Musculoskeletal

The nurse is reviewing the record of a client who has been prescribed baclofen. Which disorder would alert the nurse to contact the primary health care provider (PHCP)? 1. A seizure disorder 2. Hyperthyroidism 3. Diabetes mellitus 4. Coronary artery disease

1. A seizure disorder

A client is being discharged after application of a plaster leg cast. The nurse determines that the client understands proper care of the cast if the client makes which statement? 1. "I need to avoid getting the cast wet." 2. "I will use my fingertips to lift and move the leg." 3. "I need to cover the casted leg with warm blankets." 4. "I can use a padded coat hanger end to scratch under the cast."

1. "I need to avoid getting the cast wet."

Cyclobenzaprine is prescribed for a client to treat muscle spasms, and the nurse is reviewing the client's record. Which disorder would indicate a need to contact the primary health care provider (PHCP) regarding the administration of this medication? 1. Glaucoma 2. Emphysema 3. Hyperthyroidism 4. Diabetes mellitus

1. Glaucoma

The nurse is preparing a list of cast care instructions for a client who just had a plaster cast applied to his right forearm. Which instructions would the nurse include on the list? Select all that apply. 1. Keep the cast and extremity elevated 2. The cast needs to be kept clean and dry 3. Allow the wet cast 24 to 72 hours to dry 4. Expect tingling and numbness in the extremity 5. Use a hair dryer set on a warm to hot setting to dry the cast 6. Use a soft-padded object that will fit under the cast to scratch the skin under the cast

1. Keep the cast and extremity elevated 2. The cast needs to be kept clean and dry 3. Allow the wet cast 24 to 72 hours to dry

During the monitoring of a client's response to disease-modifying antirheumatic drugs (DMARDs), which findings would the nurse interpret as acceptable responses? Select all that apply. 1. Symptom control during periods of emotional stress 2. Normal white blood cell, platelet, and neutrophil counts 3. Radiological findings that show nonprogression of joint degeneration 4. An increased range of motion in the affected joints 3 months into therapy 5. Inflammation and irritation at the injection site 3 days after injection is given 6. A low-grade temperature when rising in the morning that remains throughout the day

1. Symptom control during periods of emotional stress 2. Normal white blood cell, platelet, and neutrophil counts 3. Radiological findings that show nonprogression of joint degeneration 4. An increased range of motion in the affected joints 3 months into therapy

The client has been taking medication for rheumatoid arthritis for 3 weeks. During the administration of etanercept, it is most important for the nurse to collect which data? 1. The white blood cell and platelet counts 2. A metallic taste in the mouth, with a loss of appetite 3. Whether the client is experiencing fatigue and joint pain 4. Whether the client is experiencing itching and edema at the injection site

1. The white blood cell and platelet counts

The nurse is evaluating the pin sites of a client in skeletal traction. The nurse would be least concerned with which finding? 1. Inflammation 2. Serous drainage 3. Pain at a pin site 4. Purulent drainage

2. Serous drainage

The nurse is planning to reinforce instructions to the client about how to stand on crutches. In the instructions, the nurse would plan to tell the client to place the crutches in which position? 1. 3 inches to the front and side of the client's toes 2. 8 inches to the front and side of the client's toes 3. 15 inches to the front and side of the client's toes 4. 20 inches to the front and side of the client's toes

2. 8 inches to the front and side of the client's toes

Dantrolene sodium is prescribed for a client experiencing flexor spasms, and the client asks the nurse about the action of the medication. The nurse responds knowing that which is the therapeutic action of this medication? 1. Depresses spinal reflexes 2. Acts directly on the skeletal muscle to relieve spasticity 3. Acts within the spinal cord to suppress hyperactive reflexes 4. Acts on the central nervous system (CNS) to suppress spasms

2. Acts directly on the skeletal muscle to relieve spasticity

The nurse is reinforcing discharge instructions to a client receiving baclofen. Which would the nurse include in the instructions? 1. Restrict fluid intake. 2. Avoid the use of alcohol. 3. Stop the medication if diarrhea occurs. 4. Notify the primary health care provider (PHCP) if fatigue occurs.

2. Avoid the use of alcohol.

The nurse is caring for the client who has had skeletal traction applied to the left leg. The client is complaining of severe left leg pain. Which action would the nurse take first? 1. Provide pin care 2. Check the client's alignment in bed 3. Medicate the client with an analgesic 4. Call the primary health care provider (PHCP)

2. Check the client's alignment in bed

The nurse is caring for a client with a fresh application of a plaster leg cast. The nurse would plan to prevent the development of compartment syndrome by which action? 1. Elevating the limb and covering it with bath blankets 2. Elevating the limb and applying ice to the affected leg 3. Keeping the leg horizontal and applying ice to the affected leg 4. Placing the leg in a slightly dependent position and applying ice

