Med surge 1- exam 4 Textbook NCLEX questions

A client with a neurological disorder has difficulty swallowing. The nurse should take special care with the client's diet because of a potential risk for imbalanced nutrition. Which measure may be taken by the nurse to ensure that the client's diet allows for easy swallowing? a) Help the client sit upright when eating and feed slowly b) Offer liquids frequently, in large quantities c) Allow optimum physical activity before meals to expedite digestion d) Instruct the client to lie on the bed when eating

a) Help the client sit upright when eating and feed slowly The nurse should help the client sit upright, flex the clients chin toward the chest, and feed slowly.

Which type of fracture occurs when a bone fragment is driven into another bone fragment? a) Impacted b) Transverse c) Spiral d) Oblique

a) Impacted

The nurse is creating a teaching plan about preventing osteoporosis for a 65 year old client. The nurse should include which topics in the teaching plan? Select all that apply. a) Increased consumption of fish b) Daily intake of 800 mg calcium c) Daily intake of 1000 IU vitamin D d) Increased consumption of low fat milk

a) Increased consumption of fish c) Daily intake of 1000 IU vitamin D d) Increased consumption of low fat milk

A patient has been brought to the ED with altered LOC, high fever, and a purpura rash on the lower extremities. The family states the patient was complaining of neck stiffness earlier in the day. Which action should the nurse do first? a) Initiate isolation precautions b) Ensure the family receives prophylaxis antibiotic treatment c) Administer prescribed antibiotics d) Apply a cooling blanket

a) Initiate isolation precautions

A patient has been diagnosed with a frontal lobe brain abscess. Which of the following nursing interventions is appropriate? a) Initiate seizure precautions b) Assess for facial weakness c) Ensure the patient is NPO d) Assess visual acuity

a) Initiate seizure precautions

Which is a contraindication for the administration of tissue plasminogen activator (t-PA)? a) Intracranial hemorrhage b) Systolic BP less than or equal to 185 mm Hg c) Age 18 years or older d) Ischemic stroke

a) Intracranial hemorrhage

Which of the following is the only known risk factor for brain tumors? a) Ionizing radiation b) Cellular telephones c) Use of hair dyes d) Head trauma

a) Ionizing radiation

Which terms refers to muscle tension being unchanged with muscle shortening and joint motion? a) Isotonic contraction b) Isometric contraction c) Fasciculation d) Contracture

a) Isotonic contraction explanation: Exercises such as swimming and cycling are isotonic. Isometric contraction is characterized by increased muscle tension, unchanged muscle length, and no joint motion. Contracture refers to abnormal shortening of muscle, joint, or both.

Pulselessness, a very late sign of compartment syndrome, may signify which of the following? a) Lack of distal tissue perfusion b) Nerve involvement c) Venous congestion d) Diminished arterial perfusion

a) Lack of distal tissue perfusion

Which description refers to an osteon? a) Microscopic functional bone unit b) Bone-forming cell c) Mature bone cell d) Bone resorption cell

a) Microscopic functional bone unit explanation: The center of an osteon contains a capillary, a microscopic functional bone unit.

Which nursing intervention will best assist the patient with chorea? a) Monitor the patient on bed rest b) Assist the patient with walking hourly c) Keep an oral airway at the bedside d) Administer pain medication every 4 hours

a) Monitor the patient on bed rest

Which of the following is a chronic, degenerative, progressive disease of the CNS characterized by the occurrence of small patches of demyelination in the brain and spinal cord? a) Multiple sclerosis b) Huntington disease c) Creutzfeldt-Jakob disease d) Parkinson's disease

a) Multiple sclerosis

A transcranial doppler ultrasonography detects cerebral vasospasm in a client experiencing lethargy 8 days following a subarachnoid hemorrhage. The nurse anticipates which therapeutic intervention? a) Nimodipine PO b) Phenytoin IV c) Fluid restriction d) Nitroprusside IV

a) Nimodipine PO Calcium channel blocker to treat vasospasm

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? a) Notify the physician b) Document the findings c) Remove the cast immediately d) Assess for pedal pulse and mobility of toes

a) Notify the physician explanation: Indentations in the cast can cause skin irritation and breakdown. The physician needs to be notified to assess the need for a new cast or manipulation of the current cast to prevent the skin breakdown.

Which diagnostic test is used for early diagnosis of HSV-1 encephalitis? a) PCR b) EEG c) MRI d) Lumbar puncture

a) PCR

Which is a hallmark sign of compartment syndrome? a) Pain b) Motor weakness c) Weeping skin surfaces d) Edema

a) Pain pain that occurs or intensifies with passive ROM

Which lobe of the brain is responsible for spatial relationships? a) Parietal b) Frontal c) Temporal d) Occipital

a) Parietal

The nurse is conducting a musculoskeletal assessment of a client in a nursing home. The client is unable to dorsiflex the right foot or extend the toes. The nurse evaluates this finding as an injury to which nerve? a) Peroneal b) Achilles c) Sciatic d) Femoral

a) Peroneal injury to peroneal nerve may also cause foot drop.

A nurse conducts the Romberg test on a client by asking the client to stand with the feet close together and the eyes closed. As a result of this posture, the client suddenly sways to one side and is about to fall when the nurse intervenes and saves the client from being injured. How should the nurse interpret the clients result? a) Positive Romberg test, indicating a problem with equilibrium b) Positive Romberg test, indicating a problem with LOC c) Negative Romberg test, indicating a problem with body mass d) Negative Romberg test, indicating a problem with vision

a) Positive Romberg test, indicating a problem with equilibrium

A client with a short arm cast is suspected to have compartment syndrome. What actions should the nurse include in the plan of care? Select all that apply. a) Provide support to the injured extremity b) Apply ice to the extremity c) Elevate the arm above the heart d) Prepare to remove the cast e) Assess neurovacular status every 8 hours

a) Provide support to the injured extremity d) Prepare to remove the cast

Which of the following statements reflect nursing interventions of a patient with post-polio syndrome? a) Providing care aimed at slowing the loss of strength and maintaining the physical, psychological and social well being of the patient b) Planning activities for evening hours rather than morning c) Administering antiretroviral agents d) Avoiding the use of heat applications in the treatment of muscle and joint pain

a) Providing care aimed at slowing the loss of strength and maintaining the physical, psychological and social well being of the patient

A client diagnosed with osteoporosis is being discharged home. Which priority education should the nurse provide? a) Remove all small rugs from the home b) Classify medications c) Participate in weight-bearing exercises d) Increase calcium and vitamin D in the diet

a) Remove all small rugs from the home

Thrombolytic therapy should be initiated within what time frame of an ischemic stroke to achieve the best functional outcome? a) 3 hours b) 9 hours c) 12 hours d) 6 hours

a) 3 hours

Which of the following is a disease in which there is a loss of motor neurons in the anterior horns of the spinal cord and motor nuclei of the lower brain stem? a) ALS b) PD c) Huntington disease d) Alzheimers disease

a) ALS

The nurse is caring for a client after a lumbar puncture. The client reports a severe headache. What actions should the nurse complete? Select all that apply. a) Administer analgesic medication b) Prepare for an epidural blood patch c) Administer fluids to the client d) Maintain the client on bedrest e) Position the client in the supine position

a) Administer analgesic medication c) Administer fluids to the client d) Maintain the client on bedrest

Which would be an inappropriate initial pain relief measure for the client with a cast? a) Application of a new cast b) Administration of analgesics c) Elevation of the involved part d) Application of cold packs

a) Application of a new cast

Which nursing action would prevent deep vein thrombosis in a client who has had an orthopedic surgery? a) Apply anti embolism stockings b) Apply cold packs c) Instruct about exercise, as prescribed d) Instruct about using client-controlled analgesia, if prescribed

a) Apply anti embolism stockings

A client is ordered to undergo CT of the brain with IV contrast. Before the test, the nurse should complete which action first? a) Assess the client for medication allergies b) Obtain two large bore IV lines c) Maintain the client NPO for 6 hours before the test d) Obtain a blood sample to evaluate BUN and creatinine concentrations

a) Assess the client for medication allergies

Which actions by the nurse demonstrate an understanding of caring for a client in traction? Select all that apply. a) Assessing the client's alignment in the bed b) Removing skeletal traction to turn and reposition the client c) Frequently assessing pain level d) Ensuring that the weights are hanging freely e) Placing a trapeze on the bed

a) Assessing the client's alignment in the bed c) Frequently assessing pain level d) Ensuring that the weights are hanging freely e) Placing a trapeze on the bed

Which interventions would be recommended for a client with dysphagia? Select all that apply. a) Assist the client with meals b) Allow ample time to eat c) Place food on the affected side of the mouth d) Test the gag reflex before offering food or fluids

a) Assist the client with meals b) Allow ample time to eat d) Test the gag reflex before offering food or fluids

Which drug should be available to counteract the effect of Tensilon? a) Atropine b) Prednisone c) Imuran d) Mestinon

a) Atropine

Which of the following is anticholinergic agent used to control tremor and rigidity in PD? a) Benztropine (Cogentin) b) Amantadine (Symmetrel) c) Levodopa (Larodopa) d) Bromocroptime mesylate (Parlodel)

a) Benztropine (Cogentin)

