This sh*t is stup*d

अब Quizwiz के साथ अपने होमवर्क और परीक्षाओं को एस करें!

The nurse is instructing a patient for whom a positron emission tomography (PET) scan has been requested. Which statement indicates to the nurse that the patient understands the instructions? 1 "I will drink plenty of fluids after the test." 2 "It's okay to have a cup of coffee before the test." 3 "Because I am diabetic, I will take my insulin just before the test." 4 "I can continue to smoke cigarettes up to 2 hours before the test."

1

The nurse is performing a neurologic assessment on an 81-year-old patient. Which physiologic change does the nurse expect to find because of the patient's age? 1 Decreased coordination 2 Increased touch sensation 3 Stability in pain perception 4 Increased sleeping during the night

1

The nurse is providing care to a patient who states, "Things just don't taste like they used to." The nurse assesses impaired secretions of the lacrimal, submandibular, and sublingual salivary glands. Which cranial nerve may be damaged? 1 Facial 2 Vagus 3 Hypoglossal 4 Glossopharyngeal

1

The nurse provides care to an intubated adult patient with hypocarbia. Which finding does the nurse report immediately to the health care provider? 1 Nonreactive, dilated pupils 2 Body temperature 97.2 °F 3 Heart rate 101 bpm 4 pH of 8.3

1

Which gamma radiation destroys intracranial lesions selectively, without damaging the surrounding healthy tissues? 1 Cobalt-60 2 Cobalt-70 3 Cobalt-50 4 Cobalt-30

1

Which group has the least risk of developing osteomalacia? 1 Caucasian population 2 Lactose intolerant individuals 3 Long-term hospitalized patients 4 People following a strict vegan diet

1

A patient arrives at the emergency department after a motor vehicle accident and indirect injury to the head. Upon assessment, it is discovered that the patient's increased intracranial pressure (ICP) is 18 mm Hg. What is the priority nursing action? 1 Notify the health care provider. 2 Apply an ice pack to the patient's head. 3 Sit the patient up at a 45-degree angle. 4 Administer an antiinflammatory to the patient.

1

A student nurse is caring for an older adult who is recovering from hip replacement. The patient has recently spiked a high temperature and appears confused. For which complication should the nurse assess this patient? 1 Infection 2 Hemorrhage 3 Fat embolism 4 Hypovolemic shock

1

The nurse is doing a neurological assessment on a patient admitted to the emergency department. The patient reports having had a slight headache, speech deficits, confusion, and blurred vision. What does the nurse suspect is happening to the patient? 1 Formation of a blood clot 2 Bleeding into the brain tissue 3 Bleeding into the subarachnoid space 4 The break off particles from aggregated thrombi

1

The nurse is teaching a patient about taking etanercept for psoriatic arthritis. Which statement by the patient indicates that further teaching is needed? 1 "I'm comfortable self-administering etanercept." 2 "I will not take etanercept if I have an infection." 3 "I can use heat at the injection site if an itchy rash develops." 4 "If I get a respiratory infection, I will seek immediate care."

3

The nurse is teaching the spouse and patient who has had a brain attack (cerebrovascular accident) about rehabilitation. Which statement by the spouse demonstrates understanding of the nurse's instruction? 1 "Rehabilitation and physical therapy are the same thing." 2 "Frequent stimulation will help with the rehabilitation process." 3 "The rehabilitation therapist will help identify changes needed at home." 4 "My spouse will no longer need to take blood pressure medication."

3

The nurse is using auditory-evoked potentials to assess a patient. What is this technique meant to detect? 1 Loss of vision 2 Degenerating diseases 3 High-frequency hearing loss 4 Nerve and spinal cord damage

3

The nurse observes bleeding and synovial fluid leakage at the insertion site in a patient after arthrocentesis. Which nursing intervention is appropriate in this situation? 1 Administering an anticoagulant 2 Applying ice to the affected area 3 Notifying the health care provider 4 Applying a bandage after cleaning the area

3

The nurse plans to use which tool to measure joint range of motion (ROM)? 1 Doppler 2 Tonometer 3 Goniometer 4 Reflex hammer

3

The nurse prepares to assess a patient with diabetes mellitus for sensory loss. Which equipment does the nurse use to perform this assessment? 1 Hammer 2 Glucometer 3 Cotton-tipped applicator 4 Nothing; the patient is asked to walk

3

The nurse provides a patient with information about how to prevent osteomalacia. Which statement made by the patient indicates the need for further teaching? 1 "I should take vitamin D supplements daily." 2 "I should include dairy products in my diet." 3 "I should exclude chicken and swordfish from my diet." 4 "I should expose myself to sunlight for at least 5 minutes a day."

3

The nurse suspects a patient has a brain tumor. What noninvasive test is most likely to be ordered to validate the presence of a brain tumor? 1 Skull x-rays 2 Computer tomography (CT) scan 3 Magnetic resonance imaging (MRI) scan 4 Magnetic resonance angiogram (MRA) scan

3

The nurse teaches a group of people in the community about traumatic brain injury (TBI) prevention. Which patient does the nurse identify as being most at risk for a TBI? 1 A 17-year-old who enjoys dancing 2 A 46-year-old diagnosed with osteoporosis 3 A 72-year-old who recently got a new pacemaker 4 A 28-year-old who plays in a company softball league

3

The patient is admitted with a diagnosis of stroke in the right cerebral hemisphere. Upon assessment, which primary deficit does the nurse expect to find? 1 Worsening aphasia 2 Agraphia 3 Impaired proprioception 4 Alexia

3

The patient who is diagnosed with severe psoriatic arthritis is scheduled to receive an oral retinoid medication. Which medication will the nurse anticipate administering to the patient? 1 Alefacept 2 Golimumab 3 Acitretin 4 Ustekinumab

3

The primary health care provider prescribes a medication to a patient with osteoarthritis. During the follow-up visit, the patient reports dark tarry stools and indigestion. Which medication may be the cause of this finding? 1 Cortisone 2 Lidoderm 3 Ibuprofen 4 Hyaluronatev

3

What does it mean if the patient has an indirect traumatic brain injury (TBI)? 1 Force was applied directly to the patient's head. 2 Force was applied to the head by an object or tool, not another body part. 3 Force was applied to another body part, but the brain was still affected. 4 Force was applied to the brain due to an accident and not an intentional injury.

3

What imaging test is best used to confirm brain death? 1 Radiography 2 Ultrasonography 3 Cerebral angiography 4 Electrocardiography

3

When caring for a patient who takes methotrexate, which laboratory data is most important for the nurse to monitor? 1 Glucose 2 Potassium 3 Complete blood count (CBC) 4 White blood cells (WBCs)

3

Which area of the brain's cerebral lobe is important for singing or playing musical instruments? 1 Limbic lobe 2 Frontal lobe 3 Parietal lobe 4 Temporal lobe

3

Which characteristic is associated with gel phenomenon? 1 Bony ankylosis 2 Fibrous adhesions 3 Morning stiffness 4 Secondary osteoporosis

3

Which condition may be detected by using the drop arm test? 1 Tendinopathy 2 Joint dislocation 3 Rotator cuff injury 4 Carpal tunnel syndrome (CTS)

3

Which drug is a bisphosphonate that is approved by the Food and Drug Administration (FDA) and is commonly used for the prevention and treatment of osteoporosis? 1 Raloxifene 2 Tiludronate 3 Ibandronate 4 Zoledronic acid

3

Which drug is considered an antithrombotic? 1 Warfarin 2 Heparin 3 Clopidogrel 4 Nimlodipine

3

Which drug is used to treat a brain tumor in a patient? 1 Codeine 2 Phenytoin 3 Lomustine 4 Dexamethasone

3

Which drug should be prescribed for increased intracranial pressure in a patient? 1 Phenytoin 2 Acetaminophen 3 Dexamethasone 4 Dexmedetomidine

3

Which fracture is most likely to be treated with implantation of a genetically engineered substance? 1 Skull 2 Wrist 3 Spine 4 Clavicle

3

Which injury is characterized by a fractured skull? 1 Diffuse injury 2 Deceleration injury 3 Open traumatic brain injury 4 Closed traumatic brain injury

3

Which is an example of a flat bone that protects the vital organs? 1 Femur 2 Patella 3 Scapula 4 Phalange

3

Which part of the body does the hallux valgus deformity affect? 1 Hand 2 Wrist 3 Foot 4 Ankle

3

Which part of the brain contains the aqueduct of Sylvius? 1 Pons 2 Medulla 3 Midbrain 4 Cerebrum

3

Which part of the pelvis is non-weight-bearing? 1 Sacrum 2 Pelvic ring 3 Pubic rami 4 Acetabulum

3

Which statement about brain abscesses is correct? 1 The white blood cell (WBC) count is decreased if a brain abscess is present. 2 Magnetic resonance imaging (MRI) cannot detect an abscess in its early stage. 3 An electroencephalogram (EEG) shows electro-cerebral silence in the area of abscess. 4 The erythrocyte sedimentation rate (ESR) is decreased if a brain abscess is present.

3

Which statement about gene mutations is correct? 1 Gene mutations are rare in the base sequence of very large genes. 2 Point mutation refers to deletion of the base at a single point of the DNA. 3 Mutations are DNA changes that are passed from one generation to another. 4 "Wild-type gene" refers to a gene that has undergone major mutations.

3

Which statement indicates to the nurse that a patient with fibromyalgia syndrome is using a complementary therapy to help relieve symptoms? 1 "My Thera-Band really helps me loosen up my arms." 2 "The brace on my lower leg is helping me walk better." 3 "Focusing on the slow stretching movements and my breathing in tai chi helps me relax." 4 "Water aerobic exercises have helped me sleep better."

3

Which statement is true regarding systemic sclerosis? 1 It involves pancytopenia. 2 It is characterized by nephritis. 3 It is also called progressive systemic disease. 4 It is also called chronic progressive inflammatory connective tissue disorder.

3

Which statement made by the patient indicates effective learning about self-management of systemic sclerosis? 1 "I will eat three large meals each day." 2 "I will include coffee in my daily diet." 3 "I will not drink large amounts of liquids." 4 "I will take a nap immediately after eating meals."

3

Which stroke syndrome includes personality and behavior changes? 1 Middle cerebral artery 2 Internal carotid artery 3 Anterior cerebral artery 4 Vertebrobasilar artery

3

Which substance is prevented from crossing the blood brain barrier (BBB)? 1 Alcohol 2 Glucose 3 Antibiotic 4 Anesthesia

3

Which term describes a benign tumor arising from cartilage? 1 Osteosarcoma 2 Giant cell tumor 3 Endochondroma 4 Osteochondroma

3

Which type of disorder is fibromyalgia syndrome (FMS)? 1 Autoimmune 2 Inflammatory 3 Chronic pain 4 Connective tissue

3

Which type of fracture does not divide the bone into two portions because the break is through only part of the bone? 1 Fragility 2 Complete 3 Incomplete 4 Compression

3

Which type of fracture extends through the skin? 1 Displaced 2 Greenstick 3 Compound 4 Comminuted

3

Which type of fracture has the highest incidence in young and young middle-aged adults? 1 Rib fractures 2 Humeral fractures 3 Femoral shaft fracture 4 Proximal femoral fractures

3

Which type of fracture is seldom immobilized by casting and requires surgical treatment with nails, rods, or screws? 1 Ankle 2 Tib-fib 3 Femoral 4 Phalangeal

3

Which voluntary muscle is controlled by the central and peripheral nervous system? 1 Smooth 2 Cardiac 3 Skeletal 4 Nonstriated

3

While assessing a patient with systemic lupus erythematosus, the nurse finds that the patient has chest pain. Which is the appropriatenursing intervention? 1 Administering analgesics 2 Providing comfort measures 3 Reporting to the primary health care provider 4 Notifying to primary health care provider as a common observation

3

While attending to a couple who are planning to have a baby, the nurse learns that a family member has a history of sickle cell disease. The nurse recommends that the couple undergo carrier testing. What is the purpose of carrier testing? 1 To confirm diagnosis of sickle cell disease in either of them. 2 To know whether they are predisposed to the disease. 3 To determine if they are carriers of the disease. 4 To determine risk of inheriting an untreatable genetic disorder.

3

A patient is in traction after a major leg injury. What nursing care is necessary for the patient? Select all that apply. 1 Inspect the skin every 14 hours 2 Remove the belt used for traction once in a day 3 Ensure the weights are freely hanging at all times 4 Inspect the traction equipment every 8 to 12 hours 5 Monitor circulation every 4 hours after traction is applied

3, 4

Which dietary supplements may be prescribed specifically to a patient with osteoarthritis (OA)? Select all that apply. 1 Iron 2 Garlic 3 Chondroitin 4 Glucosamine 5 Niacin

3, 4

A patient with suspected rheumatoid arthritis had an arthrocentesis. Which components present in the synovial fluid would indicate rheumatoid arthritis? Select all that apply. 1 Platelets 2 Red blood cells 3 Immune complex 4 Inflammatory cells 5 Rheumatoid factor

3, 4, 5

The nurse is caring for a patient exhibiting symptoms of dementia. The patient's condition is deteriorating. Which nursing interventions are the nurse's priority? Select all that apply. 1 Recommending physical exercise. 2 Instructing the patient to follow a nutritious diet. 3 Ensuring the patient's bedroom is quiet at night. 4 Employing memory aids like using alarms and notes. 5 Helping the patient stay on a regular sleep schedule.

3, 5

A patient with plantar fasciitis reports increasing pain. Inflammation is observed during the patient's physical assessment of the foot. According to the patient and the medical record, the patient has tried treating the condition with nonsteroidal antiinflammatory drugs and steroids, but all measures have been unsuccessful. The patient does not want endoscopic surgery to remove the inflamed tissue. What else can the nurse suggest to the patient for possible relief and comfort? Select all that apply. 1 Doing stretching exercises 2 Resting and icing the foot 3 Wearing shoes with orthotics 4 Soaking the foot in hot water 5 Wrapping the foot in a bandage

1, 2, 3

The nurse is caring for a 75-year old patient with dementia and disrupted sleep. Which nursing interventions are beneficial to the patient? Select all that apply. 1 Recording sleeping habits 2 Keeping environmental noise low 3 Following a regular sleeping schedule 4 Talking to the patient until he or she falls asleep 5 Changing the patient's bedtime every two days

1, 2, 3

Which diseases are associated with arthritis? Select all that apply. 1 Tuberculosis 2 Crohn's disease 3 Diabetes mellitus 4 Hyperparathyroidism 5 Congestive heart failure 6 Chronic obstructive pulmonary disease

1, 2, 3, 4

Which topics are included in patient teaching following a leg amputation? Select all that apply. 1 How to wrap the limb 2 Range-of-motion exercises 3 How to turn independently if possible 4 Exercises to prepare the limb for prosthesis 5 Appropriate application of ice packs and heating pads 6 How to inspect the area for signs of inflammation or skin breakdown

1, 2, 3, 4, 6

Which actions should the nurse take when counseling a patient who is scheduled for genetic testing? Select all that apply. 1 Establish a trusting relationship. 2 Obtain an informed consent form. 3 Assess current use of medications. 4 Construct a two-generation pedigree. 5 Assess the mental status of the patient.

1, 2, 3, 5

Which are advantages of stereotactic radiosurgery (SRS)? Select all that apply. 1 Noninvasive 2 Decreased cost 3 Surgical precision 4 Increased morbidity 5 Rapid recovery time 6 Increased length of hospitalization

1, 2, 3, 5

After reviewing the medical reports of a patient with systemic sclerosis, the nurse concludes limited cutaneous systemic sclerosis. Which findings would support this conclusion? Select all that apply. 1 Calcinosis 2 Sclerodactyly 3 Pancytopenia 4 Raynaud's phenomenon 5 Bilateral carpal tunnel syndrome

1, 2, 4

What are the risk factors for primary osteoporosis? Select all that apply. 1 Parental history of osteoporosis 2 Thin build with low body weight 3 Long-term corticosteroid drug therapy 4 Chronic low calcium and vitamin D intake 5 Immobilization of a limb following a fracture

1, 2, 4

A patient has recently undergone surgery to treat osteomyelitis. What are the signs of neurovascular compromise after the surgery? Select all that apply. 1 Paresthesia 2 Pulselessness 3 Purulent discharge 4 Uncontrollable pain 5 Paresis or paralysis 6 Presence of erythema

1, 2, 4, 5

The nurse has just provided teaching to a patient who is taking methotrexate. Which side effects does the patient identify to indicate effective teaching? Select all that apply. 1 Fever 2 Dyspnea 3 Dysphagia 4 Mouth sores 5 Constipation 6 Yellow sclera

1, 2, 4, 6

The nurse is caring for a patient who has a tumor on the brainstem. Which signs and symptoms may be present with brainstem tumors? Select all that apply. 1 Hoarseness 2 Apnea 3 Headache 4 Hearing loss 5 Aphasia 6 Bradycardia

1, 2, 4, 6

A parent of a child reports to the nurse, "My child is inactive, inattentive, and has disrupted sleep since the accident." Which part of the brain may have been affected in the child? 1 Pons 2 Medulla 3 Midbrain 4 Reticular activating system (RAS)

4

A patient experienced a stroke that caused damage to Broca's area. The nurse expects the patient to experience what phenomenon as a result of this injury? 1 Stuttering 2 Dysarthria 3 Receptive aphasia 4 Expressive aphasia

4

Which anti-rheumatic drugs are associated with allergic response after administration? Select all that apply. 1 Rituximab 2 Abatacept 3 Tocilizumab 4 Golimumab 5 Adalimumab

1, 2, 5

A patient is being discharged home after surgery for brain cancer. Which statement by the patient's spouse indicates a correct understanding of the nurse's discharge teaching? 1 "Life will be back to normal soon." 2 "The case manager will provide home care." 3 "I will have to quit my job to care for my spouse." 4 "We can find a support group through the local American Cancer Society."

4

The nurse is preparing a patient who underwent vertebroplasty for discharge. What measures should the patient take after discharge? Select all that apply. 1 Walking the next day after discharge 2 Removing the dressing after 12 hours 3 Monitoring of the puncture site for infection 4 Avoiding driving for 12 hours after discharge 5 Avoiding operating heavy machinery for 16 hours after discharge

1, 3

Which substances does brain functioning require continuously because the brain does not have the ability to store them? Select all that apply. 1 Oxygen 2 Sodium 3 Glucose 4 Serotonin 5 Potassium 6 Acetylcholine

1, 3

During the skin assessment of a patient, the nurse finds a "butterfly" rash. What diagnostic tests would the primary health care provider order to confirm the diagnosis? Select all that apply. 1 Immunoglobulins 2 Serum creatinine levels 3 Blood urea nitrogen (BUN) 4 Serum protein electrophoresis 5 Erythrocyte sedimentation rate (ESR)

1, 4, 5

In order to provide emotional support, which referrals should the nurse include in the plan of care for a patient? Select all that apply. 1 Spiritual leader 2 Anesthesiologist 3 Physical therapist 4 Religious leader 5 Psychological counselor

1, 4, 5

A patient who has undergone total hip arthroplasty is advised to do exercises. Which action made by the patient indicates a quadriceps-setting exercise? 1 Pushing the heels into the bed 2 Bending the knees to 100 degrees 3 Crossing the legs beyond the midline of the body 4 Straightening the legs and pushing the back of the knees into the bed

4

A patient with a brain tumor is experiencing increased intracranial pressure (ICP) resulting from obstruction of the flow of cerebral spinal fluid. What is this complication called? 1 Tinnitus 2 Decorticate 3 Decerebrate 4 Hydrocephalus

4

A patient with a brain tumor is prescribed lansoprazole (Prevacid). What is the purpose of lansoprazole for this patient? 1 To control nausea and vomiting 2 To decrease the blood pressure 3 To increase gastric acid secretion 4 To prevent development of stress ulcers

4

A patient is diagnosed with systemic necrotizing vasculitis. Which assessment finding will the patient demonstrate? 1 Severe muscle weakness 2 Necrosis of toes 3 Difficulty swallowing 4 Periorbital edema

2

A patient with a fracture asks the nurse about the difference between a compound fracture and a simple fracture. Which statement by the nurse is correct? 1 "Compound fracture does not extend through the skin." 2 "Simple fracture is accompanied by damage to the blood vessels." 3 "Simple fracture involves a break in the bone, with skin contusions." 4 "Compound fracture involves a break in the bone, with damage to the skin."

4

How often should the nurse assess the patient's neurologic status and vital signs in the first four to six hours following craniotomy? 1 Once every hour 2 Every 1 to 2 hours 3 Every 5 to 15 minutes 4 Every 15 to 30 minutes

4

In assessing a patient who is unconscious, what care does the nurse take when applying painful stimuli using the sternal rub? 1 Apply the sternal rub for not more than a minute. 2 Avoid the use of the sternal rub in younger patients. 3 Avoid stimuli if the patient does not respond to supraorbital pressure. 4 Use the sternal rub if the patient does not respond to mandibular pressure.

4

In which type of sarcoma does the patient experience dull pain and swelling for a long period of time? 1 Fibrosarcoma 2 Osteosarcoma 3 Ewing's sarcoma 4 Chondrosarcoma

4

Neurologic changes associated with aging and vision include the need for additional light. What is the pathophysiology underlying this change? 1 Corneal drying 2 Thinning of the lens 3 Conjunctival swelling 4 Decrease in pupil size

4

The nurse instructor is teaching nursing students about the structure of a bone. What statement made by a student indicates a need for further instruction? 1 "The shaft of the long bone is called the diaphysis." 2 "Trabeculae are filled with red and yellow bone marrow." 3 "The knoblike end of the long bone is called the epiphysis." 4 "The haversian canals run horizontally within the cortical bone."

4

The nurse is assessing a patient to evaluate the movements of the wrist. What movement does the nurse assess? Incorrect1 Rotation 2 Circumduction 3 Eversion and inversion Correct4 Pronation and supination

4

A patient who has experienced symptoms consistent with a transient ischemic attack (TIA) refuses to go to the emergency department because the symptoms resolved at home. Which statement would the clinic nurse make over the phone to convince the patient to seek care? 1 "Symptoms of TIA resolve in a few hours." 2 "Your condition could progress to a stroke." 3 "A single TIA will cause permanent brain damage." 4 "Only repeated attacks can cause significant damage."

2

A patient who sustained a transient ischemic attack (TIA) is admitted to the emergency department. The nurse is teaching the student nurse about methods to prevent another TIA. Which statement made by the student nurse indicates a need for further teaching? 1 "Aspirin should be given to the patient." 2 "The patient should be placed on a liquid diet." 3 "Antihypertensive medications should be given to the patient." 4 "Oral hypoglycemic medications should be given to the patient."

2

A patient with acute gout is prescribed colchicine. Which drug is usually added to the prescription? 1 Febuxostat 2 Ibuprofen 3 Allopurinol 4 Probenecid

2

A patient with osteoarthritis wants to use capsaicin cream. Which information should the nurse provide to the patient? 1 "You may have drowsiness for a short period after applying it." 2 "You may have a burning sensation for a short period after applying it." 3 "You may have increased blood pressure for a short period after applying it." 4 "You may have increased blood sugar levels for a short period after applying it."

2

A patient with rheumatoid arthritis reports pain when chewing and opening the mouth. Which joint involvement does the nurse suspect in this patient? 1 Cervical 2 Temporomandibular 3 Metacarpophalangeal 4 Proximal interphalangeal

2

A patient with systemic lupus erythematosus reports abdominal pain to the nurse. What could be a possible cause for this condition? 1 Presence of arteritis 2 Presence of serositis 3 Presence of myositis 4 Presence of vasculitis

2

A registered nurse is providing care for a patient admitted with status epilepticus who has a recent history of craniotomy. What is a craniotomy? 1 Stereotactic radiosurgery 2 An incision into the cranium 3 Placement of a wafer into the cranium 4 Placement of a catheter into the cerebral ventricle

2

A surgical repair was done shortly after injury in a patient with a rotator cuff injury using arthroscopy. What could a presurgical magnetic resonance imaging (MRI) of the shoulder reveal? 1 Muscular atrophy 2 Full-thickness tear 3 Fatty replacement 4 Partial-thickness tear

2

After assessing a patient with osteoarthritis, the nurse suspects crepitus. Which finding supports the nurse's assessment? 1 Inflammation near the joint 2 Grating heard when the joint is palpated 3 Enlarged joint with bone hypertrophy 4 Bony nodules at the distal interphalangeal joint

2

An 80-year-old patient experiencing severe pain in the lower jaw is diagnosed with acute osteomyelitis. Which symptom may be leastlikely found? 1 Severe throbbing pain 2 Body temperature of 102°F 3 Swelling of the affected region 4 Erythema of the affected region

2

An 80-year-old patient with uncontrolled hypertension reports pain in the right foot and is diagnosed with a hallux valgus deformity. What is the most appropriate treatment? 1 Bunionectomy 2 Custom-made shoes 3 Osteotomy of the bunion 4 Stabilization of bone using screws

2

An older adult patient is undergoing treatment for a fracture. Which pain medication must be avoided in this patient? 1 Morphine 2 Meperidine 3 Oxycodone 4 Oxycodone with acetaminophen

2

Before administering prednisone IV push to a middle-aged adult with rheumatoid arthritis (RA), the nurse notes that the patient's random blood glucose level is 139. Which action is most important for the nurse to take? 1 Instruct the patient to drink diet soda to prevent elevation of blood sugar. 2 Administer the prescribed prednisone on schedule. 3 Notify the health care provider of the random blood glucose result. 4 Review the patient's antinuclear antibody (ANA) level.

2

The incidence of what type of fracture is highest in older adults? 1 Rib 2 Hip 3 Wrist 4 Femoral shaft

2

The nurse is caring for a patient with prostate cancer who has bone metastasis. The nurse anticipates that the health care provider will prescribe which medication? 1 Calcitonin 2 Pamidronate 3 Medroxyprogesterone 4 Tamsulosin hydrochloride

2

The nurse is discussing treatment options with a patient who has a bunion. The patient is not a candidate for surgery. What does the nurse discuss with the patient? 1 Taking antibiotic medication to treat the infection 2 Getting custom shoes made to fit the deformity 3 Waiting it out for the bunion to go away on its own 4 Removing the sliver of nail stuck in the skin of the toe

2

The nurse is assessing a patient with a traumatic brain injury (TBI) after a skateboarding accident. Which symptom would concern the nurse the most? 1 Amnesia 2 Restlessness 3 Head laceration 4 Asymmetrical pupils

4

The nurse is teaching a patient with fibromyalgia. Which statement by the patient indicates that further teaching is needed? 1 "I swim because it is a low-impact exercise." 2 "I will experience increased alertness due to pregabalin." 3 "I will do stretching and strengthening exercises daily." 4 "I take a muscle relaxant to decrease my pain."

2

The nurse is caring for a patient diagnosed with breast cancer. The nurse suggests genetic testing for the immediate family members of the patient. What are the benefits of genetic testing? 1 Refers for counseling 2 Prevents occurrence of the disease 3 Provides health insurance coverage 4 Detects cancer before symptoms appear

4

The nurse is preparing a patient with osteoarthritis for self-management. What does the nurse tell the patient about exercising? 1 Use passive exercise more often than active exercise. 2 Maintain the number of repetitions of each exercise. 3 Avoid medication for mild pain. 4 Avoid resistive exercises when the joints are inflamed.

4

The nurse is providing discharge instructions to a patient who underwent total hip arthroplasty. Which instruction is most beneficial upon discharge of the patient? 1 Twist the body slowly while standing. 2 Bend the hips no more than 110 degrees. 3 Cross the legs beyond the body midline. 4 Use assistive devices for putting on shoes.

4

The nurse reads the patient's health record and sees that the patient's brain is contused. What does the nurse infer from this? 1 The patient's brain is torn. 2 The patient's brain is bruised. 3 The patient has a shearing injury. 4 The patient had a direct injury.

2

What should be the first intervention for a patient with systemic lupus erythematosus (SLE) when there is severe renal involvement? 1 Prepare the patient for plasmapheresis. 2 Administer immunosuppressants and steroids. 3 Prepare the patient for kidney transplantation. 4 Administer high doses of intravenous glucocorticoids.

2

What teaching does the nurse provide to a patient who had outpatient surgery for hallux valgus? 1 Apply a pressure dressing. 2 Wear an orthopedic boot or shoe. 3 Healing takes place within a week. 4 Avoid walking until healing takes place.

