Unit 7 Exam PrepU

A client arrives in the emergency department with a suspected bone fracture of the right arm. How does the nurse expect the client to describe the pain?

Sharp and piercing

Which is an appropriate nursing intervention in the care of the client with osteoarthritis?

Encourage weight loss and an increase in aerobic activity

A client has Paget's disease. An appropriate nursing diagnosis for this client is:

Risk for falls

Gout is the most common form of inflammatory arthritis.

TRUE

A client with a history of gout experiences an attack every 2 to 3 months despite losing weight and stopping all alcohol intake. Which question will the nurse ask when assessing this client?

"Are you taking the medication as prescribed?"

Which joint is most commonly affected in gout?

Metatarsophalangeal

Which description refers to an osteon?

Microscopic functional bone unit

A client arrives at the orthopedic clinic and reports suspecting a stress fracture of the right foot. The physician orders an x-ray with negative results. What does the nurse understand that these negative results can mean?

Purine-rich foods

A patient has a fracture of the right femur sustained in an automobile accident. What process of fracture healing does the nurse understand will occur with this patient?

Reactive phase, reparative phase, remodeling phase

A client with a musculoskeletal injury is instructed to alter the diet. The objective of altering the diet is to facilitate the absorption of calcium from food and supplements. Considering the food intake objective, which food item should the nurse encourage the client to include in the diet?

Vitamin D-fortified milk

A client has been in a motor vehicle collision. Radiographs indicate a fractured humerus; the client is awaiting the casting of the upper extremity and admission to the orthopedic unit. What is the primary treatment for musculoskeletal trauma?

immobilization

Which medication taken by the client in the previous 24 hours would be of greatest concern to the nurse caring for a client undergoing a bone biopsy?

Aspirin

A nurse is caring for an elderly female client with osteoporosis. When teaching the client, the nurse should include information about which major complication?

Bone fracture

A client tells the health care provider about shoulder pain that is present even without any strenuous movement. The health care provider identifies a sac filled with synovial fluid. What condition will the nurse educate the client about?

Bursitis

The nurse is preparing to perform a musculoskeletal assessment for a client with chronic muscle pain. Which assessment technique would be an appropriate tool to evaluate this type of pain?

Flex the bicep against resistance

Which of the following was formerly called a bunion?

Hallux valgus

Red bone marrow produces which of the following? Select all that apply.

Platelets RBCs WBCs

A client is experiencing painful joints and changes in the lungs, heart, and kidneys. For which condition will the nurse schedule this client for diagnostic tests?

Autoimmune disorders

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

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

Following a total knee replacement, the surgeon orders a continuous passive motion (CPM) device. The client asks about the purpose of this treatment. What is the best response by the nurse?

"CPM increases range of motion of the joint."

A nurse is teaching a client about rheumatoid arthritis. Which statement by the client indicates understanding of the disease process?

"It will get better and worse again."

A nurse is preparing a client with systemic lupus erythematosus (SLE) for discharge. Which instruction should the nurse include in the teaching plan?

"Monitor your body temperature."

A client asks the nurse what the difference is between osteoarthritis (OA) and rheumatoid arthritis (RA). Which response is correct?

"OA is a noninflammatory joint disease. RA is characterized by inflamed, swollen joints."

The nurse is teaching a newly diagnosed client about systemic lupus erythematosus(SLE). What statement by the client indicates the teaching was successful?

"The belief is that it is an autoimmune disorder with an unknown trigger."

A client suspected of having systemic lupus erythematosus (SLE) is being scheduled for testing. The client asks which of the tests ordered will determine positivity for the disorder. Which statement by the nurse is most accurate?

"The diagnosis won't be based on the findings of a single test but by combining all data found."

A client with a discoid facial rash caused by systemic lupus erythematosus (SLE) asks why a urine sample is needed. Which response will the nurse make to the client?

"The lupus can affect your kidney function."

The nurse is preparing a client for a surgical procedure that will allow visualization of the extent of joint damage of the knee for a client with rheumatoid arthritis and also obtain a sample of synovial fluid. What procedure will the nurse prepare the client for?

Arthroscopy

A client has a Fiberglass cast on the right arm. Which action should the nurse include in the care plan?

Assessing movement and sensation in the fingers of the right hand

Which hormone inhibits bone reabsorption and increases calcium deposit in the bone?

Calcitonin

A nurse is caring for a client with eczema. Which medication would be prescribed when an allergy is a factor causing the skin disorder?

