Musculoskeletal Disorders

A nurse is teaching a client who was recently diagnosed with carpal tunnel syndrome. Which statement should the nurse include?

"Ergonomic changes can be incorporated into your workday to reduce stress on your wrist."

A client recovering from hip replacement surgery questions the need for admission to a rehabilitation center because there are family members available at home to provide care. Which response by the nurse is best?

"The rehabilitation staff can evaluate your progress and help you recover without risking injury."

A client recovering from lumbar surgery is fitted for a contour splint. What should the nurse explain to the client about this device?

"The splint immobilizes the body part in a functional position."

The client asks the nurse what the activity limitations are while in Buck's traction. The nurse should tell the client:

"You can sit up whenever you want."

A client who has just been diagnosed with mixed muscular dystrophy asks the nurse about the usual course of this disease. How should the nurse respond?

"You may experience progressive deterioration in all voluntary muscles."

A nurse is caring for a client in skeletal traction to the left leg. The client reports pain of 8 on the 0- to-10 pain scale while the nurse is in the client's room. Which action would the nurse take first?

Assess the client's alignment in bed.

A client who has been diagnosed with osteoarthritis asks if they will eventually begin to notice deformities in their hands and fingers as the condition progresses. Which concept should the nurse include in the response?

Hand and finger deformities are associated with the development of rheumatoid arthritis.

When developing a care plan for a client newly diagnosed with scleroderma, which nursing diagnosis has the highest priority?

Impaired skin integrity

After a person experiences a closure of the epiphyses, which statement is true?

No further increase in bone length occurs.

When caring for a client with acute osteomyelitis in the right tibia, which measure is most appropriate to implement when repositioning the client's leg?

Support the leg above and below the affected area when positioning.

A clinical nurse specialist developed clinical pathways for common orthopedic conditions. In which way should the interdisciplinary team use these pathways?

as guidelines to ensure continuity of care

The nurse is evaluating a client in skin traction. Which observation indicates the traction is applied for maximum effectiveness?

The ropes are in the wheel grooves of the pulleys.

The nurse is caring for a client with a fractured fibula who has skeletal traction and skeletal pins. What would the nurse instruct the unlicensed assistive personnel (UAP) to report immediately?

The traction weights are resting on the floor.

A client who has skeletal traction to stabilize a fractured femur has not had a bowel movement for 2 days. The nurse should:

increase the client's fluid intake to 3,000 mL/day.

A nurse notes that a client has kyphosis and generalized muscle atrophy. Which problem is a priority when the nurse develops a nursing plan of care?

ineffective coughing and deep breathing

A nurse is developing a teaching plan for a client diagnosed with osteoarthritis. To minimize injury to the osteoarthritic client, the nurse should instruct the client to

install safety devices in the home.

Which equipment should the nurse plan to use to help prevent external rotation of the client's right leg postoperatively?

sandbags

When assessing an older adult as a candidate for crutch walking, the nurse should take into account that for some elderly people, crutch walking is an impractical goal primarily because of decreased:

motor coordination.

A diet plan is developed for a client with gouty arthritis. The nurse should advise the client to limit his intake of

organ meats.

The nurse is teaching a client with osteoporosis about taking alendronate sodium. The nurse emphasizes that the client is to take the medication:

with a full glass of water and remain upright for 30 minutes.

After surgery to treat a hip fracture, a client returns from the postanesthesia care unit to the medical-surgical unit. Postoperatively, how should the nurse position the client?

with the leg on the affected side abducted

Which statement by the client with rheumatoid arthritis would indicate the need for additional teaching to safely receive the maximum benefit of aspirin therapy?

"I try to take aspirin only on days when the pain seems particularly bad."

A client is experiencing an acute exacerbation of rheumatoid arthritis. What should the nursing priority be?

administering ordered analgesics and monitoring their effects

A nurse is caring for a client placed in traction to treat a fractured femur. Which nursing intervention has the highest priority?

assessing the extremity for neurovascular integrity

A male client underwent a lumbar spinal fusion yesterday. Which nursing assessment should alert the nurse to the development of a possible complication?

clear yellowish fluid on the dressing

Following a total joint replacement, which complication has the greatest likelihood of occurring?

deep vein thrombosis (DVT)

The nurse should instruct a client who is using crutches to bear weight primarily on which part of the body?

hands

The nurse teaches a client about using crutches, instructing the client to support the weight primarily on which part of the upper body?

hands

After a right total knee replacement, the client's right leg is placed in a continuous passive motion (CPM) machine. Nursing responsibilities when caring for a client with this apparatus should include:

maintaining proper positioning of the leg on the CPM machine.

