Neurological, Musculoskeletal, Autoimmune/Arthritic, Integumentary Disorders

A nurse is preparing a presentation about glucosamine to a group of clients. Which of the following information should the nurse include in the teaching? a. "Glucosamine can help relieve urinary frequency." b. "Glucosamine is used to treat viral infections." c. "Glucosamine can help relieve hot flashes." d. "Glucosamine can suppress joint inflammation."

d. "Glucosamine can suppress joint inflammation."

A nurse is completing discharge instructions with a client following an acute onset of gout. Which of the following client statements indicates an understanding of the treatment regimen? a. "I will closely follow a high-purine diet." b. "I will limit my fluid intake to 1 liter per day." c. "I will take one aspirin every day." d. "I will limit my alcohol intake."

d. "I will limit my alcohol intake."

A nurse is providing teaching to a client who has a prescription for heat therapy for treatment of cellulitis of the right lower leg. Which of the following client statements indicates an understanding of the teaching? a. "I will sit on the side of the tub and soak my right leg two times every day." b. "I'll keep a heating pad on the calf of my right leg when I am lying down." c. "I'll place my leg under a heat lamp every 3 hours." d. "I'll wrap a warm, wet towel around my right calf every 4 hours."

d. "I'll wrap a warm, wet towel around my right calf every 4 hours."

A nurse is teaching an older adult client who has herpes zoster about the order of occurrence of findings associated with this disorder. Identify the order in which the findings typically occur. 1- crusted lesions 2- paresthesia 3- postherpetic neuralgia 4- redness and swelling 5- vesicles 6- weeping blisters

2- paresthesia 4- redness and swelling 5- vesicles 6- weeping blisters 1- crusted lesions 3- postherpetic neuralgia

A nurse is preparing to administer naproxen 500 mg PO BID for a client who has osteoarthritis. The amount available is naproxen 125 mg/5 mL oral suspension. How many mL should the nurse administer per dose? (Round to nearest whole number).

20

A nurse is preparing to administer a continuous heparin infusion at 1600 units/hr. Available is heparin 25,000 units in dextrose 5% in water (D5W) 500 mL. The nurse should set the IV pump to deliver how many mL/hr? Round to the nearest whole number.

32

A nurse is caring for a client who has osteoarthritis and asks about the use of glucosamine. Which of the following statements should the nurse make? (Select all that apply). a. "Glucosamine might increase bleeding." b. "Glucosamine can help lower blood pressure." c. "Glucosamine can increase blood glucose levels." d. "Glucosamine hydrochloride has been shown to decrease the discomfort of osteoarthritis." e. "Clients who have shellfish allergies might experience reactions when taking glucosamine."

a. "Glucosamine might increase bleeding." c. "Glucosamine can increase blood glucose levels." e. "Clients who have shellfish allergies might experience reactions when taking glucosamine."

A nurse is teaching a client who has multiple sclerosis and a new prescription for dantrolene. Which of the following statements by the client indicates an understanding of the teaching? a. "I need to apply a sunscreen when I go outside." b. "I can take an over-the-counter antihistamine for allergies when I'm taking this drug." c. "I should take this medication when my spasms are bad." d. "My muscle strength should improve a lot in 2 to 3 days."

a. "I need to apply a sunscreen when I go outside."

A nurse is teaching a client who has multiple sclerosis and a new prescription for dantrolene. Which of the following statements by the client indicates and understanding of the teaching? a. "I need to apply a sunscreen when I go outside." b. "I can take an over-the-counter antihistamine for allergies when I'm taking this drug." c. "I should take this medication when my spasms are bad." d. "My muscle strength should improve a lot in 2 to 3 days."

a. "I need to apply a sunscreen when I go outside."

A nurse is teaching a client who is taking atorvastatin daily. Which of the following statements by the client indicates an understanding of the teaching? a. "I will avoid drinking grapefruit juice." b. "I should take this medication without food." c. "I should expect my stools to turn clay-colored." d. "It is not necessary to have routine lab tests done."

a. "I will avoid drinking grapefruit juice."

A nurse is teaching a client who is starting to take alendronate effervescent tablets to treat osteoporosis. Which of the following information should the nurse include? a. "Sit upright or stand for at least 30 minutes after taking this medication." b. "Take this medication with food." c. "Take this medication with orange juice." d. "Chew or suck on the tablet."

a. "Sit upright or stand for at least 30 minutes after taking this medication."

A nurse is caring for an older adult client who had a cerebrovascular accident and has left-sided weakness. The client's partner tells the nurse she is worried about the next steps of treatment for her partner. Which of the following responses should the nurse make? a. "We have begun plans to send your partner to a rehabilitation facility as soon as he is stable." b. "Your partner is too critical to consider what tomorrow will bring. Let's just concentrate on today." c. "Don't worry. Most clients like your partner start making progress after a few days of rest." d. "You will have to speak to the provider for that information. I can arrange that for you."

a. "We have begun plans to send your partner to a rehabilitation facility as soon as he is stable."

A nurse is caring for a client who has rheumatoid arthritis and tells the nurse that she wears a copper bracelet to help her feel better. Which of the following responses should the nurse make? a. "Yes, I understand that you feel better wearing your bracelet." b. "Why do you think the copper helps with your arthritis?" c. "Believing objects have powers to make you feel better has no scientific basis." d. "I think you should rely more on your medication therapy than on your bracelet."

a. "Yes, I understand that you feel better wearing your bracelet."