2. Elevating the limb and applying ice to the affected leg

The nurse is reviewing the laboratory studies on a client receiving dantrolene sodium. Which laboratory test(s) would identify an adverse effect associated with the administration of this medication? 1. Creatinine 2. Liver function tests 3. Blood urea nitrogen 4. Hematological function tests

2. Liver function tests

The nurse is evaluating the client's use of a cane for left-sided weakness. The nurse would intervene and correct the client if the nurse observed that the client performed which action? 1. Holds the cane on the right side 2. Moves the cane when the right leg is moved 3. Leans on the cane when the right leg swings through 4. Keeps the cane 6 inches out to the side of the right foot

2. Moves the cane when the right leg is moved

A client is complaining of skin irritation from the edges of a cast applied the previous day. The nurse would plan for which intervention? 1. Massaging the skin at the rim of the cast 2. Petaling the cast edges with adhesive tape 3. Using a rough file to smooth the cast edges 4. Applying lotion to the skin at the rim of the cast

2. Petaling the cast edges with adhesive tape

The nurse is monitoring a client receiving baclofen for side effects related to the medication. Which would indicate that the client is experiencing a side effect? 1. Polyuria 2. Diarrhea 3. Drowsiness 4. Muscular excitability

3. Drowsiness

The nurse witnesses a client sustain a fall and suspects that the client's leg may be fractured. Which action is the priority? 1. Take a set of vital signs 2. Call the radiology department 3. Immobilize the leg before moving the client 4. Reassure the client that everything will be fine

3. Immobilize the leg before moving the client

A client has sustained a closed fracture and has just had a cast applied to the affected arm. The client is complaining of intense pain. The nurse has elevated the limb, applied an ice bag, and administered an analgesic, which was ineffective in relieving the pain. The nurse interprets that this pain may be caused by which condition? 1. Infection under the cast 2. The anxiety of the client 3. Impaired tissue perfusion 4. The newness of the fracture

3. Impaired tissue perfusion

The nurse is checking the casted extremity of a client. The nurse needs to check for which sign indicative of infection? 1. Dependent edema 2. Diminished distal pulse 3. Presence of a "hot spot" on the cast 4. Coolness and pallor of the extremity

3. Presence of a "hot spot" on the cast

The nurse is one of several people who witness a vehicle hit a pedestrian at a fairly low speed on a small street. The individual is dazed and tries to get up, and the leg appears fractured. The nurse would plan to perform which action? 1. Try to manually reduce the fracture. 2. Leave the person for a few moments to call an ambulance. 3. Stay with the person and encourage the person to remain still. 4. Assist the person with getting up and walking to the sidewalk.

3. Stay with the person and encourage the person to remain still.

A client with acute muscle spasms has been taking baclofen. The client calls the clinic nurse because of continuous feelings of weakness and fatigue and asks the nurse about discontinuing the medication. The nurse would make which appropriate response to the client? 1. "You should never stop the medication." 2. "It is best that you taper the dose if you intend to stop the medication." 3. "It is okay to stop the medication if you think that you can tolerate the muscle spasms." 4. "Weakness and fatigue commonly occur and will diminish with continued medication use."

4. "Weakness and fatigue commonly occur and will diminish with continued medication use."

The nurse is assigned to care for a client with multiple traumas who is admitted to the hospital. The client has a leg fracture, and a plaster cast has been applied. In positioning the casted leg, the nurse would perform which intervention? 1. Keep the leg in a level position 2. Elevate the leg for 3 hours, and put it flat for 1 hour 3. Keep the leg level for 3 hours, and elevate it for 1 hour 4. Elevate the leg on pillows continuously for 24 to 48 hours

4. Elevate the leg on pillows continuously for 24 to 48 hours

The nurse has provided instructions regarding specific leg exercises for the client immobilized in right skeletal lower leg traction. The nurse determines that the client needs further teaching if the nurse observes the client doing which activity? 1. Pulling up on the trapeze 2. Flexing and extending the feet 3. Doing quadriceps-setting and gluteal-setting exercises 4. Performing active range of motion (ROM) to the right ankle and knee

4. Performing active range of motion (ROM) to the right ankle and knee

A client with a hip fracture asks the nurse why Buck's extension traction is being applied before surgery. The nurse's response is based on the understanding that Buck's extension traction has which primary function? 1. Allows bony healing to begin before surgery 2. Provides rigid immobilization of the fracture site 3. Lengthens the fractured leg to prevent severing of blood vessels 4. Provides comfort by reducing muscle spasms and provides fracture immobilization

4. Provides comfort by reducing muscle spasms and provides fracture immobilization

Alendronate is prescribed for a client with osteoporosis and the nurse is providing instructions for the administration of the medication. Which instruction would the nurse reinforce? 1. Take the medication at bedtime. 2. Take the medication in the morning with breakfast. 3. Lie down for 30 minutes after taking the medication. 4. Take the medication with a full glass of water after rising in the morning.

4. Take the medication with a full glass of water after rising in the morning.