MUSCULOSKELETAL

An 80-year-old client with dementia of the Alzheimer type is admitted to a nursing home. A family member visits and remarks how thin and wrinkled the client has become. Which response by the nurse will help the family member most to understand the aging process?

"As we age, we lose the tissue that helps puff out the skin."

Which statement by a female client with a non-weight-bearing long leg cast indicates the need for the nurse to reinforce discharge teaching?

"I am going to give myself a pedicure with red nail polish when I get home."

While awaiting the biopsy report before removal of a tumor, the client reports being afraid of a diagnosis of cancer. How should the nurse respond?

"It is very upsetting to have to wait for a biopsy report."

A client who is to have a total hip arthroplasty with an uncemented prosthesis asks, "When will I be able to get up and walk?" On what information should the nurse base an answer?

Full weight-bearing may begin the day after surgery

A client had a right above-the-knee amputation secondary to trauma sustained in a motor vehicle accident. Six days after surgery, the client falls while attempting to transfer to a chair unassisted. The nurse concludes that this fall is most likely the result of what?

Loss of balance

A client with a distal femoral fracture has a long leg cast applied. What important element of a discharge program should the nurse focus on when teaching crutch-walking?

Modifying the home environment to prevent accidents

Which muscle of the head and neck facilitates the ability to draw the lips together?

Orbicularis oris

A client after a trauma has difficulty opening his or her eyes, has abnormal motor response, and speaks inappropriate words. What is the status of the client utilizing the Glasgow Coma Scale? Record your answer using a whole number. _________

The client having pain opening the eyes scores 2 points, abnormal motor response scores 3 points, and inappropriate words scores 3 points, which adds up to 8. A client scoring 8 points on the Glasgow Coma Scale after trauma requires medium priority.

A client with dementia is admitted with a fractured hip following a fall at home. The client's family member witnessed the fall. Four hours after admission, the client's blood pressure increases to a moderately severe hypertensive level. The client pulls on the bedclothes continuously. The client's family member asks for pain medication for the client. What does the nurse conclude?

The client may be in pain and unable to respond appropriately

A client with glaucoma asks a nurse about future treatment and precautions. What information should the nurse's explanation include?

Continuation of therapy for life

What is the nurse's primary consideration when caring for a client with rheumatoid arthritis?

Comfort

A nurse admits a client with a diagnosis of cholelithiasis for surgery. The client asks many questions about the postoperative course after laparoscopic surgery. What is most important for the nurse to review with this client?

Explanation of abdominal and scapular pain

What clinical finding does the nurse expect when assessing a client with myasthenia gravis?

Fluctuating weakness of muscles innervated by the cranial nerves

A client had spinal anesthesia for surgery. On the second day after surgery the client complains of a headache. What should the nurse do?

Encourage the client to drink at least 2 L of fluids in 24 hours

Which intervention would the nurse provide to prevent the development of lower extremity contractures in a paralyzed client?

Proper positioning

A nurse is caring for a 6-year-old child who has undergone craniotomy. The parents ask what effect mannitol has. The nurse responds that this medication is given to achieve what goal?

Relieve cerebral pressure

A client diagnosed with Paget's disease is prescribed zoledronic acid. Which assessments should be performed before initiating therapy? Select all that apply.

Serum creatinine Dental examination

A client with a history of tuberculosis reports difficulty hearing. Which medication should the nurse consider is related to this response?

Streptomycin

Which cerebral lobe includes the speech area that allows the client to process words into coherent thoughts?

Temporal lobe