Which of the following is rapid, jerky, involuntary and purposeless movement of the extremities or facial muscles? a) Chorea b) Dyskinesia c) Akathisia d) Paresthesia

a) Chorea

A client who has extremity right wrist fracture complains of severe burning pain, frequent changes in skin from hot and dry to cold and feeling clammy skin that is shiny and growing more hair in the injured extremity. The nurse should anticipate providing care for what complication? a) Complex regional pain syndrome b) Heterotrophic ossification c) Reaction to an internal fixation device d) Avascular necrosis of bone

a) Complex regional pain syndrome

Which term refers to a blunt force injury to soft tissue? a) Contusion b) Fracture c) Dislocation d) Strain

a) Contusion

Which of the following are the most commonly reported clinical manifestations of MS? Select all that apply. a) Depression b) Aphasia c) Pain d) Numbness e) Spasticity f) Fatigue

a) Depression c) Pain d) Numbness e) Spasticity f) Fatigue

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? a) Describe the pain and rate it on the pain scale b) Your left toes have been amputates c) The pain is really from the nerves in your upper leg d) Pain medication usually does not help this type of pain

a) Describe the pain and rate it on the pain scale

Which term refers to the shaft of the long bone? a) Diaphysis b) Scoliosis c) Lordosis d) Epiphysis

a) Diaphysis explanation: The diaphysis is primarily cortical bone. An epiphysis is an end of a long bone. Lordosis refers to an increase in lumbar curvature of spine. Scoliosis refers to lateral curving of the spine.

Colles fracture occurs in which area? a) Distal radius b) Clavicle c) Elbow d) Humeral shaft

a) Distal radius It is usually the result of a fall on an open, dorsiflexed hand

The nurse teaching the client with a cast about home care includes which instruction? a) Dry a wet fiberglass cast thoroughly to avoid skin problems b) Keep the cast below heart level c) Fix a broken cast by applying tape d) Cover the cast with plastic or rubber

a) Dry a wet fiberglass cast thoroughly to avoid skin problems

A client diagnosed with a stroke is having difficulty forming words during communication. This would be appropriately documented as a) Dysarthria b) Diplopia c) Dysphagia d) Receptive aphasia

a) Dysarthria

A nurse is instructing the spouse of a client who suffered a stroke about the use of eating devices the client will be using. During the teaching, the spouse starts to cry and states, "One minute he is laughing, the next he's crying; I just don't understand what's wrong with him." Which statement is the best response by the nurse? a) Emotional lability is common after a stroke, and it usually improves with time b) You seem upset, and it may be hard for you to focus on the teaching, I'll come back later c) This behavior is common in clients with a stroke. Which does your spouse do more often, laugh or cry? d) You sound stressed; maybe using some stress management techniques will help

a) Emotional lability is common after a stroke, and it usually improves with time

Which term refers to a break in the continuity of a bone? a) Fracture b) Subluxation c) Dislocation d) Malunion

a) Fracture

Which is a nonmodifiable risk factor for ischemic stroke? a) Gender b) Smoking c) Hyperlipidemia d) Atrial fibrillation

a) Gender

The nurse notes that the client's left great toe deviates laterally. This finding would be recognized as which condition? a) Hallux valgus b) Flatfoot c) Pes cavus d) Hammertoe

a) Hallux valgus explanation: Hallux vagus is commonly referred to as a bunion. Hammertoes are usually pulled upward. Pes cavus refers to a foot with an abnormally high arch and a fixed equinus deformity of the forefoot.

A patient is admitted complaining of low back pain. What will best assist the nurse in determining if the pain is related to a herniated lumbar disc? a) Have the patient lie on their back and lift their leg, keeping it straight b) Ask the patient if they can walk c) Ask the patient if they have had a bowel movement d) Ask the patient if they had pain on ambulation

a) Have the patient lie on their back and lift their leg, keeping it straight

Which statement reflects the progress of bone healing? a) Serial x-rays are used to monitor the progress of bone healing. b) All fracture healing takes place at the same rate no matter the type of bone fractured c) The age of the client influences the rate of fracture healing d) Adequate immobilization is essential until ultrasound shows evidence of bone formation with ossification.

a) Serial x-rays are used to monitor the progress of bone healing explanation: The type of bone fractured, adequacy of blood supply, the surface contact of the fragments, and the general health of the client influence the rate of fracture healing. Adequate immobilization is essential until x-ray shows evidence of bone formation with ossification.

The nurse working in the orthopedic surgeon's office is asked to schedule a shoulder arthrography. The nurse determines that the surgeon suspects which finding? a) Tear in the joint capsule b) Injury to the radial nerve c) Decreased bone density d) Fracture of the clavicle

a) Tear in the joint capsule

Which client(s) is most likely to have compartment syndrome after sustaining a fracture? Select all that apply. a) The client with a plaster cast applied immediately after injury b) The client using ice to control pain in the extremity c) The client who sustained a clavicle fracture d) The client with elevated pressure within the muscles e) The client with hemorrhage in the site of injury

a) The client with a plaster cast applied immediately after injury d) The client with elevated pressure within the muscles e) The client with hemorrhage in the site of injury

What interventions will best help the patient with Huntington disease relieve anxiety and increase communication? Select all that apply. a) Use biofeedback b) Consult with a speech therapist c) Always have family present d) Employ an interpreter e) Talk as little as possible

a) Use biofeedback b) Consult with a speech therapist

The nurse teaches the client with a high risk for osteoporosis about risk lowering strategies, including which action? a) Walk or perform weight-bearing exercises outdoors b) Reduce stress c) Increase fiber in the diet d) Decrease the intake of vitamin A and D

a) Walk or perform weight-bearing exercises outdoors

The nurse is educating a group of women on the prevention of osteoporosis. The nurse recognizes the education as being effective when the group members make which statement? a) We need an adequate amount of expose to sunshine. b) Estrogen deficiency increases bone density. c) We need to consume a low-calcium, high-phosphorus diet. d) We need to increase aerobic exercise

a) We need an adequate amount of expose to sunshine.

A patient with a herniated lumbar disc has asked about nonsurgical strategies to help with mobility. What strategies will the nurse teach the patient? Select all that apply. a) Weight reduction b) Muscle relaxants c) PT d) NSAIDs e) Hydrotherapy f) Positive feedback and attitude

a) Weight reduction b) Muscle relaxants c) PT d) NSAIDs

A nurse is educating the client diagnosed with osteomalacia. Which statement by the nurse is appropriate? a) You may need to be evaluated for an underlying cause, such as renal failure. b) You will need to engage in vigorous exercise three times a week for 30 minutes. c) You will need to avoid foods high in phosphorus and vitamin D. d) You will need to decrease the amount of dairy products you consume.

a) You may need to be evaluated for an underlying cause, such as renal failure.

A client with a musculoskeletal injury is instructed to increase dietary calcium. Which statement by the nurse is appropriate? a) You need to increase the amount of vitamin D in your diet b) You need to increase the amount of non citrus fruits in your diet c) You need to increase the amount of phosphorus in your diet d) You need to increase the amount of red meat in your diet

a) You need to increase the amount of vitamin D in your diet explanation: Vitamin D is needed for the absorption of calcium

The nurse is reading the admission note for a client with a bone fracture that requires surgery. The note indicates the presence of crepitus. The nurse interprets this as being a) a crackling sound b) a closed fracture c) ecchymosis d) bleeding

a) a crackling sound

The nurse is performing a musculoskeletal assessment of a client in a nursing home who had a stroke 2 years Aho and who has right sided hemiplegia. The nurse notes that the girth of the client's right calf is 2 inches loss in diameter than the left calf. The nurse attributes the decreased girth to a) atrophy of right calf muscle b) bruising in right lower extremity c) edema in left lower extremity d) increased use of left calf muscle

a) atrophy of right calf muscle

Which is an inappropriate use of traction? a) Decrease space between opposing structures b) Minimize muscle spasms c) Immobilize a fracture d) Reduce deformity

a) decrease space between opposing structures

Meniscectomy refers to the a) excision of damaged joint fibrocartilage b) removal of a body part c) incision and diversion of the muscle fascia d) replacement of one of the articular surfaces of a joint

a) excision of damaged joint fibrocartilage most common site is the knee

Which aspect should a nurse include in the teaching plan for a client with osteomalacia? a) include calcium, phosphorus, and vitamin D supplements b) avoid any activity or exercise c) avoid green, leafy vegetables d) avoid diary products

a) include calcium, phosphorus, and vitamin D supplements

A patient is receiving mitoxantrone (Novantrone) for treatment of secondary progressive MS. This patient should be closely monitored for a) leukopenia and cardiac toxicity b) renal insufficiency c) mood changes and fluid and electrolyte alterations d) hypoxia

a) leukopenia and cardiac toxicity

Upper motor neuron lesions cause a) little to no muscle atrophy b) flaccid paralysis c) decreased muscle tone d) absent or decreased reflexes

