LPNC 103 Musculoskeletal questions

a nurse is reinforcing discharge teaching with a client who had a wound debridement for osteomyelitis. Which of the following information should the nurse include? a. antibiotic therapy should continue for 3 months b. relief of pain indicates the infection is eradicated c. airborne precautions are used during wound care d. expect paresthesia distal to the wound

correct answer: a Rationale: treatment of osteomyelitis includes continuing antibiotic therapy for 3 months

a nurse is assisting in the care of a client immediately following vertebroplasty of the thoracic spine. Which of the following actions should the nurse take? a. apply heat to the puncture site b. place the client in a supine position c. turn the client every 1 hr. d. ambulate the client within the first hour postprocedure

correct answer: b Rationale: The client should remain in a supine position with bed flat for the first 1-2 following the procedure to allow for hardening of the cement

a nurse is caring for a client who has a right hip fracture. Which of the following immobilization devices should the nurse anticipate? a. skeletal traction b. buck's traction c. halo traction d. bryant's tractions

correct answer: b Rationale: buck's traction is a temporary immobilization device applied to a client who has a femur or hip fracture to diminish muscle spasms and immobilize the affected extremity until surgery is performed

A nurse is reviewing the medical record of a female client. Which of the following findings should the nurse identify as a risk factor for osteoporosis? a. Decreased intake of sodium b. Spending several hours in the sun daily c. Increased estrogen levels d. History of anorexia nervosa

d. History of anorexia nervosa Rationale: The nurse should identify anorexia nervosa as a risk factor for osteoporosis. Inadequate protein intake can lead to a decreased bone density, increasing the risk for fractures.

A nurse is caring for a client who had a below-the-knee amputation for gangrene of the right foot. The client reports sensations of burning and crushing pain in the toes of the right foot. Which of the following statements should the nurse make? a. "An anticonvulsant medication can be helpful in relieving this type of pain." b. "try to look at the surgical wound as a reminder the limb is gone." c. "Use a cold compress intermittently to decrease these pain sensations." d. "Grief over the lost limb can sometimes case denial that the limb is really gone."

a. "An anticonvulsant medication can be helpful in relieving this type of pain." Rationale: The nurse should recognize that the client is reporting phantom limb pain, a frequent complication following amputation. The nurse should instruct the client that several medications can be used to treat the pain, including anticonvulsants and antidepressants.

A nurse in an ambulatory clinic is caring for a client who has facial trauma to the nose. Which of the following actions should the nurse take first? a. Determine the client's ability to take deep breaths b. Place a cold compress on the nasal area. c. Palpate the nasal area for crepitation d. Offer the client an analgesic medication

a. Determine the client's ability to take deep breaths Rationale: The nurse should apply the ABC priority-setting framework. This framework emphasizes the basic core of human functioning - having an open airway, being able to breathe in adequate amounts of oxygen, and circulating oxygen to the body's organs via the blood. An alteration in any of these can indicate a threat to life, and is the nurse's priority concern. When applying the ABC priority-setting framework, airway is always the highest priority because the airway must be clear and open for oxygen exchange to occur. Breathing is the second-highest priority in the ABC priority-setting framework because adequate ventilatory effort is essential in order for oxygen exchange to occur. Circulation is the third-highest priority in the ABC priority-setting framework because delivery of oxygen to critical organs only occurs if the heart and blood vessels are capable of efficiently carrying oxygen to them. Therefore, the first action the nurse should take is to acquire further data by determining the client's ability to take deep breaths.

A nurse is collecting data from a client who is 24hr post op following an above-the-elbow amputation. Which of the following findings should the nurse identify as the priority? a. Report of muscle spasms b. Inability to get dressed without assistance c. Report of feelings of anger d. Refusal to look at the affected limb

a. Report of muscle spasms Rationale: The nurse should consider Maslow's hierarchy of needs, which includes five levels of priority. The first level consists of physiological needs; the second level consists of safety and security needs; the third level consists of love and belonging needs; the fourth level consists of personal achievement and self-esteem needs; and the fifth level consists of achieving full potential and the ability to problem solve and cope with life situations. When applying Maslow's hierarchy of needs priority-setting framework, the nurse should review physiological needs first. The nurse should then address the client's needs by following the remaining four hierarchal levels. It is important, however, for the nurse to consider all contributing client factors, as higher levels of the pyramid can compete with those at the lower levels, depending on the specific client situation. The fourth level of Maslow's hierarchy of needs includes usefulness, self-worth, and self-confidence in fulfilling self-esteem needs. Therefore, the nurse should identify the report of muscle spasms, a physiological need, as the priority client finding.

