration of aspirin before the surgery.
During a general musculoskeletal assessment, which one of the following would help the nurse determine the client's muscle strength? A. Palpating the muscles and joints B. Asking the client to lift weights C. Examining the client for symmetry, size, and contour of extremities D. Applying force to the client's extremity as the client pushes against that force
D. Applying force to the client's extremity as the client pushes against that force
Which of the following is the reason why older adults are more prone to skeletal fractures? A. Because there is a 10% decrease in cortical bone B. Because of calcium deficiency C. because there is no bone reformation D. Because bone resorption is more rapid than bone formation
D. Because bone resorption is more rapid than bone formation
A 68-year-old female client who received treatment for a fracture is to be discharged because her healing is almost complete. Which of the following nursing actions is most critical for the client? A. Advise the client to avoid red meal B. Advise the client to keep the affected limb in an elevated position. C. Educate the client about the effects of menopause. D. Explore factors related to the client's home environment.
D. Explore factors related to the client's home environment.
A client has undergone hip surgery. Which of the following dietary suggestions would help the client prevent constipation? A. Intake of a high-protein diet B. Intake of a diet rich in potassium C. Intake of dairy products D. Intake of a high-fiber diet
D. Intake of a high-fiber diet
What advice can the nurse give a client with degenerative joint disease to avoid unusual stress on a joint? A. Keep shifting weight from one foot to the other. B. Perform aerobic exercises. C. Maintain complete bed rest. D. Maintain good posture.
D. Maintain good posture.
Which condition needs to be carefully assessed in a client with a fracture reduction? A. Cardiac problems B. Renal dysfunction C. Sleep disorders D. Neuromuscular and systemic complications
D. Neuromuscular and systemic complications
When explaining neuro anatomy to a client which of the following statements made by the nurse is correct? A. The brain and spinal cord are separated by the neurofibrillatory tangles. B. The brain and spinal cord are connected by the corpus callosum. C. The brain and spinal cord are connected by the tentorium. D. The brain and spinal cord are one continuous structure.
D. The brain and spinal cord are one continuous structure.