musculoskeletal EAQ

Which discharge instruction should a nurse give a client who's had surgery to repair a hip fracture?

"Don't flex your hip more than 90 degrees, don't cross your legs, and have someone help you put your shoes on."

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."

After the nurse teaches a client about wearing a back brace after a spinal fusion, which statement indicates effective teaching?

"I should wear a thin cotton undershirt under the brace."

The medication order is for 400 mg. The available medication is 300 mg in 1 mL. How many mL will you administer?

1.3mL

The nurse is caring for a client on a second course of antibiotics to eliminate osteomyelitis. It is most essential for the nurse to instruct on which aspect of daily care?

A diet high in protein and nutrients

A client is admitted following a motor vehicle accident where his left thigh was crushed beneath the vehicle. The nurse must assess for which of the following complications?

Acute renal failure

What is the most important assessment for the nurse to make when assessing peripheral pulses on a client who is post limb fracture?

Amplitude and symmetry of both extremities

A complication of Buck's extension traction would be noted by a nurse if:

Dorsiflexion developed in the affected foot

The client is being evaluated for osteoporosis. Which diagnostic test is the most accurate when diagnosing osteoporosis?

Dual-energy x-ray absorptiometry (DEXA).

During the first 24 hours after an above-the-knee amputation for vascular disease, nursing priority for stump care would be:

Elevating to reduce edema.

After a person experiences a closure of the epiphyses

No further increase in bone length occurs.

The nurse prepares a client for a bone scan. What priority assessment should the nurse perform for this client?

Presence of intravenous (IV) access

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

Sandbags

Upon a client's admission for extracapsular fracture of the left femur, how should a nurse expect the extremity to appear?

Shorter than the other leg.

The nurse is teaching a client with metastatic bone disease about measures to prevent hypercalcemia. It would be important for the nurse to emphasize?

The importance of walking

The nurse is evaluating a client in skin traction. Which of the following indicate the traction is applied for maximum effectiveness?

The ropes are in the wheel grooves of the pulleys

The nurse, assisting in applying a cast to a client with a broken arm, knows that?

The wet cast should be handled with the palms of hands

medication for osteoarthritis and hypertension

acetaminophen

In preparation for total knee surgery, a 200-lb (90.7 kg) client with osteoarthritis must lose weight. Which exercise should the nurse recommend as best if the client has no contraindications?

aquatic exercise

cause of the immune system reaction in a pt with rheumatoid arthritis

autoimmune dysfunction

bones of the ribs, shoulder blades, pelvis, and skull

flat bones

alternative therapies for chronic musculoskeletal disorder

glucosamine supplements = reduces articular pain, lessened joint tenderness, and less restricted joint movement

instrument to use when measuring range of motion

goniometer

. A nurse suspects that a client with a recent fracture has compartment syndrome. Assessment findings may include:

inability to perform active movement and pain with passive movement.

nurse would be most concerned if the pt taking cholinesterase inhibitors began exhibiting which symptom of cholinesterase inhibitor toxicity

muscles that do not relax

After which diagnostic study is it important that the patient lie quietly in semi-Fowler's position for approximately 8 hours (12 hours if oil-based dye is used)?

myelography

A client who has had a total hip replacement has a dislocated hip prosthesis. The nurse should first:

notify the orthopedic surgeon.

considered to be an almost inevitable consequence of aging

osteoarthritis

disease that has a increased chance of occurrence in a 60-yr old postmenopausal patient

osteoporosis -estrogen deficiency associated with increased bone reabsorption

When admitting a client with a fractured extremity, the nurse should first assess

the area distal to the fracture.

muscle involved in pt who reports pain in the posterior upper right arm that occurs when the lower arm is extended

triceps

treatment prescribed for a pt with compression fracture in the spine that is caused by osteoporosis and is unresponsive to analgesics

vertebroplasty

A client who had a total hip replacement 4 days ago is worried about dislocation of the prosthesis. The nurse should respond by saying:

"Activities that tend to cause adduction of the hip tend to cause dislocation, so try to avoid them."