A nurse is assessing a client who is 48 hr postoperative following open reduction and internal fixation of a fractured tibia. Which the following findings should the nurse report to the provider? a. Toes cold to the touch b. Serous drainage from the pin sites c. Blanching of the toenail beds with pressure Pink tissue around the fixator insertion sites

a. Toes cold to the touch Rationale: The nurse should monitor for and report manifestations of compartment syndrome following internal fixation. Therefore, the nurse should contact the provider immediately if the client's toes are cold to the touch.

A nurse is caring for a client who had a fiberglass cast placed on her left arm several hours ago and now reports itching under the cast. Which of the following actions should the nurse plan to take? a. Use a hair dryer on a cool setting to blow air into the cast b. Ask the provider to bivalve the cast c. Provide the client with a sterile cotton swab to rub the affected skin d. Wrap the extremity with a dry heating pad

a. Use a hair dryer on a cool setting to blow air into the cast Rationale: The nurse should provide relief for the report of itching by blowing cool air into the cast using a hair dryer on a cool setting or an empty 60-mL plunger syringe.

A nurse is caring for a client who was in a motor-vehicle crash 2 days ago and sustained fractures to his tibia, ulna, and several ribs. The client is disoriented to time and place, has a Sa02 of 87%, and the nurse notes generalized petechia on the client's skin. Which of the following complications should the nurse suspect? a. Hypovolemic shock b. Fat embolism syndrome c. Thrombophlebitis d. Osteomyelitis

b. Fat embolism syndrome Rationale: The nurse should identify the triad of neurologic changes, petechial rash, and hypoxemia as findings of fat embolism syndrome. Risk factors include multiple fractures and fracture of a long bone. Male clients are also at greater risk. The manifestations occur when fat globules occlude small blood vessels.

A nurse is caring for a client who is in skeletal traction following a femur fracture. The nurse finds the client has slid down toward the foot of the bed and the traction weight is resting on the floor. Which of the following actions should the nurse take? a. Remove the weight temporarily to reposition the client to the correct alignment in bed. b. Have the client use a trapeze to pull himself up while ensuring the weight hangs freely. c. Lift the rope off the pulley while the client rocks back and forth to reposition d. Lift the weight manually while another staff member moves the client up in bed

b. Have the client use a trapeze to pull himself up while ensuring the weight hangs freely. Rationale: The nurse should ensure that traction weight is hanging freely. The client can use an overhead trapeze bar to move up in bed, or the nurse can assist the client up, making sure to maintain proper alignment of the extremity.

a nurse is assisting with preparing a plan of care to prevent a client from developing flexion contractures following a below-the-knee amputation 24 hr ago. Which of the following actions should the nurse include in the plan of care? a. limit any type of exercise to the residual limb for the first 48 hr after surgery b. position the client prone several times each day. c. wrap the stump in a figure-eight pattern d. encourage sitting in a chair during the day

correct answer: b Rationale" the nurse should position the client prone several times each day for 20-30 min to prevent flexion contractures of the hip

A nurse is caring for a client immediately following application of a plaster cast. The nurse should monitor for and report which of the following findings as an indication of compartment syndrome? a. Sensation of heat on the surface of cast b. Paresthesias of the extremity c. Pruritus of the extremity d. Musty odor noted from cast materials

b. Paresthesias of the extremity Rationale: The nurse should identify paresthesias as a finding of compartment syndrome. Compartment syndrome involves the compression of nerves and blood vessels in an enclosed space, leading to impaired blood flow and nerve damage. Other findings include numbness, tingling, weakness, and pain that does not respond to medication.

