Lewis Chapter 60-64

when grading muscle strength, the nurse records a score of 3/5, which indicates a. no detection of muscular contraction b. a barely detectable flicker of contraction c. active movement against full resistance without fatigue d. active movement against gravity but not against resistance

d. active movement against gravity but not against resistance

a patient is scheduled for total ankle replacement. the nurse should tell the patient that after surgery he should avoid a. lifting heavy objects b. sleeping on the back c. abduction exercises of the affected ankle d. bearing weight on the affected leg for 6 weeks

d. bearing weight on the affected leg for 6 weeks

the bone cells that function in the formation of new bone tissue are called a. osteoids b. osteocytes c. osteoclasts d. osteoblasts

d. osteoblasts

a patient with a stable, closed humeral fracture has a temporary splint with bulky padding applied with an elastic bandage. the nurse notifies the provider of possible early compartment syndrome when the patient has: a. increasing edema of the limb b. muscle spasms of the lower arm c. bounding pulse at the fracture site d. pain when passively extending the fingers

d. pain when passively extending the fingers

During routine assessment of a patient with Guillain-barre syndrome, the nurse finds the patient is short of breath. the patients respiratory distress is caused by a. elevated protein levels in the CSF b. immobility resulting from ascending paralysis c. degeneration of motor neurons in the brainstem and spinal cord d. paralysis ascending to the nerves that stimulate the thoracic area

d. paralysis ascending to the nerves that stimulate the thoracic area

a patient with suspected disc herniation has acute pain and muscle spasms. the nurses responsibility is to a. encourage total bed rest for several days b. teach principles of back strengthening exercises c. stress the importance of straight-leg raises to decrease pain d. promote the use of cold and hot compresses and pain medication

d. promote the use of cold and hot compresses and pain medication

in teaching a patient with systemic lupus erythematosus about the disorder, the nurse knows the pathophysiology include a. circulating immune complexes formed from IgG autoantibodies reacting with IgG b. an autoimmune T-cell reaction that results in destruction of the deep dermal skin layer. c. immunologic dysfunction leading to chronic inflammation in the cartilage and muscles d. the production of a variety of autoantibodies directed against components of the cell nucleus

d. the production of a variety of autoantibodies directed against components of the cell nucleus

the nurse suspects an ankle sprain when a patient at eh urgent care center describes a. being hit by another soccer player during a game b. having ankle pain after sprinting around the track c. dropping a 10 pound weight on his lower leg t the health club d. twisting his ankle while running bases during a baseball game

d. twisting his ankle while running bases during a baseball game

which persons are at high risk for chronic low back pain? (select all that apply) a. 63 year old man who is a long distance truck driver b. 30 year old nurse who works on an orthopedic unit and smoked c. 55 year old construction worker who is 6 foot 2 inches and weights 250 pounds d. 44 year old female chef with prior compression fracture of the spine e. 28 year old female yoga instructor who is 5 foot 6 inches and weighs 130 pounds

a. 63 year old man who is a long distance truck driver b. 30 year old nurse who works on an orthopedic unit and smoked c. 55 year old construction worker who is 6 foot 2 inches and weights 250 pounds d. 44 year old female chef with prior compression fracture of the spine

During rehabilitation, a patient with spinal cord unjustly begins to ambulate with long leg braces, which level of injury does the nurse associate with this degree of recovery? a. L1-2 b. T6-7 c. T1-2 d. C7-8

a. L1-2

a patient with a pelvic fracture should be monitored for a. changed in urine output d. petechiae on the abdomen c. a palpable lump in the buttock d. sudden increase in blood pressure

a. changed in urine output

the increased risk for falls int he older adult is likely due to (select all that apply) a. changes in balance b. decrease in bone mass c. loss of ligament elasticity d. erosion of articular cartilage e. decrease in muscle mass and strength

a. changes in balance b. decrease in bone mass c. loss of ligament elasticity e. decrease in muscle mass and strength

