Musculoskeletal Disorders Passpoint prepu

A client has developed compartment syndrome from full thickness burns on both arms. What treatment will the nurse prepare the client for?

fasciotomy

A client is diagnosed with a long bone fracture. What potential complication related to this form of fracture should the nurse carefully monitor?

fat emboli

Which statement by the client indicates that client education regarding osteoarthritis has been effective?

"It's a noninflammatory joint disease that causes degeneration of the joints."

A school nurse is performing a scoliosis screening on a group of students. Which student would most commonly develop this condition?

13-year-old girl

Which of the following would the nurse identify as a neurotransmitter?

Acetylcholine

A client with skeletal fracture to the right leg reports severe right leg pain. Which action should the nurse take first?

Check the client's alignment in bed.

A client who was casted for a recent fracture of the right ulna reports severe pain, numbness, and tingling of the right arm. What would be the nurse's most appropriate response?

Immediately report the client's symptoms.

At the scene of a trauma, which nursing intervention is appropriate for a child with a suspected fracture?

Immobilize the extremity and then move the child to a safe place.

The community health nurse found an older adult client lying in the snow, unable to move the right leg because of a suspected fracture. What's the nurse's priority?

Immobilize the fracture in its present position.

Which of the following is a priority nursing diagnosis for the client with an amputated extremity?

Ineffective tissue perfusion: peripheral related to injury and amputation

The nurse is caring for a client with a cast on his left arm. Which data collection finding is most significant for this client?

Intact skin around the cast edges

A client is admitted for closed spine surgery to repair a herniated disk. The nurse is discussing the surgery with the client. Which instruction should the nurse reinforce in the preoperative education?

"An endoscope is used to perform the surgery."

The nurse is reinforcing education for the parents of a child scheduled for a closed reduction of a fracture. Which statement should the nurse include?

"Fracture reduction restores alignment."

A client has a long leg cast applied for a tibia fracture. Which statement made by the client would indicate to the nurse that compartment syndrome may be developing?

"I am having a decrease in sensation of my toes."

The nurse is reinforcing education for a client on preventing complications of primary osteoporosis. Which statement made by the client indicates an understanding of the education provided?

"I will be sure to take my calcium supplements."

The nurse is reinforcing education for a client regarding back safety. Which response by the client indicates the education was effective?

"I'll carry objects close to my body."

The nurse is reinforcing education for a client diagnosed with gout. What statement made by the client demonstrates an understanding by the client?

"Increasing fluid intake will cause my body to excrete more uric acid."

The nurse is caring for a client who reports of lower back pain. Which instructions should the nurse give the client to prevent back injury?

"Stand close to the object you are lifting."

The nurse is reinforcing education to the parents of a child with structural scoliosis who has been fitted for a Milwaukee brace. The parents ask how many hours per day the child should wear the brace. Which response is most accurate?

23 hours per day

A client who's being discharged with an arm cast wants to shower at home. The nurse demonstrates how to shower without getting the cast wet. For which reason is this important?

A wet cast will weaken or decompose.

A nurse is providing care to a client with an acute attack of gout. Which action should the nurse provide first?

Administer analgesics.

The client calls the nurse in the clinic and states that the cast feels very rough around the edges and is scratching the skin. What is the best response by the nurse?

Apply moleskin or pink tape around the edges.

A client sustained a femur fracture while skiing. After the client undergoes surgery to stabilize the fracture, what does the nurse determine will assist with healing of this fracture?

formation of new bone tissue

After total hip replacement, a client is receiving epidural analgesia to relieve pain. Which of the following is a nursing priority for this client?

Assessing for sensation in the legs

The nurse monitors a client receiving enoxaparin, 30 mg subQ b.i.d after hip replacement surgery. Which adverse reaction is the client most likely to experience?

Bleeding

A child has just returned to the room with a cast on the leg after open reduction of a fractured femur. What is the most appropriate action for a nurse to take when a 6 cm by 10 cm area of blood is noted on the cast?

Call the health care provider.

An X-ray of the left femur shows a fracture that extends through the midshaft of the bone and multiple splintering fragments. What is this type of fracture called?

Comminuted fracture

The nurse is making an initial visit to the home of a client who ambulates with a walker. Which finding should the nurse identify as a safety hazard when completing an assessment of the client's home?

Electrical cords are covered with a carpet.

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

Elevate the ankle.

A client with arterial insufficiency undergoes below-knee amputation of the right leg. Which action should the nurse include in the postoperative plan of care?

Elevating the stump for the first 24 hours

A client with osteoarthritis is refusing to perform independent daily care. Which approach would be most appropriate to use with this client?

Encourage the client to perform as much care as pain will allow.

A client undergoes hip-pinning surgery to treat an intertrochanteric fracture of the right hip. The nurse should include which intervention in the postoperative plan of care?

Keeping a pillow between the client's legs at all times

The nurse is reinforcing education for the parent of a neonate with clubfoot. Which information should the nurse include?