a) little to no muscle atrophy but do cause loss of voluntary control

Bone density testing in pts with post polio syndrome has demonstrated a) low bone mass and osteoporosis b) calcification of long bones c) Osteoarthritis d) no significant findings

a) low bone mass and osteoporosis

The primary North American vector transmitting arthropod-borne virus encephalitis is the a) mosquito b) flea c) horse d) tick

a) mosquito

The patient with HSV encephalitis is receiving acyclovir (Zovirax). The nurse monitors blood chemistry test results and urinary output for a) renal complications related to acyclovir therapy b) signs and symptoms of cardiac insufficiency c) signs of improvement in the patient's condition d) signs of relapse

a) renal complications related to acyclovir therapy

a 75 year old client had surgery for a left hip fracture yesterday. When completing the plan of care, the nurse should include assessment for which complications? Select all that apply. a) sepsis b) delirium c) pneumonia d) skin breakdown e) necrosis of the humerus

a) sepsis b) delirium c) pneumonia d) skin breakdown

Which is an inaccurate principle of traction? a) Skeletal traction is interrupted to turn and reposition the client b) The client must be in good alignment in the center of the bed c) The weights must hang freely d) The weights are not removed unless intermittent treatment is prescribed

a) skeletal traction is interrupted to turn and reposition the client

The nurse is conducting a community education program on hip fracture risk. The nurse evaluates that the participants understand the program when the participants determine that client at highest risk for a hip fracture is a(n) a) toddler just starting to walk b) 80-year-old man recently widowed c) high school athlete d) 30 year old pregnant woman

b) 80 year old man recently widowed

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) It is best if an orthopedic doctor applies the cast b) A splint is applied when more swelling is expected at the site of injury c) Not all fractures require a cast d) You would have to stay here much longer because it takes a cast longer to dry

b) A splint is applied when more swelling is expected at the site of injury

The nurse is completing a neurological assessment and uses the whisper test to assess which cranial nerve? a) Facial b) Acoustic c) Olfactory d) Vagus

b) Acoustic

A patient is suspected to have bacterial meningitis. What is the priority nursing intervention? a) Encourage fluid intake by mouth b) Administer prescribed antibiotics c) Assess the CSF fluid lab results d) Prepare patient for CT scan

b) Administer prescribed antibiotics

Which term refers to the failure to recognize familiar objects perceived by the senses? a) Perseveration b) Agnosia c) Agraphia d) Apraxia

b) Agnosia

Which term refers to the inability to recognize objects through a particular sensory system? a) Aphasia b) Agnosia c) Dementia d) Ataxia

b) Agnosia

Which term refers to the inability to perform previously learned purposeful motor acts on a voluntary basis? a) Agraphia b) Apraxia c) Perseveration d) Agnosia

b) Apraxia

A client is transported to the ED for a femur fracture following a MVA. What action by the nurse is the highest priority? a) Assess the diameter of the thighs every 15 mins b) Assess vital signs and LOC c) Administer pain meds per orders d) Assess pedal pulses

b) Assess vital signs and LOC

The nurse teaches the patient diagnosed with Huntington disease that it is transmitted as which type of genetic disorder? a) Autosomal recessive b) Autosomal dominant c) X-linked d) None of the above

b) Autosomal dominant

Instructions for the client with low back pain include that, when lifting, the client should a) place the load away from the body b) Avoid overreaching c) use a narrow base of support d) bend the knees and loosed the abdominal muscles

b) Avoid overreaching

A nurse is caring for a patient diagnosed with Guillain-Barre syndrome. The patient states, "Its getting harder to take a deep breath." Which of the following actions by the nurse is most appropriate? a) Encourage the patient to cough b) Call the physician and prepare for intubation c) Explain the progression of the syndrome d) Assess lung sounds

b) Call the physician and prepare for intubation

Which is an indicator of neurovascular compromise? a) Diminished pain b) Capillary refill of more than 3 seconds c) Pain upon active stretch d) Warm skin temperature

b) Capillary refill of more than 3 seconds explanation: Cap refill of more than 3 seconds is an indicator of neurovascular compromise. Other indicators include cool skin temp, pale or cyanotic color, weakness, paralysis, paresthesia, unrelenting pain, pain upon passive stretch, and absence of feeling.

Which occurs when reflexes are hyperactive when the foot is abruptly dorsiflexed? a) Flaccidity b) Clonus c) Rigidity d) Ataxia

b) Clonus

What is the term for a rhythmic contraction of a muscle? a) Atrophy b) Clonus c) Hypertrophy d) Crepitus

b) Clonus explanation: Atrophy is a shrinkage like decrease in size of a muscle. Hypertrophy is an increase in the size of a muscle.

In a client with a dislocation, the nurse should initially perform neurovascular assessments a minimum of every 15 mins until stable. Which complication does the assessments help the nurse to monitor? a) GI bleeding b) Compartment syndrome c) Ganglion cysts d) Carpal tunnel syndrome

b) Compartment syndrome

Which term refers to a grating or crackling sound or sensation? a) Fasciculation b) Crepitus c) Callus d) Clonus

b) Crepitus explanation: Crepitus may occur with movement of the ends of a broken bone or irregular joint surface. Callus is fibrous tissue that forms at the fracture site. Clonus refers to rhythmic contraction of muscle. Fasciculation refers to involuntary twitch of muscle fibers.

A client with a tibia fracture was placed in an external fixator 24 hours ago. The nurse is completing pin care and notices redness at the pin site and a small amount of serous drainage. What action by the nurse is appropriate? a) Notify the physician b) Document the findings c) Assess the client's hemoglobin and hematocrit d) Prepare for surgical removal of the fixator

b) Document the findings explanation: serous drainage and redness at the pin site is an expected finding for 48 to 72 hours after insertion.

What is the best action by the nurse to achieve optimal outcomes when caring for a client with a musculoskeletal disorder who is using a cast? a) Assess for neurovascular compromise b) Educate the client on cast care and complications c) Provide effective pain control d) Prepare the client for cast application

b) Educate the client on cast care and complications

Which term refers to a method of recording, in graphic form, the electrical activity of a muscle? a) Electrocardiography b) Electromyography c) Electrogastrography d) Electroencephalography

b) Electromyography

The nurse is caring for a client diagnosed with a subarachnoid hemorrhage resulting from a leaking aneurysm. The client is awaiting surgery. Which nursing intervention would be appropriate for the nurse to implement? Select all that apply. a) Ambulate the client every hour b) Elevated the HOB 30 degrees c) Permit friends to visit often d) Provide a dimly lit environment e) Administer docusate per order

b) Elevated the HOB 30 degrees d) Provide a dimly lit environment e) Administer docusate per order

A client asks the nurse why his residual limb cannot be elevated on a pillow. What is the best response by the nurse? a) I am sorry. We ran out of pillows. I can elevate it on a few blankets. b) Elevating the leg might lead to a flexion contracture c) Elevating the extremity may increase your chances for compartment syndrome d) You need to turn yourself side to side. If your leg is on a pillow, you would not be able to do that.

b) Elevating the leg might lead to a flexion contracture

A client has undergone a lumbar puncture as a part of a neurological assessment. The client is put under the care of a nurse after the procedure. Which important post procedure nursing intervention should be performed to ensure the client's maximum comfort? a) Administer antihistamines according to the physicians prescription b) Encourage the client to drink liberal amounts of fluids c) Help the client take a brisk walk around the testing area d) Keep the room brightly lit and play soothing music in the background

b) Encourage the client to drink liberal amounts of fluids

The nurse is caring for a client with aphasia. Which strategy will the nurse use to facilitate communication with the client? a) Avoiding the use of hand gestures b) Establishing eye contact c) Speaking loudly d) Speaking in complete sentences

b) Establishing eye contact

The trochlear nerve controls which function? a) Visual acuity b) Eye muscle movement c) Movement of the tongue d) Hearing and equilibrium

b) Eye muscle movement

Bell's palsy is a disorder of which cranial nerve? a) Vestibulocochlear (VIII) b) Facial (VII) c) Vagus (X) d) Trigeminal (V)

b) Facial (VII)

Which term describes a surgical procedure to release constricting muscle fascia so as to relieve muscle tissue pressure? a) Arthrodesis b) Fasciotomy c) Arthroplasty d) Osteotomy

b) Fasciotomy explanation: An osteotomy is a surgical cutting of bone. An arthroplasty is a surgical repair of a joint. Arthrodesis is a surgical fusion of a joint.