A nurse is providing teaching for a client who is preparing for a below the knee amputation. Which of the following statements is true regarding the post-op placement of a prosthesis? a. "You will do special exercises in advance of getting your prosthesis." b. "You will be fitted for your prosthesis at the time of surgery." c. "A special pressure dressing will remain on to cushion your prosthesis." d. "The prosthesis will be adjustable depending on what shoe you are wearing."

a. "You will do special exercises in advance of getting your prosthesis."

A nurse is teaching a client who is scheduled for a DXA to screen for osteoporosis. Which of the following instructions should the nurse include in the teaching? a. "You will need to remove all jewelry before the test." b. "You will need to lie flat for 4 hours following the test." c. "You will need to empty your bladder before the test." d. "You will need to fast for 12 hours before the test."

a. "You will need to remove all jewelry before the test."

A nurse is reviewing the medical records for four older adult clients. The nurse should plan to administer the herpes zoster vaccine to which of the following clients? a. A client who takes omeprazole for peptic ulcer disease b. A client who takes prednisone 20 mg per day for rheumatoid arthritis c. A client who is receiving chemotherapy for breast cancer d. A client who has HIV and is immunocompromised

a. A client who takes omeprazole for peptic ulcer disease

A home health nurse is reinforcing coping strategies with the family caregiver of a client who has Alzheimer's disease. Which of the following information should the nurse include in the teaching? Select all that apply. a. Actions to reduce stress b. Identification of a social support system c. Referral to available community resources d. Instruction on client medication administration e. Expected physiological changes of the disease

a. Actions to reduce stress b. Identification of a social support system c. Referral to available community resources e. Expected physiological changes of the disease

A nurse is preparing a presentation at a community center about osteoarthritis. The nurse should plan to include which of the following information? (Select all that apply). a. Affects weight-bearing joints b. Crepitus can occur in affected joints c. Affects bilateral, symmetrical joints d. Causes joint stiffness e. Causes joint pain

a. Affects weight-bearing joints b. Crepitus can occur in affected joints d. Causes joint stiffness e. Causes joint pain

A nurse is teaching a client who is to begin long-term therapy with prednisone to treat rheumatoid arthritis. The nurse should instruct the client to take which of the following supplements while taking this medication? a. Calcium and vitamin D b. Biotin and vitamin B2 c. Folic acid and vitamin C d. Pantothenic acid and vitamin B6

a. Calcium and vitamin D

A nurse is helping an older adult client ambulate in the hallway for the first time since admission. The client has brought her standard walker from home. To ensure proper use of the walker and the safety of the client, which of the following actions should the nurse take? a. Check that the client lifts the walker and then places it down in front of her. b. Walk in front of the client to guide her in moving the walker. c. Have the client move one leg forward with the walker. d. Make sure that the upper bar of the walker is level with the client's waist.

a. Check that the client lifts the walker and then places it down in front of her.

A nurse is assessing a client who has a cast in place for a fractured tibia. Which of the following actions should the nurse take first? a. Checking capillary refill b. Discussing cast care c. Managing pain d. Performing range of motion

a. Checking capillary refill

Shannon Logan is a 32-year-old female patient who is referred to a rheumatology clinic by her primary care provider with complaints of multiple joint pain and swelling, fatigue, and morning stiffness. She is an elementary school teacher and has noticed that holding a marker has become progressively more difficult over the last 7 to 8 months. Because of morning stiffness lasting for more than 1 hour, she has to get up earlier to get ready for work. She complains of bilateral hand and wrist pain as well as pain and swelling in the second and third fingers bilaterally. By the end of the work day, she is extremely tired and is unable to carry on with her usual evening activities. She has a history of mild hypertension, which is treated with hydrochlorothiazide, but is otherwise in excellent health. Ms. Logan presents with bilateral hand and wrist pain and pain and swelling in the second and third fingers. She also describes morning stiffness lasting longer than 1 hour and increased fatigue, which are symptoms consistent with RA. Initial laboratory testing reveals elevated rheumatoid factor, ESR, CRP, and anticyclic citrullinated peptide levels. Ultrasound reveals synovitis located in each wrist and bilateral second and third proximal interphalangeal joints. On the basis of the laboratory results indicating elevated rheumatoid factor, elevated ESR and CRP and anticyclic citrullinated peptide, as well as synovitis on ultrasound in the affected joints, RA is diagnosed Ms. Logan is started on ibuprofen and short-term low-dose prednisone. The rheumatologist discusses treatment options that are available to help control disease progression. Ms. Logan will most likely begin to use methotrexate to decrease the disease progression. She will follow up with the rheumatologist frequently until her disease is well controlled. The nurse is reviewing the treatment plan for Ms. Logan. It is a priority for the nurse to follow up with the provider about which part of the plan? The nurse is reviewing the treatment plan for Ms. Logan. It is a priority for the nurse to follow up with the provider about which part of the plan? a. Consider methotrexate if other options are unsuccessful in controlling pain b. Ibuprofen 600 mg PO tid c. Oxycodone 5 mg PO every 6 hours prn d. Prednisone 5 mg PO every day

a. Consider methotrexate if other options are unsuccessful in controlling pain

A nurse is assessing a client who is experiencing complications due to immobility. Which of the following findings should the nurse expect? (Select all that apply). a. Contractures of the extremities b. Polyuria c. Diarrhea d. Crackles in the lungs e. Pressure ulcers

a. Contractures of the extremities d. Crackles in the lungs e. Pressure ulcers

A nurse is reviewing the lab findings for a client who developed fat embolism syndrome (FES) following a fracture. Which of the following lab findings should the nurse expect? a. Decreased serum calcium level b. Decreased level of serum lipids c. Decreased erythrocyte sedimentation rate (ESR) d. Increased platelet count

a. Decreased serum calcium level

A young adult client with a new diagnosis of rheumatoid arthritis states, "The pain in my joints is just a temporary thing. If I keep eating right and exercising, it'll go away." The nurse should identify the client is exhibiting which of the following defense mechanisms? a. Denial b. Displacement c. Rationalization d. Reaction formation

a. Denial

A nurse at a rehab center is planning care for a client who had left hemispheric cerebrovascular accident 3 weeks ago. Which of the following goals should the nurse include in the client's rehab program? a. Establish the ability to communicate effectively. b. Compensate for loss of depth perception. c. Learn to control impulsive behavior. d. Improve left-side motor function.

a. Establish the ability to communicate effectively.