A client with muscle weakness and an abnormal gait is being evaluated for muscular dystrophy. Which test or finding confirms muscular dystrophy?

muscle biopsy

Which action may a nurse on the orthopedic unit safely delegate to a licensed practical nurse (LPN)?

obtaining vital signs during blood administration

The client with an open femoral fracture was discharged to home and reports having a fever, night sweats, chills, restlessness, and restrictive movement of the fractured leg. The nurse should interpret these findings as the client may be experiencing which complication?

osteomyelitis

The client sustained a tibia fracture and a cast was applied. The client is reporting increasing pain when flexing toes. Which symptoms does the nurse assess as associated with compartment syndrome? Select all that apply.

paresthesia pain pulselessness

The second morning after surgery for a below-the-knee amputation of the left leg, the client says, "This sounds crazy, but I feel my left toes tingling." This statement would indicate to the nurse that he is experiencing a:

phantom-limb sensation.

The nurse enters the room to do an initial assessment on a client with a fracture of the femoral head. What would be the expected findings on the affected limb?

shortening of the affected extremity with external rotation

The nurse teaches the client to perform isometric exercises to strengthen the leg muscles after arthroplasty. Isometric exercises are particularly effective for clients with rheumatoid arthritis because they:

strengthen the muscles while keeping the joints stationary.

The nurse teaches the parent of a young child with Duchenne muscular dystrophy about the disease and its management. Which statement by the parent indicates successful teaching?

"My son will probably be unable to walk independently by the time he is 9 to 11 years old."

A nurse is performing an admission assessment on a client admitted with a pelvic fracture. Which statement by the client requires the nurse to seek more information from a legal standpoint?

"Sometimes my spouse gets so angry with me."

A nurse is caring for a client who complains of lower back pain. Which instruction should the nurse give to the client to prevent back injury?

"Stand close to the object you're lifting."

A client suspected of having systemic lupus erythematosus (SLE) is being scheduled for testing. The client asks which of the tests ordered will determine if the client is positive for the disorder. Which statement by the nurse is most accurate?

"The diagnosis won't be based on the findings of a single test but by combining all data found."

A client undergoes a total hip replacement. Which statement made by the client indicates to the nurse that the client requires further teaching?

"I don't know if I'll be able to get off that low toilet seat at home by myself."

The day after a thoracotomy, a client experiencing incision pain has a temperature of 99°F (37.2°C); heart rate 96 beats/minute; blood pressure 136/86 mmHg; and shallow respirations at 24 breaths/minute, with rhonchi at the bases and an oxygen saturation of 98%. Which nursing action is the priority?

Administer analgesic medications as prescribed.

On the evening of surgery for total knee replacement, a client wants to get out of bed. What should the nurse do to safely assist the client?

Apply a knee immobilizer.

Four hours after a cast has been applied for a fractured ulna, the nurse assesses that the client's fingers are pale and cool and capillary refill is delayed for 4 seconds. How should the nurse interpret these findings?

Arterial blood supply to the fingers is decreased.

Which information should the nurse include when performing discharge teaching with a client who had an anterolateral approach for a total hip replacement? Select all that apply.

Avoid turning the toes or knee outward. Use an elevated toilet seat and shower chair. Do not extend the operative leg backwards.

A client with a broken ulna reports having pain in the casted arm that is unrelieved by pain medication. The nurse assesses the arm and notes that the fingers are swollen and difficult to separate. What should the nurse do first?

Call the health care provider (HCP) to report swelling and pain.

A client is brought to the emergency department with a painful swollen ankle. What is the nurse's most appropriate action?

Elevate the ankle.

What would be the most important nursing intervention in caring for the client's residual limb during the first 24 hours after amputation of the left leg?

Elevate the residual limb on a pillow.

A client was undergoing conservative treatment for a herniated nucleus pulposus, at L5 - S1, which was diagnosed by magnetic resonance imaging. Because of increasing neurological symptoms, the client undergoes lumbar laminectomy. The nurse should take which step during the immediate postoperative period?

Logroll the client from side to side.

A client is being discharged following an open reduction and internal fixation of the left ankle, and is to wear a non-weight-bearing cast for 2 weeks. What should the nurse teach the client to do when using crutches?

Maintain two to three finger widths between the axillary fold and underarm piece grip.

The nurse is teaching a client with osteoporosis about optimal dietary choices to reduce the severity of the condition. What instruction should the nurse provide?

Prevent effects of immobility while in traction.

A client is in balanced suspension traction to maintain alignment of a fractured tibia. Which activities are safe for the client?

Raise the hips using trapeze.

Two days after surgery to amputate their left lower leg, a client states that they have pain in the missing extremity. Which action by the nurse is most appropriate?

administer medication, as ordered, for the reported discomfort.