The nurse assesses subtle personality changes, restlessness, irritability, and confusion in a client who has sustained a fracture. The nurse suspects which complication? a) Hypovolemic shock b) Fat embolism syndrome c) Compartment syndrome d) Reflex sympathetic dystrophy syndrome

b) Fat embolism syndrome

A client has been diagnosed as having global aphasia. The nurse recognizes that the client will be unable to perform which action? a) Comprehend spoken words b) Form words that are understandable or comprehend spoken words c) Form words that are understandable d) Speak at all

b) Form words that are understandable or comprehend spoken words

Which cerebral lobe is the largest and controls abstract thought? a) Occipital b) Frontal c) Parietal d) Temporal

b) Frontal

A patient with a cervical disc herniation in the acute phase is complaining of numbness and tingling of his arms. What are the priority interventions for the nurse to perform? Select all that apply. a) Assist the patient in isometric exercises of the arms b) Have the patient wear a cervical collar daily c) Provide NSAID therapy d) Encourage exercises to strengthen the legs e) Encourage weight lifting to strengthen arms

b) Have the patient wear a cervical collar daily c) Provide NSAID therapy

Which of the following is the most common cause of acute encephalitis in the US? a) Western equine bacteria b) Herpes simplex virus

b) Herpes simplex virus

The nurse is educating a client on home care following removal of a ganglion cyst from the right wrist. Which statement by the client demonstrates that the nurse's teaching has been effective? a) I will notify my doctor if I develop redness and purulent draining for 2 days b) I will leave the dressing on until I follow up with my doctor as scheduled c) If my pain is not relieved I will use a heat pack and take some more medication d) In my hand becomes numb and cool I will elevate it above my heart

b) I will leave the dressing on until I follow up with my doctor as scheduled

The statements presented here match nursing interventions with nursing diagnoses. Which statements are true for a client with a stroke? Select all that apply. a) Self care deficit: Instruct the client on use of a walker b) Impaired swallowing: Provide a pureed diet c) Impaired verbal communication: repeat words and instructions d) Impaired physical mobility: provide wide grip utensils during meals e) Disturbed sensory perception: stand on the clients unaffected side

b) Impaired swallowing: Provide a pureed diet c) Impaired verbal communication: repeat words and instructions e) Disturbed sensory perception: stand on the clients unaffected side

A client experienced an open fracture to the left femur during a horse riding accident. For which complication is the client at highest risk? a) Complex regional pain syndrome b) Infection c) Malunion d) Depression

b) Infection

Which are contraindications for the administration of t-PA? Select all that apply. a) Systolic BP less that or equal to 185 mm Hg b) Intracranial hemorrhage c) Major abdominal surgery within 10 days d) Ischemic stroke e) 18 years or older

b) Intracranial hemorrhage c) Major abdominal surgery within 10 days

A patient has undergone a cervical discectomy. What interventions are essential to teach the patient? Select all that apply. a) Sit as much as possible; standing can cause pain b) Keep staples or sutures clean and dry c) Do not remove dressing until your next visit d) Cover incision with dry dressing e) Call health care provider if the area is red or irritated f) Avoid twisting or flexing your neck

b) Keep staples or sutures clean and dry c) Do not remove dressing until your next visit d) Cover incision with dry dressing e) Call health care provider if the area is red or irritated f) Avoid twisting or flexing your neck

Which term refers to mature compact bone structures that form concentric rings of bone matrix? a) Trabecula b) Lamellae c) Endosteum d) Cancellous bone

b) Lamellae explanation: Lamellae are mineralized bone matrices. Endosteum refers to the marrow cavity lining of hollow bone. Trabecula refers to lattice like bone structure. Cancellous bone refers to spongy, lattice like bone structure.

Which factor inhibits fracture healing? a) Exercise b) Local malignancy c) Vitamin D d) Maximum bone fragment contact

b) Local malignancy Other factors are bone loss and extensive local trauma. Factors that enhance fracture healing include proper nutrition, vitamin D, exercise, and max bone fragment contact

Which finding is considered a positive finding of the Romberg test? a) Deviation of the tongue b) Loss of balance c) Tearing of the eye d) Hoarseness in the voice

b) Loss of balance

The diagnosis of MS is based upon which of the following tests? a) Neuropsychological testing b) MRI c) CSF electrophoresis d) Evoked potential studies

b) MRI

Which clinical manifestation would be exhibited by a client following a hemorrhagic stroke of the right hemisphere? a) Inability to move the right arm b) Neglect of the left side c) Neglect of the side opposite the the hemisphere affected d) Expressive aphasia

b) Neglect of the left side

Which is the initial diagnostic test for a stroke? a) Carotid doppler b) Noncontrast computed tomography c) Transcranial doppler studies d) Electrocardiography

b) Noncontrast computed tomography

Which cranial nerve is responsible for muscles that move the eye and lids? a) Trigeminal b) Oculomotor c) Vestibulocochlear d) Facial

b) Oculomotor (III)

What nursing intervention will best help the patient with Huntington disease to increase nutrition? Select all that apply. a) Increasing high carb foods b) Phenothiazine prior to meals c) Relaxation techniques d) A pureed diet e) eliminating foods high in fat

b) Phenothiazine prior to meals c) Relaxation techniques

The nurse is caring for a patient with Huntington disease. What intervention is a priority for self care? a) ROM exercises b) Protecting the patient from falls c) Measuring electrolytes d) Assessing serum cholesterol

b) Protecting the patient from falls

Which of the following is a component of the nursing management of the patient with new variant Creutzfeldt-Jakob disease? a) Administering amphotericin B b) Providing supportive care c) Preparing for organ donation d) Initiating isolation procedures

b) Providing supportive care

After a fracture, during which stage or phase of bone healing is devitalized tissue removed and new bone reorganized into its former structural arrangement? a) Inflammation b) Remodeling c) Revascularization d) Reparative

b) Remodeling Explanation: remodeling is the final stage of fracture repair.

During which stage or phase of bone healing after fracture does callus formation occur? a) Revascularization b) Reparative c) Remodeling d) Inflammation

b) Reparative explanation: Callus formation occurs during the reparative stage, but is disrupted by excessive motion at the fracture site. Remodeling is the final stage of fracture repair during which the new bone is reorganized into the bone's former structural arrangement. During inflammation, macrophages invade and debride the fracture area. Revascularization occurs within about 5 days after the fracture.

Which is a modifiable risk factor for transient ischemic attacks and ischemic strokes? a) Thyroid disease b) Smoking c) Advanced age d) Social drinking

b) Smoking

Which is a strategy for lowering risk for osteoporosis? a) diet low in calcium and vitamin D b) Smoking cessation c) increased age d) Low initial bone mass

b) Smoking cessation

Which term refers to an injury to ligaments and other soft tissues surrounding a joint? a) Dislocation b) Sprain c) Strain d) Subluxation

b) Sprain A sprain is caused by a wrenching or twisting motion

The majority of bone infections are caused by which organism? a) Pseudomonas b) Staphylococcus aureus c) Proteus

b) Staphylococcus aureus (Cause over 50% of bone infections)

The parents of a patient intubated due to the progression of Guillain-Barre syndrome ask if their child will die. What is the best response by the nurse? a) Its too early to give a prognosis b) There are no guarantees, but a large portion of people with Guillain-Barre syndrome survive c) Dont worry your child will be fine d) Once guillan barre syndrome progresses to the diaphragm there is a significant decrease in survival

b) There are no guarantees, but a large portion of people with Guillain-Barre syndrome survive

A client with a musculoskeletal injury is instructed to alter their 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? a) Bananas b) Vitamin D-fortified milk c) Green vegetables d) Red meat

b) Vitamin D-fortified milk other dietary sources of vitamin D: fatty fish, cereals

A patient is newly diagnosed with relapsing-remitting MS. Which instruction should the nurse provide? a) You should take your medications only during times of relapse b) You must avoid stress and extreme fatigue, because these can trigger a relapse c) You will have a steady and gradual decline in function d) Your type of MS is the least common, making it difficult to manage

b) You must avoid stress and extreme fatigue, because these can trigger a relapse

While reading the client's chart, the nurse notices that the client is documented to have paresthesia. The nurse plans care for a client with a) absence of muscle tone b) abnormal sensations c) absence of muscle movement suggesting nerve damage d) involuntary twitch of muscle fibers

b) abnormal sensations

A client with a long arm cast continues to complain of unrelieved throbbing pain even after receiving opioid pain meds. Which is the priority action by the nurse? a) Assess for previous opioid drug use b) Assess for complications c) Reposition the client for comfort d) Teach relaxation techniques

b) assess for complications

An x-ray demonstrates a fracture in which a bone has splintered into several pieces. Which type of fracture is this? a) depressed b) comminuted c) compound d) impacted

b) comminuted explanation: May require open reduction and internal fixation

When the client who has experienced trauma to an extremity reports severe burning pain, vasomotor changes, and muscles spasms in the injured extremity, the nurse recognizes that the client is likely demonstrating signs of a) heterotrophic ossification b) complex regional pain syndrome c) avascular necrosis of bone d) reaction to an internal fixation device

b) complex regional pain syndrome Complex regional pain syndrome is frequently chronic and occurs most often in women.