2

What would be the best nursing intervention for a patient who presents with a callus? 1 Application of antibiotic ointments 2 Padding and applying lanolin creams 3 Surgical removal of the skin by podiatrist 4 Surgical removal of necrotic nail and skin

2

When diagnosing carpal tunnel syndrome (CTS), which test will the provider perform? 1 Paresthesia 2 Phalen test 3 Capillary refill 4 Drop arm test

2

Where does the cerebrospinal fluid (CSF) circulate? 1 The space between the skull and dura mater 2 The space between the pia mater and arachnoid 3 The space between the pia mater and dura mater 4 The space between the arachnoid and dura mater

2

Which diagnostic technique is used to measure the integrity of the cerebral vessels in a patient who sustained a traumatic brain injury? 1 Radiography 2 Ultrasonography 3 Electrocardiogram 4 Electroencephalography

2

Which drug is contraindicated for a patient with rheumatoid arthritis and multiple sclerosis? 1 Celecoxib 2 Infliximab 3 Methotrexate 4 Hydroxychloroquine

2

Which drug is given to a patient as an option to prevent early-onset seizure activity that may occur with some types of specific brain injuries? 1 Propofol 2 Phenytoin 3 Furosemide 4 Dexmedetomidine

2

Which drug is often used as adjunctive therapy to reduce the incidence of rebound from mannitol? 1 Propofol 2 Furosemide 3 Osmotic diuretic 4 Dexmedetomidine

2

Which drug is often used for treating systemic lupus erythematosus (SLE) with severe renal involvement? 1 Lupuzor 2 Cyclophosphamide 3 Belimumab 4 Acetaminophen

2

Which factor has been shown to delay stroke intervention? 1 Age 2 Gender 3 Ethnic background 4 Religious affiliation

2

Which factor indicates to the nurse the only similarity between discoid lupus erythematosus (DLE) and systemic lupus erythematosus (SLE)? 1 Feeling tired and having a temperature that runs about 100° F (37.8° C) during the day 2 Disfiguring and embarrassing rash 3 Peripheral neuropathies and cranial nerve palsies 4 High risk for renal inflammation

2

Which finding helps in assessing the motor changes of a patient with carpal tunnel syndrome (CTS)? 1 Nail brittleness 2 Muscle weakness 3 Skin discoloration 4 Increased hand sweating

2

Which genitourinary manifestation may occur in fibromyalgia syndrome? 1 Dyspnea 2 Pelvic pain 3 Constipation 4 Abdominal pain

2

Which hemorrhage results from venous bleeding into the space beneath the dura and above the arachnoid? 1 Epidural hematoma 2 Subdural hematoma 3 Intracerebral hemorrhage 4 Subarachnoid hemorrhage

2

Which injury is caused by an external force contacting the head, suddenly placing the head in motion? 1 Deceleration injury 2 Acceleration injury 3 Open traumatic brain injury 4 Closed traumatic brain injury

2

Which is a clinical manifestation of brainstem tumors? 1 Aphasia 2 Dysphagia 3 Paresthesia 4 Hyperesthesia

2

Which lifestyle change would benefit a patient who has osteoporosis? 1 Jogging 2 Walking 3 Running 4 Swimming

2

Which patient complication is most commonly associated with dysphagia? 1 Choking 2 Aspiration 3 Vomiting 4 Respiratory arrest

2

Which statement provides the most accurate piece of information about sex-linked recessive patterns of inheritance? 1 It is an X-linked dominant disorder. 2 It is more common in male children. 3 It can be passed down from the father to the son. 4 It is also passed on by mothers who are carriers for the gene to the child.

2

Which terms are related to a closed traumatic brain injury? Select all that apply. 1 Linear fracture 2 Laceration injury 3 Contusion injury 4 Contrecoup injury 5 Depressed fracture

2, 3, 4

A patient is brought to the emergency department with aphasia and right-sided hemiplegia. The nurse suspects a stroke in which area of the brain? 1 Brainstem 2 Cerebellum 3 Left cerebral hemisphere 4 Right cerebral hemisphere

3

A patient is diagnosed with osteoarthritis (OA). Which medication is considered the primary drug of choice for treatment? 1 Methotrexate (MTX) 2 Adalimumab 3 Acetaminophen 4 Leflunomide

3

A patient is intubated and cannot talk. What is the best possible Glasgow Coma score for this patient? 1 5t 2 7t 3 11t 4 15t

3

A patient who has severe peripheral vascular disease resulting in an above-the-knee amputation two months ago describes intense burning pain, numbness and tingling. The patient reports the symptoms worsen with exhaustion and stress. What is the patient most likely experiencing? 1 Infection 2 Neuroma 3 Phantom limb pain 4 Flexion contractures

3

A patient who recently suffered a broken tibia presents with edema, a great deal of pain, pale skin, and a weakened pulse. Upon palpation, the area is noted to be tense. What is most likely the concern? 1 Delayed union 2 Fat embolism syndrome 3 Acute compartment syndrome 4 Complex regional pain syndrome

3

What actions does the nurse perform to assess the sensory function of a patient with a spinal cord problem? Select all that apply. 1 The patient keeps the eyes open during the test. 2 The patient is shown the object before the assessment. 3 A cold reflex hammer is used to distinguish temperature. 4 The patient identifies sharp and dull touch in random sequence. 5 Two places on the same extremity are touched with two objects.

2, 3, 4, 5

A patient with a family history of ovarian cancer asks about the risk of developing the disorder. Which diagnostic test does the nurse identify as being the most helpful for this patient? 1 Carrier testing 2 Symptomatic testing 3 Predisposition testing 4 Presymptomatic testing

3

A patient with a head injury is admitted in the health care facility and reports a loss of perception from the skin and scalp and difficulty chewing. Which nerve does the nurse suspect to be damaged? 1 Facial nerve 2 Abducens nerve 3 Trigeminal nerve 4 Hypoglossal nerve

3

A patient with rheumatoid arthritis says to the nurse, "My eyes feel gritty." Further assessment reveals that the patient also has redness in the eyes and no tears. What does the nurse suspect in this patient? 1 Felty's syndrome 2 Caplan's syndrome 3 Sjogren's syndrome 4 Carpel tunnel syndrome

3

Abuse of which substance is most likely to result in a hemorrhagic stroke? 1 Heroin 2 Nicotine 3 Cocaine 4 Marijuana

3

A patient is at risk for a genetically inherited disorder and is advised genetic testing. Which nursing actions are appropriate? Select all that apply. 1 Encouraging the patient to agree to be tested 2 Referring the patient to any appropriate support groups 3 Asking the patient whether an agency is insisting on the testing 4 Verifying that the patient's family members have signed consent 5 Inquiring privately about the patient's wishes regarding genetic testing

2, 3, 5

The nurse is assessing a patient with a fracture of the upper arm. How does the nurse conduct the assessment? Select all that apply. 1 Elevates the extremity 2 Compares the upper extremities 3 Asks about the cause of the fracture 4 Places the patient in a supine position 5 Supports the affected arm and flex the elbow

2, 3, 5

What patient education should be provided to a patient with psoriatic arthritis who is prescribed etanercept? Select all that apply. 1 Etanercept contains a black box warning. 2 Etanercept should be self-administered cautiously. 3 Etanercept cannot be given as combination therapy. 4 Respiratory infections are the common adverse effects of etanercept. 5 Hydrocortisone cream should be used to prevent rash at the etanercept injection site.

2, 4

Which statements about afferent neurons are correct? Select all that apply. 1 They are also known as motor neurons. 2 They are also known as sensory neurons. 3 They send impulses away from the CNS. 4 They send impulses toward the central nervous system (CNS). 5 They send impulses toward the peripheral nervous system (PNS).

2, 4

When performing a physical assessment, the nurse notices the patient has an ingrown toenail. What does the nurse advise the patient? Select all that apply. 1 "Proper toenail trimming is important for avoiding plantar fasciitis." 2 "When you do not trim your nails the right way, you can get a secondary infection." 3 "Ingrown toenails can lead to further problems, such as calluses and corns." 4 "Sometimes with ingrown toenails, the necrotic nail will have to be removed surgically." 5 "It is important for you to trim your nails properly so that you do not get chronic hypertrophy of the nail lip."

2, 4, 5

Alteplase should be given within how many hours from the onset of symptoms of stroke? 1 6 2 12 3 4.5 4 1.5

3

An older adult patient has had a right open reduction and internal fixation (ORIF) of a fractured hip. Which intervention does the nurse implement for this patient? 1 Prohibit the use of antiembolic stockings 2 Re-position the patient every 3 to 4 hours 3 Keep the patient's heels off the bed at all times 4 Administer preventive pain medication before deep-breathing exercises

3

Assessment findings reveal that an older adult patient with severe osteoarthritis of the left hip can no longer perform activities of daily living (ADLs) and has had several falls in the home over the past month. To which community resource does the nurse refer the patient? 1 Local senior citizen center 2 Citizens for Better Care 3 Home health care agency 4 Meals on Wheels

3

How is Dowager's hump formed? 1 Lordosis of the spine 2 Scoliosis of the spine 3 Kyphosis of the spine 4 Kyphoscoliosis of the spine

3

In which stage of bone healing is callus formed? 1 Stage one 2 Stage two 3 Stage three 4 Stage four

3

In young adults, which is the most commonly occurring upper extremity fracture? 1 Phalangeal fracture 2 Metacarpal fracture 3 Distal radius fracture 4 Proximal humerus fracture

3

Sensation that is felt in an amputated part immediately after surgery is known as which of the following? 1 Neuroma 2 Chronic limb pain 3 Phantom limb pain 4 Flexion contracture

3

The daughter of a patient who has had a stroke asks the nurse for additional resources. What is the nurse's best response? 1 "Call hospice." 2 "Check the Internet." 3 "Go to the National Stroke Association website." 4 "The charge nurse at the desk has all of the information.

3

Which teaching about prevention of carpal tunnel syndrome (CTS) will the nurse provide to other health care employees? Select all that apply. 1 Employees should work for long stretches in front of their computers. 2 Employees should be provided with specially designed wrist rest devices. 3 Employees should not stretch fingers and wrists frequently during work hours. 4 Employees should be provided with geometrically designed computer keyboards. 5 Employees should be provided with chairs at a height that facilitates good posture.

2, 4, 5

The nurse assesses a middle-aged female patient. Which statement made by the patient causes the nurse to teach the patient about preventing hallux valgus? 1 "I carry around a heavy purse." 2 "I only exercise once or twice a week." 3 "I wear high heels to work every day." 4 "I sleep five hours a night and feel tired a lot."

3

The nurse is receiving a report from the emergency department nurse about a patient being admitted who is able to speak but unable to comprehend. Which area of the brain may have been affected? 1 Occipital 2 Limbic lobe 3 Frontal lobe 4 Temporal lobe

4

The nurse is reviewing the laboratory reports of four female patients. The nurse expects that which patient will require further testing for rheumatoid arthritis? 1 Patient A 2 Patient B 3 Patient C 4 Patient D

4

The nurse is reviewing the medication history for a patient diagnosed with rheumatoid arthritis (RA) who has been ordered to start sulfasalazine therapy. The nurse plans to contact the health care provider if the patient has which condition? 1 Glaucoma 2 Hypertension 3 Hypothyroidism 4 Sulfa allergy

4

The nurse is scoring patients on the Glasgow Coma Scale. Which patient care will the nurse prioritize over others? 1 Patient A 2 Patient B 3 Patient C 4 Patient D

4

The nurse is teaching a group of nursing students about venous thromboembolism (VTE). What statement made by a participant indicates a need for further instruction? 1 "Chemotherapy may cause VTE." 2 "Oral contraceptives may cause VTE." 3 "Smoking and immobility can cause VTE." 4 "Surgery lasting at least 1 hour can cause VTE."

4

Which instructions would the nurse give to a patient with osteoporosis who has been prescribed alendronate? Select all that apply. 1 Lie down and rest if dizziness or leg cramps occur. 2 Take the medication early in the morning with 8 ounces of water. 3 Take the prescribed doses orally once every 3 months. 4 Remain upright for 30-60 minutes after taking the medication. 5 Schedule liver function tests regularly while on this medication. 6 Discontinue the medication if chest discomfort develops.

2, 4, 6

The nurse has just received change-of-shift report about a group of patients on the neurosurgical unit. Which patient would the nurse see first? 1 Young adult patient involved in a motor vehicle crash (MVC) who is yelling obscenities at the nursing staff 2 Adult postoperative left craniotomy patient whose hand grips are weaker on the right 3 Middle-aged adult patient who had a cerebral aneurysm clipping and is increasingly stuporous 4 Older adult patient who had a carotid endarterectomy and is unable to state the day of the week

3

The nurse instructor is educating nursing students about compartment syndrome. What statement made by a nursing student indicates a need for further instruction? 1 "The color of tissue pales." 2 "It is a complication of fractures." 3 "It causes an absence of pulses." 4 "Plasma proteins leak into the interstitial space, causing edema."

3

The nurse is about to administer a contrast medium to the patient undergoing diagnostic testing. Which question does the nurse first ask the patient? 1 "Are you in pain?" 2 "Are you wearing any metal?" 3 "Are you taking ibuprofen daily?" 4 "Do you know what this test is for?"

3

The nurse is assisting a physician in assessing a patient who is complaining of wrist pain. The patient is a tennis player. The nurse observes the physician instruct the patient to thread a needle. The patient has difficulty in pinching the thread and gives up after a clumsy attempt at the task. What is the most likely reason for this? 1 The patient has suffered a wrist strain. 2 The patient has suffered a wrist sprain. 3 The patient has carpal tunnel syndrome. 4 The patient has suffered a wrist fracture.

3

After teaching self-management measures to a patient with osteoarthritis, the nurse is evaluating adequate patient education. Which statements by the patient indicate the need for more education? Select all that apply. 1 "I should exercise on both 'good' and 'bad' days." 2 "I should perform passive exercises whenever possible." 3 "I should not substitute household tasks for prescribed exercises." 4 "I should avoid resistive exercises when my joints are severely inflamed." 5 "I should not reduce the number of repetitions of exercise though pain is increased."

2, 5

The nurse is caring for a patient with a total knee arthroplasty. What action does the nurse take when the patient is using a continuous passive motion (CPM) machine? 1 Allows the patient to take control of the machine 2 Encourages the use of CPM whenever awake 3 Checks the cycle and range of motion settings at least once every 8 hours 4 Stores the machine on the floor when not in use

3

The nurse is caring for a patient with lupus erythematosus. What does the nurse teach the patient about skin protection? 1 Cleanse the skin with an antiseptic soap. 2 Rub skin completely dry after bathing. 3 Wear a large-brimmed hat when in the sun. 4 Use rubbing alcohol to clean the hands.

3

The nurse is obtaining a history on a patient who has had several transient ischemic attacks. Which risk factor in this patient's history cannot be changed with appropriate management of care? 1 Cardiovascular disease 2 Diabetes 3 Head trauma 4 Sleep apnea

3

The nurse is providing discharge instructions to a patient with chronic back pain, compromised respiratory function, visual disturbances, joint pain and aching, malaise, and weight loss. Which order in the patient's plan of care would the nurse question? 1 Send to physical therapy 2 Prescription for ibuprofen 3 Prescription for allopurinol 4 Teach deep breathing exercises

3

The nurse is reviewing the diagnostic results of a patient with a suspected brain tumor. Which tumor type indicates it is malignant? 1 Chondroma 2 Meningioma 3 Ependymoma 4 Acoustic neuroma

3

The nurse is reviewing the medical reports of four patients with gout. Which patient may have chronic tophaceous gout? 1 Patient 1 2 Patient 2 Correct3 Patient 3 Incorrect4 Patient 4

3

The nurse is teaching a patient about the difference between rheumatoid arthritis (RA) and osteoarthritis (OA). Which statement by the patient indicates a need for further teaching? 1 "RA is inflammatory. OA is degenerative." 2 "The risk factors or causes of RA are probably autoimmune, whereas OA may be caused by age, obesity, trauma, or occupation." 3 "The typical onset of RA is seen between 35 and 45 years of age, whereas the typical onset of OA is seen in patients older than 60 years." 4 "The disease pattern of RA is usually unilateral and is seen in a single joint, whereas OA is usually bilateral and symmetric, and is noted in multiple joints."

4

The nurse is teaching a patient with arthritis about energy conservation. Which statement made by the patient indicates the need for further teaching? 1 "I will take one or two naps each day." 2 "I will stick to my activity tolerance level." 3 "I will delegate responsibilities and tasks to my family members and friends." 4 "I will determine which activities are most important and save them for last."

4

The nurse is teaching a patient with arthritis about self-management of energy conservation. Which statement made by the patient needs correction? 1 "I will take two naps every day." 2 "I will establish priorities for my daily tasks." 3 "I will remain stress-free while doing my work." 4 "I will not share my responsibilities with family and friends."

4

The nurse plans to refer a patient diagnosed with osteoporosis to which community resource? 1 I Can Cope 2 CanSurmount 3 American Bone Society 4 National Osteoporosis Foundation

4

What causes osteonecrosis? 1 Use of capsaicin 2 Use of chondroitin 3 Use of glucosamine 4 Use of corticosteroids

4

What could be the diagnosis of a patient with a headache, slurred speech, and weakness of the left upper limb who has arrived at the hospital? 1 Polymyositis 2 Ankylosing spondylitis 3 Polymyalgia rheumatica 4 Systemic necrotizing vasculitis

4

What is the leading cause of death from head trauma in patients who reach the hospital alive? 1 Hypoxia 2 Hypotension 3 Internal bleeding 4 Increased intracranial pressure (ICP)

4

What is the most important variable to assess with any brain injury? 1 Heart rate 2 Blood pressure 3 Body temperature 4 Level of consciousness

4

What lab value is most affected by methotrexate? 1 Sodium 2 Potassium 3 Red blood cell count 4 White blood cell count

4

Which is a late manifestation of rheumatoid arthritis? 1 Anorexia 2 Paresthesias 3 Joint inflammation 4 Morning stiffness

4

Which region of the cerebrum controls voluntary function? 1 Gray matter 2 Broca's area 3 Basal ganglia 4 Motor cortex

4

Which type of fracture has the highest incidence in older adults? 1 Rib fractures 2 Wrist fractures 3 Humeral fractures 4 Proximal femoral fractures

4

What is the recommended daily dosage of vitamin D for patients taking chronic steroid therapy to prevent osteoporosis?___ mg

5

The nurse is assessing the cerebral motor integrity of a patient with muscle weakness. Arrange the steps of the assessment in the order in which they are performed. 1. Hold the arms perpendicular to the body. 2. Keep the palms up for 15 to 30 seconds. 3. The arm on the weak side falls with the palm pronating. 4. Ask the patient to close the eyes.

The patient is first asked to close the eyes. Then the arms are held perpendicular to the body with the palms up for 15 to 30 seconds. The arm on the weak side falls with the palms pronating or turning inwards. This pronator drift is caused when there is a cerebral or brainstem problem affecting the muscles.

A patient has come to the emergency department following a motor vehicle crash. In which order does the nurse perform the following actions to determine the patient's level of consciousness (LOC)? 1. Shake the patient gently. 2. Use painful or vigorous stimuli. 3. Ask questions in a loud voice. 4. Ask questions in a normal voice.

n order to determine LOC, the nurse should first ask the patient some questions in a normal voice. It helps in determining if the patient is alert or lethargic. If the patient does not respond, then questions should be repeated in a loud voice. If there is no response, the nurse should then shake the patient gently. If patient is unresponsive, some vigorous or painful stimuli (e.g., supraorbital pressure, trapezius muscle squeeze) can be used. If patient does not respond to any of the stimuli, it suggests that the patient is unconscious and emergency interventions are needed.

What risk factor is associated with primary osteoporosis? 1 Diabetes mellitus Correct2 Lack of physical exercise 3 Increased levels of thyroid hormone Incorrect4 Long-term treatment with corticosteroids

2

A nurse notices the lateral drift of the greater toe at the first metatarsophalangeal joint. What would be the expected diagnosis by the primary health care provider? 1 Hammertoe 2 Hallux varus 3 Hallux valgus 4 Plantar fasciitis

3

A 30-year-old patient sustains a fractured hip and experiences hypoxemia, dyspnea, and tachypnea. What complication due to the fracture should the nurse suspect from these findings? 1 The patient may have fat embolism syndrome (FES). 2 The patient may have venous thromboembolism (VTE). 3 The patient may have acute compartment syndrome (ACS). 4 The patient may have complex regional pain syndrome (CRPS).

1

The patient has sustained a traumatic amputation of the left arm after a machine accident. Number in order, first priority to last priority, the nursing actions that should be taken.1.Apply direct pressure to the amputated site 2.Elevate the extremity above the patient's heart 3.Assess the patient for breathing problems 4.Examine the amputation site

First, the airway must be assessed for breathing problems. Second, the nurse should examine the amputation site. Third, the nurse should apply direct pressure to the amputated site. Finally, the extremity should be elevated above the patient's heart to decrease bleeding.

A patient has a fractured tibia. Arrange the stages of bone healing in the order they occur. 1. Consolidation and remodeling 2. Resorption of callus 3. Formation of fibrocartilage 4. Formation of hematoma 5. Formation of callus

Fractures heal in five stages that are a continuous process. In stage one, a hematoma forms at the site of the fracture because the bone is extremely vascular. This occurs within 24 to 72 hours after the injury. Stage two occurs in 3 days to 2 weeks, when the granulation tissue begins to invade the hematoma. This prompts the formation of fibrocartilage, providing the foundation for bone healing. In stage three, bone healing occurs as a result of vascular and cellular proliferation. The fracture site is surrounded by new vascular tissue known as callus, which indicates the beginning of a nonbony union. In stage four, the callus is gradually resorbed and transformed into bone, which usually takes 3 to 8 weeks. During the fifth and final stage of healing, consolidation and remodeling of the bone continue to meet mechanical demands, which can continue up to 1 year depending on the severity of the injury.

The drug leflunomide is often used for pain management in patients with rheumatoid arthritis (RA). What is the drug's initial loading dose? Record your answer using a whole number. ___ mg

Leflunomide is a slow-acting, immune-modulating drug that reduces inflammatory disorders in patients with RA. A dosage of 100 mg for 3 days, followed by 20 mg daily reduces the occurrence of symptoms.

What is the recommended daily dosage of vitamin D for patients taking chronic steroid therapy to prevent osteoporosis?___ mg

Rheumatoid arthritis is treated with steroids, which have anti-inflammatory and immunosuppressive effects. Chronic steroid therapy causes numerous side effects, including osteoporosis. To prevent osteoporosis and maintain bone density, 400 mg of vitamin D is recommended along with 1200 mg to 1500 mg of calcium.

A patient with osteoarthritis asks the nurse about the use of glucosamine as a dietary supplement. What does the nurse teach the patient about taking this supplement? Select all that apply. 1 "Inform the health care provider before starting glucosamine." 2 "Monitor your glucose level daily." 3 "Monitor closely for hypotension." 4 "Use glucosamine with caution if you are also taking chondroitin and anticoagulant therapy." 5 "Discontinue use after a month if no beneficial effect is experienced."

1, 2

Which antibiotics are often used for treating Lyme disease in its earlier stages? Select all that apply. 1 Doxycycline 2 Amoxicillin 3 Cefotaxime 4 Minocycline 5 Ceftriaxone

1, 2

Which medications does the nurse expect to find as prescriptions for a patient with osteoarthritis? Select all that apply. 1 Diclofenac 2 Acetaminophen 3 Methotrexate 4 Leflunomide 5 Azathioprine

1, 2

A patient accidentally severed a finger while working in the kitchen. Which emergency care interventions are needed for this patient? Select all that apply. 1 Elevate the extremity above the heart level. 2 Apply direct pressure with dry gauze at the amputation site. 3 Ensure the severed finger does not come in contact with water. 4 Place the sealed plastic bag containing the severed finger in ice. 5 Place the severed finger directly in a watertight sealed plastic bag.

1, 2, 3

The instructor is teaching nursing students about benign tumors. Which tumors are usually benign? Select all that apply. 1 Choroid plexus papilloma 2 Craniopharyngioma 3 Schwannoma 4 Astrocytoma 5 Ependymoma 6 Medulloblastoma

1, 2, 3

The nurse is teaching the importance of nutrition to a 74-year-old patient who is lactose-intolerant and at risk for osteoporosis. What nutritional considerations does the nurse teach? Select all that apply. 1 Drink fruit juices fortified with calcium. 2 Limit consumption of carbonated beverages. 3 Avoid excessive intake of alcohol and caffeine. 4 Maintain a high-protein, low-carbohydrate diet. 5 Ensure activated vitamin D intake of 1200 international units per day.

1, 2, 3

The nurse is preparing a patient for a cerebral angiography. What actions does the nurse take? Select all that apply. 1 Determine if the patient is allergic to shellfish or iodine. 2 Check the patient's creatinine level before the procedure. 3 Inform the patient that the entire body will be immobilized. 4 Check that the patient is sedated before the dye is injected. 5 Notify the health care provider if the patient is at risk for nephropathy.

1, 2, 5

What should the nurse infer if the T-score of a patient is -2 in a bone mineral density (BMD) test? 1 The patient has osteopenia. 2 The patient has osteoporosis. 3 The patient's bone density is normal. 4 The patient has severe osteoporosis.

1

What should the nurse instruct the patient with systemic lupus erythematosus who is prescribed hydroxychloroquine to prevent an adverse drug effect? 1 "Have frequent eye examinations." 2 "Take the medication before breakfast." 3 "Have frequent checks of your serum electrolyte level." 4 "Use sunblock with sun protection formula (SPF) of at least 30."

1

What statement about blood type alleles is most accurate? 1 Blood type O is a recessive trait found on an autosomal chromosome. 2 Blood type O is expressed only when both parents have blood group O. 3 Blood type A is a recessive trait found on an autosomal chromosome. 4 Blood type A is expressed only when both parents have blood group A.

1

Where does the nurse expect to find a conical mass, or corn, on the patient's body? 1 Toe 2 Wrist 3 Fingers 4 Shoulder

1

Which action by unlicensed assistive personnel (UAP) in caring for a patient after a stroke requires immediate intervention by the nurse? 1 Gently pulling on a patient's flaccid arm to assist the patient up in bed 2 Using pictures to aid in communicating with a patient with aphasia 3 Reminding family members that the patient may have altered emotions 4 Assisting a patient with hemianopsia by turning the patient's plate halfway through the meal

1

Which biological response modifier may cause chest pain and difficulty breathing during infusion? 1 Infliximab 2 Etanercept 3 Tocilizumab 4 Golimumab

1

Which brain tumor is seen primarily in patients ages 40 to 70? 1 Malignant 2 Supratentorial 3 Pituitary tumors 4 Acoustic neuromas

1

Which condition is indicated in the image? 1 Brain herniation 2 Epidural hematoma 3 Subdural hematoma 4 Intracerebral hemorrhage

1

Which cranial nerve is located in the midbrain? 1 Trochlear 2 Accessory 3 Abducens 4 Trigeminal

1

Which device is most invasive for monitoring intracranial pressure? 1 Intraventricular catheter 2 Subarachnoid bolt or screw 3 Subdural/epidural catheter or sensor 4 Fiberoptic transducer-tipped catheter

1

Which diagnostic test is not necessary for a patient presenting with a brain abscess? 1 Bone scan 2 Sinus x-rays 3 Throat culture 4 Electroencephalogram (EEG)

1

Which diagnostic test is used to detect needle-like crystals in the affected joints of patients with gout? 1 Synovial fluid aspiration 2 Blood urea nitrogen (BUN) 3 Extractable nuclear antigens (ENAs) 4 Venereal disease research laboratory (VDRL) syphilis test

1

Which drug is an interleukin-1 (IL-1) receptor antagonist? 1 Anakinra 2 Rituximab 3 Abatacept 4 Tocilizumab

1

Which drug may help slow the progression of systemic sclerosis? 1 Imatinib 2 Bosentan 3 Abatacept 4 Methotrexate

1

Which drug wafers may be placed directly into the cavity created during surgical brain tumor removal? 1 Gliadel 2 Erlotinib 3 Gefitinib 4 Bevacizumab

1

Which drug will be most effective for the treatment of cerebral edema and increased intracranial pressure? 1 Mannitol 2 Furosemide 3 Dexamethasone 4 Methylprednisolone sodium succinate

1

Which finding does the nurse expect to observe in a patient with suspected common chronic osteomyelitis? 1 Ulceration of the skin 2 Erythema of the affected area 3 Constant, localized, and pulsating bone pain 4 Fever; temperature usually above 101° F (38° C)

1

Which fingers are affected by Dupuytren contracture? 1 Fourth and fifth fingers 2 Second and fifth fingers 3 Thumb and second finger 4 Second and fourth fingers

1

Which is a clinical manifestation of a cerebral tumor? 1 Aphasia 2 Dysphagia 3 Nystagmus 4 Hoarseness

1

Which is a key feature of acute osteomyelitis? 1 Fever 2 Foot ulcer 3 Localized pain 4 Sinus tract formation

1

Which is a symptom of increased intracranial pressure? 1 Irritability 2 Hypokalemia 3 Hyponatremia 4 Blurred vision

1

Which is the most common benign tumor that arises from the coverings of the brain (the meninges)? 1 Meningiomas 2 Supratentorial 3 Pituitary tumors 4 Acoustic neuromas

1

Which is the priority intervention in the management of a patient with complex regional pain syndrome (CRPS)? 1 Relieving pain 2 Treating paresis 3 Reducing edema 4 Relieving muscle spasms

1

Which is true of partial-thickness rotator cuff tears? 1 They are more painful than full-thickness tears. 2 They are more likely to result from heavy lifting. 3 They result in more weakness than full-thickness tears. 4 They result in more loss of function than full-thickness tears.

1

Which lab values may be abnormally low from blood loss during surgery or elevated if the blood was replaced? 1 Hematocrit 2 Creatinine 3 Hypoalbuminemia 4 Blood urea nitrogen

1

Which lobe of the cerebral cortex is responsible for emotional and visceral patterns connected with survival? 1 Limbic lobe 2 Frontal lobe 3 Parietal lobe 4 Occipital lobe

1

Which nursing intervention is being performed in the image?