A nurse is caring for a client who has a pelvic fracture. The client reports sudden shortness of breath, stabbing chest pain, and feelings of doom. The nurse should identify that the client is experiencing which of the following complications? a. pneumonia b. Pulmonary embolus c. Tension pneumothorax Tuberculosis

b. Pulmonary embolus Rationale: Immobility following musculoskeletal trauma places the client at an increased risk for pulmonary embolus. The client might also exhibit tachycardia, chest petechiae, and have a decreased SaO2. The nurse should notify the rapid response team immediately.

A nurse is caring for a client who is 3 days post op following a right total hip arthroplasty. While transferring to a chair, the client cries out in pain. The nurse should examine the client for which of the following manifestation of dislocation of the hip prosthesis? a. Bulging on the area of the surgical incision b. Shortening of the right leg c. Sensation of warmth over the surgical incision d. Pallor following elevation of the right leg

b. Shortening of the right leg Rationale: The nurse should monitor the client for shortening of the affected leg as an indication of dislocation of the prosthesis. Other findings include increased hip or buttock pain, limping, and rotation of the hip internally.

A nurse is caring for a client who is postoperative following shoulder surgery. The client has a prescription to keep the affected arm adducted. Which of the following instructions should the nurse provide the client? a. "Keep your arm bent at the elbow." b. "Use a pillow to prop your shoulder up close to your ear." c. "Hold your arm against the side of your body." d. "Position your arm with the shoulder at a 90-degree angle."

c. "Hold your arm against the side of your body." Rationale: Adduction means to position toward the midline of the body. Therefore, the nurse should provide these instructions to explain the provider's prescription.

A nurse is reinforcing pre op teaching with a client who is schedules for total knee arthroplasty. Which of the following statements by the client should the nurse identify as understanding the teaching? a. "I will begin using a continuous movement machine on my knee one day after surgery." b. "I should avoid taking NSAID medications for pain." c. "I should wear elastic stockings on both of my legs." d. "I will have a small weight attached to my leg to hold the joint in place after surgery."

c. "I should wear elastic stockings on both of my legs." Rationale: The purpose of elastic stockings is to prevent venous thromboembolism, which is a common complication following orthopedic surgery. Therefore, the nurse should identify this statement as understanding the teaching.

A nurse is caring for a client who is post op following a total knee arthroplasty and is prescribed a continuous passive motion machine and PCA. The client tells the nurse, "I am in so much pain." Which of the following actions should the nurse take first? a. Remind the client to push the button for the PCA device b. Discuss activities the client may use to distract from the pain c. Ask the client to describe the characteristics of the pain d. Pause the CPM machine briefly to apply a cold pack to the client's knee

c. Ask the client to describe the characteristics of the pain. Rationale: Answering this item requires application of the nursing process priority-setting framework. The nurse can use the nursing process to plan client care and prioritize nursing actions. Each step of the nursing process builds on the previous step, beginning with assessment or data collection. Before the nurse can formulate a plan of action, implement a nursing intervention, or notify a provider of a change in the client's status, she must first collect adequate data from the client. Assessing or collecting additional data will provide the nurse with knowledge to make an appropriate decision. Therefore, the first action the nurse should take is to acquire further data by asking the client to describe the characteristics of the pain.

A nurse is reviewing the medical record of a client who has a prescription for probenecid to treat gout. The nurse should identify that which of the following medications can interact with probenecid? a. Colchicine b. Naproxen c. Aspirin d. Prednisone

c. Aspirin Rationale: Aspirin can decrease the effectiveness of probenecid. The nurse should caution the client to avoid interaction between probenecid and salicylate medications.

A nurse is performing medication reconciliation for a newly admitted client who has rheumatoid arthritis (RA). Which of the following medications should the nurse identify as the treatment for this condition? a. Misoprostol b. Dantrolene c. Celecoxib d. Colchicine

c. Celecoxib Rationale: Celecoxib is a type of NSAID, called cyclooxygenase-2 (COX-2) inhibitors, used to relieve some of the manifestations caused by RA in adults. The nurse should identify that the medication is also prescribed for osteoarthritis, spondylitis, and painful menstruation.

a nurse is reinforcing teaching a client who is to have a bone scan. Which of the following statements should the nurse include? a. "You will receive an injection of a radioactive isotope when the scanning produce begins." b."You will be inside a tube-like structure during the procedure." c. "You will need to take radioactive precautions with your urine for 24 hours after the procedure." d. "You will have to urinate just before the procedure."

