Unit 1 PrepU Review

The nurse is preparing the client with a right neck mass for magnetic resonance imaging (MRI). Which question should the nurse ask? Select all that apply.

"Are you wearing any jewelry?" "Have you removed your hearing aid?" "Do you have a pacemaker?"

The nurse is conducting the admission assessment for a client who is to undergo an arthrogram. What is the priority question the nurse should ask?

"Do you have any allergies?"

The nurse is preparing the client for computed tomography. Which information should be given by the nurse?

"You must remain very still during the procedure."

When discussing lifestyle modifications with a client who has obesity, what caloric deficit should the nurse recommend in order for the client to safely lose weight?

500-1,000 calories

At its most fundamental level, what does obesity result from?

A metabolic imbalance

The nurse is providing care for an adult client who has sought care for the treatment of obesity. When performing an assessment of this client, the nurse should address what potential contributing factors? Select all that apply.

Activity level Family history and genetics Endocrine factors Microbiota

The nurse is caring for the client with chronic osteomyelitis of the jaw with a draining wound. Which nursing diagnosis is appropriate for the client? Select all that apply.

Acute pain Disturbed body image Imbalanced nutrition: less than body requirements

A client presents at an ambulatory clinic and reports pain and aching in the lower left leg. After examining the client, a health care provider determines the client has experienced a strain related to the client's exercise regimen. The treatment plan includes analgesics, rest, and cold and heat therapies. Which guideline should be included in the care plan?

After 24 hours, apply heat for periods of 15 to 30 minutes.

A client has undergone arthroscopy. After the procedure, the site where the arthroscope was inserted is covered with a bulky dressing. The client's entire leg is also elevated without flexing the knee. What is the appropriate nursing intervention required in caring for a client who has undergone arthroscopy?

Apply a cold pack at the insertion site.

A nurse in a busy emergency department provides care for many clients who present with contusions, strains, or sprains. What are treatment modalities that are common to all of these musculoskeletal injuries? Select all that apply.

Applying ice Compression dressings Resting the affected extremity Elevating the injured limb

An emergency department client is diagnosed with a hip dislocation. The client's family is relieved that the client has not suffered a hip fracture, but the nurse explains that this is still considered to be a medical emergency. What is the rationale for the nurse's statement?

Avascular necrosis may develop at the site if it is not promptly resolved.

The nurse is aware that infection is a potential complication of surgery. Which intervention should the nurse implement to prevent infection? Select all that apply.

Avoid touching sterile items unless necessary. Alert the surgical team of any breaches of sterile technique. Wear a long-sleeved, sterile gown and gloves.

A nurse is teaching a nutrition class to a group of elderly clients at a retirement center. The nurse tells the clients that as a result of aging, they will need to decrease

Calories

A 69-year-old client has maintained a consistent diet and activity level throughout adulthood. Over the past few years, however, the client has reported a gradual increase in adipose tissue. When providing health education, the nurse should address what topic?

Changes in metabolism that accompany the aging process

A client with osteoarthritis of the hip for a number of years reports a dull, aching pain with ambulation and pain shooting down the leg at night while sleeping. The nurse recognizes that the client is experiencing which type of pain?

Chronic pain

A client sustains a fractured right humerus in an automobile accident. The arm is edematous, the client states not being able to move or feel the fingers, and the nurse does not feel a pulse. What condition should the nurse be concerned about that requires emergency measures?

Compartment syndrome

The client who had a total hip replacement was discharged home and developed acute groin pain in the affected leg, shortening of the leg, and limited movement of the fractured leg. The nurse interprets these findings as indicating which complication?

Dislocation of the hip

The health care provider has prescribed alendronate for this client. Which instruction(s) will the nurse give to the client?

Drink 250 ml of water with medication. Do not take calcium and vitamin D supplements at the same time as this drug. Ensure adequate dietary intake of calcium and vitamin D while taking this drug. Report symptoms of esophageal irritation, such as burning or feeling something is stuck in the throat, to the health care provider.

Two patients have recently returned to the postsurgical unit after knee arthroplasty. One patient reports pain of 8 to 9 on a 0-to-10 pain scale, whereas the other is reporting a pain level of 3 to 4 on the same pain scale. Which rationale is identified by the nurse as most plausible for the difference in perception of pain?

Endorphin levels may vary between patients, affecting the perception of pain.

Which nursing intervention(s) will the nurse implement immediately for the client experiencing hemorrhagic shock from a surgical complication?

Ensure adequate IV access for blood transfusion and surgery. Make the client NPO. Monitor laboratory results. Place the client in a supine or recovery position. Prepare the client for immediate surgical intervention.

After a car accident, a client is admitted to an acute care facility with multiple traumatic injuries, including a fractured pelvis. For 24 to 48 hours after the accident, the nurse must monitor the client closely for which potential complication of a fractured pelvis?