More boys than girls are affected.

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

No further increase in bone length occurs.

A 69-year-old client asks the nurse what the difference is between osteoarthritis (OA) and rheumatoid arthritis (RA). Which response is correct?

OA is a noninflammatory joint disease. RA is characterized by inflamed, swollen joints.

A client is brought to the emergency department after injuring his right arm in a bicycle accident. The orthopedic surgeon tells the nurse that the client has a greenstick fracture of the arm. What does this mean?

One side of the bone is broken and the other side is bent.

The media requests information from a nurse caring for a client who is a criminal. Which statement best shows the nurse's understanding of confidentiality requirements when the client is a criminal?

The nurse shouldn't provide the media with any information about the client.

The nurse is instructing unlicensed assistive personnel (UAP) on the proper care of a client in Buck's extension traction following a fracture of his left fibula. Which observation indicates that the education was effective?

The weights are allowed to hang freely over the end of the bed.

A client asks the reason for being placed in traction prior to surgery. Which response by the nurse is most appropriate?

Traction helps to prevent trauma and overcome muscle spasms.

A client is scheduled for a laminectomy to repair a herniated intervertebral disk. When developing the postoperative plan of care, the nurse should include which action?

Turning the client from side to side, using the logroll technique

The nurse is unable to detect a dorsalis pedal pulse on the left foot. What is the priority action by the nurse?

Verify the findings with a handheld Doppler.

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

To assess the joints, the nurse asks a client to perform various movements. As the client moves the arm away from the midline, the nurse evaluates the ability to perform:

abduction.

The nurse is reinforcing education on cast care for a client with a cast on the arm. How should the nurse instruct the client to place the casted limb, if there is swelling?

above the level of the heart

A client with osteoarthritis is admitted to a medical-surgical unit. Which appropriate treatment strategies would the nurse expect when reviewing this client's chart? Select all that apply.

administration of nonsteroidal anti-inflammatory drugs (NSAIDs) calcium- and vitamin D-rich diet

A client has been prescribed a diet that limits purine-rich foods. Which would the nurse teach the client to avoid eating?

anchovies, sardines, kidneys, sweetbreads, and lentils

A client with long-standing rheumatoid arthritis has frequent reports of joint pain. The plan of care should be based on the understanding that chronic pain is most effectively relieved when analgesics are administered in which way?

at regularly scheduled intervals

A client is admitted with a possible diagnosis of osteomyelitis. Based on the documentation shown, which laboratory result is the priority for the nurse to report to the health care provider?

blood culture

Which information is the priority to include in the discharge plan for a client leaving the hospital in a leg cast?

cast care, neurovascular checks, and hygiene measures

A child in skeletal traction for a fracture of the right femur reports new and constant left calf pain. Also, the nurse notes that the child's left calf is 1 inch larger than the right and that he has nonpitting edema below the left knee. The nurse knows these signs are most consistent with which condition?

deep vein thrombosis (DVT)

The nurse is caring for a client who is experiencing an acute attack of gout and is receiving colchicine every 2 hours. What reports by the client will necessitate termination of colchicine therapy? Select all that apply.

diarrhea nausea and vomiting abdominal cramping

A client has undergone a total hip replacement on the right side. After surgery, how often should the nurse turn the client?

every 1 to 2 hours, from the unaffected side to the back

A nurse is determining the lower extremity strength of a child diagnosed with muscular dystrophy. Which muscle group is most important when planning actions to maintain maximum lower extremity function?

gluteus maximus

The nurse is instructing unlicensed assistive personnel (UAP) on how to properly position a client who underwent total hip replacement. The nurse explains that the client's hip needs to be in which position?

in an abducted position

The nurse is caring for a client who recently underwent a total hip replacement. The nurse should:

instruct the client to limit hip flexion while sitting.

The parents of a neonate diagnosed with clubfoot ask the nurse to explain talipes varus. The nurse would describe this as which condition?

inversion of the foot

After a traumatic spinal cord injury, a client requires skeletal traction. When caring for this client, the nurse must:

maintain traction continuously to ensure its effectiveness.

After treatment of compartment syndrome, a client reports experiencing paresthesia. Which symptoms should the nurse monitor?

numbness and tingling

A client arrives in the emergency department reporting that he or she fell down the stairs and thinks broke his or her leg. What data gathered by the nurse would indicate that the client might be correct in his or her assumption?

redness, warmth, pain at the site of injury

A client in skeletal traction reports pain even though receiving an analgesic 1 hour ago. The nurse offers an alternative pain management measure. Which measure can be implemented within the nursing scope of practice?

relaxation and imagery

A client has been prescribed an anti-inflammatory for osteoarthritis, and the nurse has reinforced educating the client about taking the medication. Which statement by the client indicates that the nurse's education has been effective?

"It can take up to 2 to 3 weeks for me to feel the full effects from the medication."