correct answer d. Rationale: the client will need to urinate prior to the procedure. An empty bladder promotes visualization of the pelvic bones

a nurse is collecting data from a client who has a casted compound fracture of the femur. The nurse should identify which of the following findings as a manifestation of fat emboli? a. altered mental status b. reduced bowel sounds c. swelling of the toes distal to the injury d. pain with passive movement of the foot distal to the injury

correct answer: a Rationale: altered mental status is an early manifestation of fat emboli. Other manifestations include dyspnea, chest pain, and hypoxemia

a nurse is reviewing information about capsaicin cream with a client who reports continuous knee pain from osteoarthritis. Which of the following information should the nurse reinforce? a. continuous pain relief is provided b. inspect for skin irritation and cuts prior to application c. cover the are a with tight bandages after application d. apply the medication every 2 hr during the day

correct answer: b Rationale: inspect the skin for irritation and cuts before applying capsaicin cream, because hot peppers in the cream can cause a painful burning sensation in areas of the skin breakdown.

a nurse is reinforcing dietary teaching about calcium-rich foods to a client who has osteoporosis. Which of the following foods should the nurse include in the instructions? a. white bread b. white beans c. white meat of chicken d. white rice

correct answer: b Rationale: white beans are a good source of calcium

a nurse is caring for a client who injured her lower back during a fall and describes sharp pain in her back and down her left leg. In which of the following positions should the nurse plan to place the client to attempt to decrease her pain? a. prone without use of pillows b. semi-fowlers with a pillow under the knees c. high-fowlers with the knees flat on the bed d. supine with the head flat

correct answer: b Rationale: williams position (semi-fowlers position with the knees flexed by pillows) has been found to relieve low-back pain caused by a bulging disk and nerve root involvement

a nurse is caring for a client who had an above-the-knee amputation. The client reports a sharp, stabbing type of phantom pain. Which of the following actions should the nurse take? a. remove the initial pressure dressing. b. encourage use of cold therapy c. question whether the pain is real d. administer an antiepileptic medication

correct answer: d Rationale: An antipileptic medication can relieve a sharp, stabbinh type of phantom pain.

a nurse is reviewing the health record of a client who is to undergo total joint anthroplasty. The nurse should recognize which of the allowing findings as a contraindications of this procedure? a. age 78 years b. history of cancer c. previous joint replacement d. bronchitis 2 weeks ago

correct answer: d Rationale: Recent bronchitis or infection can cause micro-organisms to migrate to the surgical are and cause the prosthesis to fail. The client is at risk for postoperative pulmonary complications

a nurse is presenting information to a group of clients at a health fair about measures to reduce the risk of amputation. which of the following information should the nurse provide? (select all that apply.) a. clients who smoke should consider smoking cessation programs b. clients who have diabetes mellitus should maintain blood glucose within the expected reference range c. Unplug electrical equipment when performing repairs d. Clients who have vascular disease should maintain good foot care e. wait 2 hr after taking pain medication before driving

correct answers: a, b, c, d Rationales: smoking cessation can decrease the development of arteriosclerosis and possible amputation of a lower extremity. Regulating blood glucose levels within a normal reference range prevents the development of arteriosclerosis and possible amputation of a lower extremity. Unplugging electrical equipment when performing repairs prevent electrocution and injury to an extremity, which can result in amputation. Maintaining good foot care prevents infection, which can result in amputation.

A nurse is contributing to the plan of care for a client who will undergo an electromyography (EMG). Which of the following actions should the nurse include in the plan of care.? (select all that apply) a. check for bruising b. apply ice to insertion sites c. determine whether the client takes a muscle relaxant d. instruct the client to flex her muscles during needle insertion e. Expect swelling, redness, and tenderness at the insertion sites

correct answers: a, b, c, d Rationales: some bruising can occur at he needle insertion sites. The nurse should apply ice to the insertion sites to prevent hematoma development. The nurse should collect data regarding the client's medications to determine whether she takes a muscle relaxant, which can decrease the accuracy of the test result. Th nurse should ask the client to reflex her muscles for an easier insertion of the needle into the muscle