a patient with a torn ligament in the knee asks what the ligament does. the nurses response is based on the knowledge the ligaments a. connect bone to bone b. provide strength to muscle c. lubricate joints with synovial fluid d. relieve friction between moving parts

a. connect bone to bone

the nurse is obtaining a health history of a patient with a fracture. which condition poses the most concern related to the muscle-skeletal system? a. diabetes b. hypertension c. chronic bronchitis d. nephrotic syndrome

a. diabetes

while performing passive range of motion for a patient, the nurse puts the elbow joint through the movements of (select all that apply) a. flexion and extension b. inversion and eversion c. pronation and supination d. flexion, extension, abduction, and adduction e. pronation, supination, rotation, and circumduction

a. flexion and extension c. pronation and supination

a patient with a humeral fracture is returning for a 4-week checkup. the nurse explains that initial evidence of healing on x-ray is indicated by a. formation of callus b. complete bony union c. hematoma at the fracture site d. presence of granulation tissue

a. formation of callus

the nurse teaches the patient with an bone the knee amputation that the residual limb should not be routinely elevated because this position promotes a. hip flexion contracture b. clot formation at the incision c. skin irritation and breakdown d. increased risk for wound dehiscence

a. hip flexion contracture

during assessment of the patient with trigeminal neuralgia, the nurse should (select all that apply) a. inspect all aspects for the mouth and teeth b. assess the gag reflex and respiratory rate and depth c. lightly palpate the affected side of the face for edema d. test for temperature and sensation perception on the face e. ask the patient to describe factors that initiate an episode

a. inspect all aspects for the mouth and teeth d. test for temperature and sensation perception on the face e. ask the patient to describe factors that initiate an episode

in teaching a patient with Sjogrens syndrome about drug therapy for this disorder, the nurse includes instruction about the use of which drug a. pregabalin (Lyrica) b. etanercept (Enbrel) c. cyclosporine (restasis) d. cyclobenzaprine (flexeril)

a. pregabalin (Lyrica)

a patient who has had surgical correction of bilateral hallucinations valves is being discharged from the same-day surgery unit. the nurse will teach the patient to a. rest frequently with the feet elevated b. wear shoes continually except with bathing c. soak the feet in warm water several times a day d. expect the feet to be numb for the next few days

a. rest frequently with the feet elevated

teach the patient with fibromyalgia the importance of limiting intake of which foods? (select all that apply) a. sugar b. alcohol c. caffeine d. red meat e. root vegetables

a. sugar b. alcohol c. caffeine

A nurse is caring for a patient newly diagnosed with chronic inflammatory demyelinating polyneuropathy (CIDP). which statement can the nurse accurately use to teach the patient about CIDP? a. "corticosteroids have little effect on this disease" b. "maintenance therapy will be needed to prevent relapse" c. "you will go into remission in approximately eight weeks" d. "you should be able to walk without help within three months"

b. "maintenance therapy will be needed to prevent relapse"

a patient with osteomyelitis undergoes surgical debridement with implantation of antibiotic beads. when the patient asks why the beads are used the nurse answers (select all that apply) a. "oral or IV antibiotics are not effective in most cases of bone infection" b. "the beads are an adjunct to debridement and antibiotics for deep infections" c. "the beads are used to deliver antibiotics directly to the site of the infection" d. "this is the safest method to deliver long-term antibiotic therapy for bone infection" e. "ischemia and bone death related to osteomyelitis are impenetrable to IV antibiotics"

b. "the beads are an adjunct to debridement and antibiotics for deep infections" c. "the beads are used to deliver antibiotics directly to the site of the infection"

a patient with osteosarcoma of the humerus shows understanding of his treatment options when he states a. "I accept that I have to lose my arm with surgery" b. "the chemotherapy before surgery will shrink the tumor" c. "this tumor is related to the melanoma I had 3 years ago" d. "I'm glad they can take the cancer with such a small scar"

b. "the chemotherapy before surgery will shrink the tumor"

when administering medications to the patient with chronic gout, the nurse recognizes which drug is used as a treatment for this disease? a. colchicine b. allopurinol c. sulfasalazine d. cyclosporine