1

Which part of the body is affected by plantar fasciitis? 1 Arch of the foot 2 Metatarsal head 3 Back of the wrist 4 Side of the toenail

1

Which part of the neuron is responsible for impulse conduction? 1 A 2 B 3 C 4 D

1

Which potential disorder should be ruled out before a patient's level of consciousness is attributed to stroke? 1 Hypoglycemia 2 Hyperkalemia 3 Hyponatremia 4 Hypertension

1

Which question does the nurse ask a patient when assessing the patient's long-term memory? 1 "Where did you attend high school?" 2 "What did you eat yesterday for lunch?" 3 "What is the name of your health care provider?" 4 "What was the day of your admission to the hospital?"

1

Which statement about chronic complications from fractures is accurate? 1 Avascular necrosis is a chronic complication of fracture. 2 Surgical repair of fractures prevents chronic complications. 3 Fat embolism syndrome is a chronic complication of fracture. 4 Prednisone therapy decreases the risk of chronic complications.

1

Which statement about the blood supply and nerve fibers of bone is accurate? 1 Very few nerve fibers are connected to the bone. 2 Sympathetic nerve fibers in the bone transmit pain signals. 3 Branches of the nutrient artery are supplied solely to the marrow. 4 The main nutrient artery of the bone enters near the end of the shaft.

1

Which statement best describes the symptoms of a transient ischemic attack (TIA)? 1 They resolve within 60 minutes. 2 They are limited to the speech area. 3 They manifest in the upper extremities. 4 They last longer than 24 hours but less than a week.

1

Which statement indicates to the nursing instructor that the nursing student understands the normal healing process of bone after a fracture? 1 "A hematoma forms at the site of the fracture." 2 "A callus is quickly deposited and transformed into bone." 3 "Calcium and vascular proliferation surround the fracture site." 4 "Granulation tissue reabsorbs the hematoma and deposits new bone."

1

Which statement is consistent with an autosomal dominant pattern of inheritance for a specific trait or characteristic? 1 The genotype cannot be predicted from the phenotype. 2 The daughter of an affected mother is a carrier of the disease. 3 Unaffected parents are able to transmit the trait to their children. 4 The trait appears consistently only in male offspring of female carriers.

1

Which statement is true regarding gout? 1 Multiple myeloma results in gout. 2 Primary gout affects people of all ages. 3 Gout is classified into two clinical stages. 4 Gout is a chronic disease in which calcium urate crystals deposit in the joints.

1

Which syndrome is associated with leukopenia in a patient with rheumatoid arthritis? 1 Felty's syndrome 2 Caplan's syndrome 3 Sjogren's syndrome 4 Carpal tunnel syndrome

1

Which syndrome may result in the compression of the median nerve? 1 Carpal tunnel syndrome (CTS) 2 Acute compartment syndrome (ACS) 3 Patello femoral pain syndrome (PFPS) 4 Complex regional pain syndrome (CRPS)

1

Which term is used to describe loss of balance in a patient with a brainstem or cerebellar injury? 1 Ataxia 2 Diplopia 3 Ovoid pupil 4 Papilledema

1

Which test used for assessing the neurologic system involves the use of a contrast agent? 1 Cerebral angiography 2 Lumbar puncture (LP) 3 Electromyography (EMG) 4 Electroencephalography (EEG)

1

Which therapy must be performed to open the skull and remove the tumor? 1 Craniotomy 2 Chemotherapy 3 Brachytherapy 4 Stereotactic radiation therapy

1

Which tool is used to measure the severity of a traumatic brain injury? 1 Glasgow Coma Scale 2 Visual analogue scale 3 Numerical rating scale 4 Geriatric depression scale

1

Which tumor in the anterior lobe of the cerebellum accounts for up to one fourth of brain tumors? 1 Pituitary tumors 2 Acoustic neuromas 3 Meningiomas tumors 4 Supratentorial tumors

1

Which type of fracture is most common in the general adult population? 1 Rib fractures 2 Wrist fractures 3 Humeral fractures 4 Proximal femoral fractures

1

Which type of fracture may occur when a person attempts to break a fall by landing on the heel of the hand when the wrist is flexed? 1 Smith fracture 2 Colles' fracture 3 Phalangeal fracture 4 Metacarpal fracture

1

Which type of stroke syndrome would most likely cause a coma in a patient? 1 Vertebrobasilar artery strokes 2 Internal carotid artery strokes 3 Middle cerebral artery strokes 4 Anterior cerebral artery strokes

1

Which type of traction is used for strain or sprain in the lower back? 1 Pelvic belt 2 Pelvic sling 3 Russell traction 4 Buck extension traction

1

While assessing a patient's bone fracture, the nurse finds that the fracture features a break across the entire width of the bone. The broken bone also extends through the skin. Which type of fracture does the nurse recognize? 1 Complete and open 2 Complete and closed 3 Incomplete and open 4 Incomplete and closed

1

n assessing a patient using a reflex hammer, the nurse places a thumb in the patient's antecubital space and strikes the thumb with the hammer. The patient's forearm and wrist rise. The nurse notes an appropriate response of which reflex? 1 Biceps 2 Triceps 3 Patellar 4 Brachioradialis

1

The nurse is teaching a patient who has undergone total joint arthroplasty about the measures to be followed at home. During a follow up visit, the nurse finds that the patient has developed complications associated with the surgery. Which actions of the patient may have contributed to complications? Select all that apply. 1 Massaging the legs 2 Taking very little fluids 3 Wearing elastic stockings 4 Keeping leg slightly abducted 5 Flexing hip beyond 90 degrees

1, 2, 5

The primary health care provider prescribed methotrexate to a patient with lupus erythematosus. Which instructions should the nurse provide to the patient? Select all that apply. 1 "You should avoid crowds." 2 "You should avoid people who are sick." 3 "You should take the medication after breakfast." 4 "You should be aware that signs of infection are a common finding." 5 "If you experience any abnormal effects after taking the drug, you should immediately tell your primary care provider."

1, 2, 5

When checking a patient with fractures, a wound, and extensive soft tissue damage for signs of infection, which results indicate that there is no infection present? Select all that apply. 1 Lack of fever 2 Negative wound culture 3 Increased phosphorous level 4 Increased serum calcium level 5 No increase in white blood cell count 6 Decreased erythrocyte sedimentation rate

1, 2, 5

Which statement by the nurse indicates an adequate understanding of the principles of emergency care of a patient with an extremity fracture? Select all that apply. 1 "I will not remove the shoes of the patient." 2 "I will cover any open areas with a dressing." 3 "I will keep the patient cool in a low head position." 4 "I will not remove any jewelry on the affected extremity." 5 "I will immobilize the joints above and below the fracture site."

1, 2, 5

The nurse is teaching a patient who likes going camping about Lyme disease. Which patient statements indicate effective learning? Select all that apply. 1 "I'll check my pets for ticks." 2 "I'll burn any tick as soon as I find it." 3 "I'll avoid wearing dark-colored clothes." 4 "I'll go for a test to check for Lyme disease within two weeks after being bitten by a tick." 5 "I'll report to the primary health care provider if I see any rash or redness around a bitten area."

1, 3, 5

What instructions for safe drug administration should be given to the patient with rheumatoid arthritis who is prescribed methotrexate (MTX)? Select all that apply. 1 "Avoid crowds." 2 "Reduce salt intake." 3 "Avoid alcohol intake." 4 "Refrigerate the medication." 5 "Report any side effects to the primary health care provider."

1, 3, 5

Which symptoms can be present with a transient ischemic attack (TIA)? Select all that apply. 1 Vertigo 2 Anosmia 3 Aphasia 4 Epistaxis 5 Blurred vision

1, 3, 5

Which signs/symptoms suggest that a patient's intracranial pressure (ICP) is increasing? Select all that apply. 1 Vomiting 2 Hypocapnia 3 Dilated pupils 4 Hypoglycemia 5 ICP level of 12 mm Hg 6 Presence of papilledema

1, 3, 6

What nursing interventions may be performed to prevent dislocation of the hip joint in a patient who has undergone total hip arthroplasty (THA)? Select all that apply. 1 Avoid hip flexion beyond 90 degrees. 2 Use aseptic technique for wound care. 3 Instruct the patient to do leg exercises. 4 Instruct the patient to wear elastic stockings. 5 Assess acute pain, rotation, and extremity shortening.

1, 5

Which instructions for joint protection does the nurse recommend for a patient with a connective tissue disease? Select all that apply. 1 Use long-handled devices such as a reacher. 2 When getting out of bed, use fingers to push off. 3 Sit in a low-back chair. 4 Bend at the waist while keeping the back straight. 5 Use adaptive devices such as Velcro closures. 6 Turn a doorknob clockwise.

1, 5

Which terms are related to an open traumatic brain injury? Select all that apply. 1 Linear fracture 2 Laceration injury 3 Contusion injury 4 Contrecoup injury 5 Depressed fracture

1, 5

The nurse observes that a patient has an ingrown toenail that is hindering the patient's ambulation. What treatments does the nurse suggest for this patient? Select all that apply. 1 Applying antibiotic ointment 2 Soaking the foot in warm water 3 Applying an ice pack to the foot 4 Treating the secondary infection 5 Applying padding and lanolin creams

1,2

The nurse is teaching a patient ways to increase vitamin D in the diet using natural foods (unfortified). Which food choices indicate the patient understands the teaching? Select all that apply. 1 Milk 2 Tofu 3 Eggs 4 Liver 5 Cheese 6 Cereals

1,2,3,4

A patient with a head injury arrives at a hospital. The patient reports an inability to close the eyes and restricted eye movement. What should the nurse suspect as the causes of these symptoms? Select all that apply. 1 Damage to the nerve present in the midbrain 2 Damage to the nerve present in the inferior pons 3 Damage to the nerve present in the olfactory bulb 4 Damage to the nerve present in the anterior gray horn 5 Damage to the nerve present in the pons-medulla junction

1, 2

A patient with a history of back trauma reports lower back pain, numbness, and pain to the legs. Which nerves should the nurse suspect are responsible for these symptoms? Select all that apply. 1 Injury to sacral nerves 2 Injury to lumbar nerves 3 Injury to cervical nerves 4 Injury to thoracic nerves 5 Injury to coccygeal nerves

1, 2

The home health nurse conducts a community presentation on Lyme disease for the residents of an assisted-living facility. Which statement from the audience indicates to the home health nurse that further instruction is needed? 1 "I will gently remove the tick with tissue and then burn it to prevent the spread of the disease." 2 "It is best to walk in the center of the trail." 3 "I should wait 4-6 weeks after being bitten by a tick to be tested for Lyme disease." 4 "I'll wear light-colored clothes with long sleeves, long pants, closed shoes, and a hat when I am walking in the woods."

1

The nurse admits an older adult patient who sustained a left hip fracture and is in considerable pain. The nurse anticipates that the patient will be placed in which type of traction? 1 Buck's traction 2 Plaster traction 3 Overhead traction 4 Balanced skin traction

1

The nurse advises a patient with a lower extremity fracture to take a multivitamin with iron after eating to prevent which condition? 1 Nausea 2 Dizziness 3 Palpitations 4 Constipation

1

The nurse assessing an older adult patient expects to see which sensory change associated with the aging process? 1 Decrease in pupil size 2 Increase in foot sensation 3 Increase in hearing acuity 4 Decrease in needed light to read

1

The nurse is assessing a patient who is reporting pain under the arch of the foot when getting out of bed in the morning. The nurse suspects the patient may have plantar fasciitis. What information does the nurse give to the patient to help manage the onset of the condition? 1 Telling the patient to manage his or her weight 2 Having the patient to reduce his or her sodium intake 3 Advising the patient to try running to loosen the tissue 4 Giving the patient weight-bearing exercises to practice

1

The nurse is assessing a patient with a hallux valgus deformity. What term is used to refer to an enlargement of the first metatarsal head commonly seen with this kind of deformity? 1 Bunion 2 Ganglion 3 Hammertoe 4 Sequestrum

1

The nurse is caring for a marathon runner with plantar fasciitis. What conservative management method does the nurse suggest? 1 "Strap the affected foot." 2 "Apply moist heat to the site." 3 "Avoid wearing shoes for a week." 4 "Perform weight-bearing exercises."

1

The nurse is caring for a patient immediately following a bunionectomy. What is the nurse's priority action? 1 Assessing the patient's neurovascular status 2 Demonstrating for the patient how to use crutches 3 Giving the patient pain medication before the anesthesia wears off 4 Providing the patient with instruction on what to eat after going home

1

A patient who is undergoing treatment for osteoarthritis reports black-colored stools, stomach upset, and difficulty breathing. The patient's blood work reveals abnormal levels of urea and creatinine. The nurse identifies that which medication is the likely cause of the patient's symptoms? 1 Ibuprofen 2 Lidocaine 3 Glucosamine 4 Cyclobenzaprine

1

The nurse is caring for a patient one day after the patient experienced a stroke. The patient is fully alert and has weakness of the right side of the body. Which assessment finding indicates an increasing intracranial pressure (ICP)? 1 The patient is no longer oriented to place. 2 The patient reports numbness of the right leg. 3 The patient has developed urinary incontinence. 4 The patient has a blood pressure of 90/62 mm Hg.

1

The nurse is caring for a patient who is diagnosed with psoriatic arthritis. Which medication does the nurse anticipate will be included in the patient's pharmacologic plan of care? 1 Alefacept 2 Indomethacin 3 Imatinib mesylate 4 Nilotinib

1

The nurse is caring for a patient who underwent kyphoplasty. Which nursing intervention is beneficial to the patient? 1 Applying ice pack to the insertion site 2 Monitoring the vital signs of the patient 3 Discontinuing anticoagulant drugs to the patient 4 Assessing the patient's ability to lie prone for at least 1 hour

1

The nurse is caring for a patient with Buck's traction. What care should the nurse provide for this patient? 1 Ensure the weights are freely hanging at all times 2 Monitor circulation every 4 hours after traction is applied 3 Inspect the skin every 12 hours for irritation or inflammation 4 Remove the belt or boot used for traction to inspect the skin once a day

1

The nurse is caring for a patient with carpal tunnel syndrome who underwent endoscopic carpal tunnel release. Which statement by the patient indicates adequate understanding of the postoperative instructions? 1 "I can lift heavy objects after 4 weeks." 2 "I will keep my affected arm below heart level." 3 "I will not move the fingers of my affected arm frequently." 4 "I don't need any assistance while performing self-management activities."

1

The nurse is caring for a patient with complex regional pain syndrome (CRPS). Which clinical sign of CRPS is a manifestation of autonomic nervous system dysfunction seen in this complication? 1 Edema 2 Paresis 3 Muscle spasm 4 Loss of function

1

A patient who sustained a head injury in a motor vehicle crash several days ago has been active and talkative, and headaches have been well controlled with acetaminophen. When performing the daily assessment, the nurse observes increased dilation of the patient's pupils and notes a sluggish response to light. Which action is correct? 1 Notify the provider immediately. 2 Reassess the patient in 2 hours. 3 Elevate the head of the bed to 60 degrees. 4 Ask the patient to read some printed material.

1

A patient with a compound fracture of the left femur is admitted to the emergency department after a motorcycle crash. Which action is mostessential for the nurse to take first? 1 Check the dorsalis pedis pulse 2 Immobilize the left leg with a splint 3 Administer the prescribed analgesic 4 Place a dressing on the affected area

1

A patient with a traumatic brain injury underwent monitoring of the intracranial pressure. Suddenly, it resulted in leakage of the cerebrospinal fluid. What would be the possible reason for the leakage? 1 Use of intraventricular catheter 2 Use of subarachnoid bolt or screw 3 Use of subdural/epidural catheter or sensor 4 Use of fiberoptic transducer-tipped catheter

1

A patient with an osteoporotic vertebral fracture is prescribed raloxifene. What should the nurse include in the assessment of this patient? 1 Assess for a history of venous thromboembolism. 2 Assess the patient's complete blood count (CBC). 3 Observe the patient for drowsiness, agitation, or anxiety. 4 Perform an oral assessment before beginning treatment.

1

A patient's laboratory report shows an intracranial pressure of 12 mmHg. Which events will occur in the patient's body? 1 The body will function normally. 2 The cerebral blood volume will be decreased. 3 The rate of absorption of the cerebrospinal fluid will increase. 4 Cerebrospinal fluid will move from cranial compartment to the spinal subarachnoid space.

1

A patient's left arm is placed in a plaster cast. Which assessment does the nurse perform before the patient is discharged? 1 Assess that the cast is dry 2 Ensure that the capillary refill of the left fingernail beds is longer than 3 seconds 3 Check the fit of the cast by inserting a tongue blade between the cast and the skin 4 Ensure that the patient has 4 × 4 gauze to take home for placement between the cast and the skin

1

A registered nurse is teaching a group of student nurses about the group of cells in the white matter of the spinal cord. Which statement made by the student nurse indicates a need for further teaching? 1 "Descending tracts begin in the brain and end in the neurons." 2 "Ascending tracts originate in the spinal cord and end in the brain." 3 "Spinothalamic tracts begin in the spinal cord and end in the thalamus." 4 "Spinocerebellar tracts begin in the spinal cord and end in the cerebellum."

1

After assessing a patient with joint inflammation, the nurse suspects refractory gout. Which medication would be prescribed? 1 Pegloticase 2 Allopurinol 3 Febuxostat 4 Indomethacin

1

An enlarged first metatarsal head is known as what? 1 Bunion 2 Hallux valgus 3 Plantar fasciitis 4 Dupuytren contracture

1

As part of the treatment plan for a patient with decreased bone density, the nurse administers zoledronic acid. The nurse infuses the medication slowly over 20 minutes. Why is the medication given slowly? 1 To prevent atrial fibrillation 2 To prevent hepatic disease 3 To prevent bronchoconstriction 4 To prevent central nervous system adverse effects

1

Athletes are likely to experience which type of fracture? 1 Fatigue 2 Fragility 3 Pathologic 4 Compression

1

The nurse is caring for a patient with systemic sclerosis. What teaching does the nurse provide to the patient's spouse about nutrition prior to discharge home? 1 Provide small frequent meals throughout the day. 2 Keep the patient's head at 90 degrees during meals. 3 Avoid solid foods and instead provide liquid foods. 4 Choose foods that increase gastric secretion.

1

The nurse is caring for a preoperative patient who is about to undergo a partial fasciectomy to treat Dupuytren contracture. The nurse ensures that the patient understands the procedure. Which statement made by the patient causes the nurse to do additional teaching? 1 "This surgery will tighten the fascia in my hand." 2 "I may need to use a splint after my surgical dressing is removed." 3 "This procedure will correct the issue with my fourth and fifth fingers." 4 "I will need to do hand stretching exercises so the muscle does not tighten back up."

1

Before administering low-molecular-weight heparin (LMWH) to an older adult patient after total knee arthroplasty, the nurse notes that the patient's platelet count is 50,000/mm 3. What action is mostimportant for the nurse to take? 1 Notify the health care provider of the platelet count. 2 Administer the prescribed LMWH on schedule. 3 Assess the activated partial thromboplastin time (aPTT). 4 Assess the International Normalized Ratio (INR).

1

Besides hallux valgus, what other foot condition does the patient in this image have? 1 Hammertoe 2 Ingrown nail 3 Plantar fasciitis 4 Morton's neuroma

1

During a patient's follow-up visit, the nurse finds that the patient's osteoarthritis does not improve with the prescribed systemic and topical medications. What medication does the nurse anticipate to be beneficial? 1 Cortisone injection 2 Lidocaine patch 5% 3 Diclofenac solution 4 Buspirone HCl cream

1

During which time frame does an acute subdural hematoma (SDH) present? 1 Within 48 hours after impact 2 Within one week after impact 3 Within two weeks after impact 4 Within two months after impact

1

How does a deceleration injury occur? 1 When the moving head is suddenly stopped or hits a stationary object. 2 When the skull is fractured or when it is pierced by a penetrating object. 3 When a mechanical force is applied either directly or indirectly to the brain. 4 When an external force makes contact with the head, suddenly placing the head in motion.

1

How many classifications exist for brain tumors? 1 2 2 3 3 6 4 9

1

In assessing the potential presence of bone erosion or dislocation in a patient, the nurse expects the provider to order which imaging assessment? 1 Skull x-ray 2 Cerebral angiography 3 Computed tomography (CT) scan 4 Magnetic resonance imaging (MRI)

1

In what lobe is Broca's area (speech area) located in the brain? 1 Frontal 2 Parietal 3 Occipital 4 Temporal

1

Nursing actions to help prevent increased intracranial pressure after a stroke include which activity? 1 Careful monitoring of temperature 2 Providing oxygen for saturation less than 96% 3 Elevating the head of the bed to 60-90 degrees 4 Clustering procedures within a short time period

1

The diagnostic test results for a patient with a spinal cord injury reveal an injury to cranial nerve VIII. Which functional disability may this patient exhibit? 1 Loss of hearing 2 Loss of sense of smell 3 Loss of central and peripheral vision 4 Loss of taste sensation from the anterior two thirds of the tongue

1

The hallux valgus deformity can cause what other condition? 1 Bunion 2 Corn 3 Callus 4 Dupuytren contracture

1

The nurse is caring for four patients. Which patient does the nurse anticipate might receive fibrinolytic therapy within a 3- to 4.5-hour window as recommended by the American Stroke Association? 1 A patient who is 60 years old 2 A patient who has a history of both stroke and diabetes 3 A patient whose anticoagulation with an international normalized ratio is 1.7 or below 4 A patient whose Baseline National Institutes of Health Stroke Scale score is over 25

1

What is the first step in emergency care of a patient with an extremity fracture? 1 Assess the patient's airway, breathing, and circulation. 2 Remove the patient's clothing to inspect the affected area. 3 Apply direct pressure on the area if there is bleeding and pressure over the proximal artery nearest the fracture. 4 Immobilize the extremity by splinting, including joints above and below the fracture site.

1

What is the function of periaqueductal gray of the brainstem? 1 To eliminate pain 2 To control the respiratory rate 3 To control skeletal muscles of the throat 4 To release the hormones into circulation

1

What is the major "relay station" of the brain? 1 Thalamus 2 Cerebrum 3 Hypothalamus 4 Cerebral cortex

1

What is the major concern related to pelvic injury? 1 Loss of blood volume 2 Avascular necrosis (AVN) 3 Risk for developing pneumonia 4 Risk for neurologic dysfunction

1

What is the most common type of pituitary tumor? 1 Adenoma 2 Sarcoma 3 Neuroma 4 Lymphoma

1

The nurse is providing care to a patient with a skull fracture. The nurse notes leakage of fluid from the patient's nose and ears. The magnetic resonance imaging report indicates hemorrhage and damage to the anterior and middle fossal regions of the brain. Which type of fracture does the nurse suspect? 1 A linear fracture 2 A depressed fracture 3 A basilar skull fracture 4 A comminuted fracture

3

The nurse is teaching a patient about preparing for an electroencephalogram (EEG). Which instruction by the nurse is correct? 1 "Refrain from washing your hair for two days before the EEG." 2 "Drink at least 240 mL of a caffeine-containing beverage 2 hours before the EEG." 3 "Wake at 2:00 the morning of the EEG and remain awake until time for the test." 4 "Small amounts of electrical current will pass through the brain as part of the EEG."

3

The nurse uses different noninvasive techniques to assess the viability of a patient's limb. What statement about these techniques is accurate? 1 A normal ABI should be less than 1. 2 ABI is used in Doppler ultrasonography. 3 Transcutaneous oxygen pressure is reliable for predicting healing. 4 The ratio of brachial systolic pressure by ankle systolic pressure is the ankle-brachial index (ABI).

3

The student nurse is discussing postoperative care with the nurse. Which statement made by the student requires correction? 1 "Check the head dressing every one to two hours for drainage." 2 "Supratentorial patients should be turned side to side to prevent pneumonia." 3 "Elevate the head of the bed (HOB) 90 degrees to promote venous drainage." 4 "Infratentorial craniotomy patients should be NPO until aware and alert."

3

Through radiographic analysis of a patient, the primary health care provider confirms a displaced fracture of the femoral neck. Which complication should the nurse monitor for in the patient? 1 Venous oozing 2 Delayed union 3 Avascular necrosis (AVN) 4 Potential for puncture of vital organs

3

To which resource should the nurse refer the patient to for upper extremity rehabilitation after trauma? 1 Physical therapy 2 Cognitive retraining 3 Occupational therapy 4 Behavior modification

3

What brain injury will be initially at a microscopic level and not detectable by computerized tomography (CT) scan? 1 Focal injury 2 Direct injury 3 Diffuse injury 4 Indirect injury

3

What complication of osteomyelitis is the most likely to occur? 1 Pathologic fractures 2 Development of malignancies 3 Formation of bone abscesses 4 Secondary arthritic changes

3

What does the nurse ask a patient to assess recall memory? 1 Mother's maiden name 2 Repetition of recent instructions 3 Time of admission to the hospital 4 Simple addition and subtraction problems

3

What does the nurse assess to evaluate a patient's gait? 1 Curvature of the spine 2 Muscle mass of the leg Correct3 Ease and length of a stride 4 Length and shape of the spine

3

What is a common symptom of acoustic neuroma? 1 Fever 2 Nausea 3 Tinnitus 4 Neck pain

3

What is considered a late postoperative complication following craniotomy? 1 Hematoma 2 Hydrocephalus 3 Wound infection or abscess 4 Increased intracranial pressure (ICP)

3

What is the first indication that central neurologic function has declined in a patient? 1 Presence of lethargy 2 Irregular depth of respirations 3 Change in level of consciousness 4 Decorticate or decerebrate posturing

3

What is the medical term for the bone disease caused by reduced blood flow to the bones in the joints? 1 Osteomyelitis 2 Osteomalacia 3 Osteonecrosis 4 Osteogenic sarcoma

3

What is the most common assessment finding associated with osteoporosis? 1 Bone pain 2 Bone abscess 3 Bone fractures 4 Bone enlargement

3

What is the name of the hormone that regulates the intestinal absorption of calcium and phosphorous? 1 Estrogens 2 Androgens 3 Glucocorticoids 4 Growth hormone

3

What is true regarding the Canadian Centre for Occupational Health and Safety with respect to health care organizations? 1 It disapproves of the involvement of employees in setting safety standards. 2 It has set up core principles for health care employees who care for transgender patients. 3 It requires work settings to have joint health and safety committees in which employees are actively involved in setting safety standards. 4 It recommends that employees follow gender-neutral language on all medical forms and documents while caring for lesbian, gay, bisexual, transgender, and queer (LGBTQ) patients.

3

What laboratory testing is most important for the patient taking acitretin for psoriatic arthritis? 1 Serum electrolytes 2 Blood urea nitrogen (BUN) 3 Liver enzymes 4 Complete blood count (CBC)

3

What may be the medications provided to prevent osteoporosis in the patient with rheumatoid arthritis who is prescribed long-term steroid therapy? 1 Calcium 750 mg and vitamin D 100 mg daily 2 Calcium 1000 mg and vitamin D 200 mg daily 3 Calcium 1500 mg and vitamin D 400 mg daily 4 Calcium 1800 mg and vitamin D 500 mg daily

3

What medication treats central nervous system (CNS) lupus? 1 Nilotinib 2 Bosentan 3 Azathioprine 4 Acetaminophen

3

What should be considered if the patient voids large amounts of very dilute urine with an increasing serum osmolarity and electrolyte concentration? 1 Polyuria 2 Neurohypophysis 3 Diabetes insipidus 4 Adrenal insufficiency

3

What signs/symptoms are characteristic of a patient who is described as lethargic? 1 The patient cannot be aroused. 2 The patient is awake and responsive. 3 The patient is drowsy but easily awakened. 4 The patient is aroused by painful stimulation.