Fat embolism

The nurse is discussing the client's risk profile and dual-energy x-ray absorptiometry (DEXA) scan score with the health care provider. Which prescription(s) for care does the nurse anticipate?

Increase intake of calcium to 1,200 mg/day. Administer a bisphosphonate. Encourage weight-bearing exercise. Encourage outdoor activity in the sun.

A nurse caring for clients with obesity understands these clients are at increased risk for developing pressure ulcers. What does the nurse recognize increases the client's risk for developing pressure ulcers? Select all that apply.

Increased adipose tissue decreases the supply of blood, oxygen, and nutrients to peripheral tissue. Skin folds are associated with more moisture and friction.

When evaluating a patient's response to acute pain, the nurse assesses for the presence of physiologic responses associated with the pain experience. Select all that apply:

Increased cardiac output Increased metabolic rate Hyperglycemia Decreased urinary output

A client is scheduled for a bone scan. A bone scan may be ordered to detect metastatic bone lesions, fractures, and certain types of inflammatory disorders. Which nursing considerations are correct in preparing a client for a bone scan? Select all that apply.

Inform the client that the radiopaque isotope will be administered intravenously. Ensure that the client does not have any allergies to the isotope. Encourage the client to drink fluids to help distribute and eliminate the isotope.

A nurse is developing a teaching plan for a client diagnosed with osteoarthritis. What instruction should the nurse give to the client to minimize injury?

Install safety devices in the home.

A client has a history of osteoarthritis. Which signs and symptoms should the nurse expect to find on physical assessment?

Joint pain, crepitus, Heberden's nodes

A nurse is preparing to discharge a client from the emergency department after receiving treatment for an ankle sprain. While providing discharge education, the nurse should encourage what action?

Keep an elastic compression bandage on the ankle.

The client has suffered an injury to the right leg and is reporting pain at the level of "5" on a scale of 0 to 10. The client has a history of peripheral artery disease (PAD). The client requests nonpharmacologic interventions. What interventions are appropriate for the nurse to perform? Select all that apply.

Massage the client's back and shoulders. Teach the client to perform slow, rhythmic breathing. Turn on the television to a show the client asks to watch. Assist the client to perform guided imagery.

A client with a herniated lumbar disc has asked about nonsurgical strategies to help with mobility. What strategies will the nurse teach the client? Select all that apply.

Muscle relaxants Weight reduction Physical therapy Nonsteroidal anti-inflammatory medications

A client scheduled to undergo an electromyography asks the nurse what this test will evaluate. What is the correct response from the nurse?

Muscle weakness

The nurse is collaborating with the health care provider on a plan of care for a 54-year-old male client with osteomyelitis of the left femur secondary to uncontrolled type 1 diabetes. Which answer choice presents prescriptions for care that the nurse should anticipate for this client.

Perform neurovascular checks of lower extremities every 8 hours. Administer IV antibiotic based on culture and sensitivity report. Administer ibuprofen 400 mg orally three times daily, as needed for pain. Make referral to dietitian to discuss nutrition for healing and blood glucose control. Provide education on self-blood glucose monitoring and insulin administration.

A nurse is caring for a client who is postoperative day 1 following a total arthroplasty of the right hip. How should the nurse position the client?

Place a pillow between the legs.

A client is diagnosed with several fractured ribs after a motor vehicle crash. Which actions will the nurse take when caring for this client? Select all that apply.

Provide analgesics as prescribed. Instruct on the use of an incentive spirometer. Demonstrate the use of a pillow to splint the area. Remind to take deep breaths and cough every hour.

The nurse is caring for the client with chronic osteomyelitis of the jaw with a draining wound. Which client goal is a priority for the client? Select all that apply.

The client will experience a tolerable level of pain. The client will demonstrate wound care. The client will maintain adequate nutritional intake.

Which of the following is a true statement with regards to the nursing process of pain control?

The use of physiologic signs to indicate pain is unreliable.

A nurse cares for older adults with obesity and understands that this particular population is impacted differently than the general population. What does the nurse understand is true regarding older adults with obesity? Select all that apply.

They are at greater risk for falls. They are admitted to nursing homes more than other older adults. They have lower SpO2 levels.

The client has just been diagnosed with osteomyelitis. What are possible causes of osteomyelitis? Select all that apply.

Trauma, such as penetrating wounds or compound fractures Vascular insufficiency in clients with diabetes or peripheral vascular disease Surgical contamination, such as pin sites of skeletal traction

A client is preparing for discharge from the emergency department after sustaining an ankle sprain. The client is instructed to avoid weight bearing on the affected leg and is given crutches. After instruction, the client demonstrates proper crutch use in the hallway. What additional information is most important to know before discharging the client?

Whether the client needs to navigate stairs routinely at home

A nurse is caring for a client with obesity and diabetes after abdominal surgery. What is the client at increased risk for?