A nurse in the emergency department is caring for a client who has a compression fracture of a spinal vertebra. During transport to the facility, the client was medicated with IV morphine. On arrival, the neurosurgeon determined urgent surgical intervention is indicated for the fracture. Staff members have been unable to reach the client's family. Which of the following actions should the nurse anticipate the surgeon taking? a. Invoking implied consent b. Delaying the surgery until a member of the client's family is reached c. Asking the client to sign the surgical consent form d. Prescribing naloxone to reverse the effects of the morphine

a. Invoking implied consent

A nurse is developing a plan of care for a client who has a fracture to achieve the outcome of functional healing. To assist in meeting this goal, which of the following nursing interventions is the highest priority? a. Maintain immobilization and alignment. b. Provide optimal nutrition and hydration. c. Promote independence in activities of daily living. d. Provide relief from pain and discomfort.

a. Maintain immobilization and alignment.

The spouse of a client brought to the ED reports that 6 hours ago, her husband began having difficulty finding words. The client has since become progressively worse. Upon assessment, you note right hemiparesis and urine incontinence. An hour later after a CT scan, the client is diagnosed with a left hemisphere stroke. The client is admitted to the acute medical unit. The client's wife must leave her husband's bedside for 2 hours to run errands. Which nursing action is appropriate to contribute to client safety while she is gone? a. Maintain the bed in a low position b. Apply restraints c. Place the call light in the patient's right hand d. Sit with the patient for 2 hours until the wife returns

a. Maintain the bed in a low position

A nurse is caring for a client who has rheumatoid arthritis and is experiencing difficulty feeding herself using adaptive devices. The nurse should initiate a referral with which of the following members of the interprofessional health care team? a. Occupational therapist b. Social worker c. Registered dietitian d. Speech pathologist

a. Occupational therapist

A nurse is caring for an adolescent client who has a newly applied fiberglass cast for a fractured tibia. Which of the following is the priority action for the nurse to take? a. Perform a neurovascular assessment. b. Explain the discharge instructions to the client and parents. c. Provide reassurance to the client and parents. d. Apply an ice pack to the casted leg.

a. Perform a neurovascular assessment.

A nurse is teaching a client who has rheumatoid arthritis about increasing physical rest as part of her treatment plan. Which of the following outcomes of this intervention should the nurse document as a goal for this client? a. Reduced joint stress b. Maintenance of joint function c. Suppression of the inflammatory process d. Decreased stiffness

a. Reduced joint stress

A nurse is teaching a client about risk factors for osteoporosis. Which of the following factors should the nurse include in the teaching? (Select all that apply.) a. Sedentary lifestyle b. Obesity c. Aging d. Caffeine intake e. Secondhand smoke

a. Sedentary lifestyle c. Aging d. Caffeine intake e. Secondhand smoke

A nurse in an urgent care center is caring for a client who has a greenstick fracture of the forearm. The nurse should explain that which of the following injuries has occurred with a greenstick fracture? a. The bone is cracked lengthwise but did not break all the way through. b. Fragments of bone have splintered into the surrounding tissue. c. The bone ends have been forced toward each other. d. Sharp edge of the bone has broken through the skin.

a. The bone is cracked lengthwise but did not break all the way through.

A nurse is caring for an older adult client who has a fractured hip and will require rehab care. The client's family asks the nurse for information about this type of care. Which of the following explanations should the nurse provide? a. This service began with the client's admission to the hospital. b. This service focuses on teaching the primary caregiver to meet the client's needs. c. The emphasis is on the client's complete recovery from the illness or injury. d. Services are centered in long-term care facilities.

a. This service began with the client's admission to the hospital.

A nurse is reviewing risk factors for osteoporosis with a group of nursing students. The nurse should include that which of the following types of medications therapy is a risk factor for osteoporosis? a. Thyroid hormones b. Anticoagulants c. NSAIDs d. Cardiac glycosides

a. Thyroid hormones

A nurse is teaching a client who has chronic tophaceous gout about his new prescription for allopurinol. The nurse should explain that the purpose of this medication is to reduce blood level of which of the following substances? a. Uric acid b. Chloride c. Interleukin 1 d. Potassium

a. Uric acid

A nurse is providing teaching to a client who has a skin infection and a new prescription for gentamicin topical cream. Which of the following instructions should the nurse provide? a. Wash the affected area with soap and water before applying cream. b. Increase intake of fluids while using this medication. c. The medication might cause temporary blurred vision. d. Apply the cream to large areas around the infection.

a. Wash the affected area with soap and water before applying cream.

An occupational health nurse is instructing workers at an industrial facility about emergency procedures to take in the event of a traumatic amputation of a finger. Which of the following guidelines should the nurse include for preserving an amputated part for possible surgical reattachment? a. Wrap the amputated finger in dry, sterile gauze. b. Place the amputated finger in crushed ice. c. Put the amputated finger in a sealed, waterproof plastic bag. d. Secure the hand of the lost finger to the abdomen with an elastic bandage. e. Prevent the amputated finger from contacting water.

a. Wrap the amputated finger in dry, sterile gauze. c. Put the amputated finger in a sealed, waterproof plastic bag. e. Prevent the amputated finger from contacting water.