3

When a patient is on a ventilator and wakes up and is attempting to breathe at a rate other than what the ventilator is set to, which drug is administered? 1 Gliadel 2 Erlotinib 3 Propofol 4 Mannitol

3

Which activity related to genetic counseling best illustrates the role of the medical-surgical nurse? 1 Tells the patient's family the results 2 Discloses the results of a genetic test to the patient and family members 3 Ensures that the patient understands the consequences of having a genetic test performed 4 Urges the patient with a positive family history for a genetic disorder to undergo genetic testin

3

Which anti-rheumatoid drug may increase the risk of opportunistic infections in patients? 1 Rituximab 2 Tocilizumab 3 Golimumab 4 Hydroxychloroquine

3

Which antiepileptic drug is used to prevent seizures? 1 Gliadel 2 Erlotinib 3 Phenytoin 4 Bevacizumab

3

Which cells stimulate the fight or flight response? 1 The sympathetic nervous system (SNS) cells originating in gray matter from S2 through S4 2 The parasympathetic nervous system (PNS) cells originating in gray matter from S2 through S4 3 The sympathetic nervous system (SNS) cells originating in gray matter from T1 through L2 or L3 4 The parasympathetic nervous system (PNS) cells originating in gray matter from T1 through L2 or L3

3

Which clinical sign of complex regional pain syndrome (CRPS) does the nurse know to be a manifestation of the sensory perception abnormalities seen in this syndrome? 1 Change in color 2 Excessive sweating 3 Intense burning pain 4 Change in temperature

3

Which condition is effectively treated with rest, ice, compression, and elevation (RICE)? 1 Joint dislocation 2 Rotator cuff injury 3 Achilles tendinopathy 4 Carpal tunnel syndrome

3

Which condition should the nurse infer from the positive result for the test depicted in this figure? 1 Strain 2 Sprain 3 Carpal tunnel syndrome (CTS) 4 Complex regional pain syndrome (CRPS)

3

Which cranial nerve allows a person to feel a light breeze on the face? 1 VII (facial) 2 I (olfactory) 3 V (trigeminal) 4 III (oculomotor)

3

Which describes secondary brain injuries? 1 Result in contusion 2 Caused by indirect forces 3 Occur after the initial injury 4 Cause additional injuries in the body

3

Which group of patients is most likely to experience carpal tunnel syndrome (CTS)? 1 Men over 50 2 Men under 50 3 Women over 50 4 Women under 50

3

Which individual has the highest chance of developing carpal tunnel syndrome (CTS)? 1 A 60-year old male 2 A 45-year-old male 3 A 60-year-old female 4 A 45-year-old female

3

Which initial site is the most common source of emboli for those experiencing embolic stroke? 1 Lung 2 Liver 3 Heart 4 Spleen

3

The nurse is evaluating a patient's equilibrium. When the patient stands with eyes closed, the patient begins to sway back and forth; with the eyes open, the patient remains erect. How does the nurse identify this assessment? 1 Pronator drift 2 Romberg sign 3 Positive Babinski's sign 4 Ipisilateral phenomenon

2

Which injury occurs when the skull is fractured or when it is pierced by a penetrating object? 1 Acceleration injury 2 Deceleration injury 3 Open traumatic brain injury 4 Closed traumatic brain injury

3

Which intervention is beneficial in the management of anoxia when it occurs as a result of a witnessed cardiac arrest in a patient? 1 Inducing a barbiturate coma 2 Placing an intraventricular catheter 3 Performing therapeutic hypothermia 4 Performing decompressive craniectomy

3

The nurse is monitoring a patient after supratentorial surgery. Which sign does the nurse report immediately to the provider? 1 Periorbital edema 2 Decorticate positioning 3 Bilateral ecchymoses of both eyes 4 Moderate amount of serosanguineous drainage on the head dressing

2

The nurse is performing a rapid neurologic assessment on a trauma patient. Which assessment finding is normal? 1 Increased lethargy 2 Constriction of pupils 3 Decerebrate posturing 4 Minimal response to stimulation

2

Which is a priority problem for the older adult patient diagnosed with bone cancer? 1 Reduced mobility related to weakness and fatigue 2 Altered self-esteem related to fear of death and dying 3 Potential for injury related to weakness and drug therapy 4 Pain of a chronic nature related to tumor invasion of other organs

3

Which is an alternative surgery to the traditional surgery used for curing brain tumors? 1 Enucleation surgery 2 Trabeculectomy surgery 3 Stereotactic radiosurgery 4 Laser trabeculoplasty surgery

3

Which is one of the causes of secondary osteoporosis? 1 Older age 2 Current smoking 3 Diabetes mellitus 4 High alcohol intake

3

Which long-term drug therapy increases the risk of developing ischemic bone necrosis? 1 Ketorolac 2 Ibuprofen 3 Prednisone 4 Acetaminophen

3

Which medication treats chronic gout? 1 Colchicine 2 Pegloticase 3 Allopurinol 4 Indomethacin

3

The nurse is providing education for a patient taking amitriptyline for fibromyalgia. Which statement by the patient indicates the need for further teaching? 1 "Taking amitriptyline helps me sleep." 2 "Taking amitriptyline helps my dizziness." 3 "Taking amitriptyline helps decrease my pain." 4 "Taking amitriptyline helps reduce my muscle spasms."

2

The nurse is providing postoperative care to a patient immediately following an osteotomy for the correction of hammertoe. What information does the nurse tell the patient? 1 "You will need to stay in a wheelchair for several weeks." 2 "You can put all of your weight on your foot in a few weeks." 3 "You will be able to walk out of the hospital in about three hours." 4 "You must come back in two weeks so we can remove the screws."

2

The nurse is reviewing the risk factors for Dupuytren contracture with a patient. Which finding causes the nurse to believe the patient may be at risk for developing this condition? 1 The patient is female. 2 The patient has diabetes. 3 The patient is left-handed. 4 The patient is African American.

2

The nurse is taking the history of an adult female patient. Which factor places the patient at risk for osteoporosis? 1 Consuming one alcoholic drink per week Correct2 Working at a desk and playing the piano for a hobby Incorrect3 Consuming 12 ounces of carbonated beverages daily 4 Having a hysterectomy and taking estrogen replacement therapy

2

The nurse is teaching a patient about how to decrease recurrences of fibromyalgia. Which statement by the patient indicates that further teaching is needed? 1 "I will try to avoid my triggers." 2 "I will rest whenever I have pain." 3 "I will establish a regular sleep pattern." 4 "I will find healthy ways to cope with stress."

2

Which nursing intervention helps prevent the incidence of osteomyelitis in a patient receiving hemodialysis? 1 Using clean technique for needle cannulation 2 Using Standard Precautions 3 Instructing the patient to brush teeth after every meal 4 Maintaining clean dressing change technique for long-term intravenous (IV) catheters

3

Which patient is at the highest risk for a fatigue fracture? 1 A patient with bone cancer 2 A patient with osteoporosis 3 A patient who runs every day 4 An older patient with osteoporosis

3

Which procedure does the nurse anticipate for the patient with suspected muscular dystrophy? 1 Arthroscopy 2 Myelography 3 Muscle biopsy 4 Magnetic resonance imaging (MRI)

3

Which procedure to treat a vertebral compression fracture involves injecting bone cement through the skin directly into the fracture site, allowing the patient to go home the next day? 1 Spinal fusion 2 Laminectomy 3 Vertebroplasty 4 Preferred vertebral augmentation

3

Which statement by the nurse is the most effective when communicating with a patient who was just been diagnosed with fibromyalgia after waiting for over 10 years for a diagnosis? 1 "You must be so happy to finally have a diagnosis." 2 "Now that you finally have a diagnosis, things will be easier." 3 "Tell me what you are feeling after finally getting a diagnosis." 4 "If I were you, I would be so thankful that you finally got a diagnosis."

3

Which statement by the patient indicates a need for further teaching about self-management of systemic lupus erythematosus? 1 "I will use moisturizers." 2 "I will pat my skin dry after showers." 3 "I will use sunblock with sun protection factor (SPF) 15." 4 "I will wear long sleeves and cover my legs when going out in the sunlight."

3

Which statement is true regarding neurologic changes in older adults? 1 Intellect declines with aging. 2 Pupil size increases with aging. 3 Older adults may need more time to retrieve information. 4 Neurological changes affect only sensory perception with aging.

3

Which type of trauma increases a patient's risk for hospital-acquired infection? 1 Malunion 2 Osteonecrosis 3 Open fractures 4 Compartment syndrome

3

While assessing a patient with a spinal cord injury, the nurse finds that the patient is unable to lift a hand. Which cranial nerve may be damaged? 1 X 2 V 3 XI 4 IV

3

While performing a neurological assessment, the nurse finds that the patient can be aroused only with painful stimulation. What is the expected level of consciousness? 1 Lethargic 2 Comatose 3 Stuporous 4 Unconscious

3

The nurse is teaching a patient and family about home care after a stroke. Which statement made by the patient's spouse indicates a need for further teaching? 1 "My husband may get depressed." 2 "I should spend all my time with my husband in case I'm needed." 3 "My husband must take his medicine every day to help prevent another stroke." 4 "The physical therapist will show us how to use the equipment so my husband can climb the stairs and get into and out of bed."

2

The nurse is teaching a patient with a long-leg cast about care of the extremity after cast removal. What statement made by the patient indicates a need for further teaching? 1 "I will have to wear elastic bandages." 2 "I will remove dead skin by gently scrubbing." 3 "I will have to support my lower extremity with pillows." 4 "I must exercise slowly as instructed by my physical therapist."

2

The nurse is teaching a patient with bunions on both feet about bone resection and fusion. Which statement made by the patient indicates that more teaching is needed? 1 "This will be a same-day procedure." 2 "Healing time will take two weeks for each foot." 3 "The surgeon will operate on one foot at a time." 4 "I will be allowed to put partial weight on my foot."

2

The nurse manager is observing a nurse caring for a patient after surgery for carpal tunnel release. Which statement made by the nurse requires correction? 1 "Before you are discharged, you will receive a prescription for an analgesic to manage pain." 2 "It's important for you to keep your fingers as still as possible the first day after surgery." 3 "We'll position your hand and arm above your heart to reduce swelling." 4 "Let's talk to your spouse about what kind of assistance you might need for the first six weeks home."

2

The nurse meets with a patient who reports having a ganglion. Which part of the body will the nurse inspect? 1 Foot 2 Wrist 3 Elbow 4 Thumb

2

The nurse observes a student nurse care for an adult patient with moderate traumatic brain injury (TBI). Which action made by the student nurse causes the nurse to intervene? 1 Log rolling the patient during turning 2 Elevating the head of the bed to 15 degrees 3 Maintaining the patient's head in a neutral position 4 Monitoring peripheral oxygen saturation continuously

2

The nurse prepares to perform a neurovascular assessment on a patient with closed multiple fractures of the right humerus. Which technique does the nurse use? 1 Auscultate lung sounds 2 Assess sensation of the right upper extremity 3 Inspect the abdomen for tenderness and bowel sounds 4 Assess the level of consciousness and ability to follow commands

2

The nurse provides discharge planning to a patient who has been prescribed methotrexate (MTX). Which vitamin is included to help decrease some of the side effects of MTX? 1 Niacin 2 Folic acid 3 Vitamin D 4 Vitamin K

2

The nurse provides teaching to a patient who has a callus. Which statement made by the patient indicates proper learning? 1 "I will apply antibiotic ointment onto the callus twice per day." 2 "I should be sure to pad that part of my foot so it doesn't have too much pressure on it." 3 "I will need to stay off of my foot for two weeks after the callus is surgically removed." 4 "I have to draw up a warm bath or soak my foot in a basin with warm water every day."

2

The nurse receives a patient in the emergency department (ED) who experienced a stroke. The patient is alert and requests something to eat from the nurse. Which is the best action the nurse can take? 1 Provide thickened fluids to the patient. 2 Assess the swallowing ability of the patient. 3 Obtain a prescription to give intravenous fluids. 4 Assess the level of consciousness in the patient.

2

The nursing instructor is teaching a group of student nurses about the synaptic knobs in a neuron. Which statement made by a student nurse indicates effective learning? 1 "Synaptic knobs are white lipid coverings over the axons." 2 "Synaptic knobs manufacture, store, and release neurotransmitters." 3 "Synaptic knobs are located between the gaps in myelinated axons." 4 "Synaptic knobs transfer impulses along the efferent and afferent pathways."

2

What should the nurse expect the primary health care provider to prescribe to the patient who has chronic back pain, visual disturbances, and weight loss? 1 Antibiotics and disease-modifying antirheumatic drugs 2 Nonsteroidal anti-inflammatory drugs and disease-modifying antirheumatic drugs 3 Nonsteroidal anti-inflammatory drugs, steroid therapy, and disease modifying antirheumatic drugs 4 Nonsteroidal anti-inflammatory drugs, analgesics, antibiotics, and disease modifying antirheumatic drugs

2

Which best describes hydrocephalus? 1 A collection of blood 2 An abnormal increase in cerebrospinal fluid 3 The shifting and herniating of brain tissue downward 4 The fluid accumulation between the cells of the brain

2

Which category of osteomyelitis is related to a bone infection that is caused by a skin infection of the adjacent tissues? 1 Exogenous 2 Contiguous 3 Endogenous 4 Hematogenous

2

Which class of drugs would be administered to a patient experiencing a constant, dull, and burning phantom limb pain (PLP)? 1 Opioids 2 Beta blockers 3 Antiepileptics 4 Antispasmodics

2

Which condition damages a patient's brain tissue and contributes to cerebral vasodilation and increased intracranial pressure (ICP)? 1 Hematoma 2 Hypoxemia 3 Hypotension 4 Cerebral edema

2

Which condition is the biggest risk factor for hip fracture? 1 Anemia 2 Osteoporosis 3 Atherosclerosis 4 Diabetes mellitus

2

Which cranial nerve is responsible for eye movement via the superior oblique muscles? 1 Optic 2 Trochlear 3 Abducens 4 Oculomotor

2

Which device gives an accurate measurement of intracranial pressure (ICP)? 1 Subarachnoid bolt 2 Intraventricular catheter 3 Subdural/epidural catheter 4 Fiber optic transducer tipped catheter

2

Which foot disorder is one of the most common causes of heel pain? 1 Callus 2 Plantar fasciitis 3 Morton's neuroma 4 Hypertrophic ungual labium

2

Which injury occurs when the moving head is suddenly stopped or hits a stationary object? 1 Acceleration injury 2 Deceleration injury 3 Open traumatic brain injury 4 Closed traumatic brain injury

2

Which intervention is most appropriate for the patient who was prescribed hydroxychloroquine and developed retinal damage? 1 Decreasing the dose of the drug 2 Discontinuing the drug completely 3 Discontinuing the drug for a few days 4 Continuing the treatment with no change

2

Which is the best nursing action to prevent complications in an older adult patient who has undergone total hip arthroplasty and is under postoperative care? 1 Prohibiting the patient from coughing 2 Using an abduction pillow to prevent adduction 3 Measuring the temperature to assess infection 4 Giving medication for pain only when the patient asks verbally

2

Which is the best way to decrease the risk for osteoporosis in a patient who has just been diagnosed with the disease? 1 Increase nutritional intake of calcium. 2 Walk for 30 minutes three times a week. 3 Increase nutritional intake of phosphorus. 4 Engage in high-impact exercise, such as running.

2

Which medical term refers to bone infection caused by bacteria, viruses, or fungi? 1 Osteocalcin 2 Osteomyelitis 3 Osteomalacia 4 Osteonecrosis

2

Which medication is beneficial in patients with acute gout? 1 Aspirin 2 Ibuprofen 3 Pregabalin 4 Acetaminophen

2

Which medication is used to treat cerebral edema by pulling water out of the extracellular space of the edematous brain tissue? 1 Propofol 2 Mannitol 3 Furosemide 4 Dexmedetomidine

2

Which medication would be beneficial to the patient with fibromyalgia syndrome who develops nerve pain? 1 Tramadol 2 Pregabalin 3 Amitriptyline 4 Nortriptyline

2

Which motor clinical manifestation may be seen in a patient with complex regional pain syndrome (CRPS)? 1 Edema 2 Paresis 3 Change in color 4 Excessive sweating

2

Which occupational activity predisposes a person to carpal tunnel syndrome (CTS)? 1 Overextension of the wrist 2 Grasping during wrist flexion 3 Pinching during wrist extension 4 Putting weight on the hand during wrist flexion

2

Which parameter is assessed before prescribing epoetin alfa to a patient who has undergone total hip arthroplasty (THA)? 1 Blood pressure 2 Decreased hemoglobin 3 Decreased respiratory rate 4 Elevated body temperature

2

Which statement about subdural hematoma (SDH) is accurate? 1 It results from arterial bleeding. 2 It has the highest mortality rate. 3 Acute SDH presents within 24 hours after impact. 4 It involves bleeding between the dura mater and the skull.

2

Which stroke syndrome has clinical features such as perpetual, spatial, and visual field deficit? 1 Internal carotid artery strokes 2 Middle cerebral artery strokes 3 Anterior cerebral artery strokes 4 Posterior cerebral artery strokes

2

Which syndrome is characterized by symptoms such as scoliosis and excessive height with elongated hands and feet? 1 Reiter's syndrome 2 Marfan syndrome 3 Fibromyalgia syndrome 4 Chronic fatigue syndrome

2

Which syndrome is characterized by the presence of rheumatoid nodules in the lungs? 1 Felty's syndrome 2 Caplan's syndrome 3 Sjogren's syndrome 4 Carpal tunnel syndrome

2

Which task does the nurse plan to delegate to the nursing assistant caring for a group of patients in the neurosurgical unit? 1 Prepare a patient who is going to radiology for a cerebral arteriogram. 2 Attend to the care needs of a patient who has had a transcranial Doppler study. 3 Assist the health care provider in performing a lumbar puncture on a confused patient. 4 Educate a patient about what to expect during an electroencephalogram (EEG).

2

Which tumors produce ataxia, autonomic nervous system dysfunction, vomiting, drooling, hearing loss, and vision impairment? 1 Papilledema 2 Infratentorial 3 Meningiomas 4 Hydrocephalus

2

Which type of brain tumor is considered malignant? 1 Meningioma 2 Chondrosarcoma 3 Acoustic neuroma 4 Choroid plexus papilloma

2

While assessing a patient with acute gout, the nurse finds inflammation of joints of the great toe. Which condition doe the nurse suspect in the patient? 1 Tophi 2 Podagra 3 Calcinosis 4 Periungual lesions

2

While assessing a patient with fever, pain, and fatigue, the nurse notices joint inflammation and myositis. Which medication does the nurse anticipate will be prescribed? 1 Topical cortisone 2 Acetaminophen 3 Methotrexate 4 Hydroxychloroquine

2

While assessing a patient with systemic sclerosis, the nurse finds thickening and hardening of the skin on the fingers. What does the nurse document in the patient's health record? 1 Calcinosis 2 Sclerodactyly 3 Telangiectasia 4 Bilateral carpal tunnel syndrome

2

While reviewing the medical reports of a patient, the nurse finds that the patient has class IV pulmonary arterial hypertension. Which medication would be prescribed? 1 Nilotinib 2 Bosentan 3 Probenicid 4 Febuxostat

2

Why is carpal tunnel syndrome (CTS) beginning to be found in much younger patients than previously? 1 More elementary schools are introducing tennis programs. 2 The use of handheld mobile devices has increased among children. 3 Nutrition deficiencies are becoming more common in young children. 4 Adolescents are more likely to engage in risky thrill-seeking behaviors.

2

A nurse is discussing sleeping patterns of older adults with the caregiver of a 75-year-old patient. Which caregiver statement indicates understanding? Select all that apply. 1 "Older adults fall asleep early and wake up late." 2 "Older adults have changes in circadian rhythms." 3 "Older adults have an inclination for daytime napping." 4 "Older adults require less sleep than younger adults." 5 "Older adults spend less time awake in bed before falling asleep."

2, 3

A patient with a left ankle fracture is using a cane for support. What statements about the use of a cane are correct? Select all that apply. 1 The cane is placed on the left side. 2 A hemi-cane will provide more support for the patient. 3 The top of the cane is parallel to the stylus of the wrist. 4 The elbow of the arm holding the cane is flexed at 45 degrees. 5 The patient's unaffected leg and arms are assessed for strength.

2, 3

The nurse is teaching a patient about strategies for coping effectively with connective tissue disease. Which statement by the patient indicates that further teaching is needed? Select all that apply. 1 "I will seek support from my friends and family." 2 "I will use ice on my joints whenever I have pain." 3 "I will see my health care provider on a weekly basis." 4 "I will eat a balanced diet and get exercise as my health allows." 5 "I will find out as much as I can about my connective tissue disease."

2, 3

Which statements are true regarding the various types of casting materials for immobilization? Select all that apply. 1 Fiberglass takes several days to dry. 2 Plaster is not commonly used for casting. 3 Fiberglass can dry and become rigid in minutes. 4 Fiberglass increases the risk of skin breakdown. 5 Plaster is the most common material used for casting.

2, 3

A 67-year-old patient is diagnosed with plantar fasciitis. What conservative management does the nurse suggest? Select all that apply. 1 "Avoid prolonged rest." 2 "Strap the affected foot." 3 "Apply an ice pack to the site." 4 "Wear shoes with good support." 5 "Perform weight-bearing exercises." 6 "Avoid cortisone medications."

2, 3, 4

What postoperative care is expected after hip replacement surgery for an older patient? Select all that apply. 1 Re-positioning the patient every 4 hours 2 Encouraging the patient for early ambulation 3 Monitoring the patient frequently to prevent falls 4 Inspecting the patient's heels every 8 to 12 hours 5 Instructing the patient to maintain bedrest for a week

2, 3, 4

Which are physical findings of a patient who has a mild traumatic brain injury (TBI)? Select all that apply. 1 Irritability 2 Headache 3 Dizziness 4 Fatigue 5 Depression

2, 3, 4

Which parameters should be monitored in an older adult patient with osteoarthritis (OA) who is taking 3500 g of acetaminophen daily? Select all that apply. 1 Serum glucose 2 Serum bilirubin 3 Serum albumin 4 Prothrombin time 5 Low-density lipoproteins

2, 3, 4

vWhich arthroplasty surgeries are commonly performed in patients with rheumatoid arthritis (RA)? Select all that apply. 1 Hemiarthroplasty 2 Phalangeal arthroplasty 3 Metatarsal arthroplasty 4 Metacarpal arthroplasty 5 Total shoulder arthroplasty

2, 3, 4

A lumbar puncture (LP) is ordered for a patient. Which interventions does the nurse perform immediately after the procedure? Select all that apply. 1 Withhold fluids. 2 Obtain vital signs. 3 Monitor for headache. 4 Monitor the patient for a delayed allergic response. 5 Assess neurologic status

2, 3, 5

What interventions should be performed for a patient with polymyositis? Select all that apply. 1 Managing organ dysfunction 2 Teaching about dietary needs 3 Providing support for physical therapy 4 Frequent echocardiography monitoring 5 Teaching about complications of long-term steroid therapy

2, 3, 5

What statements about amputation are correct? Select all that apply. 1 Traumatic amputations are caused by peripheral vascular diseases. 2 Lisfranc and Chopart amputations are types of midfoot amputations. 3 In a Syme amputation, most of the foot is removed but the ankle remains. 4 Lower extremity amputations are less common in black and Hispanic populations. 5 Lower extremity amputations are more common than upper extremity amputations.

2, 3, 5

Which factors are implicated in the greatest number of injuries associated with traumatic brain injuries (TBIs)? Select all that apply. 1 Mornings 2 Weekends 3 Alcohol use 4 Winter months 5 Evenings and nights

2, 3, 5

Which statements about complex regional pain syndrome (CRPS) are accurate? Select all that apply. 1 It makes the skin hot and dry. 2 It is also known as reflex sympathetic dystrophy. 3 It is characterized by paresis and muscle spasms. 4 It can be managed by intramuscular phentolamine. 5 It can be managed by biphosphonates and antidepressants.

2, 3, 5

Which complications can result from a fracture? Select all that apply. 1 Swelling 2 Infection 3 Hemorrhage 4 Callus formation 5 Crush syndrome 6 Acute compartment syndrome

2, 3, 5, 6

The nurse is teaching safety measures to a patient with rheumatoid arthritis who is on methotrexate therapy. Which statements should the nurse include? Select all that apply. 1 "You should eat a calcium-rich diet." 2 "You should avoid crowded places." 3 "You should avoid alcoholic beverages." 4 "You should take folic acid supplements." 5 "You should have your eyes examined for every 6 months."

2, 3,4

In which positions can the nurse assess a patient with a shoulder or upper arm fracture? Select all that apply. 1 Prone 2 Sitting 3 Supine 4 Standing 5 Semi-Fowler

2, 4

The results of a patient's cerebral spinal fluid analysis have been obtained. Which results does the nurse identify as normal? Select all that apply. 1 Glucose 25 mg/dL 2 Lactic acid 20 mg/dL 3 Total protein 75 mg/dL 4 Color is clear or colorless 5 Less than 5 lymphocytes/mm 2

2, 4, 5

The student nurse is providing postoperative care to an older adult who has undergone total hip arthroplasty. Which actions of the nurse indicate the need for further teaching? Select all that apply. 1 Reorienting the patient frequently 2 Keeping the patient's heels on the bed 3 Encouraging the patient to breathe deeply and cough 4 Preventing the patient from getting out of the bed 5 Using the incentive spirometer every five hours

2, 4, 5

What statements about performing a closed reduction for a dislocated clavicle are correct? Select all that apply. 1 It does not require sedation or analgesics. 2 It is most commonly used for simple fractures. 3 A fiberglass synthetic cast is used to immobilize the arm. 4 The ends of the bones are manually pulled and realigned. 5 A commercial immobilizer is used to keep the bone in place.

2, 4, 5

Which statements are accurate regarding the assessment of pain and temperature sensation in a patient? Select all that apply. 1 Test for each sensation separately. 2 Test for one sensation, which is sufficient. 3 Test all parts of the extremities one by one. 4 Test for pain sensation with the help of sharp or dull objects. 5 Test for temperature sensation with the help of a cold reflex hammer.

2, 4, 5

While assessing a patient, the nurse concludes that the patient has a severe form of scleroderma. Which symptoms in the patient support the nurse's conclusion? Select all that apply. 1 Althralgia 2 Digit necrosis 3 Joint contractures 4 Periungual lesions 5 Sausage-like fingers

2, 4, 5

A patient is diagnosed with systemic sclerosis and esophagitis. What nursing interventions are beneficial? Select all that apply. 1 Providing liquids in the diet 2 Administering histamine antagonists 3 Providing three large meals each day 4 Providing little amount of caffeine in the diet 5 Elevating the head of the patient at least 60 degrees starting at the beginning of a meal until an hour after eating

2, 5

The nurse is teaching a patient regarding care after a cast has been removed from the patient's arm. Which patient statements indicate a need for further learning? Select all that apply. 1 "I should wear elastic bandages to prevent swelling." 2 "I should remove any dead skin by scrubbing the area slowly." 3 "I should use pillows to support my arm if I experience any discomfort." 4 "I should exercise slowly, following the instructions of my physical therapist." 5 "I should inform the nurse immediately if I have a decreased range of motion."

2, 5

What are the cardiovascular manifestations of systemic lupus erythematosus (SLE)? Select all that apply. 1 CNS lupus 2 Pericarditis 3 Interstitial fibrosis 4 Myocardial fibrosis 5 Raynaud's phenomenon

2, 5

A patient has sustained a fracture of the left tibia. The extremity is immobilized using an external fixation device. Which postoperative instruction does the nurse include in this patient's teaching plan? 1 "Wear the same clothing that is normally worn." 2 "Clean the pin site when any drainage is noticed." 3 "Use pain medication as prescribed to control pain." 4 "Apply bacitracin if signs or symptoms of infection develop around pin sites."

3

A patient is admitted with a stroke (brain attack). Which tool does the nurse use to facilitate a focused neurologic assessment of the patient? 1 Reflex hammer 2 Intracranial pressure monitor 3 National Institutes of Health Stroke Scale (NIHSS) 4 Mini-Mental State Examination (MMSE; mini-mental status exam)

3

A patient is examined in a sitting or standing position for what type of fracture? 1 Leg 2 Pelvic 3 Upper arm 4 Lower arm

3

A patient is having difficulty understanding spoken and written words and is saying made-up words and meaningless speech. What would be the possible reason behind the patient's condition? 1 Mixed aphasia 2 Global aphasia 3 Receptive aphasia 4 Expressive aphasia

3

A patient is scheduled to undergo a cerebral angiography. What is the purpose of this diagnostic test? 1 To determine the origin of seizure activity 2 To study the biochemical functions of the brain 3 To detect a blockage in the arteries or veins of the brain 4 To study cerebral blood flow and the presence of a neoplasm

3

A patient is undergoing a magnetic resonance imaging (MRI) test. Which contrast medium is used in this procedure? 1 Iodine 2 Barium 3 Gadolinium 4 Ipodate sodium

3

A patient recently has had an amputation of the right hand. Which statement by the patient, who was right-handed, indicates that he or she is coping effectively? 1 "People will look at me differently." 2 "Clothing will cover my missing hand." 3 "I can learn to write with my left hand." 4 "I'll need help with all of my personal care."

3

A patient reports hair loss, swelling, and redness of knees to the nurse. The test reports of the patient reveal inflammation of five joints. Which condition does the nurse suspect in the patient? 1 Gout 2 Scleroderma 3 Lupus erythematosus 4 Raynaud's phenomenon

3

A patient who underwent a cerebral angiography had a catheter inserted into the femoral artery at the groin. What action does the nurse take after the procedure? 1 Apply a warm compress around the site. 2 Reduce the patient's oral and IV fluid intake. 3 Keep the extremity straight and immobilized. 4 Maintain a pressure dressing over the site for an hour.

3

A patient with a traumatic brain injury from a motor vehicle crash is monitored for signs of increased intracranial pressure (ICP). Which sign does the nurse monitor for? 1 Dizziness 2 Reactive pupils 3 Changes in breathing pattern 4 Increasing level of consciousness

3

A 40-year-old patient who is 36 hours into recovering from a fractured pelvis begins experiencing hypoxemia, dyspnea, and tachypnea. For which complication should the nurse first assess the patient? 1 Infection 2 Fat embolism 3 Hypovolemic shock 4 Acute compartment syndrome

2

A doctor is performing a closed reduction on a simple fracture. During the procedure, the nurse notices that the patient's end-tidal carbon dioxide levels falls to 30 mm Hg, and the respiratory rate calls to 10 breaths/minute. What is the best response? 1 Take the patient's temperature. 2 Rub the patient's sternum and encourage breathing. 3 Manage any pain with fentanyl, hydromorphone (Dilaudid), or morphine sulfate. 4 Use an x-ray to confirm that the bone ends are aligned before the bone is immobilized.

