Adult 1 Final Musculoskeletal

D. Have the client hold the palm of hand up while the nurse percusses over the median nerve

A healthcare provider asks a nurse to test a client for Tinel's sign to diagnose carpal tunnel syndrome. What should the nurse do to perform the assessment? A. Have the client stretch the fingers around a ball and squeeze with force. B. Have the client make a fist and open the hand against resistance. C. Have the client pronate the hand while the nurse palpates the radial nerve. D. Have the client hold the palm of hand up while the nurse percusses over the median nerve

B. Fat embolism syndrome

The nurse assesses subtle personality changes, restlessness, irritability, and confusion in a client who has sustained a fracture. The nurse suspects which complication? A. Hypovolemic shock B. Fat embolism syndrome C. Delirium D. Compartment syndrome

C. Ensuring adequate calcium and vitamin D intake

The nurse is planning an education program for women of childbearing years. What does the nurse recognize as the primary prevention of osteoporosis? A. Engaging in non-weight bearing exercises daily B. Having a DEXA scan beginning at age 35 C. Ensuring adequate calcium and vitamin D intake D. Undergoing assessment of serum calcium levels every year

B. Capillary refill of left fingers greater than 3 seconds

Which nursing assessment would be indicative of compartment syndrome in the client with a cast applied to the left forearm 3 hours earlier? A. Radial pulses palpable and 2+ bilaterally B. Capillary refill of left fingers greater than 3 seconds C. Fingers pink and warm and move freely D. Absence of numbness and tingling

A. B. & E. Skin breakdown Pneumonia Sepsis

A 75-year-old patient had surgery for a left hip fracture yesterday. When completing the plan of care, the nurse should include assessment for which complications? Select all that apply. A. Skin breakdown B. Pneumonia C. Delirium D. Necrosis of the humerus E. Sepsis

C. Maintaining correct body alignment

A client is in Buck's traction after fracturing his right hip. The nurse should include which action in the care plan? A. Removing the weights once every shift B. Keeping the client in semi-Fowler's position C. Maintaining correct body alignment D. Maintaining the bed in the knee gatch position

C. "Pace yourself and rest frequently, especially after exercise"

A client with osteoarthritis expresses concerns that the disease will prevent the ability to complete daily chores. Which suggestion should the nurse offer? A. "Do all your chores in the evening, when pain and stiffness are least pronounced." B. "Do all your chores in the morning, when pain and stiffness are least pronounced." C. "Pace yourself and rest frequently, especially after exercises." D. "Do all your chores after performing morning exercises to loosen up."

B. Should being the day after surgery

A nurse is developing a teaching plan for a patient who must undergo an above-the-knee amputation of the left leg. After a leg amputation, exercise of the remaining limb: A. should begin immediately postoperatively. B. should begin the day after surgery. C. is not necessary. D. begins at a rehabilitation center.

B. Osteomyelitis

A variety of complications can occur after a leg amputation. Which is not a possibility in the immediate postoperative period? A. Hematoma B. Osteomyelitis C. Hemorrhage D. Infection

B. "CPM increases range of motion of the joint."

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? A. "CPM delivers analgesic agents directly into the joint." B. "CPM increases range of motion of the joint." C. "CPM prevents injury by limiting flexion of the knee." D. "CPM strengthens the muscles of the leg."

A. 1200 mg: 1,000 IU

Health education for a woman over 50 years old includes providing information about importance of adequate amounts of calcium and vitamin D to prevent osteoporosis. Select the daily dosage of calcium and vitamin D that the nurse should recommend. A. 1,200 mg; 1,000 IU B. 1,400 mg; 1,200 IU C. 1,800 mg; 1,600 IU D. 1,600 mg; 1,400 IU

A. "It is called phantom pain and may come and go."

The nurse is caring for a patient who had a surgical amputation on the left leg related to complication from diabetes. The client asks the nurse, "If my leg is really gone, then why am I having such bad pain?" What is the best response by the nurse? A. "It is called phantom pain and may come and go." B. "You are only imagining that you are having pain." C. "This is called false leg pain and is a brain dysfunction." D. "You will continue to have pain, and you will have to learn to live with it."

D. Never cross the affected leg when seated

The nurse teaches the patient which intervention to avoid hip dislocation after replacement surgery? A. Bend forward only when seated in a chair B. Keep the knees together at all times C. Avoid placing a pillow between the legs when sleeping D. Never cross the affected leg when seated

C. Physical therapy and exercise

What intervention is a priority for a patient diagnosed with osteoarthritis? A. Colchicine B. Allopurinol C. Physical therapy and exercise D. Hydrotherapy

A. Pain

What is a hallmark sign of compartment syndrome? A. pain B. edema C. motor weakness D. weeping skin surfaces

A. Avoid overreaching

When teaching a client how to prevent low back pain as a result of lifting, a nurse should instruct the client to: A. avoid overreaching. B. use a narrow base of support. C. bend the knees and loosen the abdominal muscles. D. place the load away from the body.