Chlorpheniramine

The nurse is caring for a client with a new onset of gout. What medication does the nurse anticipate will be ordered by the health care provider?

Colchicine

The nurse is reviewing the medication administration record of the client. Which medication would lead the nurse to suspect that the client is suffering from an acute attack of gout?

Colchicine

Which of the following is a term used to describe a soft tissue injury produced by a blunt force?

Contusion

The nurse teaches the client that the presence of crystals in the synovial fluid obtained from arthrocentesis confirms which disease process?

Gout

The presence of crystals in synovial fluid obtained from arthrocentesis is indicative of

Gout

Which assessment suggests to the nurse that a client with systemic lupus erythematous is having renal involvement?

Hypertension

The nurse is preparing to assess the spine of an older adult. Which actions will the nurse take during this assessment? Select all that apply.

Measure height Ask the client to bend backward Ask the client to bend forward at the waist

A client has sustained a long bone fracture and the nurse is preparing the client's care plan. Which of the following should the nurse include in the care plan?

Monitor temperature and pulses of the affected extremity

The nurse is caring for a client with ankylosing spondylitis (AS). Which medication will the nurse expect to be prescribed for this client?

Nonsteroidal anti-inflammatory drugs (NSAIDs)

Which orthopedic surgery is done to correct and align a fracture after surgical dissection and exposure of the fracture?

Open reduction

Which of the following is the most common and most fatal primary malignant bone tumor?

Osteogenic sarcoma (osteosarcoma)

A patient comes to the clinic and informs the nurse of numbness, tingling, and a burning sensation in the arm from the elbow down to the fingers. What type of symptom would this be documented as?

Parasthesia

Which nursing intervention is essential in caring for a client with compartment syndrome?

Removing all external sources of pressure, such as clothing and jewelry

The nurse is assessing the client for scoliosis. What will the nurse have the client do to perform the assessment?

Stand behind the client and ask the client to bend forward at the waist.

_________________ affects the cartilaginous joints of the spine and surrounding tissues, making them rigid, decreasing mobility, and leading to kyphosis (a stooped position).

Ankylosing Spondylitis (AF)

A client is experiencing an acute exacerbation of rheumatoid arthritis. What should the nursing priority be?

Administering ordered analgesics and monitoring their effects

A patient is diagnosed with osteogenic sarcoma. What laboratory studies should the nurse monitor for the presence of elevation?

Alkaline phosphatase

A nurse is managing the care of a client with osteoarthritis. What is the appropriate treatment strategy the nurse will teach the about for osteoarthritis?

Administration of nonsteroidal anti-inflammatory drugs (NSAIDs)

The side effect of bone marrow depression may occur with which medication used to treat gout?

Allopurinol

A client with gout has been advised to lose weight. The client informs the nurse of plans to go on a "guaranteed rapid weight loss" plan that involves fasting and heavy exercise. Which response would be most appropriate?

"There might be some difficulties with your plan and fasting."

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 caring for a client with a warm and painful toe from gout. What medication will the nurse administer?

Colchicine

The nurse is assessing the feet of a patient and observes an overgrowth of the horny layer of the epidermis. What does the nurse recognize this condition as?

Corn

Morton neuroma is exhibited by which clinical manifestation?

Swelling of the third (lateral) branch of the median plantar nerve

The autoimmune reaction that causes rheumatoid arthritis originates in the ______________ tissue.

Synovial

The nurse is teaching a client about rheumatic disease. What statement best helps to explain autoimmunity?

"Your symptoms are a result of your body attacking itself."

The community health nurse is assessing the risk factors for osteoporosis in a female client at a health fair. Select risk factors

66 years of age Asian heritage Postmenopausal status Takes fluticasone inhaler for asthma

The client displays manifestations of compartment syndrome. What treatment will the nurse expect the client to be scheduled for?

A fasciotomy

While reading a client's chart, the nurse notices that the client is documented to have paresthesia. The nurse plans care for a client with

Abnormal sensations

The nurse intervenes to assist the client with fibromyalgia to cope with which symptoms?

Chronic fatigue, generalized muscle aching, and stiffness

Three distinct characteristics of the pathophysiology of rheumatic diseases are inflammation, autoimmunity, and ______________.

Degeneration

Which term refers to the shaft of the long bone?

Diaphysis

A client with scleroderma is experiencing an exacerbation of symptoms. Which findings indicate to the nurse that the client has CREST syndrome? Select all that apply.