.A nurse is caring for a teenager immediately following surgical correction of severe scoliosis. Which interventions should the nurse expect to be part of the care plan? Select all that apply.

Administer pain medication around the clock

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

Assessing for sensation in the legs

A client comes to the emergency department reporting pain in the right leg. When obtaining the history, the nurse learns that the client has a history of obesity and hypertension. Based on this information the nurse anticipates the client having which musculoskeletal disorder?

Degenerative joint disease

A client has undergone a lumbar laminectomy and has just returned to the nursing unit. It is essential for the nurse to perform which of the following activities during this period?

Neurovascular checks

Because a client has bursitis, plans for nursing interventions should include?

Rest

Which nursing diagnosis takes highest priority for a client with a compound fracture?

Risk for infection related to effects of trauma

A nurse is teaching a female client about preventing osteoporosis. Which teaching point is correct?

The recommended daily allowance of calcium may be found in a wide variety of foods.

risk factor modifiable for a 65 yr old woman regarding bone health

lack of exercise

During a routine physical examination on a 75-year-old female client, a nurse notes that the client is 5 feet, 3/8 inches (1.6 m) tall. The client states, "How is that possible? I was always 5 feet and 1/2 inches (1.7 m) tall." Which statement is the best response by the nurse?

"After menopause, the body's bone density declines, resulting in a gradual loss of height."

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 nurse is caring for a client with a spinal cord injury. The client is experiencing blurred vision and has a blood pressure of 204/102 mm Hg. What should the nurse do first?

"Women of African descent are at the greatest risk for osteoporosis."

After instructing a 40-year-old woman about osteoporosis after menopause, the nurse determines that the client needs further instruction when the makes which client statement?

"Women of African descent are at the greatest risk for osteoporosis."

Which of the following instructions regarding body mechanics would be most appropriate for helping a client to avoid back injury?

Avoid prolonged sitting and standing

A client fractured his femur yesterday. Monitoring for which potential complication must be included by the nurse in the client's plan of care?

Fat emboli syndrome

A client has been diagnosed with osteoporosis after a bone density test and is asking what has caused it. Discussion of risk factors would include which of the following?

Heavy smoking, sedentary lifestyle, and high intake of carbonated drinks

A client has been hospitalized after an automobile accident. A full leg cast was applied in the emergency room. The MOST important reason for the nurse to elevate the casted leg is to ?

Improve venous return

The client is diagnosed with osteoarthritis. Which sign/symptom should the nurse expect the client to exhibit?

Joint stiffness.

To ensure safe postoperative care of a client after a total hip arthroplasty, which actions are most appropriate for the nurse to perform? Select all that apply.

Limit movements resulting in internal rotation and adduction of the affected hip.

The nurse should plan to use an abduction pillow (or splint) after a total hip replacement to:

Prevent dislocation of the prosthesis.

A client has bilateral knee pain from osteoarthritis. In addition to taking the prescribed NSAID, the nurse should instruct the client to

Start a regular exercise program

A client has a leg immobilized in traction. Which observation by the nurse indicates that the client understands actions to take to prevent muscle atrophy?

The client performs isometric exercises to the affected extremity three times per day.

A client is scheduled to undergo an open reduction internal fixation of the right femur. The night before surgery, the nurse administers zolpidem as ordered. Which statement about zolpidem is correct?

The nurse should administer the drug immediately before bedtime

medications to treat gout

colchicine allopurinol probenecid corticosteroids

diagnostic test procedure where needle electrodes are inserted into skeletal muscles to record electrical activity

electromyogram (EGM)

The nurse assesses which of the following clinical manifestations in a client with osteomyelitis? Select all that apply:

fever, chills, night sweats, nausea, malaise, restlessness

musculoskeletal disorder of chronic pain of unknown cause

fibromyalgia