Medical Management of arthropod-borne virus (arboviral) encephalitis is aimed at a) preventing renal insufficiency b) controlling seizures and increased intracranial pressure c) preventing muscular atrophy d) maintaining hemodynamic stability and adequate cardiac output

b) controlling seizures and increased intracranial pressure

Which would be consistent as a component of self-care activities for the client with a cast? a) Frequently place the casted extremity in a dependent position b) Cushion rough edges of the cast with tape c) Use a plastic hanger wrapped in gauze to scratch under the cast d) Cover the cast with plastic to insulate it

b) cushion rough edges of the cast with tape

An x-ray demonstrates a fracture in which the fragments of bone are driven inward. This type of fracture is referred to as a) comminuted b) depressed c) compound d) impacted

b) depressed explanation: depressed skull fractures occur as a result of blunt trauma.

Which is a sympathetic effect of the nervous system? a) decreased blood pressure b) dilated pupils c) increased peristalsis d) decreased respiratory rate

b) dilated pupils

Which interventions should a nurse implement as part of initial pain relief for the client with a cast? Select all that apply. a) Apply a new cast b) Elevate the involved part c) Provide passive ROM d) Administer analgesics e) Apply cold packs

b) elevate the involved part d) administer analgesics e) apply cold packs

Which term refers to a fracture in which one side of a bone is broken and the other side is bent? a) spiral b) greenstick c) oblique d) avulsion

b) greenstick

Which is a benefit of a CPM device when applied after knee surgery? a) It provides active ROM b) It promotes healing by increasing circulation and movement of the knee joint c) It prevents infection and controls edema and bleeding d) It promotes healing by immobilizing the knee joint

b) it promotes healing by increasing circulation and movement of the knee joint

with fractures of the femoral neck, the leg is a) adducted & internally rotated b) shortened, adducted, & externally rotated c) shortened, abducted, & internally rotated d) abducted & externally rotated

b) shortened, adducted, & externally rotated

An example of a flat bone is the a) Femur b) Sternum c) Vertebra d) metacarpals

b) sternum explanation: metacarpal is a short bone, femur is a long bone, vertebra is an irregular bone

Which term refers to moving away from midline? a) Eversion b) Inversion c) Abduction d) Adduction

c) Abduction explanation: Adduction is moving toward the midline. Inversion is turning inward. Eversion is turning outward.

Which statement describes paresthesia? a) Involuntary twitch of muscle fibers b) Absence of muscle tone c) Abnormal sensations d) Absence of muscle movement suggesting nerve damage

c) Abnormal sensations explanation: Abnormal sensations, such as burning, tingling, and numbness, are referred to as paresthesias. The absence of muscle tone suggesting nerve damage is paralysis. Fasciculation is the involuntary twitch of muscle fibers. Absence of muscle tone is flaccid.

Myasthenia gravis occurs when antibodies attack which receptor site? a) GABA b) Serotonin c) Acetlycholine d) Dopamine

c) Acetlycholine

Which of the following medication classifications should be avoided in the treatment of brain tumors? a) Osmotic diuretics b) Corticosteroids c) Anticoagulants d) Anticonvulsants

c) Anticoagulants

If warfarin is contraindicated as a treatment for stroke, which medication is the best option? a) Clopidogrel b) Ticlodipine c) Aspirin d) Dipyridamole

c) Aspirin

Which hormone inhibits bone resorption and increases deposit of calcium in the bone? a) Growth hormone b) Vitamin D c) Calcitonin d) Sex hormones

c) Calcitonin explanation: Calcitonin, secreted by the thyroid gland in response to elevated blood calcium levels, inhibits bone reabsorption and increases the deposit of calcium in the bone.

Which medication directly inhibits osteoclasts, thereby reducing bone loss and increasing BMD? a) Teriparatide (Forteo) b) Raloxifene (Evista) c) Calcitonin (Miacalcin) d) Vitamin D

c) Calcitonin (Miacalcin) explanation: Raloxifene reduces the risk of osteoporosis by preserving BMD without estrogenic effects on the uterus. Teriparatide has been recently approved by the FDA for the treatment of osteoporosis.

Which group is at greatest risk for osteoporosis? a) Asian women b) African American women c) Caucasian women d) Men

c) Caucasian women explanation: small framed, non obese caucasian women are at greatest risk for osteoporosis.

When an infection is blood borne, the manifestations include which symptom? a) Hypothermia b) Hyperactivity c) Chills d) Bradycardia

c) Chills explanation: Manifestations of blood borne infection includes chills, high fever, rapid pulse, and generalized malaise.

Which cleansing solution is the most effective for use in completing pin site care? a) Betadine b) Hydrogen peroxide c) Chlorhexidine d) Alcohol

c) Chlorhexidine explanation: water and saline are alternate choices. Hydrogen peroxide and betadine are cytotoxic to osteoblasts and damage healthy tissue

The nurse is caring for a client scheduled to have MRI. The nurse contacts the health care provider to cancel the MRI when the nurse reads which element in the client's medical history? a) Colostomy b) Tumor removal c) Cochlear implant d) Skin graft

c) Cochlear implant

Which of the following manifestations is inconsistent with the diagnosis of Guillain-Barr syndrome? a) Areflexia b) Orthostatic hypotension c) Cognitive decline d) Ascending weakness

c) Cognitive decline

Which are clinical manifestations of a fracture? a) Deformity b) Pain c) Crepitus d) Lenghtening

c) Crepitus

The nurse is caring for a client with a history of transient ischemic attacks (TIAs) and moderate carotid stenosis who has undergone a carotid endarterectomy. Which postoperative finding would cause the nurse the most concern? a) BP 128/86 b) Mild neck edema c) Difficulty swallowing d) Neck pain rated 3 out of 10

c) Difficulty swallowing Need to assess cranial nerve function (facial VII, Vagus X, spinal accessory XI, and hypoglossal XII)

Which term refers to a flexion deformity caused by a slowly progressive contracture of the palmar fascia? a) Callus b) Hallux valgus c) Dupuytren contracture d) Hammertoe

c) Dupuytren contracture

Which general nursing measure is used for a client with a fracture reduction? a) Promote intake of omega-3 fatty acids b) Assist with intake of immune-enhancing tube feeing formulas c) Encourage participation in ADLs d) Examine the abdomen for enlarged liver or spleen

c) Encourage participation in ADLs

Which neurotransmitter inhibits pain transmission? a) Acetylcholine b) Serotonin c) Enkephalin d) Dopamine

c) Enkephalin

A client with a right below the knee amputation is being transferred from the post anesthesia care unit to a med Surg unit. What is the highest priority nursing intervention by the receiving nurse? a) Document the receiving report from the transferring nurse b) Delegate the gathering of enough pillows for proper positioning and comfort c) Ensure that a large tourniquet is in the room d) Review the physicians orders for type and frequency of pain medication

c) Ensure that a large tourniquet is in the room explanation: client is at risk for hemorrhage

Aneurysm rebleeding occurs most frequently during which timeframe after the initial hemorrhage? a) First 2 weeks b) First 48 hours c) First 2-12 hours d) First week

c) First 2-12 hours

Dupuytren contracture causes flexion of which area(s)? a) Thumb b) Index and middle fingers c) Fourth and fifth fingers d) ring finger

c) Fourth and fifth fingers and frequently the middle finger

Which anatomic part supplies CSF to the subarachnoid space and down the spinal cord on the dorsal surface? a) Third ventricle b) Lateral ventricle c) Fourth ventricle d) Arachnoid villus

c) Fourth ventricle

Which of the following is the most common type of brain neoplasm? a) Neuroma b) Angioma c) Glioma d) Meningioma

c) Glioma

Which is the most common motor dysfunction seen in clients diagnosed with a stroke? a) Hemiparesis b) Ataxia c) Hemiplegia d) Diplopia

c) Hemiplegia (paralysis of one side of the body)

Which type of cast encloses the trunk and a lower extremity? a) Short-leg b) Body cast c) Hip spica d) Long-leg

c) Hip spica explanation: A body cast encloses the trunk. A long-leg cast extends from the junction of the upper and middle third of the thigh to the base of the toes. A short-leg cast extends from below the knee to the base of the toes.