a nurse is reinforcing discharge teaching on home safety for an older adult client who has osteoporosis. Which of the following information should the nurse include? (select that all apply) a. remove throw rugs in walkways b. use prescribed assistive devices c. remove clutter from the environment d. walk with caution on icy surfaces e. maintain lighting of doorway areas

correct answers: a, b, c, e Rationale: removing throw rugs in walkways can help to prevent a fall and bone fracture. Assistive devices can can help to prevent a fall and bone fracture. Removing clutter from the environment can help prevent tripping, falling, and a bone fracture. Good lighting in doorway areas can prevent a fall and bone fracture

a nurse is reinforcing teaching with a client about how to manage an external fixation device upon discharge. Which of the following client statements indicate understanding? (select all that apply) a. "I will clean the pins twice a day" b. "I will use a separate cotton swab for each pin" c. "I will report loosening of the pin to my doctor" d. "I will clean the pins with tap water and antibacterial soap" e. "I will report increased redness at the pin sites"

correct answers: a, b, c, e Rationales: Clean the external fixation pins or or two times each day to remove exudate that cam harbor bacteria. Using a separate cotton swab on each pin will decrease the risk of cross contamination, which could cause pin pin site infection. Notify the provider if a pin is loose so the provider can tighten the pin to percent damage to the tissue and bone. The client should report redness, heat, and drainage at the pin sites, which can indicate an infection that can lead to osteomyelitis

a nurse is caring for a client following a below-the-elbow amputation. Which of the following actions should the nurse take? (select all that apply) a. encourage dependent positioning of the residual limb b. inspect for presence and amount of drainage on the dressing c. implement shrinkage intervention of the residual limb d. wrap the residual limb in a circular manner using gauze e. observe for body image changes

correct answers: a, b, c, e Rationales: The nurse should place the residual limb in a dependent position to improve circulation to the end of the stump and promote healing. The nurse should inspect the residual limb for the presence and amount of drainage to observe for bleeding and early manifestations of infection. The nurse should prepare the residual limb to include shrinkage interventions before fitting of the prosthesis. The nurse should monitor the client for feelings of depression, anger, withdrawal, and grief due to body image changes.

a nurse is reviewing information with a client who has osteoarthritis of the hip ad knee. Which of the following instructions should the nurse reinforce? (select all that apply) a. apply heat to joints to alleviate pain b. ice inflamed joints following activity c. install an elevated toilet seat d. take tub baths e. complete high-energy activities in the morning

correct answers: a, b, c, e Rationales: applying heat to joints can provide temporary relief of pain. Applying ice to inflamed joints following activity can decrease edema. An elevated toilet seat can decrease strain and pain of the affected joints. Encouraging high-energy activity in the morning is recommended as part of a daily routine to promote independence.

a nurse is admitting a client to the orthopedic unit following a total knee arthroplasty. Which of the following actions should the nurse take? (select all that apply) a. check continuous passive motion device settings b. palpate dorsal pedal pulses c. place a pillow under the knees d. elevate heels off the bed e. apply heat therapy to the incision

correct answers: a, b, d rationales: the nurse should check the continuous passive motion device settings to determine if the settings are as prescribed. The nurse should check the strength of the pulses of both lower extremities to help determine adequate circulation. The nurse should prevent pressure ulcers on the client's heels by elevating the heels off the bed with a pillow

A nurse is collecting data from an older adult client who has arteriosclerosis and is scheduled for a right lower extremity amputation. Which of the following are expected findings in the affected extremity? (select all that apply) a. skin cool to touch from mid-calf to the toes b. lowering leg appearing dusky when client is sitting c. palpable pounding pedal pulse d. lack of hair on lower leg e. blackened areas on several toes

correct answers: a, b, d, e rationales: the client can have a coolness of the affected extremity where decreased vascularization starts. The affected extremity can become dusky when sitting due to decreased vasculariztion of the extremity. The client can have decreased hair growth on areas of the affected extremity due to decreased vascularization. The client can have blackened areas on several toes suggestive of gangrene due to decreased vascularization to the affected extremity.