A nurse is caring for a client who is taking naproxen following an exacerbation of rheumatoid arthritis. Which of the following statements by the client requires further discussion by the nurse? a. "I signed up for a swimming class." b. "I've been taking an antacid to help with indigestion." c. "I've lost 2 pounds since my appointment 2 weeks ago." d. "The naproxen is easier to take when I crush it and put it in applesauce."

b. "I've been taking an antacid to help with indigestion."

A nurse in an acute care facility is assessing a client who had hip surgery and has Alzheimer's disease. The nurse asks the client how therapy went that morning. Which of the following statements by the client should the nurse document as confabulation? a. "This morning, this morning, this morning..." b. "It was good. The Queen of England visited me there." c. "I just don't remember what I did this morning." d. "Snip, snap. Take a nap."

b. "It was good. The Queen of England visited me there."

A nurse is teaching a client who has anew prescription for colchicine to treat gout. Which of the following instructions should the nurse include? a. "Take this medication with food if nausea develops." b. "Monitor for muscle pain." c. "Expect to have increased bruising." d. "Increase your intake of grapefruit juice."

b. "Monitor for muscle pain."

A nurse is providing teaching to a client who has widespread psoriasis and a prescription for phototherapy. The nurse should include which of the following information in the teaching? a. "You will have a morning and afternoon session on each treatment day." b. "Treatment might be interrupted if areas of redness and tenderness develop." c. "Treatments will be given in a series of three days on and three days off." d. "You should purchase dark glasses in case the light bothers your eyes."

b. "Treatment might be interrupted if areas of redness and tenderness develop."

A nurse is teaching a client who has a new prescription for clopidogrel. Which of the following instructions should the nurse include? a. "Take this medication with food." b. "You might have to stop taking this medication 5 days before any planned surgeries." c. "Take this medication three times daily." d. "Expect to have black-colored stools while taking this medication."

b. "You might have to stop taking this medication 5 days before any planned surgeries."

A nurse is teaching a client who has a new prescription for simvastatin. Which of the following instructions should the nurse include? a. "You should expect brown-colored urine." b. "You should avoid grapefruit juice." c. "You should monitor for ringing in the ears." d. "You should take the medication in the morning."

b. "You should avoid grapefruit juice."

A nurse is providing nutritional teaching to a client who has osteoporosis. Which of the following foods should the nurse recommend as being the highest in calcium? a. 1 cup carrot strips b. 3 oz canned salmon c. 1 cup chopped chicken breast d. 1 plain baked potato

b. 3 oz canned salmon

A nurse is teaching a newly licensed nurse about the difference between a plaster cast and a synthetic cast. Which of the following information should the nurse include in the teaching? a. Drying time is prolonged with a synthetic cast. b. A synthetic cast is weighs less. c. A plaster cast requires expensive equipment for application. d. A synthetic case immobilizes bone fractures more effectively.

b. A synthetic cast is weighs less.

The spouse of a client brought to the ED reports that 6 hours ago, her husband began having difficulty finding words. The client has since become progressively worse. Upon assessment, you note right hemiparesis and urine incontinence. An hour later after a CT scan, the client is diagnosed with a left hemisphere stroke. Which assessment findings does the nurse anticipate? (Select all that apply.) a. Left sided neglect b. Aphasia c. Right sided paralysis d. Right visual field deficit e. Impulsiveness

b. Aphasia c. Right sided paralysis d. Right visual field deficit

The nurse providing care for Ms. Logan should include which lifestyle modifications into the plan of care? (Select all that apply.) The nurse providing care for Ms. Logan should include which lifestyle modifications into the plan of care? (Select all that apply.) a. Limit range-of-motion exercise to reduce stress on joints. b. Begin range-of-motion exercises to increase flexibility of joints. c. Begin high-carbohydrate, low-protein diet. d. Begin non-impact aerobic exercise for weight control. e. Begin impact aerobic exercise for weight control.

b. Begin range-of-motion exercises to increase flexibility of joints. d. Begin non-impact aerobic exercise for weight control.

A nurse is teaching a client who has a new prescription for aspirin to treat rheumatoid arthritis. The nurse should include to monitor for which of the following adverse effects of this medication? a. Constipation b. Bleeding c. Blurred vision d. Insomnia

b. Bleeding

A nurse is teaching an older adult client who has an intracapsular fracture of the right hip following a fall about the purpose of Buck's extension traction. The nurse should include which of the following information in the teaching? a. Buck's extension traction will reduce the fracture. b. Buck's extension traction will relieve muscle spasms. c. Buck's extension traction will maintain alignment of the pins. d. Buck's extension traction will allow supported movement of the extremity.

b. Buck's extension traction will relieve muscle spasms.

A nurse is caring for a client who is receiving a continuous IV infusion of heparin. Which of the following actions should the nurse take? a. Administer 50,000 units of heparin by IV bolus every 12 hr. b. Check the activated partial thromboplastin time (aPTT) every 4 hr. c. Have vitamin K available on the nursing unit. d. Use IV tubing specific for heparin sodium when administering the infusion.

b. Check the activated partial thromboplastin time (aPTT) every 4 hr.