2

A patient with bone cancer is scheduled for a right upper extremity amputation. Which statement by the patient's husband indicates an effective coping strategy? 1 "I'll try to limit her visitors." 2 "The family will avoid direct discussion of my wife's amputation." 3 "I'll have to find ways to help my wife focus on positive aspects of her body." 4 "My family will use diversional methods to help her not focus on the amputation."

3

A family member of a patient who experienced a stroke is anxious and says to the nurse, "Something is the matter with Grandpa. All he does is cry!" Which response by the nurse is best at this time? 1 "It sounds like he is depressed, so I will inform the provider." 2 "He is emotionally labile and may have this behavior for some time." 3 "That is a symptom of brain stem deterioration and is to be expected." 4 "He is experiencing hemianopsia, which should begin to fade over time."

2

A nurse is assessing a perimenopausal patient's musculoskeletal system. The nutrition history is especially important because women generally do not get enough of which nutrient in their diet? 1 Sodium 2 Calcium 3 Potassium 4 Magnesium

2

A nurse is providing care for a newly admitted patient diagnosed with progressive muscular dystrophy. Which laboratory test does the nurse expect to be elevated? 1 Serum calcium 2 Creatinine kinase 3 Serum phosphorus 4 Alkaline phosphatase

2

A patient diagnosed with exacerbation of systemic sclerosis (SSc) asks the nurse why a foot board and a bed cradle have been placed on the bed. The nurse explains that they are used for what purpose? 1 Inspect skin for lesions or changes 2 Promote comfort from Raynaud's phenomenon 3 Prevent foot drop and contractures 4 Decrease chilling of the extremities

2

A patient gradually becomes weak, lethargic, and confused following a craniotomy. What electrolyte alteration may be causing the patient's status change? 1 Hypermagnesemia 2 Hyponatremia 3 Hypocalcemia 4 Hyperkalemia

2

A patient has a grade III compound fracture of the right tibia. To prevent infection, which intervention does the nurse implement? 1 Leave the site open to the air to keep it dry 2 Use strict aseptic technique when cleaning the site 3 Assist the patient to shower daily and pat the wound site dry 4 Apply bacitracin ointment to the site daily with a sterile cotton swab

2

A patient has a history of deep vein thrombosis (DVT) in the lower leg. The patient arrives at the emergency department due to fears of having a stroke. Given this history, what type of stroke might the nurse first suspect? 1 Ischemic 2 Embolic 3 Hemorrhagic 4 Hypertensive

2

A patient has been admitted with a diagnosis of a stroke (brain attack). The nurse suspects that the patient has had a right hemisphere stroke because the patient exhibits which symptoms? 1 Aphasia and cautiousness 2 Impulsiveness and smiling 3 Quick anger and frustration 4 Inability to discriminate words

2

A patient has symptoms of rheumatoid arthritis (RA). Which laboratory finding indicates to the nurse that the patient may have RA? 1 Total serum complement, 75 units/mL 2 Positive total antinuclear antibody (ANA) 3 Erythrocyte sedimentation rate (ESR), 20 mm/hr 4 Beta-globulin level, 1.0 g/dL

2

A patient has undergone a kyphoplasty. What discharge teaching should the nurse provide to the patient and family? 1 Remove the dressing after 12 hours 2 Monitor the puncture site for infection 3 Avoid driving for 48 hours after surgery 4 Start activities a day after the dressing is removed

2

A patient in the emergency department (ED) has slurred speech, confusion, and visual problems, and has been having intermittent episodes of worsening symptoms. The symptoms have a gradual onset. The patient also has a history of hypertension and atherosclerosis. What does the nurse suspect that the patient is probably experiencing? 1 Embolic stroke 2 Thrombotic stroke 3 Hemorrhagic stroke 4 Transient ischemic attack

2

A patient is admitted to the emergency department for a stroke. Which intervention helps provide proper care for the patient? 1 Monitor the patient's vital signs at least every 4 hours. 2 Maintain the head of the patient in a midline, neutral position. 3 Keep the head of the patient's bed elevated at a 20-degree angle. 4 Provide oxygen therapy once the patient's oxygen saturation is less than 86%.

2

A patient is being educated on the prevention of carpal tunnel syndrome (CTS). What is a measure the nurse can suggest to help prevent CTS? 1 Tensing the wrist while gripping Correct2 Stretching the fingers periodically 3 Setting the work chair to the lowest height Incorrect4 Avoiding reliance on wrist rests at a keyboard

2

A patient is being prepared for a lumbar puncture to extract cerebrospinal fluid (CSF). What should the nurse instruct the patient? 1 One test tube of CSF fluid will be collected. 2 The patient must lie still in a fetal side-lying position. 3 The procedure is conducted under general anesthesia. 4 There may be pain in the hand(s) when the spinal needle is inserted.

2

A patient is brought to the emergency department with sudden onset of right-sided paralysis and difficulty speaking. A family member is worried that these symptoms will be permanent. Based on the patient's symptoms, the nurse anticipates which outcome? 1 Permanent deficits are likely 2 Improvement over several days 3 Improvement over weeks to months 4 Improvement within 24 hours of onset

2

A patient is considering treatments for a malignant brain tumor. Which statement by the patient indicates a need for further instruction by the nurse? 1 "A combination of treatments might be necessary." 2 "Antibiotics will help minimize the size of the tumor." 3 "In a craniotomy, holes are cut in the skull to access the tumor." 4 "The goal is to decrease tumor size and improve survival time."

2

A patient is diagnosed with chronic osteomyelitis. What feature does the nurse expect to assess in the patient? 1 Swelling around the affected area 2 Ulceration resulting in the sinus tract 3 Presence of temperature above 101° F 4 Pulsating pain that worsens with movement

2

A patient is receiving IV administration of recombinant tissue plasminogen activator (rtPA) therapy. Which sign/symptom alerts the nurse that the infusion should be discontinued? 1 Hypotension 2 Report of headache 3 Report of feeling warm 4 Hyponatremia

2

A patient is scheduled for an electroencephalogram. What should the nurse teach the patient prior to the test? 1 Avoid any fluids on the day of the test. 2 Avoid central nervous system depressants. 3 A blindfold and earplugs may be used during the test. 4 Maintain nothing by mouth (NPO) status the night before the test.

2

A patient reports to the nurse an inability to identify the taste of foods. Which cranial nerve would have been affected in the patient? 1 Optic nerve 2 Facial nerve 3 Olfactory nerve 4 Oculomotor nerve

2

A patient sustains a stable fracture of the distal radius. Which type of cast is most suitable? 1 Long-arm cast 2 Short-arm cast 3 Thumb spica cast 4 Hanging-arm cast

2

A patient with rheumatoid arthritis reports cervical pain radiating down one arm. Which intervention should the nurse implement in this situation? 1 Administering analgesics immediately 2 Administering antibiotics immediately 3 Notifying the primary health care provider immediately 4 Suggesting long-term arm exercises to relieve the pain

3

A patient's short-leg cast has been removed. What should the nurse teach the patient about caring for the extremity after cast removal? 1 Perform weight-bearing exercises 2 Avoid placing the extremity on pillows 3 Apply elastic bandages around the extremity 4 Scrub the affected extremity well to remove dead, scaly skin

3

After recovering from a head injury, a patient tells the nurse, "I'm finding it difficult to play tennis. My hands and legs aren't coordinating with each other." Which portion of the brain may be damaged? 1 Cerebrum 2 Forebrain 3 Cerebellum 4 Diencephalon

3

After removing the cast from a nondisplaced ulnar bone fracture in the 8th week after being injured, the patient reports pain and swelling at the site. Further investigations revealed a fracture of the right radial bone. What might be the reason behind the fracture? 1 Primary osteoporosis 2 Primary osteomyelitis 3 Secondary osteoporosis 4 Secondary osteomyelitis

3

After reviewing the prescription list of a patient with rheumatoid arthritis, the nurse advises calcium supplements. Which drug on the patient's prescription list requires calcium supplements to prevent side effects? 1 Infliximab Incorrect2 Abatacept Correct3 Prednisone 4 Methotrexate

3

After undergoing a supratentorial surgery, a patient is sent for laboratory investigations. The laboratory report of the patient reveals an increased serum osmolarity, decreased urine osmolarity, and a urine output of 8 L/24hr. What does the nurse infer from the laboratory report? 1 Cerebral salt wasting 2 Inflammation of the meninges 3 Posterior pituitary gland failure 4 Syndrome of inappropriate antidiuretic hormone

3

Carpal tunnel syndrome (CTS) occurs when which nerve in the wrist is compressed? 1 Ulnar 2 Radial 3 Median 4 Anterior interosseous

3

The health care provider orders an electroencephalogram (EEG) for a patient who may have a sleep disorder. Which teaching will the nurse provide before the test? 1 Fast for six hours before the test. 2 Avoid sleeping in a prone position. 3 Sleep less the night before the test. 4 Avoid alcohol and tobacco 36 hours before the test.

3

The nurse assessing a patient for spinal alignment observes a lateral curve of the spine. How does the nurse document this finding? 1 Lurch 2 Lordosis 3 Scoliosis 4 Kyphosis

3

The nurse is attending to a patient diagnosed with an X-linked recessive condition. What does the nurse inform the patient about X-linked recessive inheritance pattern? 1 The trait is higher in females than males in a family. 2 The trait is passed from all mothers to their daughters. 3 The trait is transmitted from all fathers to their daughters. 4 Female carriers have a 100% risk of passing the gene to their children.

3

The nurse is caring for a female patient diagnosed with rheumatoid arthritis who is prescribed methotrexate. Which instruction should the nurse provide for safe and effective care? 1 "You should report hair loss." 2 "You should report chest pain." Correct3 "You should strictly use birth control." 4 "You should discontinue the therapy if the symptoms are suppressed."

3

The nurse is caring for a middle-aged patient diagnosed with rheumatoid arthritis. Which patient statement requires further assessment for unproductive coping strategies? 1 "I'm letting my husband do most of the cooking, but I help plan the menus." 2 "Since I started taking etanercept, I can walk up and down the stairs of my home easier." 3 "My husband is getting used to having sex only once a month." 4 "I worry about what's going to happen to me if my husband cannot take care of me, but he says he'll hire someone if he must."

3

The nurse is caring for a patient who is experiencing tachypnea followed by periods of apnea. Assessment findings include nonreactive pupils and an abnormal protrusion of the brainstem into other brain tissue. The nurse identifies that the patient is experiencing what complication? 1 Hydrocephalus 2 Uncal herniation 3 Central herniation 4 Intracerebral hemorrhage

3

The nurse is caring for an older adult patient diagnosed with osteoarthritis. Which patient statement indicates to the nurse that the patient is using effective coping strategies? 1 "I do not know how long my wife will be able to take care of me at home." 2 "The bus is coming to pick me up from the senior center three times a week so I can play cards." 3 "I am helping with the dishes and laundry, but I hurt so badly when I am doing it." 4 "I do not know how much longer my neighbor can continue to help clean my house."

2

The nurse is developing a plan of care for a patient with metastatic bone cancer. What is an appropriate goal of treatment to include in the plan of care for this patient? 1 Reconstruct the bone and aid in bone grafting. 2 Improve the quality of life and promote pain relief. 3 Determine the stage of cancer and extent of bone damage. 4 Cure the cancerous bone, cartilage, and metastatic lesions.

2

The nurse is caring for a patient with a confirmed thrombotic stroke, whose onset of symptoms began 2 hours earlier. The nurse expects the health care provider to prescribe the administration of which drug? 1 Dopamine to maintain blood pressure 2 Epinephrine to promote vasoconstriction 3 Recombinant tissue plasminogen activator 4 Verapamil to prevent ventricular dysrhythmias

3

The nurse is caring for an older patient post hip-repair surgery. What postoperative care must the nurse perform for this patient? 1 Re-position the patient every 4 hours 2 Inspect the patient's heels once a day 3 Monitor the patient frequently to prevent falls 4 Instruct the patient to maintain bedrest for a week

3

The nurse is educating a patient who is scheduled for endoscopic carpal tunnel release (ECTR) surgery for carpal tunnel syndrome (CTS). Which statement made by the patient shows understanding of the procedure? 1 "It will take a couple of months to recover, but I'll be grateful when my CTS is cured." 2 "My spouse is going to need to help me unload groceries and wash dishes for a couple of days." 3 "This surgery will require a small incision, but the pain might be worse than it would be with open surgery." 4 "My surgeon is doing ECTR because it is more effective than OCTR, and I don't want to have to have another surgery."

3

The nurse is overseeing a nursing student who is serving as an advocate for a patient undergoing genetic testing. Which nursing student statement indicates effective understanding of patient autonomy? 1 "I will refer the patient to the appropriate support groups." 2 "I'll discuss potential health problems with the patient who tests positive." 3 "I'll evaluate the patient's understanding of potential issues and health problems." 4 "I'll support the patient's decision to decline testing if that is what the patient decides."

4

The nurse is providing instructions to a patient with systemic sclerosis and prescribed bosentan. Which statement made by the nurse needs correction? 1 "You should come back for follow-up testing for liver enzyme levels." 2 "You should be aware that the medication may cause liver toxicity." 3 "You should be aware that the medication may cause birth defects." 4 "You should take high doses of the medication if your symptoms get aggravated."

4

The nurse is reviewing the medical histories for four patients with head injuries. Which patient should the nurse suspect to have an injury to the parietal lobe? 1 Patient 1 2 Patient 2 3 Patient 3 4 Patient 4

4

The nurse provides care to a patient who experienced a mild traumatic brain injury (MTBI) one day ago. The patient inquires about how long the symptoms will last. Which is the best response by the nurse? 1 "You should already be starting to feel better." 2 "Sometimes these symptoms will never go away." 3 "Your symptoms will start to resolve within a couple of months." 4 "Some or most of your symptoms will likely go away within 48 more hours."

4

The nurse provides education about safety precautions to a patient who has undergone right total hip arthroplasty. Which statement from the patient indicates the need for additional teaching? 1 "I should avoid twisting my body when moving." 2 "I should avoid crossing my legs to be more comfortable." 3 "I should avoid putting more weight on my right leg while walking." 4 "I should avoid adaptive devices when putting on shoes and socks."

4

The nurse suspects vasculitis in a patient with rheumatoid arthritis. Which finding in the patient supports the nurse's conclusion? 1 Visual disturbances 2 Pain when opening the mouth 3 Subcutaneous nodules on the arms 4 Ischemic skin lesions around the nail bed

4

The nurse uses a hand brace to immobilize the wrist of a patient who has undergone surgery for carpal tunnel syndrome. What should the nurse explain to the patient about the hand brace? 1 "It helps to avoid swelling." 2 "It helps to improve mobility." 3 "It helps to prevent bleeding." 4 "It helps to provide relief from pain."

4

The nursing instructor is teaching a group of nursing students about emergency care for extremity fractures. What statement made by a participant indicates a need for further teaching? 1 "I should not remove the patient's shoes." 2 "I should cut the clothing over the affected area." 3 "I should apply a splint above and below the fracture." 4 "I should not apply direct pressure on the affected area."

4

The nursing instructor is teaching a group of nursing students about ganglions. Which statement made by a student indicates the need for further instruction? 1 "It is painless on palpation but often causes joint discomfort." 2 "It is common in people between the ages of 15 and 50 years." 3 "A small needle is used to aspirate fluid from a small-sized ganglion cyst." 4 "Activity should be avoided for 24 hours after surgery of a large ganglion cyst."

4

The patient presents with wrist pain that is worse at night and has started to radiate to the shoulder and neck. An x-ray reveals no damage to any bones in the wrist. The Phalen maneuver is positive. The patient works as a data manager and exercises three days a week roller blading. What is the most likely diagnosis? 1 Strained wrist 2 Sprained wrist 3 Wrist fracture 4 Carpal tunnel syndrome (CTS)

4

The registered nurse is teaching a student nurse regarding questions to ask a patient with traumatic brain injury during the assessment. Which statement made by the student nurse indicates ineffective learning? 1 "I will obtain the patient's history of alcohol." 2 "I will check the patient's level of consciousness." 3 "I will ask for the place, location, and time of the injury." 4 "I will wait until the patient gains consciousness to answer my questions about the injury

4

The serum calcium level of a patient with a femoral fracture is 12 mg/dL. What type of fracture does the nurse suspect that the patient has? 1 Fatigue fracture 2 Buckled fracture 3 Greenstick fracture 4 Pathologic fracture

4

The student nurse is preparing medication charts for four patients with inflammatory disorders. Which medication chart needs correction? 1 Patient 1 2 Patient 2 3 Patient 3 4 Patient 4

4

Upon performing a physical examination of a patient, the nurse observes that the ring finger and the little finger are bent toward the palm and cannot be extended. What condition does this finding indicate? 1 Morton's neuroma 2 Nerve impingement 3 Carpal tunnel syndrome 4 Dupuytren's contracture

4

Using a blunt object, the nurse gently scrapes the sole of the patient's foot from the heel to the toe. Which reflex is the nurse assessing? 1 Pronator drift 2 Romberg sign 3 Proprioception 4 Babinski's reflex

4

What can lead to organ dysfunction or failure? 1 Reiter's syndrome 2 Marfan syndrome 3 Polymyalgia rheumatica 4 Systemic necrotizing vasculitis

4

What class of medication decreases inflammation and slows down the progression of systemic sclerosis? 1 Immunosuppressants 2 Histamine antagonists 3 Endothelin receptor antagonists 4 Oral tyrosine kinase inhibitors (TKIs)

4

What complication of osteoporosis can cause a patient to lose up to 3 inches of height in 20 years? 1 Osteopenia 2 Fallophobia 3 Osteomalacia 4 Dowager's hump

4

What consequence of excessive wrist extension may result in carpal tunnel syndrome? 1 Reduced blood supply 2 Increased nerve compression 3 Increased volume of the synovium 4 Increased pressure in the lower portion of the carpal tunnel

4

What intervention is most commonly used to treat strains? 1 RICE 2 Bracing 3 Splinting 4 Muscle relaxants

4

What is a diagnostic finding of acute gout? 1 Decreased level of platelets 2 Elevated serum level uric acid 3 Decreased level of white blood cells 4 Elevated erythrocyte sedimentation rate (ESR)

4

What is a hammertoe? 1 Medial deviation of the hallux, away from the first metatarsal bone 2 Medial deviation of the first metatarsal and lateral deviation of the hallux 3 Stiffness due to bone spurs that affects the metatarsophalangeal joint at the base of the hallux 4 Dorsiflexion of the metatarsophalangeal joint with plantar flexion of the proximal interphalangeal joint next to it

4

What is an early manifestation of fat embolism syndrome? 1 Lethargy 2 Petechiae 3 Headache 4 Low arterial oxygen

4

What is the appropriate minimum weight of the pulling force in skeletal traction? 1 5 pounds 2 7 pounds 3 10 pounds 4 15 pounds

4

What is the characteristic feature of Bouchard's nodes? 1 Excess fluid in the joint 2 Atrophy of the skeletal muscle 3 Bony nodules at the distal interphalangeal joints 4 Bony nodules at the proximal interphalangeal joints

4

What is the function of the cerebral cortex? 1 To regulate emotions 2 To control temperature and cognition 3 To control creativity, memory, and intelligence 4 To translate impulses into understandable feelings

4

What is the function of the part indicated as A in the figure? 1 Providing structure to the neuron 2 Regulating cerebrospinal fluid (CSF) 3 Providing protection for the neuron 4 Conducting impulses to the cell body

4

What is the pathophysiology of osteoporosis? 1 Increased osteocytic activity over osteoblastic activity 2 Increased osteoblastic activity over osteocytic activity 3 Increased osteoblastic activity over osteoclastic activity 4 Increased osteoclastic activity over osteoblastic activity

4

What is the purpose for using magnetic resonance spectroscopy (MRS)? 1 It uses only limited amounts of radiation. 2 It provides detailed images of bone tissue. 3 It is the only test that can be safely used during pregnancy. 4 It is used to detect abnormalities in the brain's biochemical processe

4

What is the purpose of the Glasgow Coma Scale used by health care personnel? 1 To detect motor functions 2 To test sensory perception 3 To assess the cranial nerves 4 To assess level of consciousness

4

What is the rationale for the nurse to assess a patient's sleeping habits? 1 To establish pain tolerance 2 To gather demographic data 3 To identify neurologic problems 4 To identify changes in pattern, duration, and intensity

4

What physiological change would prompt the nurse to instruct an older patient to wear shoes while walking? 1 Altered balance 2 Slower processing time 3 Change in perception of pain 4 Decreased sensory perception of touch

4

What type of complication would a patient with the condition depicted in the image be at risk for developing? 1 Embolic stroke 2 Thrombotic stroke 3 Intracerebral hemorrhage 4 Subarachnoid hemorrhage

4

When a patient is experiencing discomfort after a craniotomy, what should be the postoperative care nurse's main focus? 1 Meningiomas 2 Hydrocephalus 3 Cerebral edema 4 Intracranial pressure

4

When differentiating between fat embolism and blood clot embolism, which statement is true? 1 Blood clot embolism usually results within 48 hours of injury. 2 Blood clot embolism is more likely to result in the development of petechiae. 3 Fat embolism is more likely to result in the need for a pulmonary embolectomy. 4 Fat embolism is more likely to occur with fractures of the long bones.

4

When using a hand brace to treat carpal tunnel syndrome (CTS), the occupational therapist (OT) will often put the wrist in which position? 1 Full flexion 2 Slight flexion 3 Full extension 4 Slight extension

4

Which abnormality occurs during embryonic development? 1 Aneurysm 2 Vasospasm 3 Atherosclerosis 4 Arteriovenous malformation

4

Which action is appropriate for a patient managing osteoarthritis with prescribed exercises? 1 Maintain the usual number of repetitions when inflammation is severe. 2 Substitute prescribed exercises with household tasks. 3 Use passive and active-assist rather than active exercises whenever possible. 4 Avoid resistive exercises when joints are severely inflamed.

4

Which antirheumatic drug acts by inhibiting tyrosine kinase? 1 Infliximab 2 Etanercept 3 Abatacept 4 Tofacitinib

4

Which assessment strategy does the nurse use to assess the function of cranial nerve VII? 1 Asks the patient to swallow. 2 Requests that the patient stick out the tongue. 3 Requests that the patient move the eyes in all six directions. 4 Asks the patient to raise the eyebrows and grimace or puff the cheeks.

4

Which assessment will the nurse perform to detect side effects after administering the drug golimumab? 1 Blood pressure 2 Pedal pulses 3 Serum electrolytes 4 Temperature

4

Which biologic is approved for administration once a month for patients with rheumatoid arthritis and psoriatic arthritis? 1 Infliximab 2 Abatacept 3 Etanercept 4 Golimumab

4

Which bone fracture complication is also known as ischemia-edema cycle? 1 Crush syndrome 2 Fat embolism syndrome 3 Venous thromboembolism 4 Acute compartment syndrome

4

Which brain injury is caused by blunt force? 1 Acceleration injury 2 Deceleration injury 3 Open traumatic brain injury 4 Closed traumatic brain injury

4

Which chronic metabolic disease causes decreased bone density and possible fracture? 1 Scoliosis 2 Lordosis 3 Arthralgias 4 Osteoporosis

4

Which clinical finding is associated with a diagnosis of early-stage osteoarthritis? 1 Fissures and ulceration 2 Osteophytes in joint space 3 Secondary joint inflammation 4 Opaque and yellowish-brown cartilage

4

Which complication causes a brain tumor to expand and invade, infiltrate, compress, and displace normal brain tissue? 1 Papilledema 2 Meningiomas 3 Supratentorial 4 Cerebral edema

4

Which complication is associated with compartment syndrome? 1 Osteomyelitis 2 Pulmonary edema 3 Retinal hemorrhage 4 Myoglobinuria renal failure

4

Which complication of fractures can be treated with minimally invasive surgical sympathectomy? 1 Carpal tunnel syndrome (CTS) 2 Fat embolism syndrome (FES) 3 Acute compartment syndrome (ACS) 4 Complex regional pain syndrome (CRPS)

4

Which complication resulting from a fracture might necessitate the use of an implanted device to block pain perception? 1 Carpal tunnel syndrome (CTS) 2 Fat embolism syndrome (FES) 3 Acute compartment syndrome (ACS) 4 Complex regional pain syndrome (CRPS)

4

Which complication results from changes in capillary endothelial tissue permeability, allowing the plasma to seep into the extracellular spaces? 1 Papilledema 2 Meningiomas 3 Hydrocephalus 4 Cerebral edema

4

Which condition can manifest in a patient undergoing fluoroquinolone therapy? 1 Sprain 2 Joint dislocation 3 Rotator cuff injury 4 Achilles tendinopathy

4

Which condition is the consequence of pannus formation in a patient with rheumatoid arthritis? 1 Vasculitis 2 Pericarditis 3 Paresthesias 4 Bony ankylosis

4

Which condition may occur as a result of fluid volume overload, syndrome of inappropriate antidiuretic hormone (SIADH), or steroid administration? 1 Meningitis 2 Dehydration 3 Hypokalemia 4 Hyponatremia

4

Which condition occurs when the posterior pituitary gland releases too much antidiuretic hormone, causing water retention? 1 Cerebral salt wasting 2 Atrial natriuretic factor 3 Cerebrospinal fluid leak 4 Syndrome of inappropriate antidiuretic hormone

4

Which consequence of vasculitis in patients with rheumatoid arthritis would the nurse monitor for? 1 Decrease in WBC count 2 Weakness in all extremities 3 Inflammation of pericardium 4 Ulceration in the lower extremities

4

Which description accurately defines a closed reduction? 1 Procedure that does not require general anesthesia 2 Commercial immobilizer that is used to keep the bone in place 3 Fiberglass synthetic cast used to immobilize an upper extremity 4 Process where the ends of the bones are manually pulled and realigned

4

Which diagnostic test is done to detect subtle changes in brain tissue and show more specific details of a brain injury? 1 Radiography 2 Ultrasonography 3 Electrocardiogram 4 Magnetic resonance imaging

4

Which diagnostic test requires the nurse to know whether the patient is allergic to iodine-based contrast? 1 Arthroscopy 2 Tomography 3 Electromyography (EMG) 4 Computed tomography (CT)

4

Which disorder affects the hand or part of the hand? 1 Bunion 2 Hallux valgus 3 Plantar fasciitis 4 Dupuytren contracture

4

Which disorder affects the hand or part of the hand? Incorrect1 Bunion 2 Hallux valgus 3 Plantar fasciitis Correct4 Dupuytren contracture

4

Which division of the nervous system activates the mechanism of "fight or flight" response? 1 Central nervous system (CNS) 2 Peripheral nervous system (PNS) 3 Parasympathetic nervous system 4 Sympathetic nervous system (SNS)

4

Which drug is usually administered to control cerebral edema? 1 Erlotinib 2 Gefitinib 3 Bevacizumab 4 Dexamethasone

4

Which ethnic group has the highest prevalence of stroke? 1 Asians and Caucasians 2 Hispanic men and women 3 African-American men and women 4 American Indians and Alaskan Natives

4

Which finding might suggest that the drainage from a patient's ear is cerebrospinal fluid (CSF)? 1 It is clear. 2 It dries to crystals. 3 It has a purulent odor. 4 It is positive for glucose.

4

Which group is at the highest risk for stroke? 1 White men 2 Latino men 3 Black women 4 Alaskan Native men

4

Which information is most important for the nurse to communicate to the health care provider about a patient who is scheduled for cerebral angiography? 1 Allergy to penicillin 2 History of bacterial meningitis 3 The patient's dose of metformin held today 4 Poor skin turgor and dry mucous membranes

4

Which intervention does the nurse suggest to a patient with a leg amputation to help cope with loss of the limb? 1 Talking with a psychiatrist about the amputation 2 Drawing a picture of how the patient sees him- or herself 3 Engaging in diversional activities to avoid focusing on the amputation 4 Talking with an amputee close to the patient's age who has had the same type of amputation

4

Which is a deformity of the hand? Incorrect1 Bunion 2 Plantar fasciitis 3 Morton's neuroma Correct4 Dupuytren's contracture

4

Which is a positive finding of the Phalen's maneuver? 1 Paresthesia of the palmar side of the thumb 2 Paresthesia of the palmar side of the thumb and index finger 3 Paresthesia of the palmar side of the thumb, index finger, and middle finger 4 Paresthesia of the palmar side of the thumb, index finger, middle finger, and half of the ring finger

4

Which is caused by an obstruction of the normal cerebrospinal fluid pathway (CSF) from edema? 1 Hypokalemia 2 Blurred vision 3 Hyponatremia 4 Hydrocephalus

4

Which is the most common musculoskeletal trauma in runners? 1 Tendinopathy 2 Joint dislocation 3 Carpal tunnel syndrome 4 Patellofemoral pain syndrome

4

Which level of brain injury is present in a patient with a Glasgow Coma Scale score ranging from 9 to 12? 1 Comatose brain injury 2 Mild traumatic brain injury 3 Severe traumatic brain injury 4 Moderate traumatic brain injury

4

Which lobe of the cerebral cortex is located in the area of the brain parallel to the ears? 1 Frontal 2 Parietal 3 Occipital 4 Temporal

4

Which may be the largest cistern of the spinal cord? 1 From the level of the first sacral vertebra to the fifth sacral vertebra (S1-S5) 2 From the level of the first lumbar vertebra to the fifth lumbar vertebra (L1-L5) 3 From the level of the first thoracic vertebra to the fifth thoracic vertebra (T1-T5) 4 From the level of the second lumbar vertebra to the second sacral vertebra (L2-S2)

4

Which musculoskeletal disorder is the dorsiflexion of any metatarsophalangeal (MTP) joint that has plantar flexion of the proximal interphalangeal joint next to it? 1 Corn 2 Callus 3 Bunion 4 Hammertoe

4

Which musculoskeletal trauma occurs after minimal trauma to a bone that has been weakened due to disease? 1 Osteonecrosis 2 Fatigue fracture 3 Crush syndrome 4 Fragility fracture

4

Which nursing action is appropriate when a patient requests spiritual guidance during a preoperative assessment? 1 Ask the family to pray for the patient during the procedure 2 Request that the surgeon review the procedure with the patient 3 Tell the patient to contact his or her religious leader after surgery 4 Offer assistance to arrange for a hospital chaplain to talk with the patient before surgery

4

Which nursing intervention takes priority in a patient with dysphagia? 1 Monitor intake and output hourly. 2 Keep an emergency tracheostomy kit at the bedside. 3 Maintain the head of the bed in an elevated position at least 30-45 degrees. 4 Keep the patient on strict NPO status until he or she can swallow safely.