Wound dehiscence

A client who has fallen and injured a hip cannot place weight on the leg and is in significant pain. After radiographs indicate intact but malpositioned bones, what would the physician diagnose?

dislocation

A nurse is caring for a client who has just had an arthroscopy as an outpatient and is getting ready to go home. The nurse should teach the client to monitor closely for what postprocedure complication?

fever

The client is being seen at the women's health clinic for a 6-month follow up for osteoporosis. Which finding(s) indicates an effective outcome?

has had no fractures has joined a walking program at a local senior center serum calcium level 8.3 mg/dl (96 mmol/l) has increased dietary calcium and vitamin D

A patient is diagnosed with osteomyelitis of the right leg. What signs and symptoms does the nurse recognize that are associated with this diagnosis? (Select all that apply.)

pain erythema fever

The nurse is working with a sedentary adult client who has expressed a determination to lose weight over the next several months, despite the presence of other major health problems. What is the nurse's best advice for this client?

"It might be challenging to start an exercise program, but we'll start with a few minutes per day."

A client has been experiencing progressive increases in knee pain and diagnostic imaging reveals a worsening effusion in the synovial capsule. The nurse should anticipate what diagnostic procedure?

Arthrocentesis

Which of the following diagnostic studies are done to relieve joint pain due to effusion?

Arthrocentesis

A patient is scheduled for a procedure that will allow the physician to visualize the knee joint in order to diagnose the patient's pain. What procedure will the nurse prepare the patient for?

Arthroscopy

A nurse is caring for a client placed in traction to treat a fractured femur. Which nursing intervention has the highest priority?

Assessing the extremity for neurovascular integrity

The nurse is assessing an 86-year-old postoperative client who has an unexpressive, stoic demeanor. The client is curled into the fetal position and diaphoretic, and the vital signs are elevated. On a 10-point scale, the client indicates a pain level of "3 or so." How should the nurse treat this client's pain?

Believe what the client says, reinforce education, and reassess often.

Regarding tolerance and addiction, the nurse understands that

although clients may need increasing levels of opioids, they are not addicted.

A client's intractable neuropathic pain is being treated using a multimodal approach to analgesia. After administering a recently increased dose of IV morphine to the client, the nurse has returned to assess the client and finds the client unresponsive to verbal and physical stimulation with a respiratory rate of five breaths per minute. The nurse has called a code blue and should anticipate the administration of what drug?

naloxone

A client sustains an injury to the ligaments surrounding a joint. What will the nurse identify this injury as?

sprain

Which term refers to an injury to ligaments and other soft tissues surrounding a joint?

sprain

The nurse is teaching a client with osteoarthritis about the disease. What is the most important client focus for disease management?

strategies for remaining active

A client has been given a patient-controlled analgesia (PCA) device to control postoperative pain. The client expresses concern about administering too much of the analgesic and accidentally overdosing. What topic should the nurse teach the client about?

the limits on dose and frequency that are programmed into the PCA

A nurse is planning discharge instructions for the client with osteomyelitis. What instructions should the nurse include in the discharge teaching?

"You will receive IV antibiotics for 3 to 6 weeks."

A nurse is reviewing a client's activities of daily living prior to discharge from total hip replacement. The nurse should identify what activity as posing a potential risk for hip dislocation?

Bending down to put on socks

A client with a fractured fibula has an external fixator device applied. Which interventions to care for this device will the nurse add to the client's plan of care? Select all that apply.

Cover sharp fixator pins with caps Elevate the extremity to heart level Monitor neurovascular status every 2 to 4 hours

The nurse assesses a client after total right hip arthroplasty and observes a shortening of the extremity. The client reports severe pain in the right side of the groin. What is the priority action of the nurse?

Notify the health care provider.

The nurse provides teaching to a client with osteoarthritis (OA). Which statement(s) indicate that teaching about pain management and functional ability were effective? Select all that apply.

"I will need to lose some weight." "I will increase the amount of walking I do every day."

A nurse is teaching a group of adults on the risks of obesity on neurological health. What statement will the nurse include in the teaching regarding obesity and the risk for developing Alzheimer disease?

"Individuals with obesity are twice as likely to develop Alzheimer disease than those who do not have obesity."

A client has just returned from the postanesthesia care unit (PACU) following left tibia open reduction internal fixation. The client is reporting pain, and the nurse is preparing to administer intravenous hydromorphone. Prior to administering the drug, the nurse should prioritize which assessment?

Respiratory Status

A nurse is writing a care plan for a client admitted to the emergency department (ED) with an open fracture. The nurse will assign priority to what nursing diagnosis for a client with an open fracture of the radius?

Risk for infection

A nurse is collaborating with the physical therapist to plan the care of a client with osteomyelitis. What principle should guide the management of activity and mobility in this client?

Stress on the weakened bone must be avoided.