a nurse is assisting with health screenings at a health fair. The nurse should identify that which of the following clients are at risk for osteoporosis? (select all that apply) a. 40 year old client who takes prednisone for asthma b. 30 year old client who jogs 3 miles daily c. 45 year old client who takes phenytoin for seizures d. 65 year old client who has a sedentary lifestyle e. 70 year old clientwho has smoked for 50 years

correct answers: a, c, d, e Rationale: Prednisone affects the absorption and metabolism and places the client at risk for osteoporosis. Phenytoin affects the absorption and metabolism of calcium and places the client at risk for osteoporosis. a sedentary lifestyle places the client at risk for osteoporosis because bones need the stress of weight bearing activity for bone rebuilding and maintenance. Smoking increases the risk for osteoporosis because it decreases osteogenesis.

a nurse is collecting data from a client who had an external fixation device applied 2 hr ago for a fracture of the left tibia and fibula. The nurse should identify which of the following findings as manifestations of compartment syndrome? (select all that apply) a. intense pain when the left foot is passively moved b. capillary refill of 3 sec on the left toes c. hard, swollen muscle in the left leg d. burning and tingling of the left foot e. client report of minimal pain relief following a second dose of opioid medication

correct answers: a, c, d, e Rationales: Intense pain of the left foot when passively moved can indicate pressure moved can indicate passively moved can indicate pressure edema on nerve endings and is a manifestation of compartment syndrome. A hard, swollen muscle on the affected extremity indicates edema build-up in the area of injury and is a manifestation of compartment syndrome. Burning and tingling of the left foot indicates pressure from edema on nerve endings and is an early manifestation of compartment syndrome. Minimal pain relief after receiving opioid medication can indicate pressure from edema on nerve endings and is an early manifestation of compartment syndrome

a nurse is contributing to the plan of care for a client who is postoperative following an anthroscopy of the knee. Which of the following actions should the nurse take.? (select all that apply.) a. inspect color and temperature of the extremity b. apply warm compresses to incision sites c. place pillows under the extremity d. administer analgesic medication e. check pulse and sensation in the foot

correct answers: a, c, d, e Rationales: inspecting color and temperature of the affected extremity helps identify alterations in circulation. Elevating the leg helps decrease swelling and pain in the affected extremity. Administering analgesic medication helps relieve joint pain in the affected extremity. Checking pulse and sensation of the affected extremity helps identity alterations in circulation

a nurse is assisting with planning discharge teaching for a client who had a total hip arthroplasty. Which of the following instructions should the nurse include? (select all that apply) a. clean the incision daily with soap and water b. turn the toes inward when sitting or lying c. sit in a straight-backed armchair d. bend at the waist when putting on socks e. use a raised toilet seat

correct answers: a, c, e Rationales: The client should wash the surgical incision daily with soap and water to decrease the risk of infection. Using a straight-backed armchair decreases the chance of bending at a greater than 90 degree angle, which cab cause dislocation of the hip prosthesis. Using a toilet riser decreases the chance of bending greater then 90 degree, which can cause dislocation of the hip prosthesis.

a nurse is reinforcing teaching with a client who has a history of low-back injury. which of the following instructions should the nurse reinforce with the client to prevent low-back pain? (select all that apply) a. engage in regular exercise, including walking b. sit for up to 10hr each day to rest the back c. maintain weight within 25% of ideal body weight d. create a smoking cessation plan e. wear low-healed shoes

correct answers: a, d, e Rationales: Regular exercise, including walking or swimming, is a strategy that can prevent low back pain. Stopping or cutting down in smoking can decrease low back pain, as smoking can cause disk degeneration. Wearing low-heeled, well fitting shoes can prevent low back pain. the nurse should instruct the client to avoid high-heeled shoes.

a nurse is assisting with a preoperative teaching plan for a client who is scheduled to have a total hip arthroplasty. Which of the following should the nurse include in the teaching plan? (select all that apply) a. complete autologous blood donation b. sit in a low reclining chair c. cross legs when in bed d. use an abductor pillow when turning e. perform isometric exercises

correct answers: a, d, e Rationales: The nurse should encourage the client to donate autologous blood to use postoperatively. The nurse should instruct the client to place an abductor device or pillow between the legs when turning to prevent dislocation pf the affected hip. The nurse should instruct the client to perform isometric exercises to prevent blood clots and maintain muscle tone

a nurse is collecting data from a client who has osteoarthritis of the knees ad fingers. Which of the following manifestations should the nurse expect to find? (select all that apply) a. heberden's nodes b. swelling of all joints c. small body frame d. enlarged joint size e. limp wen walking

correct answers: a, d, e rationales: Heberden's nodes are enlarged nodules on the distal interphalangeal joints of the hands and feet of a client who has osteoarthritis. a client can manifest enlarged joints due to bone hypertrophy. A client can manifest a limp when walking due to pain from inflammation in the localized joint.