4

Which part of the brain controls the functions of the "master gland"? 1 Thalamus 2 Epithalamus 3 Diencephalon 4 Hypothalamus

4

Which part of the brain plays a major role in controlling the autonomic nervous system (ANS)? 1 Cerebrum 2 Cerebellum 3 Epithalamus 4 Hypothalamus

4

Which patient action reflects appropriate self-management of lupus erythematosus? 1 Avoids using lotion on dry areas 2 Uses harsh soap to clean the skin 3 Avoids cosmetics that contain moisturizers 4 Uses sun-blocking agents with a sun protection factor of at least 30

4

Which patient diagnosed with neurologic injury is typically at highestrisk for depression? 1 Older man with a mild stroke 2 Young woman with a mild stroke 3 Older man with a spinal cord injury 4 Young man with a spinal cord injury

4

Which physiologic change related to compartment syndrome is responsible for symptoms of flexed posture and unequal pulses in a patient? 1 Anaerobic metabolism 2 Pressure on nerve endings 3 Increased capillary permeability 4 Increased production of lactic acid

4

Which question should the nurse ask while interviewing a patient with carpal tunnel syndrome (CTS)? 1 "Do you lift heavy weights?" 2 "Do you regularly wear high heels?" 3 "Do you participate in strenuous sports?" 4 "Do you do hand exercise in an excessive fashion?"

4

Which stage of bone healing occurs in a patient 3 days to 2 weeks after a fracture? 1 Callus formation 2 Bone remodeling 3 Hematoma formation 4 Fibrocartilage formation

4

An older adult patient with a history of arthritis sustained a minor accident. The patient reports pain, numbness of the fingers, and difficulty raising the shoulder. Which nerve injuries should the nurse suspect? Select all that apply. 1 Injury to the cervical spinal nerve C1 2 Injury to the cervical spinal nerve C2 3 Injury to the cervical spinal nerve C3 4 Injury to the cervical spinal nerve C4 5 Injury to the cervical spinal nerve C7

4, 5

The nurse is caring for a postoperative patient with total joint arthroplasty. What actions does the nurse take to prevent venous thromboembolism (VTE) postoperatively? Select all that apply. 1 Massage the legs. 2 Keep the legs slightly abducted. 3 Use the knee gatch on the bed. 4 Apply elastic stockings. 5 Administer anticoagulants.

4, 5

The nurse is caring for a patient with hypertrophic ungual labium. The nurse prepares to teach the patient about treatment for the condition. Which actions will the nurse include? Select all that apply. 1 Using lanolin creams 2 Avoiding open-toe shoes 3 Excising the conical mass 4 Removing the necrotic nail 5 Taking antibiotics for secondary infections

4,5

A 70-year-old male patient who underwent an open reduction internal fixation (ORIF) surgery experiences a seizure after 24 hours. Which drug can cause seizures related to its toxic metabolites? 1 Tramadol 2 Ketorolac 3 Morphine 4 Meperidine

4

A 70-year-old patient has an infected tibial fracture. What is the estimated healing time? 1 30 days 2 45 days 3 60 days 4 90 days

4

A 73-year-old patient is being discharged after falling and fracturing the radius and ulna. What can the nurse tell the patient regarding the length of healing time? 1 Healing takes about four weeks. 2 Complete healing takes about six weeks. 3 Residual complications will last over a year. 4 Complete healing may last three months or longer.

4

A 78-year-old patient reports difficulty sleeping at night. What age-related impairment does the nurse recognize could be the reason for this disturbance? 1 Cognition 2 Immunity 3 Wound healing 4 Stimuli response

4

A Glasgow Coma Scale is ordered on a patient. The nurse observes these signs and symptoms upon initial assessment: opens eyes to sound; localizes pain; confused conversation. Which number would the nurse record as this patient's Glasgow Coma Scale score? 1 8 2 15 3 13 4 12

4

A caregiver reports that the patient's mild dementia has worsened. The patient demonstrates impaired physical function and lack of self-management. Which condition does the nurse anticipate? 1 Hypoxia 2 Hypertension 3 Gastroenteritis 4 Sleep deprivation

4

A chemical sympathetic nerve block may be used to manage complex regional pain syndrome (CRPS). Which drug, administered intravenously, is used to block sympathetic nerve receptors? 1 Bupivacaine 2 Amitriptyline 3 Prednisolone 4 Phentolamine

4

A nurse is caring for a doctor's office worker with carpal tunnel syndrome (CTS) and informs the patient that U.S. federal and state legislation has been passed to ensure that all health care organizations (HCOs) provide ergonomically appropriate workstations for their employees. Which nursing statement regarding CTS is true? 1 "CTS is the rarest type of repetitive stress injury." 2 "CTS affects only the nondominant hand and not the dominant hand." 3 "Men older than 50 years are much more likely to experience CTS than are women." 4 "Occupational health nurses helped in developing ergonomically designed furniture to decrease CTS."

4

A nurse is listening to family members discuss feelings of guilt and anger over a patient's traumatic brain injury. How does the nurse document this type of assessment? 1 Imaging 2 Physical 3 Laboratory 4 Psychosocial

4

A nurse is monitoring the blood pressure of a patient with gout. Upon inflating the cuff, the patient experiences pain and numbness in the wrist. Which musculoskeletal injury does the nurse suspect in the patient? 1 Strain 2 Sprain 3 Tendinopathy 4 Carpal tunnel syndrome (CTS)

4

A nurse is teaching a patient scheduled to undergo an electroencephalogram (EEG). Which action of the patient implies a good understanding about the instructions? 1 Does not wash the hair before the test 2 Takes central nervous system stimulants before the test 3 Takes central nervous system depressants before the test 4 Avoids any caffeine-containing beverages on the day of the test

4

A patient diagnosed with Dupuytren's contracture reports functional impairment of the right hand. What treatment is required to relieve his condition? Incorrect1 Splinting 2 Physiotherapy 3 Radiation therapy Correct4 Surgical fasciectomy

4

A patient has experienced a right-hemisphere stroke. What is an important nursing action while caring for this patient? 1 Allow independent ambulation to facilitate self-care. 2 Encourage family members to provide total care to maintain safety. 3 Wash the patient's affected side and have the patient wash the other. 4 Stand on the patient's left side when talking to increase the visual field

4

A patient has received contrast medium. Which teaching does the nurse provide to avoid any neurologic health problems after the procedure? 1 "Avoid sunlight." 2 "Rest in bed for 24 hours." 3 "Practice memory drills this afternoon." 4 "Drink at least 1000-1500 mL of water today."

4

A patient has undergone a below-knee amputation of the right leg as a result of severe peripheral vascular disease. In the postoperative care teaching, the nurse instructs the patient to notify the health care provider if which change occurs? 1 Ability to flex and extend the right knee 2 Absence of erythema and tenderness at the surgical site 3 Mild to moderate pain controlled with prescribed analgesics 4 Observation of a large amount of serosanguineous or bloody drainage

4

A patient hospitalized for hypertension presses the call light and reports "feeling funny." When the nurse gets to the room, the patient is slurring words and has right-sided weakness. What does the nurse do first? 1 Calls the provider 2 Performs a neurologic check 3 Assists the patient to a sitting position 4 Assesses airway, breathing, and circulation

4

A patient is admitted to the emergency department (ED) following a traumatic brain injury. After examining the patient, the nurse reports that the patient is comatose. What does the nurse mean by this assessment? 1 The patient is fully alert. 2 The patient is drowsy and sleepy. 3 The patient is arousable with vigorous stimulation. 4 The patient is unconscious and cannot be aroused.

4

A patient is brought to the emergency department (ED) via ambulance after a motor vehicle crash. What condition does the nurse assess for first? 1 Pain 2 Bleeding 3 Head injury 4 Respiratory distress

4

A patient is diagnosed with polymyalgia rheumatica and given high-dose steroid therapy to achieve remission of the disease. Which statement made by the nursing student regarding the patient's disease needs correction by the precepting nurse? 1 "This therapy causes proximal muscle weakness." 2 "This disorder is an autoimmune, genetic-based disease." 3 "This disease mostly affects middle-aged and older women." 4 "This is a complex syndrome associated with the HLA-27 allele."

4

A patient is eating a soft diet while recovering from a stroke. The patient reports food accumulating in the cheek of the affected side. What is the nurse's best response? 1 "Let's see if the dietitian can help." 2 "Let's advance your diet to solid food." 3 "Next time you eat, try lifting your chin when you swallow." 4 "Let's see if the speech-language pathologist can help."

4

A patient is experiencing swelling and sudden changes in skin temperature. The nurse refers the patient to The Reflex Sympathetic Dystrophy Syndrome Association (RSDSA). With what disorder might this organization assist patients in coping? 1 Tinnitus 2 Malignant tumors 3 Muscular dystrophy (MD) 4 Complex regional pain syndrome (CRPS)

4

A patient is postoperative for craniotomy surgery to remove a tumor in the brain. The nurse notes periorbital edema and ecchymoses of both eyes. Which action is correct? 1 Elevate the head of the bed. 2 Perform a visual examination. 3 Notify the provider immediately. 4 Apply cold compresses to both eyes.

4

A patient is prescribed the bisphosphonate (BP) alendronate for osteoporosis. What does the nurse teach the patient? 1 "Take the medication only once a month." 2 "Take the medication along with breakfast." 3 "Check liver function before starting the medication." 4 "Take the medication early in the morning with 8 ounces of water."

4

The emergency room nurse is assessing a patient who presents with a stroke. The nurse finds that the patient shows perseveration, loss of deep sensation, and decreased touch sensation. What should the nurse infer from these symptoms? 1 The patient had a vertebrobasilar artery stroke. 2 The patient had a middle cerebral artery stroke. 3 The patient had an internal carotid artery stroke. 4 The patient had a posterior cerebral artery stroke.

4

The novice nurse is learning about interventions for carpal tunnel syndrome (CTS). Which statement indicates a need for further education? 1 "Patients who begin practicing yoga sometimes experience fewer symptoms." 2 "Nonsteroidal antiinflammatory drugs (NSAIDs) are typically given to relieve pain and inflammation." 3 "Surgery may be performed to relieve pressure on the median nerve." 4 "An occupational therapist (OT) will fit a brace with the wrist in neutral position or slight flexion."

4

The nurse assesses a patient who is suffering from dementia and metabolic disorders. Which diagnostic test will be most beneficial to assess the patient's condition? 1 Cerebral angiography 2 Computed tomography (CT) scan 3 Magnetic resonance imaging (MRI) 4 Positron emission tomography (PET)

4

The nurse assesses the loss of pain and pressure in a patient with a spinal cord injury. Which part of the spinal cord is affected as depicted in the figure? 1 A 2 B 3 C 4 D

4

The nurse finds lidocaine 5% patch in the prescription of a patient with osteoarthritis. Upon examining, the nurse finds that the patient is on procainamide therapy, a class I antiarrhythmia drug. What is the nurse's appropriate course of action? 1 Instruct the patient to apply lidocaine 5% patch at night. 2 Instruct the patient to apply lidocaine 5% patch for a small duration. 3 Administer IV fluid and electrolytes before applying lidocaine 5% patch. 4 Avoid applying lidocaine 5% to the patient and tell the primary healthcare provider.

4

The nurse is assessing a patient with a neurologic condition who is reporting difficulty chewing when eating. The nurse anticipates that which cranial nerve has been affected? 1 Facial 2 Abducens 3 Trochlear 4 Trigeminal

4

The nurse is caring for a patient after a fracture. Which complication of fractures manifests as a clinical triad of sensory perception abnormalities, motor dysfunction such as paresis and muscle spasm, and autonomic nervous system abnormalities? 1 Carpal tunnel syndrome (CTS) 2 Fat embolism syndrome (FES) 3 Acute compartment syndrome (ACS) 4 Complex regional pain syndrome (CRPS)

4

The nurse is caring for a patient who had an arthrocentesis for removal of excessive synovial fluid. What intervention does the nurse perform for this patient? 1 Use a warm compress for pain. 2 Rest the affected joint for 12 hours. 3 Avoid the use of acetaminophen. 4 Monitor the site for bleeding or leakage of synovial fluid.

4

The nurse is caring for a patient with an open wound from chronic osteomyelitis. How does the nurse ensure that this patient receives increased tissue perfusion? 1 Using Standard Precautions for wound care. 2 Applying clean technique when changing dressings. 3 Managing wound irrigation through the window of a cast. 4 Exposing the affected area to a high concentration of oxygen.

4

The nurse is developing a teaching plan for a patient diagnosed with osteoarthritis (OA). The nurse includes which instruction in the teaching plan? 1 Begin a running program. 2 Take up knitting to slow down joint degeneration. 3 Eat at least two cups of yogurt per day. 4 Wear supportive shoes.

4

The nurse is educating a patient about glucosamine supplements. Which nursing instruction about glucosamine supplements is appropriate? 1 "You should take glucosamine if you are breastfeeding." 2 "You should take glucosamine if you have hypertension." 3 "Be aware that glucosamine can cause constipation." 4 "The recommended dose of glucosamine is based on your body weight."

4

The nurse is evaluating the collaborative care of a patient with traumatic brain injury (TBI). What is the most important goal for this patient? 1 Preventing further injury 2 Increasing cerebral perfusion 3 Preventing respiratory distress 4 Achieving the highest level of functioning

4

The nurse is instructing a local community group about ways to reduce the risk for musculoskeletal injury. What information does the nurse include in the teaching plan? 1 "Avoid contact sports." 2 "Avoid rigorous exercise." 3 "Avoid driving in inclement weather." 4 "Wear helmets when riding a motorcycle."

4

The nurse is obtaining information from the parent of a child with a head injury. Which statement made by the mother indicates the damage to frontal lobe of the child's brain? 1 "My child is unable to see properly." 2 "My child is unable to speak clearly." 3 "My child is unable to play guitar properly." 4 "My child is unable to concentrate on school work."

4

Which drugs need to be discontinued before surgery to decrease the risk for venous thromboembolism? Select all that apply. 1 Vitamin C 2 Vitamin K 3 Antianginal drugs 4 Oral contraceptive drugs 5 Nonsteroidal anti-inflammatory drugs

1, 4, 5

While explaining mutations to a patient, how does the nurse characterize a germline mutation? Select all that apply. 1 DNA changes that occur in sex cells 2 Presence of a wild-type gene sequence 3 DNA changes that occur after conception 4 DNA changes that occur in somatic cells 5 Mutations that can be passed on to children

1, 5

Rheumatoid arthritis (RA) affects most of the synovial joints. Which joint may be involved in the most severe cases? 1 Sacroiliac 2 Temporomandibular 3 Metacarpophalangeal 4 Proximal interphalangeal

2

The nurse is educating a pregnant patient about babies inheriting certain traits from the parents. Which statement by the patient indicates the need for additional teaching? 1 A person with B and B blood-type gene alleles expresses blood group B. 2 A person with B and O blood-type gene alleles expresses blood group O. 3 A person with A and B blood-type gene alleles expresses blood group AB. 4 A person with A and B blood-type gene alleles expresses blood group A.

2

The nurse is explaining the clinical manifestations of joint involvement of rheumatoid arthritis with a nursing student. What is the best way to describe a Baker's cyst? 1 Enlarged liver and spleen 2 Enlarged popliteal bursae behind the knee 3 Presence of rheumatoid nodules in the lungs 4 Presence of small, brownish spots around the nail bed

2

The nurse suspects that a patient has an autosomal dominant genetic disorder. Which finding supports the nurse's suspicion? 1 The patient has anemia. 2 The patient has increased blood glucose levels. 3 The patient has pain and inflammation around the weight-bearing joints. 4 The patient has shortness of breath, frequent chest infections, and accumulation of thick and sticky mucus.

2

What complication in patients with lupus erythematosus causes organ failure? 1 Serositis 2 Vasculitis 3 Pericarditis 4 Pleural effusions

2

What is the drug of choice to treat fibromyalgia syndrome (FMS) in a 72-year-old patient with memory impairment? 1 Tramadol 2 Trazodone 3 Amitriptyline 4 Nortriptyline

2

What is the priority nursing intervention for a patient with systemic lupus erythematosus (SLE)? 1 Instructing that fatigue may occur 2 Instructing the patient on how to protect the skin 3 Teaching the patient to monitor the body temperature 4 Suggesting that the patient identify support systems and coping strategies

2

What medication causes transient lupus-like syndrome? 1 Belimumab 2 Procainamide 3 Glucocorticoid 4 Cyclophosphamide

2

Which condition is associated with the presence of HLA- B27? 1 Felty's syndrome 2 Reiter's syndrome 3 Sjogren's syndrome 4 Carpal tunnel syndrome

2

Which finding in the physical assessment may be associated with osteoarthritis? 1 Depression 2 Impaired mobility 3 Altered body image 4 Decreased quality of life

2

Which medication would the nurse expect to be prescribed for the patient with Lyme disease? 1 Allopurinol 2 Amoxicillin 3 Colchicine 4 Ustekinumab

2

Which statement is true about the role of a gene in the synthesis of a specific protein? 1 Genes have no role in protein synthesis. 2 A gene contains the code for a specific protein. 3 For protein synthesis, all DNA is transcribed into RNA. 4 A dominant gene triggers protein synthesis, and a recessive gene inhibits protein synthesis.

2

What are the criteria for an autosomal recessive (AR) pattern of inheritance? Select all that apply. 1 The characteristic is found more in females. 2 The children of two affected parents will be affected. 3 The characteristic may not be observed in the parents. 4 The characteristic is found in approximately 25% of the family members. 5 The affected persons cannot transmit the characteristic to the child if the partner is a carrier.

2, 3, 4

What physical assessment findings does the nurse anticipate for a patient diagnosed with systemic lupus erythematosus (SLE)? Select all that apply. 1 Weight gain 2 Abdominal pain 3 Discoid lesions 4 Inflamed red rash 5 Deep vein thrombosis

2, 3, 4

In analyzing a three-generation pedigree for a patient, which questions help determine the genetic implications of a health trait? Select all that apply. 1 Where on the chart does the patient appear? 2 Is a pattern evident, or does the trait appear to be sporadic? 3 Do affected or unaffected individuals have children affected by the trait? 4 Is the trait present in every generation, or does it skip one or more generations? 5 Is the trait expressed equally among male and female family members, or is it expressed unequally?

2, 3, 4, 5

Which statements about DNA replication are most accurate? Select all that apply. 1 Each set has two new strands of DNA. 2 DNA replicates every time a cell divides. 3 One set of DNA moves into one new cell. 4 Two sets of double-stranded DNA are formed. 5 Replicated DNA organizes into a chromosome form.

2, 3, 4, 5

Systemic necrotizing vasculitis is characterized by ischemia. What are the clinical manifestations observed with cerebral ischemia? Select all that apply. 1 Vertigo 2 Severe pain 3 Skin lesions 4 Necrosis of fingers or toes 5 Visual changes

2, 4

A patient presents in the emergency department with dysphagia, periorbital edema, lilac eyelid rash (DM), and severe muscle weakness. Which disease is consistent with these assessment findings? 1 Ankylosing spondylitis 2 Polymyalgia rheumatica 3 Polymyositis/dermatomyositis 4 Reiter's syndrome

3

A patient who recently underwent total hip arthroplasty and is on anticoagulants is preparing for discharge from the hospital. Which information is most important for the nurse to provide to the patient and caregiver? 1 Use an abduction pillow between the legs. 2 Keep heels off the bed. 3 Avoid using a straight razor. 4 Reorient frequently.

3

What is a clinical manifestation of systemic sclerosis? 1 Alopecia 2 Mouth ulcers 3 Hardening of the skin 4 Dry, scaly, raised rash on the face

3

What is the benefit of prescribing trazodone over other tricycle antidepressants such as amitriptyline to treat fibromyalgia? 1 Reduce pain 2 Promote sleep 3 Reduce confusion 4 Reduce muscle spasms

3

What is the effect of gene mutation and amino acid sequencing on insulin and blood sugar control? 1 No insulin is produced. 2 Limited insulin is produced.3 Ineffective insulin is produced. 4 Excessive insulin is produced.

3

Which condition might require genetic counseling for a patient? 1 Peptic ulcer disease 2 Migraine headache 3 Huntington's disease 4 Hodgkin's lymphoma

3

Which is an example of an autosomal recessive (AR) disorder? 1 Hemophilia 2 Breast cancer 3 Beta thalassemia 4 Type 2 diabetes mellitus

3

Which medication used in the treatment of gout prevents the conversion of xanthine to uric acid? 1 Colchicine 2 Pegloticase 3 Allopurinol 4 Probenecid

3

Which metabolic disorder may be responsible for the development of joint degradation in the patient with osteoarthritis (OA)? 1 Aging 2 Hemophilia 3 Diabetes mellitus 4 Sickle cell disease

3

A patient with ankylosing spondylitis is being treated with a first-line disease-modifying antirheumatic drug (DMARD). Which DMARD drug does the nurse anticipate will be prescribed for this patient? 1 Abatacept 2 Infliximab 3 Tocilizumab 4 Methotrexate

4

Chronic rheumatoid arthritis (RA) can manifest as one of several associated syndromes. Which of the following is the most common in advanced RA? 1 Paresthesias 2 Felty's syndrome 3 Caplan's syndrome 4 Sjogren's syndrome

4

The nurse encourages a patient who has undergone total hip joint arthroplasty to drink fluids and instructs the patient's caregivers not to massage the leg. The nurse also observes for signs of redness, swelling, and pain in the patient's leg. Which complication is the nurse seeking to avoid with these interventions? 1 Dislocation 2 Infection 3 Hypotension 4 Venous thromboembolism

4

What complication is common in both diffuse and limited systemic sclerosis? 1 Telangiectasia 2 Esophageal dysmotility 3 Bilateral carpal tunnel syndrome 4 Gastroesophageal reflux disease (GERD)

4

What is the gastrointestinal sign of systemic lupus erythematosus? 1 Ulcers 2 Dysphagia 3 Esophagitis 4 Abdominal pain

4

What medication used in the treatment of lupus erythematosus decreases the risk for skin lesions? 1 Belimumab 2 Azathioprine 3 Methotrexate 4 Hydroxychloroquine

4

Which drug is beneficial for a patient with osteoarthritis who is having painful muscle spasms? 1 Diclofenac 2 Hyaluronic acid 3 Acetaminophen 4 Cyclobenzaprine hydrochloride

4

Which is the first symptom that occurs in a patient with the diffuse form of systemic sclerosis (SSc)? 1 Calcinosis 2 Sclerodactyly 3 Esophageal dysmotility 4 Symmetric, pitting edema

4

Which statement describes systemic lupus erythematosus (SLE)? 1 It is nonfatal. 2 It affects men more often than women. 3 It is an acute, nonprogressive disorder. 4 It is characterized by spontaneous remissions and exacerbations.

4

Which statement given by the patient would make the nurse suspect a diagnosis of Raynaud's phenomenon? 1 "I have difficulty swallowing." 2 "I find red-colored lesions around my nail beds." 3 "I find redness and swelling on my great toe." 4 "I have severe pain in my fingers, and they turn blue in cold conditions."

4

Which statement is associated with minimally invasive surgery? 1 It involves more scarring. 2 It results in a slow recovery. 3 It increases postoperative pain. 4 It enables a shorter hospital stay.

4

A patient who is allergic to penicillin is being treated for early-stage Lyme disease. Which medication will the nurse anticipate administering to the patient? 1 Erythromycin 2 Doxycycline 3 Amoxicillin 4 Etanercept

1

What brain injury is confined to a specific area of the brain? 1 Focal injury 2 Direct injury 3 Diffuse injury 4 Indirect injury

1

What causes corns? 1 Friction 2 Infection 3 Hammertoe 4 Ingrown nails

1

What helps in distinguishing cerebrospinal fluid from other fluids when it is placed on a white absorbent paper or linen? 1 Halo sign 2 Battle sign 3 Hematoma 4 Cerebral edema

1

What is a cardiovascular manifestation of systemic lupus erythematosus (SLE)? 1 Pericarditis 2 Pleural effusion 3 Interstitial fibrosis 4 Myocardial fibrosis

1

What is inserted to drain cerebrospinal fluid to another area of the body when there is a long-term treatment required for chronic hydrocephalus? 1 Surgical shunt 2 Implanted shunt 3 Hemodialysis catheter 4 Ventriculostomy catheter

1

A patient reports a history of wrist pain after an attempt to break a fall by landing on the heel of the hand with an extended wrist. Which type of fracture should the nurse suspect? 1 Colles' fracture 2 Phalangeal fracture 3 Metacarpal fracture 4 Proximal humerus fracture

1

What is the best explanation of an open traumatic brain injury (TBI)? 1 An injury in which the skull is fractured 2 An injury in which the skull remains intact 3 An injury that damages only the brain tissue 4 An injury in which there is increased intracranial pressure (ICP)

1

What is the cause of primary osteoarthritis? 1 Aging 2 Obesity 3 Joint injury 4 Heavy manual work

1

What is the excessive stretching of a muscle or tendon? Correct1 Strain Incorrect2 Sprain 3 Ligament tear 4 Meniscus tear

1

A 75-year-old patient with craniopharyngiomas has to undergo surgery. Which procedures recognized by the nurse would be mosteffective? Select all that apply. 1 Biopsy 2 Craniotomy 3 Craniectomy 4 CyberKnife radiosurgery 5 Gamma knife radiosurgery

4, 5

The nurse anticipates providing collaborative care for a patient with a traumatic amputation of the right hand with which health care team members? Select all that apply. 1 Psychologist 2 Speech therapist 3 Physical therapist 4 Respiratory therapist 5 Occupational therapist

1, 3, 5

A primary health care provider prescribes nonsteroidal anti-inflammatory drugs (NSAIDs), steroid injections, and physical therapy to a patient with a rotator cuff injury. What could a magnetic resonance imaging (MRI) of the shoulder reveal? 1 No tear at all 2 Muscular atrophy 3 Full-thickness tear 4 Partial-thickness tear

4

A young boy reports severe pain in the shoulder region after throwing a ball. The primary health care provider instructs the nurse to perform a "drop arm test." Which type of injury does the nurse suspect in the patient? 1 Strain 2 Sprain 3 Tendinopathy 4 Rotator cuff injury

4

After rotator cuff surgery, when are pendulum exercises typically started? Incorrect1 One week after surgery 2 Two weeks after surgery 3 On the first postoperative day Correct4 On the third postoperative day

4

An injury that is caused by an external force contacting the head, placing the head in sudden motion, is known as what? 1 Focal injury 2 Diffuse injury 3 Deceleration injury 4 Acceleration injury

4

An older adult patient has multiple tibial and fibular fractures of the left lower extremity after a motor vehicle crash. Which pain medication does the nurse anticipate will be requested for this patient? 1 Ibuprofen 2 Meperidine 3 Cyclobenzaprine 4 Patient-controlled analgesia (PCA) with morphine

4

A patient reports feeling disoriented after having been hit in the head with heavy material from a construction site. Although the patient's MRI results do not show evidence of brain damage and the patient did not lose consciousness, the patient is unable to remember events immediately following the accident, including how the patient ended up at the hospital. The nurse understands that the patient most likely has which condition? 1 Mild traumatic brain injury 2 Acute traumatic brain injury 3 Severe traumatic brain injury 4 Moderate traumatic brain injury

1

A patient sustains a tibial fracture, and a cast is applied. The primary health care provider advises that a window is cut on the cast. What is the objective of this action? 1 To inspect the skin 2 To prevent edema 3 To prevent skin dryness 4 To prevent tissue swelling

1

A patient who has undergone total knee arthroplasty (TKA) is under postoperative care. The primary health care provider advised the patient to use a continuous passive motion (CPM) machine. Which nursing action is most important during use of the CPM machine? 1 Assessing the patient's response to the machine 2 Storing the machine on the floor when not in use 3 Turning on the machine while the patient is having a meal 4 Placing the controls of the machine in reach when the patient is confused

1

A 70-year-old woman brought to the emergency department is diagnosed with acute ischemic stroke with a NIH Stroke Scale score of 20. A family member reports last seeing the patient as normal (LSN) 3.5 hours before evaluation. The patient has an INR of 1.4. The nurse anticipates that the patient will not be eligible for fibrinolytic therapy for which reason? 1 INR 1.4 2 Female gender 3 Age older than 65 years 4 High NIH Stroke Scale score

1

A patient develops syndrome of inappropriate antidiuretic hormone (SIADH) following a craniotomy with brain tumor removal. What medical management should the nurse expect? 1 Fluid restriction 2 Low-sodium diet 3 Desmopressin (DDAVP) 4 Intravenous (IV) hetastarch (Hespan)

1

A patient diagnosed with a stroke is receiving recombinant tissue plasminogen activator (rtPA) through one intravenous line. The nurse discovers that the second line has infiltrated and removes it. The insertion site continues to bleed even after the nurse applies pressure on it. What is the priority nursing action? 1 Discontinue the rtPA infusion. 2 Take the patient's vital signs. 3 Inform the primary health care provider. 4 Apply a pressure bandage on the puncture site.