A physician prescribes raloxifene to a hospitalized client. The client's history includes a right hip fracture, hysterectomy, DVT, and hypertension. Which action by the nurse demonstrates safe nursing care? a) Having the patient sit upright for 30-60 mins following administration b) Administering the raloxifene with food or milk c) Holding the raloxifene and notifying the physician d) Administering the raloxifene in the evening

c) Holding the raloxifene and notifying the physician explanation: Raloxifene is contraindicated in clients with a hx of DVT

Which term refers to blindness in the right or left half of the visual field in both eyes? a) Scotoma b) Nystagmus c) Homonymous hemianopsia d) Diplopia

c) Homonymous hemianopsia occurs with occipital lobe tumors

The nurse is assessing the muscle tone of a client with cerebral palsy. Which description does the nurse determine to be an expected assessment of this client's muscle tone? a) Flaccid b) Atrophied c) Hypertonic d) Atonic

c) Hypertonic

Which of the follow meds is the most effective agent in the treatment of Parkinson's disease? a) Benztropine (Cogentin) b) Amantadine (Symmetrel) c) Levodopa (Larodopa) d) Bromocroptime mesylate (Parlodel)

c) Levodopa (Larodopa)

A client who was in a MVA is diagnosed with a stable T7 spinal fracture with no neurologic deficits. Which nursing intervention should the nurse implement? a) Withhold opioid pain medication to prevent ileus b) Sit the client upright in a padded chair for meals c) Maintain bed rest with the HOB at 20 degrees d) Maintain NPO status for surgical repair

c) Maintain bed rest with the HOB at 20 degrees

The nurse is caring for a client diagnosed with a hemorrhagic stroke. The nurse recognizes that which intervention is most important? a) Administering a stool softener b) Elevating the HOB to 30 degrees c) Maintaining a patent airway d) Monitoring for seizure activity

c) Maintaining a patent airway

Which term describes the fibrous connective tissues that cover the brain and spinal cord? a) Dura mater b) Pia mater c) Meninges d) Arachnoid mater

c) Meninges

The nurse teaches the client which intervention to avoid hip dislocation after replacement surgery? a) Avoid placing a pillow between the legs when sleeping b) Keep knees together at all times c) Never cross the affected leg when seated d) Bend forward only when seated in a chair

c) Never cross the affected leg when seated explanation: crossing the affected leg may result in dislocation of the hip joint after total hip replacement.

Which term refers to the failure of fragments of a fractured bone to heal together? a) Subluxation b) Dislocation c) Nonunion d) Malunion

c) Nonunion explanation: When nonunion occurs, the client reports persistent discomfort and movement at the fracture site.

Localized rapid bone turnover, most commonly affecting the skull, femur, tibia, pelvic bones, and vertebrae, is characterized by which of the following bone disorders? a) Osteoporosis b) Osteomalacia c) Osteitis deformans d) Osteomyelitis

c) Osteitis deformans explanation: Osteitis deformans (Paget disease) results in bone that is highly vascularized and structurally weak, predisposing to pathologic fractures.

Which condition is a metabolic bone disease characterized by inadequate mineralization of bone? a) Osteoarthritis b) Osteoporosis c) Osteomalacia d) Osetomyelitis

c) Osteomalacia

Which of the following terms is used to describe edema of the optic nerve? a) Angioneurotic edema b) Scotoma c) Papilledema d) Lymphedema

c) Papilledema

Which nerve is assessed when the nurse asks the client to dorsiflex the ankle and extend the toes? a) Median b) Ulnar c) Peroneal d) Radial

c) Peroneal

The emergency department nurse teaches clients with sports injuries to remember the acronym PRICE. This acronym stands for which combo of treatments? a) Protection, rest, ice, circulation examination b) Pressure, rotation, ice, compression, examination c) Protection, rest, ice, compression, elevation d) Pressure, rotation, immersion, compression, elevation

c) Protection, rest, ice, compression, elevation

Which of the following reflects basic nursing measures in the care of the patient with viral encephalitis? a) Administering amphotericin B b) Monitoring cardiac output c) Providing comfort measures d) Administering narcotic analgesics

c) Providing comfort measures dimmed lights, limited noise, and analgesics

Which set of symptoms characterize Korsakoff syndrome? a) Severe dementia and myoclonus b) Tremor, rigidity, and bradykinesia c) Psychosis, disorientation, delirium, insomnia, and hallucinations d) Choreiform movement and dementia

c) Psychosis, disorientation, delirium, insomnia, and hallucinations

Which term refers to a disease of a nerve root? a) Contracture b) Involucrum c) Radiculopathy d) Sequestrum

c) Radiculopathy explanation: When the client reports radiating pain down the leg, the client is describing radiculopathy. Involucrum refers to new bone growth around the sequestrum. Sequestrum refers to dead bone in an abscess cavity. Contracture refers to abnormal shortening of muscle or fibrosis of joint structures.

A client is placed in traction for a femur fracture. The nurse would document which expected outcomes of traction? Select all that apply. a) Full ROM to extremity b) Decreased pedal pulse c) Realignment of the fracture d) Minimization of muscle spasms e) Increased ability to bear weight f) Reduction of deformity

c) Realignment of the fracture d) Minimization of muscle spasms f) Reduction of deformity

A frontal lobe brain abscess produces which manifestation? a) Localized headache b) Ataxia c) Seizures d) Nystagmus

c) Seizures a frontal lobe brain abscess produces seizures, hemiparesis, and frontal headache

Which laboratory study indicates the rate of bone turnover? a) Serum phosphorus b) Urine calcium c) Serum osteocalcin d) Serum calcium

c) Serum osteocalcin (bone GLA protein)

Most cases of osteomyelitis are caused by which microorganism? a) Escherichia coli b) Proteus species c) Staphylococcus aureus d) Pseudomonas species

c) Staphylococcus aureus

In chronic osteomyelitis, antibiotics are adjunctive therapy in which situation? a) Vitamin supplements b) Wound irrigation c) Surgical debridement d) Wound packing

c) Surgical debridement

Morton neuroma is exhibited by which clinical manifestation? a) Inflammation of the foot-supporting fascia b) High arm and a fixed equinus deformity c) Swelling go the third (lateral) branch of the median plantar nerve d) Longitudinal arch of the foot is diminished

c) Swelling go the third (lateral) branch of the median plantar nerve

Skull sutures are an example of which type of joint? a) Diarthrosis b) Ampiarthrosis c) Synarthrosis d) Aponeuroses

c) Synarthrosis explanation: Skull sutures are considered synarthrosis joints and are immovable. Amphiarthrosis joints allow limited movement, such as a vertebral joint. Diarthrosis joints are freely movable joints such as the hip and the shoulder. Aponeuroses are broad, flat sheets of connective tissue.

Which of the following statements describes the pathophys of post-polio syndrome? a) Post-polio syndrome is caused by a long term intake of a low protein high fat diet in polio survivors b) The exact cause is unknown, but latent poliovirus is suspected c) The exact cause is unknown, but aging or muscle overuse is suspected d) Post-polio syndrome is caused by an autoimmune response

c) The exact cause is unknown, but aging or muscle overuse is suspected

Which nerve is assessed when the nurse asks the client to spread all fingers? a) Median b) Peroneal c) Ulnar d) Radial

c) Ulnar explanation: Asking the client to spread all fingers allows the nurse to assess motor function affected by ulnar innervation, while pricking the fat pad at the top of the small finger allows assessment of the sensory function affected by the ulnar nerve. The peroneal nerve is assessed by asking the client to dorsiflex the ankle and to extend the toes. The radial nerve is assessed by asking the client to stretch out the thumb, then the wrist, and then the fingers at the metacarpal joints. The median nerve is assessed by asking the client to touch the thumb to the little finger.

A client is being discharged home with a long arm cast. What education should the nurse include to prevent disuse syndrome in the arm? a) Abduction and adduction of the shoulder b) Repositioning the arm in the cast c) Use of isometric exercises d) Proper use of a sling

c) Use of isometric exercises explanation: isometric exercises allow for use of the muscle without moving the bone. Doing isometric exercises every hour while the client is awake will help prevent disuse syndrome.

Which is one of the most common causes of death in clients diagnosed with fat emboli syndrome? a) myocardial infarction b) Pulmonary embolism c) acute respiratory distress syndrome d) Stroke

c) acute respiratory distress syndrome

The initial symptoms of new variant Creutzfeldt-Jakob disease include which of the following? a) memory and cognitive impairment b) akathisia and dysphagia c) anxiety, depression, and behavioral changes d) diplopia and bradykinesia

c) anxiety, depression, and behavioral changes

Which insult or abnormality can cause an ischemic stroke? a) intracerebral aneurysm rupture b) arteriovenous malformation c) cocaine use d) trauma

c) cocaine use

The nurse working in the emergency department receives a call from the x-ray department communicating the the client the nurse is caring for has a fracture in the shaft of the tibia. The nurse tells the physician that the client's fracture is in the a) scoliosis b) epiphysis c) diaphysis d) lordosis

c) diaphysis

Lower motor neuron lesions cause a) increased muscle tone b) hyperactive and abnormal reflexes c) flaccid muscles d) no muscle atrophy

c) flaccid muscles and muscle atrophy, decreased muscle tone, and loss of voluntary control

Which orthopedic surgery is done to correct and align a fracture after surgical dissection and exposure to the fracture? a) Total joint arthroplasty b) Arthrodesis c) Open reduction d) Joint arthroplasty

c) open reduction

The nurse is assessing a young client during an annual sports physical at school. The assessment reveals that the client has lateral curving of the spine. The nurse reports to the health care professional that the assessment revealed a) lordosis b) diaphysis c) scoliosis d) epiphysis

c) scoliosis

The nurse is conducting a musculoskeletal assessment on a client documented to have rheumatoid arthritis. Which would the nurse anticipate finding when inspecting the client's fingers? a) Hard nodules adjacent to the joints b) Hard nodules of bony overgrowth c) Soft, subcutaneous nodules along the tendons d) soft nodules along the palmar surface

c) soft, subcutaneous nodules along the tendons

Which device is designed specifically to support and immobilize a body part in a desired position? a) Trapeze b) Brace c) Splint d) Continuous passive motion (CPM) device

c) splint explanation: a splint may be applied to a fractured extremity initially until swelling subsides. A brace is an externally applied device to support a body part, control movement, and prevent injury. A CPM device is an instrument that moves a body part to promote healing and circulation. A trapeze is an overhead device to promote client mobility in bed.