A nurse is modifying the diet of a client who has Parkinson's disease and is prescribed selegiline, an MAOI. Which of the following foods should the nurse eliminate? a. Fresh fish b. Cheddar cheese c. Cherries d. Chicken

b. Cheddar cheese

A nurse is teaching a client who has rheumatoid arthritis about taking methotrexate. Which of the following information should the nurse include? a. Take an antiemetic 1 hr following administration. b. Drink 2 to 3 L of water per day. c. Take the medication with an NSAID. d. Rinse mouth 2 times per day with an alcohol based mouthwash.

b. Drink 2 to 3 L of water per day.

A nurse is caring for a female client who has rheumatoid arthritis and asks the nurse if it is safe for her to take aspirin. The nurse should recognize which of the following findings in the client's history is a contraindication to this medication? a. Report of recent migraine headaches b. History of gastric ulcers c. Current diagnosis of glaucoma d. Prior reports of amenorrhea

b. History of gastric ulcers

A nurse is teaching a client who has left hemiparesis how to use a cane. Which of the following instructions should the nurse include? a. Remove the rubber tip when using the cane. b. Hold the cane on the right side to provide support for the weaker leg. c. Place the cane approximately 61 cm (24 in) in front of her feet before advancing. d. Advance the right leg and the cane together to support the weaker leg.

b. Hold the cane on the right side to provide support for the weaker leg.

A nurse is caring for a client who has a femur fracture. The nurse suspects that the client has fat embolism syndrome. Which of the following findings should the nurse identify as an early manifestation of fat embolism syndrome? a. Petechiae b. Hypoxemia c. Headache d. Precordial chest pain

b. Hypoxemia

A nurse in a provider's office is assessing a client who has rheumatoid arthritis. Which of the following findings is a late manifestation of this condition? a. Anorexia b. Knuckle deformity c. Low-grade fever d. Weight loss

b. Knuckle deformity

A nurse is obtaining a medical history from a client who is requesting the herpes zoster vaccine. The nurse should identify which of the following findings as a contraindication for receiving this vaccine? a. Postoperative hip arthroplasty b. Long-term use of prednisone for COPD c. History of varicella as an adolescent d. Recent travel to the Middle East

b. Long-term use of prednisone for COPD

A nurse is assessing a client following the application of a leg cast for the treatment of a fracture. If the cast is too tight, which of the following findings should the nurse expect to observe first? a. Change in temperature of the toes. b. Pallor of the toes. c. Edema of the toes. d. Inability to move toes.

b. Pallor of the toes.

The nurse monitors for which common symptom of compartment syndrome? The nurse monitors for which common symptom of compartment syndrome? a. Petechiae b. Passive pain at rest c. Muscle spasms with movement d. Redness to the area

b. Passive pain at rest

A nurse is assessing a client who has ataxia. Which of the following actions should the nurse take to evaluate the client's ability to safely ambulate? a. Observe for the presence of Kernig's sign. b. Perform a Romberg's test. c. Check the function of cranial nerve V. d. Inspect for the presence of clubbing.

b. Perform a Romberg's test.

A nurse is planning care for a client who is post-op following a total hip arthroplasty. Which of the following interventions should the nurse include in the plan of care? a. Instruct the client to avoid movement of the affected leg. b. Prevent hip flexion of the affected extremity c. Position the lower extremities so that they are touching. d. Ensure that the client's heels are touching the bed.

b. Prevent hip flexion of the affected extremity

A nurse is caring for a client who has a prescription for balanced skeletal traction with a Thomas splint for the treatment of a fractured femur. Which of the following interventions should the nurse implement to prevent pressure points from developing around the edges of the splint? a. Apply lotion to the skin under the edges of the splint. b. Reposition the client to keep him from staying in the same position in bed. c. Remove the weights for a few minutes each hour. d. Apply a foot plate to the bed.

b. Reposition the client to keep him from staying in the same position in bed.

A nurse is teaching a client who has gout about medications. The nurse should teach the client to avoid the use of which of the following types of medication? a. NSAIDs b. Salicylates c. Antihistamines d. Expectorants

b. Salicylates

A nurse in a provider's office is collecting a health hx from a client who is at risk for primary osteoporosis. Which of the following findings is a risk factor for the development of osteoporosis? a. Obesity b. Sedentary lifestyle c. Long-term use of diuretics d. Prolonged stress

b. Sedentary lifestyle

A nurse in a clinic is assessing a client. Which of the following findings should the nurse identify as a risk factor for osteoporosis? a. Drinks one alcoholic beverage per day b. Smokes 1 pack of cigarettes per day c. Large body stature d. History of bone fracture during childhood

b. Smokes 1 pack of cigarettes per day

A nurse is teaching a client who has a new prescription for ibuprofen to treat hip pain. Which of the following instructions should the nurse include in the teaching? a. Expect ringing in your ears. b. Take the medication with food. c. Store the medication in the refrigerator. d. Monitor for weight loss.

b. Take the medication with food.

A nurse is caring for a client who sustained a femur fracture in an automobile accident and is placed into skeletal traction. The nurse may remove the weights from the traction device if which of the following occurs? a. The client complains of pain. b. The client develops a life-threatening situation. c. The client needs to have an x-ray of the femur performed. d. The client has to be repositioned in the bed.

b. The client develops a life-threatening situation.

A nurse is caring for a client who has shingles with multiple skin lesions. Which of the following actions by the nurse require intervention by the nurse's supervisor? a. The nurse wears an N95 respirator mask. b. The nurse admits another client who has shingles to the client's double room. c. The nurse wears gloves when providing direct care to the client. d. The nurse wears a gown when bathing the client.

b. The nurse admits another client who has shingles to the client's double room.