A client asks for information about osteoarthritis. Which statement should the nurse include when reinforcing education for the client on this condition?

"Osteoarthritis is the most common form of arthritis."

A client with osteoarthritis tells the nurse she is concerned that the disease will prevent her from doing her chores. Which suggestion should the nurse offer?

"Pace yourself and rest frequently, especially after activities."

A nurse is reinforcing education with a postmenopausal client. What should the nurse advise the client to do to help prevent osteoporosis? Select all that apply.

"Perform weight-bearing exercises three times per week." "Limit alcohol consumption and don't smoke." "Eat foods high in calcium, vitamin D, and protein."

The X-rays of a client who was brought to the emergency department after falling on ice reveal a leg fracture. After a cast is applied and allowed to dry, the nurse teaches the client how to use crutches. Which instruction should the nurse provide about climbing stairs?

"Place the unaffected leg on the first step, followed by the crutches and the injured leg, which should move together."

The nurse is caring for an elderly female with osteoporosis. When teaching the client, the nurse should include information about which major complication of this condition?

Bone fracture

A 22-year-old client with an external fixation device attached to his left thigh is unable to bear weight on his left leg. He asks a nurse if he can take a shower on his third postoperative day. After a review of the physician's orders, the nurse notes an order stating, "Client may shower ten (10) days after surgery." In order to meet the client needs, what appropriate action will the nurse take?

Explain that he is not permitted to shower, but the nursing assistant can help him with a sponge bath.

A client admitted to the hospital for internal fixation of a fractured left femur is attending physical therapy to learn how to use crutches. After the session, a nurse observes improper crutch use by the client. How should the nurse intervene?

Gently remind the client of the proper technique.

The infection control team has identified a 25% infection rate on the orthopedic floor. The nursing staff members are asked to record their care activities by recording them in a log to help identify the cause of the high infection rate. Which of the following care activities should be recorded in the activity log?

Hand washing between client contacts

A client seeks care for low back pain of 2 weeks' duration. Which data collection finding suggests a herniated intervertebral disk?

Pain radiating down the posterior thigh

A nurse is caring for a confused client with a fractured hip who is trying to get out of bed. Which action should the nurse take first?

Reorient the client to the surroundings.

Which nursing diagnosis is most appropriate for an elderly client with osteoarthritis?

Risk for injury related to altered mobility

A child is brought to the school nurse with the index finger of the left hand partially amputated and hanging by a shred of skin. Bleeding is moderate. What is the appropriate action by the nurse?

Securely wrap the hand and finger and place them in a cold water-filled baggie.

On a visit to the family physician, a client reports painful swelling on the lateral side of the great toe, at the metatarsophalangeal joint. After determining that the swelling is a bunion, the physician injects an intra-articular corticosteroid. The client asks the nurse what causes bunions. Which answer is correct?

Some bunions are congenital; others are caused by wearing shoes that are too short or narrow.

A client is admitted to an acute care facility with osteomyelitis. Which organism usually causes this infection?

Staphylococcus aureus

The nurse is caring for a client with a long leg cast. Which nursing intervention can bestprevent foot drop?

Support the foot with 90 degrees of flexion.

A client calls the clinic and informs the nurse that there is a foul odor coming from the cast. What is the best response by the nurse?

Tell the client to come to the clinic immediately since the foul odor may be a sign of infection.

The nurse is caring for a female client with osteoarthritis who is being discharge to home. Which items would the nurse reinforce the use of in order to assist the client to dress independently at home? Select all that apply.

skirts with elastic waists jackets with Velcro closures bras with front closure

During data collection of a newly admitted client, the nurse observes a reddened area on the left heel. The nurse applies pressure to the reddened area and notes that it does not blanch when pressure is relieved. When documenting the findings, which appropriate stage would the nurse assign to this pressure sore?

stage I

Which activity in a child with muscular dystrophy should a nurse anticipate difficulty with first?

standing

A client presents with pain and warmth in his big toe and reduced urine output. The health care provider suspects gouty arthritis. The nurse can expect the health care provider to confirm this diagnosis by ordering which diagnostic tests?

synovial fluid analysis and serum uric acid level

A client is admitted to the emergency department with a foot fracture and the care provider is placing the foot in a brace. What education will the nurse reinforce as to the reason the brace is important to wear?

to act as a splint

A client with osteoarthritis may be on bed rest for prolonged periods. Which nursing intervention would be appropriate for these clients?

turning the client every 2 hours, and encouraging coughing and deep breathing

The nurse is caring for a child with a Harrington rod placement. Which data gathered by the nurse would be of greatest concern 2 days postoperatively?

urine output less than 30 mL/hr

A child with muscular dystrophy has lost complete control of his lower extremities. There is some strength bilaterally in the upper extremities, but poor trunk control. Which mechanism would be the most important to have on the wheelchair?

wheelchair belt