1

A patient experiences paresthesia when the primary health care provider slightly taps over the median nerve on the wrist. Which finding is observed in the patient? 1 Tinel's sign 2 Chvostek sign 3 Babinski's sign 4 Trousseau sign

1

A patient has Buck's traction applied to help align the fractured bone. What should be the maximum weight of the pulling force? 1 10 pounds 2 15 pounds 3 20 pounds 4 25 pounds

1

A patient has been admitted to the hospital with symptoms of an embolic stroke. What etiologic factor in the patient's history places the patient at particular risk for this type of stroke? 1 Atrial fibrillation 2 Aortic aneurysm 3 Diabetes mellitus 4 Irritable bowel disease

1

A patient has had a sequestrectomy of the right fibula for osteomyelitis 1 day ago. Which assessment finding requires the nurse to contact the surgeon immediately? 1 Paresis of right lower extremity 2 Swelling of the right lower extremity 3 1+ to 2+ bilateral palpable pedal pulses 4 Pain of right lower extremity on movement

1

A patient has just returned to the unit after having a cerebral angiography. Which symptom does the patient display that causes the nurse to act immediately? 1 Bleeding 2 Urge to void 3 Severe headache 4 Increased temperature

1

A patient has undergone a single-photon emission computed tomography (SPECT). Which post-procedural instruction does the nurse give the patient? 1 "Return to your usual activity." 2 "Continue to use the ice pack." 3 "Keep the head of the bed flat." 4 "Call me if you have any itching."

1

A patient is in skeletal traction. Which nursing intervention ensures proper care of this patient? 1 Inspect the skin at least every 8 hours 2 Remove the traction weights only for bathing 3 Ensure that pins are not loose, and tighten as needed 4 Ensure that weights are attached to the bed frame or placed on the floor

1

A patient is prescribed lidocaine 5% patches for knee pain. What does the nurse teach this patient about this therapy? 1 Apply the patch on clean, intact skin. 2 Keep the patch in place for 6 hours. 3 Avoid using more than one patch at a time. 4 Obtain a complete blood count before beginning therapy.

1

A patient is recovering from an above-knee amputation resulting from peripheral vascular disease. Which statement indicates that the patient is coping well after the procedure? 1 "It will take me some time to get used to this." 2 "I do not want any visitors while I'm in the hospital." 3 "My spouse will be the only person to change my dressing." 4 "I can't believe that this has happened to me. I can't stand to look at it."

1

A patient recovering from a stroke reports double vision that is preventing the patient from effectively completing activities of daily living (ADLs). How does the nurse help the patient compensate? 1 Covers the affected eye 2 Places objects in the patient's field of vision 3 Approaches the patient on the affected side 4 Encourages turning the head from side to side

1

The nurse is explaining desired outcomes of tumor management to a patient undergoing chemotherapy and radiation for a brain tumor. Which statement made by the patient indicates teaching was successful? 1 "The goal of chemotherapy and radiation for my cancer is to decrease tumor size, improve my quality of life, and to improve my survival time." 2 "The goal of chemotherapy and radiation for my cancer is to eliminate the tumor and reverse all neurologic deficits." 3 "The goal of chemotherapy and radiation is to shrink my tumor until it is completely gone." 4 "The goal of chemotherapy and radiation is to make me feel better after each treatment."

1

The nurse is giving instructions to an older adult patient with sensory impairment. Which statement made by the patient shows effective learning? 1 "I will wear shoes while walking." 2 "I will sit in a darker place while reading." 3 "I will stay in the same position for hours." 4 "I will refrain from watching my feet while walking."

1

The nurse is preparing a discharge plan for a patient who has been ordered prednisone. What instruction does the nurse give this patient? 1 Avoid crowds and people with infection. 2 Observe for dehydration. 3 Monitor for decreased blood pressure. 4 Increase fluid intake.

1

The nurse is recording the output from a Hemovac drain of a patient one-day postoperative following infratentorial craniotomy. For the past eight hours, the total amount of drainage is 45 mL. What action should the nurse take? 1 Continue to monitor the output. 2 Increase the intravenous (IV) fluid rate. 3 Call the neurosurgeon and report the output. 4 Quickly take the vital signs and call for the rapid response team.

1

The nurse is teaching a group of older adults about transient ischemic attack (TIA). Which statement made by a participant indicates a need for further teaching regarding TIAs? 1 "There is a loss of central vision." 2 "Symptoms last less than 24 hours." 3 "A TIA is a warning sign for ischemic stroke." 4 "A TIA of any kind is a medical emergency."

1

The nurse is teaching a patient about Lyme disease prevention. Which statement made by the patient indicates that further teaching is needed? 1 "I will dispose of the tick by burning it." 2 "I will wear closed shoes or boots and a hat or cap." 3 "I will bathe immediately after being in an infested area and inspect my body for ticks." 4 "After removing a tick, I will clean the tick area with an antiseptic such as rubbing alcoho

1

The nurse is teaching a patient about the care that should be taken when receiving anakinra treatment. Which statement made by the patient indicates a need for further teaching? 1 "I will get a measles vaccination." 2 "I will monitor the injection site for any reaction." 3 "I will have regular checks of my white blood cell (WBC) count." 4 "I will report to the primary health care provider when cough or fever develops."

1

The nurse is teaching a patient with arthritis about exercise. Which statement by the patient indicates that further teaching is needed? 1 "I will exercise only on good days." 2 "I will do the exercises prescribed for me." 3 "I will do active exercises whenever possible." 4 "I will do my exercises in addition to my normal activities."

1

The nurse is teaching a patient with systemic lupus erythema (SLE) about self-management. Which statement by the patient indicates effective teaching? 1 "I will avoid sunlight." 2 "I will avoid Ivory soap." 3 "I will use clotrimazole on any skin lesions." 4 "I will use powder on any moist skin areas."

1

The nurse is teaching the patient about taking acitretin for psoriatic arthritis. Which statement indicates the best understanding by the patient? 1 "I will take acitretin daily with food." 2 "I will take acitretin daily at bedtime." 3 "I will take acitretin daily after I wake up." 4 "I will take acitretin daily without food."

1

The nurse is working with a student nurse performing a neurological assessment. Which action by the student nurse requires intervention? 1 Increasing the room light before testing pupil reaction 2 Determining orientation by asking the patient the year and month 3 Measuring hand strength by having the patient squeeze the student's fingers 4 Observing lower extremity movement by requesting the patient to kick out each leg

1

The nurse reviews the chest x-ray report of a patient who is a coal miner and notes rheumatoid nodules in the lungs. The nurse also notes that the lung biopsy report revealed severe inflammation and fibrosis of the lung. Which complication does the nurse suspect in the patient? 1 Caplan's syndrome 2 Felty's syndrome 3 Fibrotic lung disease 4 Chronic obstructive pulmonary disease

1

The registered nurse is teaching a student nurse about post-surgery management of a patient who underwent supratentorial surgery. Which statement made by the student nurse indicates ineffective learning? 1 "The patient should be placed in a supine position." 2 "Cardiac monitoring of the patient should be done." 3 "The patient should be re-positioned every 2 hours." 4 "The NPO status of 24 hours after the surgery should be maintained."

1

The student nurse is providing dietary instructions to a patient with gout. Which statement made by the student nurse needs correction? 1 "You should eat shellfish." 2 "You should avoid diuretics." 3 "You should avoid organ meats." 4 "You should take alkaline ash foods."

1

The urinary analysis reports of a patient reveal the excretion of 850 mg of uric acid in 24 hours. Which medication would be beneficial to the patient? 1 Probenecid 2 Methotrexate 3 Imatinib mesylate 4 Hydroxychloroquine

1

What assessment finding helps the nurse to identify rheumatoid arthritis in a patient with joint pain? 1 Presence of bilateral joint swelling 2 Pain in weight-bearing joints 3 Crepitus may be felt or heard 4 Joint stiffness after inactivity

1

The nurse just completed discharge teaching to a patient with polymyositis/dermatomyositis. Which statement made by the patient indicates the best understanding of self-management related to this disorder? Select all that apply. 1 "I will watch for signs and symptoms of infection such as fever, sore throat, and congestion." 2 "If swallowing becomes difficult, I will need to see a speech therapist." 3 "I may need a physical therapist to teach me exercises to improve my strength and flexibility." 4 "I will need to include nonpharmacologic strategies to manage chronic back pain." 5 "I may experience pain due to periods of rapid bone growth."

1, 2, 3

What teaching should the nurse provide to the older adult patient with osteoarthritis who is prescribed cyclobenzaprine hydrochloride? Select all that apply. 1 "Avoid driving." 2 "Avoid alcohol intake." 3 "Do not operate heavy machinery." 4 "Do not stand for a prolonged time." 5 "Take the drug before breakfast in the morning."

1, 2, 3

Which factors contraindicate administering alteplase more than three hours after stroke onset? Select all that apply. 1 Age older than 80 years 2 History of both diabetes and stroke 3 Use of warfarin or other anticoagulants 4 Imaging evidence of middle cerebral artery involvement 5 National Institutes of Health Stroke Scale (NIHSS) score less than 25

1, 2, 3, 4

A patient has joint inflammation. Which interventions should the nurse add to the discharge plan of care? Select all that apply. 1 Apply ice packs 2 Apply heat packs 3 Ensure adequate rest 4 Begin a running program 5 Perform daily stretching exercises

1, 2, 3, 5

What are the symptoms of secondary gout? Select all that apply. 1 Renal calculi 2 Hyperuricemia 3 Altered urination 4 Joint inflammation 5 Occurrence of tophi

1, 2, 3, 5

A patient with a neurologic disorder has undergone a cerebral angiography. Which interventions does the nurse perform immediately after the procedure? Select all that apply. 1 Check vital signs. 2 Apply an ice pack to the site. 3 Remove the pressure dressing. 4 Keep the extremity immobilized. 5 Check pulses distal to the injection site.

1, 2, 4, 5

Impairments of which functions can be the result of traumatic brain injury (TBI)? Select all that apply. 1 Mobility 2 Cognition 3 Reproduction 4 Sensory perception 5 Psychosocial function

1, 2, 4, 5

How is endoscopic carpal tunnel release (ECTR) different from open carpal tunnel release (OCTR)? Select all that apply. 1 ECTR is less costly than OCTR. 2 ECTR is less invasive than OCTR. 3 ECTR is less commonly used than OCTR. 4 ECTR is associated with a shorter period of postoperative pain than is OCTR. 5 ECTR is associated with a longer period of postoperative numbness than is OCTR.

1, 2, 5

The nurse is caring for a patient with acute compartment syndrome (ACS). What physiologic changes are observed in a patient with this condition? Select all that apply. 1 Release of histamine 2 Pressure on nerve endings 3 Decrease of capillary pressure 4 Decrease in lactic acid production 5 Increase in compartment pressure

1, 2, 5

A patient reports burning and gnawing pain in the back of the neck, upper chest, trunk, low back, and extremities. The patient also experiences mild to severe fatigue and sleep disturbances. Which other symptoms may be seen in such patients? Select all that apply. 1 Numbness or tingling in the extremities 2 Multiple joint pain with redness or swelling 3 Neurologic problems such as forgetfulness 4 Substantial impairment in short-term memory 5 Postexertional malaise lasting more than 24 hours

1, 3

The nurse educator is teaching a group of nursing students about different types of neurological assessments for patients with traumatic brain injury. Which statements made by the students indicate the need for further instruction? Select all that apply. 1 "Diplopia may indicate hydrocephalus." 2 "Ataxia may indicate damage to the cerebellum." 3 "Changes in motor function may indicate damage to the optic chiasm." 4 "Changes in the level of consciousness may indicate damage to the cerebral cortex." 5 "Abnormal posture may indicate dysfunction in the motor tracts of the spinal cord."

1, 3

The nurse is taking the medical history of a patient. Which patient statements indicate a likelihood of carpal tunnel syndrome (CTS)? Select all that apply. 1 "My wrist and fingers feel numb." 2 "It hurts if I move my wrist upwards." 3 "I have severe pain in my wrist at night." 4 "I don't have much sensation around my wrist." 5 "I have severe pain in my wrist in the mornings."

1, 3, 4

What are the major concerns related to pelvic fractures? Select all that apply. 1 Venous oozing 2 Thigh spasticity 3 Arterial bleeding 4 Hypovolemic shock 5 Fat embolism syndrome 6 Acute compartment syndrome

1, 3, 4

The nurse is educating a group of people at a community center about emergency care for physical trauma. What should the nurse teach this group? Select all that apply. 1 Immobilize the extremity 2 Remove the person's shoes 3 Cut the clothing over the affected area 4 Remove jewelry on the affected extremity 5 Call 911 then assess for airway, breathing, and circulation

1, 3, 4, 5

Which are risk factors for stroke? Select all that apply. 1 Smoking 2 Female gender 3 High blood pressure 4 Use of oral contraceptives 5 Previous stroke or transient ischemic attack (TIA)

1, 3, 4, 5

Which complications are associated with Lyme disease? Select all that apply. 1 Carditis 2 Hyperuricemia 3 Facial paralysis 4 Meningitis 5 Peripheral neuritis

1, 3, 4, 5

Which techniques does the nurse utilize in assessing pain response in an unconscious patient? Select all that apply. 1 Sternal rub 2 Abdominal thrust 3 Mandibular pressure 4 Supraorbital pressure 5 Finger hyperextension 6 Trapezius muscle squeeze

1, 3, 4, 6

A patient who had a total hip arthroplasty will be discharged from the hospital shortly. What teaching does the nurse provide for this patient? Select all that apply. 1 Use a walker as an ambulatory aid. 2 Cleanse the hip incision with antiseptic solution. 3 Sit up in a firm, supporting chair during the daytime. 4 Perform postoperative exercises such as crossing over of the legs. 5 Avoid bending the hips more than 90 degrees.

1, 3, 5

A patient with a torn meniscus has undergone a meniscectomy. What intervention will prevent swelling? Select all that apply. 1 Apply ice 2 Monitor the dressing 3 Use knee immobilizer 4 Elevate the leg with one or two pillows 5 Use continuous passive motion (CPM) machine

1, 4

In assessing function of the cranial nerves (CN), the nurse offers a patient a garlic roll and the patient identifies it correctly by both taste and smell. How does the nurse document this finding? Select all that apply. 1 CN I is functional. 2 CN II is functional. 3 CN X is functional. 4 CN IX is functional. 5 CN IV is functional. 6 CN VIII is functional.

1, 4

The nurse is educating an arthritis patient about joint protection. Which patient statement indicates a need for further learning? Select all that apply. 1 "I should hold objects using one hand." 2 "I should use a hairbrush with a long handle." 3 "I should bend at my knees rather than at my waist." 4 "I should turn doorknobs in a clockwise direction every time." 5 "I should use the entire palm of both my hands to get out of bed."

1, 4

Which statements made by the patient with Lyme disease indicate ineffective learning about self-management techniques? Select all that apply. 1 "I will burn the tick as soon as I find it." 2 "I will inspect for ticks after being in an infested area." 3 "I will wear closed shoes or boots when going into heavily wooded areas." 4 "I will go for a test to check for Lyme disease within 2 weeks after being bitten by a tick." 5 "I will report to the primary health care provider if any rash or redness is seen in the bitten area."

1, 4

Which words can be used to classify primary brain injuries? Select all that apply. 1 Open 2 Focal 3 Diffuse 4 Closed 5 Accelerated 6 Decelerated

1, 4

A rock climber has sustained an open fracture of the right tibia after a 20-foot fall. The nurse plans to assess the patient for which potential complications? Select all that apply. 1 Osteomyelitis 2 Congestive heart failure 3 Urinary tract infection (UTI) 4 Fat embolism syndrome (FES) 5 Acute compartment syndrome (ACS)

1, 4, 5

The nurse is assessing an older adult patient with a neurologic disorder. Which questions does the nurse ask to test the patient's remote memory? Select all that apply. 1 "What is your date of birth?" 2 "What is your current home address?" 3 "What is the name of your health care provider?" 4 "What are the names of the schools you attended?" 5 "What is the name of the city where you were born?"

1, 4, 5

The nurse is attending to a patient with osteoarthritis. What nonpharmacologic interventions does the nurse suggest to this patient? Select all that apply. 1 Use a small pillow under the head or neck. 2 Use a large pillow under the knee. 3 Avoid elevating the legs when sleeping. 4 Use moist heating pads that are not heavy. 5 Wear supportive shoes with foot insoles.

1, 4, 5

The nurse is giving a presentation to a hiking club regarding self-management techniques for preventing Lyme disease. Which strategies are appropriate for the nurse to include in the teaching? Select all that apply. 1 Walking in the center of a hiking trail 2 Disposing of a tick by burning it with a match 3 Using tweezers to remove a tick from the skin 4 Wearing light clothing when engaged in outdoor activities in wooded areas 5 Avoiding areas with thick underbrush, especially in the spring and summer months 6 Waiting 2-3 weeks after being bitten by a tick before being tested for Lyme disease

1, 4, 5

What are the advantages of open reduction with external fixation over other surgical techniques? Select all that apply. 1 Promotes minimal blood loss compared with internal fixation. 2 Reduces the risk for the development of pin-site infections. 3 Stabilizes comminuted fractures requiring bone grafting. 4 Maintains closed fracture alignment not possible with a cast.

1, 4, 5

What are the important aspects of emergency care in a patient who has a sports-related injury? Select all that apply. 1 Application of ice intermittently for 24 to 48 hours 2 Application of heat intermittently for 24 to 48 hours 3 Mobilization of the joint above and below the injury 4 Immobilization of the joint until spinal cord injury is ascertained 5 Assessment of the neurovascular status in the area distal to the injury

1, 4, 5

What interventions may be utilized to manage a patient with chronic osteomyelitis? Select all that apply. 1 Irrigating wounds through the window of a cast 2 Administering systemic antibiotic therapy for 2 weeks 3 Applying strict aseptic technique for dressing changes 4 Exposing the affected area to hyperbaric oxygen therapy 5 Packing the wound with bone cement bead impregnated with antibiotic

1, 4, 5

The nurse is providing discharge teaching to a patient who had a carotid stent placement. The nurse instructs the patient to contact the health care provider at the occurrence of which symptoms? Select all that apply. 1 Headache 2 Weight gain 3 Constipation 4 Neck swelling 5 Severe neck pain 6 Muscle weakness

1, 4, 5, 6

Which assessment findings are associated with psoriatic arthritis? Select all that apply. 1 Stiff, painful joints 2 Blurred vision 3 Abdominal pain 4 Scaly, itchy rash 5 Neck pain 6 Fingernail pitting

1, 4, 5, 6

What are the most common causes of traumatic brain injuries (TBIs) in the United States? Select all that apply. 1 Falls 2 Violence 3 Collisions 4 Sports-related injuries 5 Motor vehicle accidents

1, 5

An older patient with rheumatoid arthritis reports a burning and tingling sensation in the legs. Further assessment reveals foot drop in the patient. Which condition does the nurse suspect as a clinical manifestation of vasculitis present in rheumatoid arthritis? 1 Quadriplegia 2 Osteoporosis 3 Caplan's syndrome 4 Peripheral neuropathy

4

A patient was involved in a car crash and sustained an injury to the left side of the head. The patient is experiencing a severe headache, nausea, and vomiting. The Glasgow Coma Score of the patient is 10. The patient underwent neurological assessments and tests which revealed diplopia, decrease in level of consciousness, and ovoid pupil. What would the nurse infer from the patient's condition? 1 The patient's pupils are dilated. 2 The patient's optic chiasma or optic tract is damaged. 3 The patient is suffering from severe traumatic brain injury. 4 The patient has motor dysfunction on the left side of the head.

2

A patient with a newly diagnosed high-grade malignant glioma is receiving interstitial chemotherapy. What is the major drug used for this type of treatment? 1 Lomustine (CCNU) 2 Carmustine (BCNU) 3 Vincristine (Oncovin) 4 Procarbazine (Matulane)

2

How is a partial-thickness tear generally manifested in a patient with a rotator cuff injury? 1 Weakness 2 Severe pain 3 Muscle atrophy 4 Loss of function

2

In a patient with compartment syndrome, what is the physiologic change that causes pallor? 1 Increased tissue pressure 2 Decreased oxygen to tissues 3 Pressure on the nerve endings 4 Increased capillary permeability

2

In assessing a patient's cerebellar function, what does the nurse ask the patient to do to assess gait? 1 Stand on one foot, then on the other. 2 Walk across the room, turn, and return. 3 Run the heel of one foot down the shin of the other leg. 4 Stand with arms at the side, feet and knees close together.

2

In teaching a patient with acute secondary gout, which instruction about preventing recurrence is most important for the nurse to include? 1 "Limit your intake of fruits and vegetables." 2 "Weight Watchers has healthy meal plans." 3 "Limit fluid intake to 1500 mL/day." 4 "Discuss with your health care provider about having your estrogen and progesterone levels checked to see where you are in menopause."

2

The caregiver of a patient with a head injury reports to the nurse that the patient is unable to speak. Which part of the cerebral cortex should the nurse suspect is affected in the patient? 1 Limbic lobe 2 Broca's area 3 Pareital lobe 4 Wernicke's area

2

The laboratory results for a patient who sustained a stroke shows the presence of proteins in the cerebrospinal fluid. What should the nurse infer from the reports? 1 The patient had an embolic stroke. 2 The patient had a thrombotic stroke. 3 The patient had a hemorrhagic stroke. 4 The patient had a transient ischemic attack.

2

The nurse assesses poor wound healing and worsening cognitive symptoms in a patient with dementia. What does the nurse anticipate may be the causative factor? 1 Anxiety 2 Insomnia 3 Depression 4 Unhygienic conditions

2

The nurse correctly identifies the speech area of the brain as being located in which region of the cerebrum? 1 Limbic area 2 Broca's area 3 Wernicke's area 4 Hypothalamic area

2

The nurse documents that a patient with a brain tumor has developed papilledema. What is papilledema? 1 Swelling of the tongue 2 Swelling of the optic disk 3 Swelling of the thyroid gland 4 Swelling of the acoustic nerve

2

The nurse encourages a patient who has undergone total joint arthroplasty to use the incentive spirometer every 2 hours. The nurse also encourages the patient to breathe deeply and cough frequently. Which complication is the nurse seeking to prevent by using this intervention? 1 Infections 2 Atelectasis 3 Pressure ulcers 4 Postural hypotension

2

The nurse has just received report on a group of patients. Which patient does the nurse assess first? 1 Older adult who has expressive aphasia after a left-sided stroke 2 Adult who had a cerebral arteriogram and has a cool, pale right leg 3 Middle-aged adult who has a headache after undergoing a lumbar puncture 4 Young adult who was in a car accident and has a Glasgow Coma Scale score of 13

2

The nurse is assessing a patient admitted with a stroke. What assessment finding would indicate that the patient experienced a stroke to the right hemisphere? 1 Slowness 2 Denial of the illness 3 Anger and frustration 4 Deficit in the right visual field

2

The nurse is assessing the skeletal system of an African-American patient. What must the nurse know to assess the patient correctly? 1 African Americans have lesser bone density than Asians. 2 African Americans have a decreased incidence of osteoporosis. 3 African Americans have less bone density than Irish Americans. 4 African Americans have a shorter stature than Egyptian Americans.

2

The nurse is assessing the verbal response of a patient on a Glasgow scale. What score does the nurse determine when the patient makes incomprehensible sounds? 1 1 2 2 3 3 4 4

2

The nurse is assisting a patient who had a right total hip arthroplasty with getting up from bed. What action does the nurse take? 1 Stands on the left side of the bed when assisting patient 2 Reminds the patient to stand on the left leg after getting out of bed 3 Lifts the patient and assists the patient to stand 4 Asks the patient to pivot on the right side to sit in the chair

2

The nurse is caring for a patient who has undergone total hip arthroplasty. What interventions does the nurse provide to prevent the complication of dislocation? 1 Avoids the use of abduction devices 2 Assesses the patient for extremity shortening 3 Places pillows on either side of the patient to prevent movement 4 Keeps the patient's heels off the bed

2

The nurse is caring for a post-operative patient who underwent supratentorial surgery. Which treatment should be avoided if the patient's fluid loss is 8 L/hr? 1 Fluid therapy should be given to the patient. 2 Aqueous vasopressin should be administered to the patient. 3 Desmopressin acetate should be administered to the patient. 4 Hormonal replacement therapy should be given to the patien

2

The patient asks the nurse to explain exactly what fibromyalgia is. What is the appropriate response by the nurse? 1 "Fibromyalgia is an inflammatory disease with symptoms of stiffness, tenderness, and pain located at specific sites. Increased muscle tenderness may be caused by the inability to tolerate pain, possibly related to dysfunction in the brain, especially the thalamus and hypothalamus." 2 "Fibromyalgia is a chronic pain syndrome with symptoms of stiffness, tenderness, and pain located at specific sites. Increased muscle tenderness may be caused by the inability to tolerate pain, possibly related to dysfunction in the brain, especially the thalamus and hypothalamus." 3 "Fibromyalgia is an inflammatory disease with symptoms of stiffness, tenderness, and pain located at specific sites. Increased muscle tenderness may be caused by the inability to tolerate pain, possibly related to dysfunction in the brain, especially the limbic system and basal ganglia." 4 "Fibromyalgia is a chronic pain syndrome with symptoms of stiffness, tenderness, and pain located at specific sites. Increased muscle tenderness may be caused by the inability to tolerate pain, possibly related to dysfunction in the brain, especially the limbic system and basal ganglia."

2

The patient has a flat, poorly defined mass on the sole of the foot. What does this patient most likely have? 1 Corn Correct2 Callus Incorrect3 Bunion 4 Hypertrophic ungual labium

2

The patient's blood test shows a count of 12,000 white blood cells (WBCs) per microliter. Which finding does the nurse suspect is causing this laboratory value? 1 The patient has hallux valgus. 2 The patient has an inflamed ingrown toe nail. 3 The patient has bilateral Dupuytren contracture. 4 The patient has a callus on the dorsal side of the foot.

2

The student nurse is preparing a patient with osteoarthritis for home care self-management. Which nursing instruction needs correction? 1 "Do not bend at your waist." 2 "Turn doorknobs clockwise." 3 "Use a small pillow under your head." 4 "Use utensils with an extended handle for eating."