A nurse is providing teaching for a client who is post-op following below-the-knee amputation. The nurse should instruct the client that which of the following nutrients is necessary for wound healing? a. Vitamin B1 b. Vitamin C c. Folate d. Vitamin E

b. Vitamin C

A nurse is reviewing discharge instructions with a client who has rheumatoid arthritis and a new prescription for prednisone. Which of the following statements by the client indicates an understanding of the teaching? a. "I should take my flu vaccine within one week of starting this medication." b. "I can expect a sore throat for the first week after starting this medication." c. "I should eat more bananas while taking this medication." d. "I should take aspirin for minor aches and pains while taking this medication."

c. "I should eat more bananas while taking this medication."

A nurse is caring for a client who has dementia due to Alzheimer's disease and was admitted to a long-term care facility following the death of her partner of 40 years. The client states, "I want to go home; my husband is waiting for me to cook dinner." Which of the following responses by the nurse is appropriate? a. "This is where you live now." b. "This is a safer place for you to live." c. "Tell me what you like to cook for dinner." d. "Your family said there is no one to care for you at home."

c. "Tell me what you like to cook for dinner."

A nurse is reviewing the cause of gout with a group of nurses. Which of the following statements should the nurse make? a. "Uric acid levels drop and calcium forms precipitate." b. "Tophi form in the kidneys and they impair the excretion of uric acid." c. "The intra-articular deposition of urate crystals causes inflammation." d. "Articular cartilage thins, leading to splitting and fragmentation."

c. "The intra-articular deposition of urate crystals causes inflammation."

A nurse is teaching the family of an older adult client who has a new diagnosis of dementia. Which of the following statements should the nurse include in the teaching? a. "Dementia is characterized by a sudden onset of confusion." b. "An altered level of consciousness is associated with dementia." c. "The signs of dementia are progressive and irreversible." d. "Dementia can be triggered by a high fever or dehydration."

c. "The signs of dementia are progressive and irreversible."

A nurse is teaching a client about risk factors for osteoarthritis. Which of the following factors should the nurse include in the teaching? (Select all that apply). a. Bacteria b. Diuretics c. Aging d. Obesity e. Smoking

c. Aging d. Obesity e. Smoking

A nurse is caring for a client who has right-sided paralysis from a stroke. Which of the following interventions should the nurse implement to prevent footdrop? a. Place sandbags to maintain right plantar flexion. b. Position soft pillows against the bottom of the feet. c. Apply a protective boot to the right ankle. d. Splint the right lower extremity to maintain proper alignment.

c. Apply a protective boot to the right ankle.

A nurse who is off duty finds a woman who has collapsed and has right-sided weakness and slurred speech. Which of the following actions should the nurse take? a. Obtain the telephone number of the client's provider. b. Find a location for the client to sit. c. Call emergency services. d. Drive the client to the nearest emergency department.

c. Call emergency services.

A nurse is planning care for a client who has pelvic fractures and will require bed rest and traction for 4-6 weeks. The client is a stay at home mother and her husband travels extensively for his job. Which of the following effects should the nurse consider when planning care for the family? a. Loss of privacy b. Decrease in income c. Changes in family members' roles and tasks d. Loss of autonomy for the children

c. Changes in family members' roles and tasks

A nurse is caring for a client in the emergency department who had a traumatic amputation of his left arm in an industrial accident. The nurse should expect the client to be experiencing which of the following of Kubler-Ross's stages of grief? a. Bargaining b. Depression c. Denial d. Acceptance

c. Denial

A nurse is reinforcing teaching with a client who has a new prescription for colchicine orally to treat gout. The nurse should inform the client that which of the following findings is an adverse effect of colchicine? a. Increased appetite b. Urinary retention c. Diarrhea d. Sore throat

c. Diarrhea

A nurse is teaching a client who has a prosthetic limb due to a right below-the-knee amputation about prosthesis and stump care. Which of the following instructions should the nurse include in the teaching? a. Keep the prosthesis in direct contact with the residual limb. b. Apply a moisturizing lotion or oil to the stump daily. c. Dry the prosthesis socket completely before applying it to the limb. d. Expect some skin irritation from the prosthesis.

c. Dry the prosthesis socket completely before applying it to the limb.

Because Zachary has lost a significant amount of blood, what complication should the nurse monitor for? Because Zachary has lost a significant amount of blood, what complication should the nurse monitor for? a. Hyperkalemia b. Metabolic alkalosis c. Hypotension d. Bradycardia

c. Hypotension

A nurse is teaching a group of clients about osteoarthritis. Which of the following recommendations should the nurse include in the teaching? a. Use Echinacea to manage joint pain. b. Apply ice to the joint before exercising. c. Maintain a recommended body weight. d. Reduce the amount of purine in the diet.

c. Maintain a recommended body weight.

A nurse is formulating a teaching plan about herpes zoster for a group of older adults at a community center. The nurse should include which of the following information in the plan? a. Herpes zoster is easily spread to family and friends who have had chickenpox in the past. b. The lesions are contagious to others only if they are draining. c. Many clients experience pain in the affected area for weeks after the lesions have resolved. d. Vesicles will appear followed by pain and or itching.

c. Many clients experience pain in the affected area for weeks after the lesions have resolved.

A nurse is shopping and finds a woman who has collapsed with right-sided weakness and slurred speech. Which of the following action should the nurse take? a. Provide the client with water to test the gag reflex. b. Perform carotid massage. c. Notify emergency management services. d. Drive the client to the nearest medical facility.

c. Notify emergency management services.