Difficulty swallowing Capillary lesions on the skin

The nurse caring for a client, who has been treated for a hip fracture, instructs the client not to cross their legs and to have someone assist with tying their shoes. Which additional instruction should the nurse provide to client?

Do not flex the hip more than 90 degrees

What term refers to a flexion deformity caused by a slowly progressive contracture of the palmar fascia?

Dupuytren contracture

The nurse is gathering a health history for a client with osteoarthritis. What clinical manifestation will the nurse expect to find?

Early morning stiffness

A client is diagnosed with a fracture of a diarthrosis joint. What is an example of this type of joint?

Elbow

The nurse is reviewing the diagnostic test findings of a client with rheumatoid arthritis. What would the nurse expect to find?

Elevated erythrocyte sedimentation rate

The client returns to the nursing unit following an open reduction with internal fixation of the right hip. Nursing assessment findings include temperature 100.8 degrees Fahrenheit, heart rate 112 beats per minute, respiratory rate 28 breaths per minute, and blood pressure 86/58. There is no urine in the Foley catheter collection bag. The nurse interprets these findings as indicating which complication?

Hypovolemic shock

The nurse is discussing life management with the client with rheumatoid arthritis in a health clinic. What assessment finding indicates the client is having difficulty implementing self-care?

Increased fatigue

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

Infection related to effects of trauma

Osteoarthritis is known as a disease that

Is the most common and frequently disabling of joint disorders.

Which points should be included in the medication teaching plan for a client taking adalimumab?

It is important to monitor for injection site reactions.

A client visits an orthopedic specialist because of pain beginning in the low back and radiating behind the right thigh and down below the right knee. The doctor suspects a diagnosis of sciatica. The nurse knows that the origin of the pain is between which intervertebral disks?

L4, L5, and S1

A variety of complications can occur after a leg amputation. Which is not a possibility in the immediate postoperative period?

Osteomyelitis

The nurse is performing a health history with a new client in the clinic. What is the most common reason for a client to seek medical attention for arthritis?

Pain

The major goal when caring for a patient with rheumatic disease is ____________.

Pain control

The nurse observes a client with a shuffling gait. What disease is commonly associated with a shuffling gait?

Parkinson's Disease

In patients with systemic lupus erythematosus (SLE) _________ is the most common cardiac manifestation.

Pericarditis

A client is diagnosed with systemic lupus erythematosus (SLE). Which of the following would be most appropriate for the nurse to use to evaluate the client' s stage of disease?

Review the client's medical record

A nurse is planning the care of a client who will require a prolonged course of skeletal traction. When planning this client's care, the nurse should prioritize interventions related to what risk nursing diagnosis?

Risk for impaired skin integrity

The nurse is caring for a client who lives alone and had a total knee replacement. An appropriate nursing diagnosis for the client is:

Risk for ineffective therapeutic regimen management

A client has a fracture that is being treated with open rigid compression plate fixation devices. What teaching will the nurse reinforce to the client about how the progress of bone healing will be monitored?

Serial x-rays will be taken

A hallmark of rheumatologic diseases is autoimmunity, where the body mistakenly recognizes its own tissue as a foreign pathogen (antigen).

TRUE

Alkylating agents and purine analogues are the first line of pharmacologic therapy for people with systemic lupus erythematous because of their effect on overall immune function.

TRUE

Risk factors for rheumatoid arthritis and its progression include older age, nulliparity, and obesity.

TRUE

A client is taking ibuprofen for the treatment of osteoarthritis. What education will the nurse give the client about the medication?

Take the medication with food to avoid stomach upset.

The most definitive indicator of rheumatoid arthritis is the rheumatoid factor which is present in 100% of all diagnosed patients.

FALSE

A nurse assesses a client in the health care provider's office. Which assessment findings support a suspicion of systemic lupus erythematosus (SLE)?

Facial erythema, pericarditis, pleuritis, fever, and weight loss

A patient has had a stroke and is unable to move the right upper and lower extremity. During assessment the nurse picks up the arm and it is limp and without tone. How would the nurse document this finding?

Flaccidity

Which of the following are associated with compartment syndrome? Select all that apply.

Trauma from accidents Surgery Casts Tight bandages Crushing injuries

The nurse recognizes that rheumatoid arthritis is characterized by:

Ulnar deviation

When teaching a client how to prevent low back pain as a result of lifting, the nurse should instruct the client to:

Avoid overreaching