A. Carpal tunnel syndrome

Which common problem of the upper extremity results from entrapment of the median nerve at the wrist? A. Carpal tunnel syndrome B. Ganglion cyst C. Dupuytren contracture D. Impingement syndrome

B. C. & E. Fat embolism Compartment syndrome Deep vein thrombosis

A client is admitted to the orthopedic unit with a fracture femur after a motorcycle accident. The client ahs been placed in traction until his femur can be rodded in surgery. For what early complications should the nurse monitor this client? Select all that apply. A. Complex regional pain syndrome B. Fat embolism C. Compartment syndrome D. Systemic infection E. Deep vein thrombosis

C. Fasciotomy

A client with a fracture develops compartment syndrome that requires surgical intervention. What treatment will the nurse most likely prepare the client for? A. Joint replacement B. Amputation C. Fasciotomy D. Bone graft

C. Elderly postmenopausal woman

A healthcare provider diagnosis primary osteoporosis to a patient who has lost bone mass. For which patient is primary osteoporosis most common? A. Young menstruating woman B. Elderly man who smokes C. Elderly postmenopausal woman D. Young child with IBS

B. Obesity

A nurse is assessing a client with possible osteoarthritis. What is the most significant risk factor for primary osteoarthritis? A. congenital deformity B. obesity C. age D. trauma

A. Limit hip flexion of the client's hip when the client sits up

A nurse is caring for a client who recently underwent a total hip replacement. What is the best action by the nurse for client care? A. Limit hip flexion of the client's hip when the client sits up B. Ease the client slowly onto a normal toilet seat C. Allow the client's legs to be crossed at the knees when out of bed D. Use soft chairs when the client is sitting out of bed

D. Anticoagulation therapy

The nurse is assigned to care for a patient who has had a total knee arthroplasty yesterday. What type of pharmacologic therapy does the nurse anticipate administering to this patient to prevent complications related to the surgery? A. Antiemetic therapy B. Antidysrhythmic therapy C. Antineoplastic therapy D. Anticoagulaton therapy

A. Early morning stiffness

The nurse is gathering a health history for a client with osteoarthritis. What clinical manifestation will the nurse expect to find? A. early morning stiffness B. joint pain that increases with rest C. small joint involvement D. subcutaneous nodules

A. B. & D. Excruciating pain Decreased sensory function Loss of motion

The nurse suspects compartment syndrome for a casted extremity. What characteristic symptoms would the nurse assess that would confirm these suspicions? Select all that apply. A. Excruciating pain B. Decreased sensory function C. Capillary refill less than 3 seconds D. Loss of motion E. 2+ peripheral pulses in affected distal pulse

A. is the most common and frequently disabling of joint disorders.

The nurse teaches the client that osteoarthritis: A. is the most common and frequently disabling of joint disorders. B. most commonly affects young males. C. affects the cartilaginous joints of the spine and surrounding tissues. D. requires early treatment because most damage occurs early on in the disease course.

B. Prone

Which of the following positions should be avoided in severe low back pain? A. Lateral recumbent B. Prone C. Supine D. Head & thorax elevated 30 degrees

A. D. & E. The client with hemorrhage in the site of injury The client with a plaster cast applied immediately after injury The client with elevated pressure within the muscles

Which patient(s) is most likely to have compartment syndrome after sustaining a fracture? Select all that apply. A. The client with hemorrhage in the site of injury B. The client who sustained a clavicle fracture C. The client using ice to control pain in the extremity D. The client with a plaster cast applied immediately after injury E. The client with elevated pressure within the muscles

D. Bone fracture

A nurse is caring for an elderly female client with osteoporosis. When teaching the client, the nurse should include information about which major complication? A. Dowager's hump B. Loss of estrogen C. Negative calcium balance D. Bone fracture

A. C. & D. Presence of anemia Osteoporosis Female gender

A nurse is caring for an older woman with a hip fracture. What are appropriate risk factors for the nurse to consider related to the client's hip fracture. Select all that apply. A. presence of anemia B. history of diverticulitis C. osteoporosis D. female gender E. muscular agility

D. " I will eat more dairy products to increase my calcium intake"

A nurse is teaching a client with osteoporosis about dietary selections. What client statement indicates the teaching was effective? A. "I will decrease my intake of popcorn, nuts, and seeds." B. "I will eat more fruits to increase my potassium intake." C. "I will decrease my intake of red meat." D. "I will eat more dairy products to increase my calcium intake."

A. "The physical therapist will likely help you get up using a walker the day after your surgery."

A patient is being prepared for a total hip arthroplasty, and the nurse is providing relevant education. The patient is concerned about being on bed rest for several days after the surgery. The nurse should explain what expectation for activity following hip replacement? A. "The physical therapist will likely help you get up using a walker the day after your surgery." B. "Our goal will actually be to have you walking normally within 5 to 7 days of your surgery." C. "For the first 2 weeks after the surgery, you can use a wheelchair to meet your mobility needs." D. "Actually, patients are only on bed rest for 2 to 3 days before they begin walking with assistance."

B. Assess for complications

A patient with a long arm cast continues to complain of unrelieved throbbing pain even after receiving opioid pain medication. Which is the priority action by the nurse? A. Assess for previous opioid drug use B. Assess for complications C. Teach relaxation techniques D. Reposition the client for comfort

B. Within 24 hours

An older adult patient had a hip replacement. When should the patient begin with assisted ambulation with a walker? A. Between 2 and 3 weeks B. Within 24 hours C. After 1 week D. 72 hours postoperatively

A. Limit hip flexion to 90 degrees

When discussing physical activities with the client who just undergone a right total hip replacement, which instruction should the nurse provide? A. "Limit hip flexion to 90 degrees." B. "Avoid weight bearing until the hip is completely healed." C. "Intermittently cross and uncross your legs several times each day." D. "Perform rotation exercises each day."

D. Hemorrhage

Which factor may contribute to compartment syndrome? A. disuse syndrome B. venous thromboembolus C. macular lesion D. hemorrhage

C. Carpal tunnel syndrome

While the nurse is performing a physical assessment, the patient reports numbness, tingling, and pain when the nurse percusses lightly over the median nerve. What should this assessment indicate to the nurse? A. Compartment syndrome B. Decreased nerve conduction C. Carpal tunnel syndrome D. Impingement syndrome