A nurse is teaching a client about medications that prevent osteoporosis. The nurse should instruct the client that which of the following medications is prescribed to prevent osteoporosis? a. Levothyroxine b. Calcitonin c. Raloxifene d. Allopurinol

c. Raloxifene

A nurse is caring for a client who has osteoporosis and takes a daily calcium supplement. Which of the following adverse effects of calcium should the nurse suspect when the client reports having flank pain? a. Hepatitis b. Hip fracture c. Renal stones d. Pancreatitis

c. Renal stones

A nurse in a long-term care facility is caring for an older adult client who has dementia and begins to have frequent episodes of urinary incontinence. After the provider determines no medical cause for the client's incontinence, which of the following interventions should the nurse initiate to manage this behavior? a. Remind the client to tell the nurse when he has to urinate. b. Use adult diapers to prevent frequent clothing changes. c. Take the client to the bathroom every 2 hr. d. Request a prescription for an indwelling urinary catheter.

c. Take the client to the bathroom every 2 hr.

A nurse is assessing a client's ability to ambulate with crutches using a three-point gait. Which of the following actions should the nurse identify as a risk to the client's safety? a. The client pushes downward on the handgrips. b. The client stands in a tripod position prior to walking. c. The client places partial weight on the affected leg. d. The client keeps the elbows in a flexed position.

c. The client places partial weight on the affected leg.

A nurse is caring for a client who has a fractured ulna and a new prescription for cyclobenzaprine. Before administration, which of the following explanations should the nurse provide to explain the purpose of the medication? a. The medication will kill microorganisms that can cause infection at the fracture site. b. Cyclobenzaprine will reduce itching that might occur as the fracture begins to heal. c. The medication will relieve muscle spasms that might occur with a fracture. d. Cyclobenzaprine will relieve any nausea associated with a fracture.

c. The medication will relieve muscle spasms that might occur with a fracture.

A nurse is making a home visit to a client who has Alzheimer's disease and the client's partner. Which of the following observations indicates to the nurse that the partner is experiencing caregiver role strain? a. The partner has placed locks at the top of the doors leading to the outside. b. The partner has hired a house cleaner. c. The partner has lost 20 lb in the past 2 months. d. The partner redirects the client when the client is frustrated.

c. The partner has lost 20 lb in the past 2 months.

A nurse is providing teaching to a client who has a new prescription for hydroxychloroquine to treat mild manifestations of rheumatoid arthritis. Which of the following information should the nurse include in the teaching? a. This medication should be taken between meals. b. This medication can turn skin an orange color. c. Wear sunglasses when out in bright sunshine. d. Avoid crushing the medication.

c. Wear sunglasses when out in bright sunshine.

Which statement made by Ms. Logan regarding methotrexate indicates that teaching has been effective? Which statement made by Ms. Logan regarding methotrexate indicates that teaching has been effective? a. "I guess I'll have to cut back to drinking only one beer a day." b. "If my joint pain and swelling get worse, I'll take more methotrexate then notify the doctor at my next appointment." c. "Since the doctor ordered me to take six methotrexate pills a week, I can take one a day Sunday through Friday and skip taking a pill on Saturday." d. "My husband and I will use two effective means of birth control to prevent pregnancy if I start methotrexate."

d. "My husband and I will use two effective means of birth control to prevent pregnancy if I start methotrexate."

A nurse is assessing a client after administering IV vancomycin. Which of the following findings is the nurse's priority to report to the provider? a. Localized redness at the catheter insertion site b. Client report of a headache c. Client report of tinnitus d. Audible inspiratory stridor

d. Audible inspiratory stridor

A nurse is caring for a client who had total hip arthroplasty 1 day ago and is receiving morphine sulfate by PCA pump for pain control. The client reports nausea and vomiting. Which of the following actions should the nurse take? a. Insert a nasogastric tube. b. Administer an antiemetic. c. Encourage use of the incentive spirometer. d. Auscultate bowel sounds.

d. Auscultate bowel sounds.

A nurse is assessing a client who has a new diagnosis of systemic lupus erythematosus (SLE). The nurse should identify which of the following as a cutaneous manifestation of SLE? a. Facial pallor b. Muscle atrophy c. Foot ulcers d. Butterfly rash on face

d. Butterfly rash on face

A nurse is caring for a client who has Parkinson's disease and is taking diphenhydramine 25 mg PO TID. Which of the following therapeutic outcomes should the nurse expect to see? a. Delay in disease progression b. Improved bladder function c. Relief of depression d. Decreased tremors

d. Decreased tremors

The spouse of a client brought to the ED reports that 6 hours ago, her husband began having difficulty finding words. The client has since become progressively worse. Upon assessment, you note right hemiparesis and urine incontinence. Which of the following is the priority nursing intervention for this client at this time? a. Provide perineal care b. Assess for gag reflex c. Perform linen and gown change d. Elevate the head of the bed.

d. Elevate the head of the bed.

The nurse caring for Ms. Logan after the initiation of methotrexate therapy monitors for which clinical manifestation? The nurse caring for Ms. Logan after the initiation of methotrexate therapy monitors for which clinical manifestation? a. Decreased ESR b. Weight loss c. Weight gain d. Elevated liver enzymes

d. Elevated liver enzymes

A nurse is teaching a female client who has a new diagnosis of systemic lupus erythematosus (SLE). The nurse should recognize the need for further teaching when the client identifies which of the following as a factor that can exacerbate SLE? a. Sunlight b. Pregnancy c. Infection d. Exercise

d. Exercise

A nurse is assessing a client who has systemic lupus erythematosus (SLE). Which of the following findings should the nurse expect? a. Wrinkles in the skin b. Constipation c. Iritis d. Facial rash