2

What assessment finding typically indicates there is a fracture of the hip? 1 Skin color 2 Groin pain 3 Inability to void 4 Blood in the urine

2

What consequence of excessive wrist flexion may lead to carpal tunnel syndrome (CTS)? 1 Reduced blood supply 2 Increased nerve compression 3 Increased volume of the synovium 4 Increased pressure in the carpal tunnel

2

What describes traumatic brain injury (TBI)? 1 Injury to the brain from a congenital condition 2 Damage to the brain from an external mechanical force 3 Impairment of the brain caused by neurodegeneration 4 Diminishing functionality of the brain due to internal forces

2

What does the nurse teach a patient with osteomalacia to include in the daily diet? 1 Calcitonin 2 Vitamin D 3 Vitamin A 4 Phosphorus

2

What does the reticular activating system (RAS) in the brainstem control? 1 Visual functions 2 Awareness and alertness 3 Speech and thought processes 4 Functions of the pituitary gland

2

What is a Dupuytren's contracture? 1 Contracture due to fibrosis within the muscle 2 Contracture of the hand due to palmar fibromatosis 3 Contracture due to necrosis of the flexor muscle fibers 4 Contracture due to interference with the circulation due to pressure, injury, or cold

2

What is a Dupuytren's contracture? Incorrect1 Contracture due to fibrosis within the muscle Correct2 Contracture of the hand due to palmar fibromatosis 3 Contracture due to necrosis of the flexor muscle fibers 4 Contracture due to interference with the circulation due to pressure, injury, or cold

2

What is a round, benign cyst that is often found on the wrist? 1 Bunion 2 Ganglion 3 Hallux valgus 4 Plantar fasciitis

2

What is the excessive stretching of a ligament? 1 Strain 2 Sprain 3 Ligament tear 4 Tendon rupture

2

What is the function of the anterior spinocerebellar tract of the spinal cord? 1 To regulate complexity of hand and finger movements 2 To transmit proprioceptive impulses from the lower extremities 3 To transmit sensory perception of the position of the body to the thalamus 4 To carry sensory perception of pain, temperatures, light touch, and pressure

2

What is the generic name for the bisphosphonate drug zoledronic acid? 1 Boniva 2 Reclast 3 Actonel 4 Fosamax

2

What is the major complication of supratentorial surgery? 1 Hematocrit 2 Hemorrhage 3 Hypokalemia 4 Hypernatremia

2

What is the most common type of benign brain tumor? 1 Astrocytoma 2 Meningioma 3 Glioblastoma 4 Medulloblastoma

2

What kind of reflex is displayed with an abnormal Babinski's sign? 1 Plantar flexion of all toes 2 Dorsiflexion of the great toe 3 Absence of abdominal reflex 4 Umbilicus deviates toward the stimulus

2

What manifestation is usually seen in fat embolism but not in blood clot embolism? 1 Dyspnea 2 Petechiae 3 Increased pulse 4 Altered mental status

2

What method does the nurse use to evaluate the movements of the shoulder? Incorrect1 Rotation Correct2 Circumduction 3 Eversion and inversion 4 Pronation and supination

2

What might be the consequence of early ambulation of a patient who underwent open reduction internal fixation (ORIF) surgery? 1 Atelectasis 2 Surgical site healing 3 Surgical site infection 4 Venous thromboembolism

2

Four patients are admitted in the hospital for hip surgery. Which patient is a candidate for minimally invasive surgery? 1 Patient A 2 Patient B 3 Patient C 4 Patient D

4

How many categories are on the National Institutes of Health Stroke Scale (NIHSS)? 1 8 2 9 3 10 4 11

4

A 30-year-old patient suffers a pelvic fracture. His partial oxygen concentration (PaO 2) drops to 70 mm Hg. There is an increase in the erythrocyte sedimentation rate (ESR) and serum lipid levels. The serum calcium level drops to 7 mg/dL. Which complication should the nurse suspect? 1 Hypovolemic shock 2 Venous thromboembolism 3 Fat embolism syndrome (FES) 4 Acute compartment syndrome

3

A 40-year-old patient reports severe sharp pain in the arch of the foot, which aggravates when the patient either gets out of bed or gets up from a prolonged sitting posture. What diagnosis does the nurse anticipate? 1 Bunion 2 Hallux valgus 3 Plantar fasciitis 4 Morton's neuroma

3

A 60-year-old male patient who underwent an open reduction internal fixation (ORIF) complains of constipation. Which drug may have caused this complication? 1 Ketorolac 2 Naproxen 3 Oxycodone 4 Acetaminophen

3

A basketball player falls, landing on the outstretched right hand. The player reports feeling a popping sensation upon impact, and now the area of the injury is bruised and swollen. Based on this information, what does the team medical staff most likely direct the player to do in the first 48 hours following the injury? 1 Apply ice only. 2 Apply heat only. 3 Apply ice and use compression. 4 Apply heat and use compression.

3

A construction worker who reports pain in the vertebral column and hips is diagnosed with secondary osteoarthritis (OA). What does the nurse tell the patient may have been the cause? 1 Aging 2 Genetic changes 3 Trauma or abuse 4 Obesity

3

A diabetic patient is admitted to the health care facility with a foot ulcer. The nurse teaches wound care to the patient and the caregiver to prevent the risk for which condition? 1 Osteoarthritis 2 Osteoporosis 3 Osteomyelitis 4 Osteomalacia

3

A football player is admitted to the emergency department with a sprained ankle. What emergency care is needed for the patient with this type of injury? 1 Do not apply a splint below the injury. 2 Do not apply a splint above the injury. 3 Use elastic wrap for the first 24 to 48 hours. 4 Apply warm compresses for the first 24 hours.

3

A novice nurse is learning about the use of endoscopic carpal tunnel release (ECTR) and open carpal tunnel release (OCTR) for treatment of carpal tunnel syndrome (CTS). Which statement reflects understanding of the two procedures? 1 "OCTR is more invasive and is associated with a longer period of postoperative pain." 2 "Many patients do not opt for ECTR because it is generally a more expensive procedure." 3 "Major complications are rare with both ECTR and OCTR, though CTS can recur." 4 "ECTR and OCTR are both used to relieve pressure on the radial nerve in the wrist."

3

A nurse is preparing a presentation on carpal tunnel syndrome (CTS) to be given to a group of employees in an office. Which statement does the nurse need to revise before finalizing the presentation? 1 "Federal and state laws require that all businesses provide ergonomically appropriate workstations." 2 "It's helpful to set a reminder to take regular short breaks away from your computer throughout the day." 3 "For the most appropriate positioning, set the height of your chair 30 in away from the floor." 4 "Wrist rest devices positioned in front of your keyboard can support your wrists and help prevent CTS."

3

A nurse is reviewing the diagnostic reports for a patient who reports joint swelling and pain along with dryness in the eyes, mouth, and vagina. What does the nurse infer from these findings? 1 Felty's syndrome 2 Reiter's syndrome 3 Sjogren's syndrome 4 Carpal tunnel syndrome

3

A patient diagnosed with rheumatoid arthritis (RA) is started on methotrexate. Which statement made by the patient indicates to the nurse that further teaching is needed regarding drug therapy? 1 "Drinking alcoholic beverages should be avoided." 2 "The health care provider should be notified 3 months before a planned pregnancy." 3 "Any side effects of this drug will be mild." 4 "I will avoid any live vaccines."

3

A patient has a Buck extension traction. What type of injury does the patient most likely to have? 1 Fracture of the pelvis 2 Cervical fracture of the spine 3 Fracture of the hip before surgery 4 Fracture of the humerus with involvement of the shoulder and clavicle

3

A patient has a brain tumor classified as supratentorial. Where is the tumor located? 1 At the meninges 2 Below the tentorium 3 Above the tentorium 4 At the cerebellar pontine angle

3

A patient has a callus of the foot. What treatment does the nurse anticipate for this patient? 1 Removal of sliver by podiatrist 2 Treatment of secondary infection 3 Application of padding and lanolin cream 4 Surgical removal of necrotic nail and skin

3

A patient has a short-leg cast following a fracture of the ankle. What does the nurse teach the patient about managing the fracture? 1 Apply ice for the first 12 hours 2 Report if the cast is not tight enough 3 Elevate the affected leg on several pillows 4 Avoid walking to prevent damage to the cast

3

A patient has a sprained ankle. What nonsurgical method of treatment does the nurse suggest to the patient? 1 Apply an ankle brace or splint 2 Perform range of motion exercises 3 Alternate hot and cold compresses 4 Avoid weight-bearing exercise until recovery is complete

3

A patient has had surgery for carpal tunnel syndrome (CTS). What does the nurse teach the patient before discharge? 1 Elevate the affected arm to heart level 2 Restrict hand movements for 2 weeks after surgery 3 Check neurovascular status of the fingers every hour 4 Take prescribed nonsteroidal anti-inflammatory drugs (NSAIDs) on an empty stomach

3

While assessing a patient with systemic sclerosis, the nurse anticipates organ failure. What findings support this anticipation? Select all that apply. 1 Chest pain 2 Abdominal pain 3 Decreased urine output 4 Increased blood pressure 5 Characteristic blue-colored digits

3, 4

While reviewing the previous medical records of a patient with a "butterfly" rash, the nurse finds that the patient has been on prednisone therapy for 5 years. Which complications are likely to occur in the patient? Select all that apply. 1 Pancreatitis 2 Organ failure 3 Osteonecrosis 4 Muscle atrophy 5 Mesentric arteritis

3, 4

The patient with rheumatoid arthritis complains of cervical pain. What complications of cervical/spinal column involvement does the nurse monitor for in the patient? Select all that apply. 1 Fatigue 2 Swan neck 3 Paresthesias 4 Quadraparesis 5 Compromised respiratory function

3, 4, 5

Which instructions should the nurse give to ensure drug safety in a patient with gout who is prescribed febuxostat? Select all that apply. 1 "Take the drug before meals." 2 "Have your blood pressure checked regularly." 3 "Drink a glass of water after taking each dose." 4 "Undergo a liver function test every 2 months." 5 "Have a complete blood count check periodically."

3, 4, 5

Which statement is true regarding a ganglion cyst? Select all that apply. 1 Ganglion cysts have malignant potential. Incorrect2 Ganglion cysts cause severe pain on palpation. Correct3 Ganglion cysts can rapidly disappear and recur. Correct4 Treatment includes the aspiration of cystic fluid with a fine needle. Correct5 Ganglion cysts form due to the degeneration of synovium surrounding the tendon.

3, 4, 5

The nurse is creating a nursing plan for management of a pelvic fracture. For which complications will the nurse monitor this patient? Select all that apply. 1 Nephritis 2 Pneumonia 3 Arterial bleeding 4 Blood volume loss 5 Abdominal rigidity 6 Blood in urine and stool

3, 4, 5, 6

Which symptoms does the nurse anticipate in a patient who is in the late stage of rheumatoid arthritis (RA)? Select all that apply. 1 Anorexia 2 Paresthesias 3 Deformities 4 Osteoporosis 5 Severe fatigue 6 Peripheral neuropathy

3, 4, 5, 6

The nurse is assessing a patient with a history of mild traumatic brain injury. The patient reports sleep disturbances. Which findings should the nurse observe for in the patient? Select all that apply. 1 Amnesia 2 Irritability 3 Drowsiness 4 Nervousness 5 Sleeping for long hours

3, 5

How much time will it take for the symptoms of a transient ischemic attack to resolve? 1 1 to 2 hours 2 3 to 4 hours 3 5 to 6 hours 4 30 to 60 minutes

4

If a patient has a traumatic brain injury (TBI) with ataxia, what does that mean? 1 The patient has hypotension. 2 The patient has a blood clot. 3 The patient cannot see colors. 4 The patient has a loss of balance.

4

A patient is receiving recombinant tissue plasminogen activator (rtPA) for an acute ischemic stroke. What nursing intervention does the nurse perform first to properly take care of the patient? 1 Perform neurologic assessments and check vital signs every hour. 2 Start antihypertensive drugs as prescribed if the patient's systolic blood pressure is greater than 150 mm Hg. 3 Inform the patient that he or she may experience symptoms such as headache and nausea during treatment. 4 Ensure that the prescribed follow-up computed tomography (CT) scan is done after treatment is completed and before starting antiplatelet drugs.

4

A patient presents with pain in the front of the knee. The patient reports being an avid runner. What will the nurse be most likely to suggest? 1 Surgery to repair a tendon 2 Alternating application of heat and cold 3 Rest, ice, compression, and elevation (RICE) 4 A brace and nonsteroidal antiinflammatory drugs (NSAIDs)

4

A patient reports pain around the knee with stiffness when it is flexed. Which type of musculoskeletal trauma does the nurse suspect in the patient? 1 Tendinopathy 2 Joint dislocation 3 Carpal tunnel syndrome 4 Patellofemoral pain syndrome

4

A patient who had an open reduction of the ankle complains of intense, burning pain. The primary health care provider instructs the nurse to intravenously administer phentolamine. What condition is the health care team likely treating? 1 Carpal tunnel syndrome (CTS) 2 Fat embolism syndrome (FES) 3 Acute compartment syndrome (ACS) 4 Complex regional pain syndrome (CRPS)

4

A patient who is a jackhammer operator reports pain and numbness in the wrist. Which musculoskeletal trauma does the nurse suspect in the patient? 1 Strain 2 Sprain 3 Tendinopathy 4 Carpal tunnel syndrome (CTS)

4

A patient who is an avid runner has suffered a muscle strain. Which management advice given by the nurse is most helpful to the patient? 1 "You will likely need to have surgery to repair the damage." 2 "The best approach is RICE: rest, ice, compression, and elevation." 3 "We will get you a prescription for muscle relaxants, and we'll splint it for two weeks." 4 "Alternate heat and cold on the ankle, stay off it, and take a nonsteroidal antiinflammatory drug (NSAID) for the pain."

4

A patient who underwent therapy for carpal tunnel syndrome (CTS) reports prolonged periods of pain and numbness. Which therapeutic procedure is associated with recovery from this procedure? 1 Ultrasound therapy 2 Hand brace immobilization 3 Open carpel tunnel release (OCTR) 4 Endoscopic carpel tunnel release (ECTR)

4

A patient with Alzheimer's disease is scheduled to undergo a positron emission tomography (PET) scan. Which intervention does the nurse implement for this patient before the test? 1 Administer a glucose solution before the test. 2 Instruct the patient to remove earplugs during the test. 3 Inject the patient with IV deoxyglucose, tagged to an isotope. 4 Ensure the patient has been NPO for 4-12 hours before the test.

4

A patient with Grade 3 meningiomas has to undergo surgery. The nurse is teaching the patient about the precautions to take before surgery. Which statement made by the patient shows a need for further learning? 1 "I will eat a healthy diet." 2 "I will do aerobic exercises." 3 "I will not eat anything for at least 8 hours before the surgery." 4 "I will not drink alcohol for at least 8 hours before the surgery."

4

A patient with a newly diagnosed brain tumor complains of a headache. What medication is likely to be prescribed for this patient? 1 Ibuprophen (Motrin) 2 Procarbazine (Matulane) 3 Acetylsalicylic acid (Aspirin) 4 Codeine and acetaminophen (Tylenol, ACE-Tabs)

4

A patient with a pelvic fracture is advised to undergo external fixation. Which part of the pelvis might have been involved in the fracture? 1 Fibula 2 Iliac crest 3 Pubic rami 4 Acetabulum

4

A patient with a rotator cuff injury has undergone surgery. During analgesia, the peripheral nerve was blocked. What complication may be seen in the patient? 1 Bruising of arm 2 Swelling of arm 3 Bleeding of arm 4 Numbing feeling of the arm

4

A patient with an acute ischemic stroke is admitted to the emergency department. The nurse is teaching a student nurse about potential medications the patient may need. Which statement made by the student nurse shows ineffective learning? 1 "Antihypertensive drugs should be given to the patient." 2 "The infusion should be stopped if bleeding, nausea, or vomiting occurs." 3 "Neurologic assessments should be performed every 10-15 minutes during the infusion period." 4 "A programmable pump should be used to deliver an initial dose of 120 mg over 2 hours with 10% of the dose given intravenously.

4

A patient with bone cancer is most susceptible to what type of fracture? 1 Stress fracture 2 Simple fracture 3 Compound fracture 4 Spontaneous fracture

4

A patient with rheumatoid arthritis is prescribed hydroxychloroquine for joint and muscle pain. Which statements should the nurse include in the teaching? 1 "You should report hair loss." 2 "You should report chest pain." 3 "You should follow strict birth control." 4 "You should report any sign of blurred vision or headache."

4

A patient with rheumatoid arthritis with joint swelling had an arthrocentesis. Which post-procedure instruction, provided by the student nurse, needs correction? 1 "You should take acetaminophen if you have pain." 2 "You have to apply ice on the affected joint for 24 hours after the procedure." 3 "You have to immediately notify the health care provider if swelling increases." 4 "You should move the affected joint frequently during the first 24 hours after surgery."

4

A patient's brain tumor has increased in size and is placing pressure on the pituitary gland. The nurse is alert for which manifestation indicative of pituitary gland dysfunction? 1 Diabetes mellitus 2 Decorticate posturing 3 Thyroid-stimulating hormone (TSH) dysfunction 4 Syndrome of inappropriate diuretic hormone (SIADH)

4

A primary health care provider advises a patient to avoid wearing high heels. Which traumatic condition does the nurse suspect in the patient? 1 Strain 2 Sprain 3 Rotary cuff injury 4 Achilles tendinopathy

4

Which statement by a nursing student about the health economics associated with osteoporosis indicates a need for further teaching by the nursing instructor? 1 "The estimated cost of osteoporosis-related health care in the United States is about $18 billion annually." 2 "By 2040, this estimated annual cost is expected to be doubled or tripled as the baby boomers become older adults." 3 "Cost of dual-energy x-ray absorptiometry (DXA) screening is far less than the financial, social, and health care costs of osteoporosis." 4 "Peripheral quantitative ultrasound (pQUS) is rarely used as a screening tool for osteoporosis detection because of its high cost."

4

Which statement is true regarding osteoarthritis? 1 Pain worsens after rest in early stage of the disease. Incorrect2 Pain is caused by the nerve supply to the cartilage. 3 Pain diminishes after activity in early stage of the disease. Correct4 Pain is caused by spasms of the surrounding muscles.

4

Which statement is true regarding the meninges? 1 The outside layer is the pia matter. 2 The meninges are the protecting covering of the brain. 3 The subarachnoid space is located between arachnoid and dura matter. 4 The dura matter between the cerebral hemispheres and the cerebellum is the tentorium.

4

Which statement made by the student nurse indicates understanding of neurogenic pulmonary edema? 1 "Neurogenic pulmonary edema is easily treated with intravenous mannitol." 2 "Most patients with neurogenic pulmonary edema have poor cardiac ejection fractions." 3 "Neurogenic pulmonary edema is an expected complication following craniotomy." 4 "Most patients with neurogenic pulmonary edema do not survive."

4

Which syndrome is described as a dysfunction of the central and peripheral nervous systems, leading to severe chronic pain? 1 Carpal tunnel syndrome (CTS) 2 Fat embolism syndrome (FES) 3 Acute compartment syndrome (ACS) 4 Complex regional pain syndrome (CRPS)

4

Which treatment beams are widely dispersed over the surface of the head to prevent damage to healthy brain tissue? 1 Brachytherapy 2 Chemotherapy 3 Interstitial radiation therapy 4 Stereotactic radiation therapy

4

Which treatment is also known as gamma knife treatment? 1 Chemotherapy 2 Brachytherapy 3 Interstitial radiation therapy 4 Stereotactic radiation therapy

4

Which tumor arises from the sheath of Schwann cells in the peripheral portion of cranial nerve VIII? 1 Meningiomas 2 Supratentorial 3 Pituitary tumors 4 Acoustic neuromas

4

Which type of fracture is most commonly complicated by delayed union because of poor perfusion? 1 Fractures of the pelvis 2 Fractures of the spine 3 Fractures of the femoral region 4 Fractures of the tibia and fibula

4

Which type of stroke is caused by aneurysm or hypertension? 1 Embolic stroke 2 Ischemic stroke 3 Thrombotic stroke 4 Hemorrhagic stroke

4

Which type of stroke shows interrupted vessel integrity and bleeding that occurs into the brain tissue or into the subarachnoid space? 1 Embolic stroke 2 Ischemic stroke 3 Thrombotic stroke 4 Hemorrhagic stroke

4

Which type of traction is used to correct bone deformities of the lower extremities? 1 Pelvic belt 2 Pelvic sling 3 90-90 traction 4 Russell's traction

4

While assessing a patient that sustained trauma, the nurse finds that the patient has difficulty in speaking. Which cranial nerve may be affected in the patient? 1 V 2 XI 3 IV 4 XII

4

While caring for a patient with rheumatoid arthritis, the nurse finds that the patient has a single hot, swollen, and painful wrist joint. Which is the best nursing intervention for this patient? 1 Applying ice immediately 2 Administering analgesics immediately 3 Administering antibiotics immediately 4 Notifying the primary health care provider

4

While reviewing a patient's chart from the previous shift, the nurse reads the phrase, "The patient continues to demonstrate decorticate posturing." From this entry, what does the nurse expect the patient to exhibit? 1 Tonic-clonic seizure activity 2 Responding to yes or no questions by blinking 3 No movement from the waist down, and bowel and bladder incontinence 4 Clenched fists and arms bent in toward the body, with wrists and fingers held on the chest

4

While reviewing the laboratory test reports of a patient, the nurse finds a false-positive venereal disease research laboratory (VDRL) syphilis test. Which condition does the nurse suspect in the patient? 1 Gout 2 Osteoarthritis 3 Rheumatoid arthritis 4 Lupus erythematosus

4

While reviewing the results of a patient's lumbar puncture, the nurse notes the pressure was identified as greater than 25 cm H 2O. Which interpretation of this finding is correct? 1 The level is low. 2 The level is slightly elevated. 3 The finding is within normal limits. 4 The level requires immediate surgical intervention.

4

he nurse is teaching a young patient about ways to prevent osteoporosis in later adulthood. Which information does the nurse provide? Incorrect1 "Engage in a weight-loss program." 2 "Avoid exposure to the sun before 10:00 a.m." 3 "Consume a high-protein, low-carbohydrate diet." Correct4 "Limit the consumption of carbonated beverages."

4

n assessing the patient's neurologic status, the nurse notes the patient is able to move the eyes in all six directions. Which set of cranial nerves (CN) does the nurse document as intact? 1 CN V and X 2 CN VII and IX 3 CN I, II, and IV 4 CN III, IV, and VI

4

During assessment, the nurse notes that a patient cannot identify the month, cannot state his or her age correctly, the arm and leg drift when elevated, and that the patient is silent when asked to identify common items. The nurse should document what total score in the patient's medical record based on the National Institutes of Health Stroke Scale (NIHSS)? Record your answer using a whole number. ______

A patient who is unable to name the month or state his or her current age is assigned a score of 2. Drifting of the arm and leg when elevated is assigned a score of 1. A score of 3 is given for an inability to name common objects. The total score for this patient is 6.

What are the events of an arthrocentesis in chronological order? 1. Aspirate a sample of synovial fluid. 2. Administer a local anesthetic. 3. Insert a large-gauge needle into the joint. 4. Use ice and rest the affected joint for 24 hours. 5. Send the sample of aspirated fluid to the lab for analyzing.

An arthrocentesis is an invasive procedure used to treat joint swelling caused by excess synovial fluid. Administering a local anesthetic to the joint is the first step. It is followed by inserting a large-gauge needle into the joint. Then, a sample of synovial fluid is aspirated. The aspirated fluid is sent to the lab to determine volume, cloudiness, and white blood cell count. After the arthrocentesis procedure, ice is applied on the area and the affected should rest for 24 hours.

Arrange the following nursing actions pertaining to the emergency care of a patient who experiences a fracture in the correct sequence. 1. Manage pain 2. Control bleeding by direct pressure 3. Assess airway, breathing, and circulation 4. Render cardiopulmonary resuscitation (CPR), if necessary

Assessing the patient's airway, breathing, and circulation (ABC) are the first actions that need to be taken when caring for a patient suffering from a fracture. CPR is then provided, if needed. Any bleeding is controlled by applying direct pressure to the area and applying digital pressure over the artery above the fracture. After assessment and stabilization, pain is managed with intravenous (IV) opioids.

Arrange in the correct order the process of sequestrum formation as it occurs in osteomyelitis. 1. Sequestrum formation 2. Vascular thrombosis 3. Ischemia of bone tissue 4. Stimulation of inflammatory response 5. Release of exudate into the bone tissue 6. Invasion of pathogenic microorganisms

Invasion of pathogenic microorganisms stimulates the inflammatory response in bone tissue. Once inflammation is established, there is vascular thrombosis and release of exudate (pus) into bony tissue. Ischemia of bone tissue follows and results in necrotic bone. This area of necrotic bone separates from surrounding bone tissue, and sequestrum is formed.

A patient weighing 165 pounds will begin receiving recombinant tissue plasminogen activator (rtPA) to treat an ischemic stroke. The nurse expects an order to administer how many milligrams of rtPA in the first minute of the infusion? Record your answer using two decimal places. Use a leading zero if applicable. ___ mg

Patients receiving rtPA should receive 0.9 mg/kg over 60 minutes with 10% of that dose given as a bolus over the first minute. This patient weighs 165 lbs, or 75 kg. The total dose for this patient is 67.5 mg (0.9 × 75 = 67.5). Ten percent of that is 6.75 mg.

A 30-year-old male patient diagnosed with Reiter's syndrome presents with painful urination and a throbbing, swollen left knee. In which order should the nurse perform the following actions? 1. Ice left knee 2. Teach prevention 3. Administer celecoxib 4. Administer intravenous antibiotics

The first action should be to administer the antibiotic to target the microorganism, which is the most important aspect of the infection. The next priority is to treat the pain, so the nurse should administer celecoxib, which is an NSAID that helps with the pain management. Icing the left knee will help with the swelling and pain. Finally, sexually transmitted disease is often the cause of Reiter's syndrome, so the nurse should teach how the infection is acquired and the importance of condom use.

The nurse assesses a patient and notes partial hemianopia, ataxia in the right limb only, and no auditory comprehension. Painful stimulation is needed for the patient to make movements. Based on the National Institutes of Health Stroke Scale (NIHSS), what is the total score for this patient?______

The score given for partial hemianopia is 1, and the nurse assigns a score of 2 if painful stimulation is required to make movements. The score assigned for ataxia in only the right limb is 1, and a score of 3 is given for a lack of auditory comprehension. The total score for this patient is 7 (1 + 2 + 1 + 3 = 7).

The nurse is caring for a patient who is diagnosed with early-stage Lyme disease. Which medication does the nurse anticipate will be included in the patient's pharmacologic plan of care? 1 Doxycycline 2 Golimumab 3 Pregabalin 4 Febuxostat

1

The nurse is teaching a nursing student about measures to facilitate sleep in patients with arthritis. Which statement made by the nursing student indicates a need for further teaching? 1 "I should provide cold beverages before sleeping." 2 "I should administer a hypnotic drug 30 minutes before sleep." 3 "I should maintain a quiet environment in the patient's room." 4 "I should instruct the patient to elevate the legs with a pillow while sleeping."

1

The primary health care provider prescribes epoetin alfa to a patient before knee replacement surgery. What is the reason behind this prescription? 1 To prevent anemia 2 To prevent infection 3 To prevent vomiting 4 To prevent prosthetic failure

1

What is the pathophysiology of Marfan syndrome? 1 Autosomal dominant disorder resulting from mutations in the fibrillin I gene (FBNI) 2 Complex syndrome associated with the HLA- 27allele causing a triad of arthritis, conjunctivitis, and urethritis 3 Autoimmune, genetic-based disease affecting middle-aged and older women most often and causing proximal muscle weakness 4 Autoimmune, inflammatory disease affecting the spine and thought to be genetic (strongly associated with specific variations in the HLA- 27 allele on chromosome 6)

1

Which antidepressant drug is often used to treat nerve pain in patients with fibromyalgia syndrome? 1 Pregabalin 2 Trazodone 3 Nortriptyline 4 Amitriptyline

1

Which disease manifests as fever, weight loss, generalized weakness, fatigue, and the inflammation of the proximal interphalangeal (PIP) and metacarpophalangeal (MCP) joints of the hands? 1 Rheumatoid arthritis (RA) 2 Fibromyalgia syndrome (FMS) 3 Chronic fatigue syndrome (CFS) 4 Systemic lupus erythematosus (SLE)

1

Which drug may be administered to a patient undergoing knee arthroplasty to reduce postoperative pain? 1 Capsaicin 2 Cefazolin 3 Dalteparin 4 Enoxaparin

1

Which element is a risk factor for osteoarthritis (OA)? 1 Thin build 2 Obesity 3 Non-smoker 4 Male

1

Which information about autosomal recessive disorders is correct? 1 If both the parents are affected, all children are affected. 2 If both the parents are unaffected, children remain unaffected. 3 The trait is expressed even when heterozygous alleles are present. 4 The trait is more common among the female members of the family.

1

Which was the first drug approved to treat systemic lupus erythematosus? 1 Belimumab 2 Methotrexate 3 Acetaminophen 4 Hydroxychloroquine

1

What are the factors that may lead to osteoarthritis (OA)? Select all that apply. 1 Aging 2 Obesity 3 Genetics 4 Rheumatoid arthritis (RA) 5 Systemic lupus erythematosus (SLE)

1, 2, 3

What are the stage II complications of Lyme disease? Select all that apply. 1 Meningitis 2 Dysrhythmias 3 Facial paralysis 4 Chronic fatigue 5 Memory problems

1, 2, 3

Which laboratory and diagnostic tests are used to detect osteoarthritis (OA)? Select all that apply. 1 C-reactive protein assay 2 X-ray studies 3 Rheumatoid factor assay 4 Antinuclear antibody test 5 Magnetic resonance imaging

1, 2, 5

Which statements may be used to describe osteoarthritis (OA)? Select all that apply. 1 Obesity is a risk factor. 2 It is an autoimmune disorder. 3 Its disease process is degenerative. 4 It usually affects the upper extremities first. 5 Its disease pattern is bilateral and symmetric.

1, 3

What are the clinical manifestations of dermatomyositis? Select all that apply. 1 Severe muscle weakness 2 Iritis 3 Eyelid rash 4 Periorbital edema 5 Weight loss

1, 3, 4

When assessing the patient who is diagnosed with Lyme disease, which signs or symptoms does the nurse expect the patient to demonstrate? Select all that apply. 1 Erythema migrans 2 Itchy rash 3 Joint stiffness 4 Muscle pain 5 Podagra

1, 3, 4

What are the clinical manifestations of temporal arteritis? Select all that apply. 1 Fever 2 Stiffness 3 Headache 4 Weight loss 5 Visual disturbances

3 and 5

Which are the early manifestations of rheumatoid arthritis? Select all that apply. 1 Anemia 2 Deformities 3 Inflammation 4 Low-grade fever 5 Morning stiffness

3,4

What is the dosage limit of acetaminophen in the treatment of osteoarthritis (OA)?___ mg

3000


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