b. allopurinol

the most common early symptom of a spinal cord tumor is: a. urinary incontinence b. back pain that worsens with activity c. paralysis below the level of involvement d. impaired sensation of pain, temperature, and light touch

b. back pain that worsens with activity

A patient with a T4 spinal cord injury has neurogenic shock due to sympathetic nervous system dysfunction. what would the nurse recognize as characteristic of this condition? a. tachycardia b. hypotension c. increased cardiac output d. peripheral vasoconstriction

b. hypotension

in assessing the joints of a patient with osteoarthritis, the nurse understands that Bouchard's nodes a. are often red, swollen, and tender b. indicate osteophyte formation at the PIP joints c. are the result of panes formation at the DIP joints d. occur from deterioration of cartilage by proteolytic enzymes

b. indicate osteophyte formation at the PIP joints

a patient with rheumatoid arthritis has articular involvement. the nurse recognizes these characteristic changes include (select all that apply) a. bamboo-shaped fingers b. metatarsal head dislocation in feet c. noninflammatory pain in large joints d. asymmetric involvement of small joints e. morning stiffness lasting 60 minutes or more

b. metatarsal head dislocation in feet e. morning stiffness lasting 60 minutes or more

the nurse should teach the patient with ankylosing spondylitis the importance of a. avoiding extremes in environmental temperatures b. regularly exercising and maintaining proper posture c. maintaining patient usual physical activity during flares d. applying hot and cool compresses for relief of local symptoms

b. regularly exercising and maintaining proper posture

a patient with osteoarthritis is scheduled for total hip arthroplasty. the nurse explains the purpose of this procedure is to (select all that apply) a. fuse the joint b. replace the joint c. prevent further damage d. improve or maintain ROM e. decrease the amount of destruction in the joint

b. replace the joint d. improve or maintain ROM

what is the most important to include in the teaching plan for a patient with osteopenia? a. lose weight b. stop smoking c. eat a high protein diet d. start swimming for exercise

b. stop smoking

in caring for a patient after a spinal function, the nurse would report which finding to the health care provider? a. the patient has a single episode of emesis b. the patient is unable to move the lower extremities c. the patient is nauseated and has not voided in 4 hours d. the patient reports of pain at the bone graft donor site

b. the patient is unable to move the lower extremities

an abnormal assessment finding of the musculoskeletal system is a. equal leg length bilaterally b. ulnar deviation and subluxation c. full range of motion in all joints d. muscle strength of 5/5 in all muscles

b. ulnar deviation and subluxation

a patient is scheduled for a bone scan. the nurse explains that this diagnostic test involves a. incision or puncture of the joint capsule b. insertion of small needles into certain muscles c. administration of radioisotope before the procedure d. placement of skin electrodes to record muscle activity

c. administration of radioisotope before the procedure

the nurse suspects a neuromuscular problem based on assessment of a. exaggerate strength with movement b. increased redness and heat below the injury c. decreased sensation distal to the fracture site d. purulent drainage at the site of an open fracture

c. decreased sensation distal to the fracture site

a patient with spinal cord injury has severe neurologic deficits. what is the most likely mechanism of injury for this patient? a. compression b. hyperextension c. flexion-rotation d. extension-rotation

c. flexion-rotation

a patient undergoing rehabilitation for a C7 spinal cord injury tells the nurse he must have the flu because he has a bad headache and nausea. the nurses first priority is to a. call the health care provider b. check the patients temperature c. measure the patients blood pressure d. elevate the head of the bed to 90 degrees

c. measure the patients blood pressure

a patient with a comminuted fracture of the tibia is to have an open reduction with internal fixation (ORIF) of the fracture. the nurse explains that ORIF is indicated when a. the patient is unable to tolerate prolonged immobilization b. the patient cannot tolerate the surgery for a closed reduction c. other nonsurgical methods cannot achieve adequate alignment d. a temporary cast would be too unstable to provide normal mobility

c. other nonsurgical methods cannot achieve adequate alignment