d. Facial rash

Zachary White is a 29-year-old male driver involved in a head-on motor vehicle collision. He was ejected from his vehicle, and his right leg was trapped under the vehicle until the medics arrived on scene. He is awake, alert, and yelling from the severe pain in his right leg. Upon closer inspection, he has an open right femur fracture that is bleeding profusely and is missing a chunk of muscle. The EMS placed Zachary's right leg in a splint, started two large-bore IV lines, and transported him to the emergency department. Zachary's breath smells of alcohol, and his family member states that he was at a party. He has no past medical history and is not allergic to any medications. Zachary demonstrates classic symptoms of an open, displaced femur fracture. The emergency department provider immediately consults with the orthopedic surgeon, and 45 minutes later, Zachary is taken to the operating room. After significant irrigation of the open right femur fracture, the surgeon conducts an open reduction with placement of an external fixator. Zachary is admitted to the ortho floor from the operating room at 0600 in the morning. Frequent nursing assessments noting the six Ps are performed to assess neurovascular function. Laboratory testing to include serum myoglobin and CPK are ordered. His urine remains clear yellow, ruling out the presence of rhabdomyolysis. His pain is controlled with PO oxycodone. His provider's orders include the provision of adequate hydration and nutrition and an order for physical therapy to evaluate his readiness for exercise and ambulation using assistive devices. If he continues to improve, he will be discharged to home soon. Zachary has undergone placement of an external fixator for an open displaced femur fracture. Immediately following surgery, he begins to exhibit dyspnea, pleuritic chest pain, anxiety, and tachycardia. The nurse suspects which complication? a. Pneumothorax b. Myocardial infarction c. Deep vein thrombosis d. Fat embolism

d. Fat embolism

The spouse of a client brought to the ED reports that 6 hours ago, her husband began having difficulty finding words. The client has since become progressively worse. Upon assessment, you note right hemiparesis and urine incontinence. An hour later after a CT scan, the client is diagnosed with a left hemisphere stroke. The client is admitted to the acute medical unit after 7 hours. His wife asks if her husband will receive IV fibrinolytic therapy. What is the appropriate nursing response? a. Fibrinolytic agents must be administered within 6 to 6.5 hours of symptom onset b. The fibrinolytic agent will be given within the next 30 minutes c. Fibrinolytic agents will be administered to your husband in the morning d. Fibrinolytic agents must be administered within 3 to 4.5 hours of symptom onset

d. Fibrinolytic agents must be administered within 3 to 4.5 hours of symptom onset

A nurse is developing a teaching plan for a client who has psoriasis. Which of the following actions should the nurse include in the plan? a. Maintain occlusive dressings on the lesions throughout the day and remove them at bedtime. b. Eliminate the use of products containing salicylic acid. c. Avoid friction over scaly lesions while bathing. d. Identify effective stress reduction techniques.

d. Identify effective stress reduction techniques.

A nurse is caring for a client who had a stroke involving the left cerebral hemisphere. The nurse should monitor for which of the following findings? a. Impaired sense of humor b. Loss of depth perception c. Poor judgment d. Intellectual impairment

d. Intellectual impairment

Following the surgical procedure for an open displaced femur fracture, what action does the nurse frequently perform? a. ROM exercises b. Pain assessments c. Dressing changes d. Neurovascular assessments

d. Neurovascular assessments

A nurse is teaching about risk factors of developing a stroke with a group of older adult clients. Which of the following non-modifiable risk factors should the nurse include in the teaching? a. History of smoking b. Obesity c. History of hypertension d. Race

d. Race

A nurse is assessing a client prior to the administration of morphine. The nurse should recognize that which of the following assessments is the priority? a. Pupil reaction b. Urine output c. Bowel sounds d. Respiratory rate

d. Respiratory rate

A home health nurse is planning care for a client who has Alzheimer's disease. The client's partner is her primary caregiver and reports not having enough time to complete his errands. Which of the following referrals should the nurse plan to make? a. Hospice care b. Restorative care c. Mental health care d. Respite care

d. Respite care

A nurse is providing discharge teaching to a client who had a total hip arthroplasty. Which of the following information should the nurse include in the teaching? a. Use a twisting motion when turning to pick an object up. b. Cleanse the incision with hydrogen peroxide. c. Bend at the waist to put shoes on when sitting. d. Sit with legs apart at the ankles.

d. Sit with legs apart at the ankles.

A nurse is caring for a toddler who has a fractured right femur and is tin Bryant traction. When determining that the traction is appropriately assembled, the nurse should observe which of the following? a. Skin straps maintain the leg in an extended position. b. Weights are attached to a pin that is inserted into the femur. c. A padded sling is under the knee of the affected leg. d. The buttocks is elevated slightly off of the bed.

d. The buttocks is elevated slightly off of the bed.

A nurse is monitoring a client who took an overdose of acetaminophen 72 hr ago. The nurse should identify which of the following findings as a manifestation of acetaminophen poisoning? a. Constipation b. Xerostomia c. Tinnitus d. Vomiting

d. Vomiting

A nurse is providing teaching to a client who has psoriasis and a new prescription for the topical corticosteroid cream betamethasone valerate. Which of the following information should the nurse include in the teaching? a. The medication should be applied in a thick layer to completely cover the lesions. b. The medication should be applied every 2 hr. c. Rubbing the medication vigorously into the lesions will increase its absorption. d. Wrapping plastic around the site can increase the medication's effectiveness.

d. Wrapping plastic around the site can increase the medication's effectiveness.

A nurse is caring for a client who has a new diagnosis of systemic lupus erythematosus (SLE) and asks where this disease originates within the body. The nurse should tell the client that SLE originates in which of the following locations of the body? ​a. Muscle tissue ​b. Connective tissue c. Lymphatic system d. Peripheral vascular system

​b. Connective tissue