Which body movement involves moving toward the midline? a) Abduction b) Eversion c) Pronation d) Adduction

d) Adduction explanation: Pronation is turning inward.

The nurse is caring for a client with a hip fracture. The physician orders the client to start taking a bisphosphonate. Which medication would the nurse document as given? a) Denosumab b) Raloxifene c) Teriparatide d) Alendronate

d) Alendronate

Which of the following nursing interventions is appropriate for a patient with double vision in the right eye due to MS? a) Exercise the right eye twice daily b) Place needed items on the right Side c) Administer eye drops as needed d) Apply an eye patch to the right eye

d) Apply an eye patch to the right eye

Which is useful in identifying acute or chronic tears of the joint capsule or supporting ligaments of the knee, shoulder, ankle, hip, or wrist? a) EMG b) Bone densitometry c) Meniscography d) Arthrography

d) Arthrography

Which of the following is the priority nursing intervention for a patient in myasthenic crisis? a) Ensuring adequate nutritional support b) Preparing for plasmapheresis c) Administering IVIG per orders d) Assessing respiratory effort

d) Assessing respiratory effort

Which term refers to the inability to coordinate muscle movements, resulting in difficulty walking? a) Agnosia b) Spasticity c) Rigidity d) Ataxia

d) Ataxia

Lesions in the temporal lobe may result in which type of agnosia? a) Visual b) Relationship c) Tactile d) Auditory

d) Auditory

A client is scheduled for an EEG. The client inquires about any diet related prerequisites before the EEG. Which diet related advice should the nurse provide to the client. a) Decrease the amount of minerals in the diet b) Avoid eating food for at least 8 hours before the test c) Include an increased amount of minerals in the diet d) Avoid taking sedative drugs or drinks that contain caffeine for at least 8 hours before the test

d) Avoid taking sedative drugs or drinks that contain caffeine for at least 8 hours before the test

Which common problem of the upper extremity results from entrapment of the median nerve at the wrist? a) mpingement syndrome b) Ganglion c) Dupuytren's contracture d) Capral tunnel syndrome

d) Capral tunnel syndrome explanation: Carpal tunnel syndrome is commonly due to repetitive hand activities. A ganglion is a collection of gelatinous material near the tendon sheaths and joints that appears as a round, firm, cystic swelling, usually on the dorsal of the wrist. Dupuytren contracture is a slowly progressive contracture of the palmar fascia. Impingement syndrome is associated with the shoulder and may progress to a rotator cuff tear.

A 45 year old client presents to the ED reporting trouble speaking and numbness of the right arm and leg. The nurse suspects ischemic stroke. Which insult or abnormality can cause an ischemic stroke? a) Intracerebral aneurysm rupture b) Trauma c) Arteriovenous malformation d) Cocaine use

d) Cocaine use

An x-ray demonstrates a fracture in which a bone has splintered into several pieces. Which type of fracture is this? a) Impacted b) Compound c) Depressed d) Comminuted

d) Comminuted

Which type of fracture is one in which the skin or mucous membrane extends to the fractured bone? a) Complete b) Simple c) Incomplete d) Compound

d) Compound

Which is a circulatory indicator of peripheral neurovascular dysfunction? a) Weakness b) Paralysis c) Paresthesia d) Cool skin

d) Cool skin explanation: Indicators of peripheral neurovascular dysfunction related to circulation include pale, cyanotic, or mottled skin with a cool temp. Weakness and paralysis are related to motion. Paresthesia is related to sensation.

Which would be contraindicated as a component of self-care activities for the client with a cast? a) Cushioning rough edges of the cast with tape b) Do not attempt to scratch the skin under a cast c) Elevate the casted extremity to heart level frequently d) Cover the cast with plastic to insulate it

d) Cover the cast with plastic to insulate it explanation: The cast should be kept dry, but do not cover it with plastic or rubber because this causes condensation.

Which of the following is a rare, transmissible, progressive fatal disease of the CNS characterized by spongiform degeneration of the gray matter of the brain? a) Parkinson's disease b) Huntingtons disease c) Multiple sclerosis d) Creutzfeldt-Jakob disease

d) Creutzfeldt-Jakob disease causes severe dementia and myoclonus

If a client has a lower motor neuron lesion, the nurse would expect the client to exhibit a) Hyperactive reflexes b) No muscle atrophy c) Muscle spasticity d) Decreased muscle tone

d) Decreased muscle tone

Which structural and motor change is related to aging and may be assessed in geriatric clients during an examination of neurologic function? a) Increased autonomic nervous system responses b) Increased pupillary responses c) Enhanced reaction and movement times d) Decreased or absent deep tendon reflexes

d) Decreased or absent deep tendon reflexes

Which statement reflects nursing management of the client with expressive aphasia? a) Speak clearly to the client in simple sentences, and use gestures or pictures when able b) Speak slowly and clearly to assist the client in forming the sounds c) Frequently reorient the client to time, place, and situation d) Encourage the client to repeat sounds of the alphabet

d) Encourage the client to repeat sounds of the alphabet

The nurse is preparing the patient for an acetylcholinesterase inhibitor test to rule out myasthenia gravis. Which of the following is the priority nursing action? a) Assess facial weakness 5 minutes after injection b) Administer edrophonium chloride (Tensilon) per orders c) Document the results d) Ensure atropine is readily available

d) Ensure atropine is readily available

What safety actions does the nurse need to take for a client receiving oxygen therapy who is undergoing magnetic resonance imaging (MRI)? a) Check the clients oxygen saturation level using a pulse ox after the client has been placed on the MRI table b) Note that no special safety actions need to be taken c) Securely fasten the client's portable oxygen tank to the bottom of the MRI table after the client has been positioned on the top of the MRI table d) Ensure that no client care equipment containing metal enters the room where the MRI is located

d) Ensure that no client care equipment containing metal enters the room where the MRI is located

The patient with a brain tumor may be at increased risk for aspiration. The most important nursing intervention includes which of the following? a) Monitoring vital signs b) Assisting with self care c) Frequent reorientation d) Evaluation of gag reflex and ability to swallow

d) Evaluation of gag reflex and ability to swallow

The client is scheduled for a meniscectomy of the right knee. The nurse would plan postoperative care based on what surgical procedure? a) Replacement of knee with artificial joint b) Incision and diversion of the muscle fascia c) Replacement of one of the artificial surfaces of a joint d) Excision of damaged joint fibrocartilage

d) Excision of damaged joint fibrocartilage

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? a) Remove the cast immediately, notifying the physician b) Administer anti anxiety and pain meds c) Call for assistance and hold the client in the required position until the cast has dried d) Explain that the sensation being felt is normal and will not burn the client

d) Explain that the sensation being felt is normal and will not burn the client explanation: A fiberglass cast will give off heat while applied. It is a normal and temporary sensation

Which of the following is the most common clinical manifestation of MS? a) Spasticity b) Ataxia c) Pain d) Fatigue

d) Fatigue

A client has been prescribed alendronate for the prevention of osteoporosis. Which is the highest priority nursing intervention associated with the administration of the medication? a) Assess for the use of corticosteroids b) Encourage the client to get yearly dental exams c) Ensure adequate intake of vitamin D in the diet d) Have the client sit upright for at least 30 minutes following administration

d) Have the client sit upright for at least 30 minutes following administration explanation: This will prevent irritation and potential ulceration of the esophagus.

Which factor may contribute to compartment syndrome? a) Disuse syndrome b) Venous thromboembolism c) Macular lesion d) Hemorrhage

d) Hemorrhage

Which of the following diseases is a chronic, progressive, hereditary disease of the nervous system that results in progressive involuntary dancelike movements and dementia? a) MS b) Parkinsons disease c) Creutzfeldt-Jakob disease d) Huntington disease

d) Huntington disease

Which of the following is a degenerative neurologic disorder? a) Osteomyelitis b) Glioma c) Paget's disease d) Huntington disease

d) Huntington disease

Which factor inhibits fracture healing? a) Immobilization of the fracture b) Age of 35 years c) Increased vitamin D and calcium in the diet d) Hx of diabetes

d) Hx of diabetes

The nurse has been educating a patient newly diagnosed with MS. Which of the following statements by the patient indicates an understanding of the education? a) I will take hot baths to decrease spasms b) I should participate in non-weight bearing exercises c) The exercises should be completed quickly to reduce fatigue d) I will stretch daily as directed by the physical therapist

d) I will stretch daily as directed by the physical therapist

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? a) Ligaments b) Bones c) Muscles d) Joints

d) Joints

Which should be included in the teaching plan for a client diagnosed with plantar fasciitis? a) Plantar fasciitis presents as acute onset pain localized to the ball of the foot that occurs when pressure is placed on it and diminishes when pressure is released b) Complications of plantar fasciitis include neuromuscular damage and decreased ankle ROM c) The pain of plantar fasciitis diminishes with warm water soaks d) Management of plantar fasciitis includes stretching exercises

d) Management of plantar fasciitis includes stretching exercises explanation: Management also includes wearing shoes with support and cushioning the relieve pain, orthotic devices, and use of NSAIDs. Plantar fasciitis presents as acute-onset heel pain experienced upon taking the first steps in the morning.

Which of the following diseases is associated with decreased levels of dopamine due to destruction of pigmented neuronal cells in the substantia nigra in the basal ganglia of the brain? a) MS b) Huntington disease c) Creutzfeldt-Jakob disease d) Parkinson's disease

d) Parkinson's disease

The nurse is caring for a client with dysphagia. Which intervention would be contraindicated while caring for this client? a) Assisting the client with meals b) Allowing ample time to eat c) Testing the gag reflex before offering food or fluids d) Placing food on the affected side of the mouth

d) Placing food on the affected side of the mouth

Which well-recognized sign of meningitis is exhibited when the client's neck is flexed and flexion of the knees and hips is produced? a) Nuchal rigidity b) Positive Kerning's sign c) Photophobia d) Positive Brudzinski sign

d) Positive Brudzinski sign

A client with a traumatic amputation of the right lower leg is refusing to look at the leg. Which action by the nurse is most appropriate? a) Request a referral to OT b) Encourage the client to perform ROM exercises to the right leg c) Provide wound care without discussing the amputation d) Provide feedback on the client's strengths and available resources

d) Provide feedback on the client's strengths and available resources

A client with CVA is prescribed medication to treat the disorder. The client wants to know what other measures may help reduce CVA. Which is an accurate suggestion for the client? a) Increase intake of proteins and carbohydrates b) Increase body weight moderately c) Increase hydration and the intake of fluids d) Reduce hypertension and high blood cholesterol

d) Reduce hypertension and high blood cholesterol

What is the term for a lateral curving of the spine? a) Epiphysis b) Lordosis c) Diaphysis d) Scoliosis

d) Scoliosis

The initial symptoms of variant Creutzfeldt-Jakob disease include which of the following? a) Akathisia and dysphagia b) Muscle rigidity, memory impairment, and cognitive impairment c) Diplopia and bradykinesia d) Sensory disturbance, limb pain, and behavioral changes

d) Sensory disturbance, limb pain, and behavioral changes

Which neurotransmitter demonstrates inhibitory action, helps control mood and sleep, and inhibits pain pathways? a) Norepinephrine b) Enkephalin c) Acetylcholine d) Serotonin

d) Serotonin

Which is indicative of a right hemisphere stroke? a) Slow, cautious behavior b) Altered intellectual ability c) Aphasia d) Spatial- perceptual deficits

d) Spatial- perceptual deficits

Which statements reflect the nursing management of a client with receptive aphasia? a) Frequently reorient the client to time, place, and situation b) Speak clearly to the client in simple sentences; use gestures or pictures c) Encourage the client to repeat sounds of the alphabet d) Speak slowly and clearly to assist the client in forming the sounds

d) Speak slowly and clearly to assist the client in forming the sounds

A 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? a) Vitamin supplements b) Wound irrigation c) Wound packing d) Surgical debridement

d) Surgical debridement

Which cerebral lobe contains the auditory receptive areas? a) Frontal b) Parietal c) Occipital d) Temporal

d) Temporal

Which statement is accurate regarding care of a plaster cast? a) The cast must be covered with a blanket to keep it moist during the first 24 hours b) The cast will dry in about 12 hours c) A dry plaster cast is dull and gray d) The cast can be dented while it is damp

d) The cast can be dented while it is damp explanation: The cast will dry in 24-72 hours, a freshly applied cast should be exposed to circulating air to dry, a dry plaster cast is white and shiny.

A client diagnosed with a right ulnar fracture asks why the cast needs to go all the way up the arm. What is the best response by the nurse? a) The method allows for the fastest healing time and the greatest mobility b) When a spica cast is ordered, the arm must be immobilized c) This allows for the strength in the arm to remain consistent d) The joint above the fracture and below the fracture must be immobilized

d) The joint above the fracture and below the fracture must be immobilized

Which diagnostic test may be performed to evaluate blood flow within intracranial blood vessels? a) MRI b) cerebral angiography c) Computed tomography d) Transcranial doppler

d) Transcranial doppler

Which cranial nerve is responsible for facial sensation and corneal reflex? a) Oculomotor b) Vestibulocochlear c) Facial d) Trigeminal

d) Trigeminal (V) it is also responsible for mastication

The nurse teaches the client with a high risk for osteoporosis and risk-lowering strategies, including which action? a) Decrease the intake of Vitamin A and D b) Increase fiber in the diet c) Reduce stress d) Walk or perform weight bearing exercises

d) Walk or perform weight bearing exercises

The nurse is assessing the clients mental status. Which question will the nurse include in the assessment? a) Can you count backwards from 100 b) Are you having hallucinations now c) Can you write your name on this piece of paper d) Who is the president of the US

d) Who is the president of the US

A client is scheduled for standard EEG testing to evaluate a possible seizure disorder. Which nursing intervention should the nurse perform before the procedure? a) Maintain NPO status 6 hours before the procedure b) Sedate the client before the procedure, per orders c) Instruct the client that a standard EEG takes 2 hours d) Withhold anticonvulsant medications to 24-48 hours before the exam

d) Withhold anticonvulsant medications to 24-48 hours before the exam

Health promotion efforts to decrease the risk for ischemic stroke involve encouraging a healthy lifestyle including a) a high-protein diet and increased weight-bearing exercise b) eating fish no more than once a month c) a low-cholesterol, low-protein diet and decreased aerobic exercise d) a low-fat, low-cholesterol diet and increased exercise

d) a low-fat, low-cholesterol diet and increased exercise

When is it advisable for the nurse to apply heat to a sprain or contusion? a) immediately b) do not apply at all c) only after a week d) after 2 days

d) after 2 days explanation: after 2 days swelling is not likely to increase and as a result heat application reduces pain and relieves edema by improving circulation

Which is a neurovascular problem caused by pressure within a muscle area that increases to such an extent that microcirculation diminishes? a) Fasciculation b) Hypertrophy c) Remodeling d) Compartment syndrome

d) compartment syndrome

The homecare nurse is evaluating the musculoskeletal system of a geriatric client whose previous assessment was within normal limits. The nurse initiates a call to the health care provider and/or emergency services when which change is found? a) increased joint stiffness b) decreased flexibility c) decreased agility d) decreased right-sided muscle strength

d) decreased right-sided muscle strength

Fracture healing occurs in four areas, including the a) fascia b) bursae c) cartilage d) external soft tissue

d) external soft tissue explanation: Fracture healing occurs in four areas, including the bone marrow, bone cortex, periosteum, and the external soft tissue, where a binding callus (fibrous tissue) stabilizes the fracture.

Lifestyle risks for osteoporosis include a) a low protein, high fat diet b) lack of aerobic exercise c) an estrogen deficiency or menopause d) lack of expose to sunshine

d) lack of expose to sunshine

A patient with fungal encephalitis receiving amphotericin B complains of fever, chills, and body aches. The nurse knows that these symptoms a) indicate renal toxicity and worsening of the patient's condition b) indicate the need for immediate blood and CSF cultures c) are primarily associated with infection with Coccidoides immitis and Aspergillus d) may be controlled by the administration of Benadryl and acetaminophen approximately 30 minutes prior to administration of amphotericin.

d) may be controlled by the administration of Benadryl and acetaminophen approximately 30 minutes prior to administration of amphotericin.

A fracture is considered pathologic when it a) involves damage to the skin or mucous membranes b) results in a fragment of bone being pulled away by a ligament or tendon and its attachment c) presents as one side of the bone being broken and the other side being bent d) occurs through an area of diseased bone

d) occurs through an area of diseased bone

Corticosteroids are used In the management of brain tumors to a) prevent extension of the tumor b) identify precise location of the tumor c) facilitate regeneration of neurons d) reduce cerebral edema

d) reduce cerebral edema promotes a smoother more rapid recovery after treatment

The nurse has completed evaluating the clients cranial nerves. The nurse documents impairment of the right cervical nerves (CN IX and CN X). Based on these findings, the nurse should instruct the client to a) have their spouse bring the clients glasses b) wear any hearing aids while in the hospital c) use the walker when walking d) refrain from eating and drinking for now

d) refrain from eating and drinking for now

Which principle applies to the client in traction? a) Knots in the ropes should touch the pulley b) Weights should rest on the bed c) Weights are removed routinely d) Skeletal traction is never interrupted

d) skeletal traction is never interrupted explanation: Knots in the rope or the footplate must not touch the pulley or foot of the bed

A client is actively hallucinating during an assessment. The nurse would be correct in documenting the hallucination as a disturbance in a) motor ability b) intellectual function c) emotional status d) thought content

d) thought content