a nurse is assisting in the admission of an older adult client who has suspected osteoporosis. Which of the following findings should the nurse expect? (select all that apply) a. history of consuming one glass of wine daily b. loss in height of 5.1 cm (2 in) c. body mass index 21 d. Kyphotic curve at upper thoracic spine e. history of lactose intolerance

correct answers: b, c, d, e Rationale: The loss of 2 inches of height is suggestive of osteoporosis due to fractures of the vertebral column. The client who has a BMI of 21 is at risk of developing osteoporosis due to low body weight and thin body build, suggesting decreased bone mass. Kyphosis curve is highly suggestive of osteoporosis due to fractures of the vertebrae causing the curve. Lactose intolerance is highly suggestive of osteoporosis due to possible lack of calcium intake

a nurse is collecting data on a client who is scheduled to undergo a right knee anthroplasy. The nurses should expect which of the following findings? (select all that apply.) a. skin reddened over the joint b. pain when bearing down c. joint crepitus d. swelling of the affected joint e. limited joint motion

correct answers: b, c, d, e. Rationales: Pain when bearing weight is an expected finding due to degeneration of the joint. Joint crepitus due to degeneration of the joint tissue is an expected finding. Swelling of the affected joint due to degeneration of the joint tissue is an expected finding. Limited joint motion is due to degeneration of the joint tissue and is an expected finding.

a nurse is reinforcing preoperative teaching with a client who is to undergo an anthroscopy to repair a shoulder injury. Which of the following statements should the nurse include? (select all that apply.) a. "avoid damage or moisture to the cast on your arm." b. "inspect your incision daily for indications of infection c. "apply ice packs to the area for the first 24 hours." d. "keep your arm in a dependent position." e. "perform isometric exercises."

correct answers: b, c, e. Rationales: The client should inspect the incision for evidence of infection. The client should apply ice packs to the affected area for the first 24 hr to reduce swelling and discomfort. the client should perform the isometric exercises as prescribed

A nurse is reinforcing teaching with clients at a health fair about dual energy x-ray absorptiometry (DXA) scans. Which of the following information should the nurse include in the teaching? (select all that apply.) a. "The test requires the use of contrast material." b. "The hip and spine are the usual areas the device scans." C. "The scan detects osteoarthritis." d. "Bone pain can indicate a need for a scan." e. "At age 40, you should have a baseline scan."

correct answers: b, d, e Rationales: the most common areas for a DXA scan are the hip and spine for more clear visualization of a large are of bone. Bone pain, loss of height, and fractures can indicate the need for a DXA scan. A baseline scan at age 40 is helpful for comparison with a scan during the postmenopausal period

A nurse is teaching a client who has a new prescription for alendronate for treatment of osteoporosis. Which of the following statements by the client indicates understanding of the teaching? a. "I will take the medication in the evening." b. "I will drink a full glass of milk with the medication." c. "I will take the medication at mealtime." d. "I will sit upright after taking the medication."

d. "I will sit upright after taking the medication." Rationale: A client taking alendronate should sit upright for 30 min after administration to prevent esophageal irritation and ulceration. Therefore, the nurse should identify this statement as indicating an understanding of the teaching.

A nurse is discussing the difference between RA and osteoarthritis with a newly hired nurse. Which of the following information should the nurse include about osteoarthritis? a. "Osteoarthritis is caused by autoimmune processes." b. "Osteoarthritis causes joints to become red and hot." c. "Osteoarthritis affects other organ systems." d. "Osteoarthritis can impair a joint on a single side of the body."

d. "Osteoarthritis can impair a joint on a single side of the body." Rationale: The nurse should identify unilateral joint involvement as a finding of osteoarthritis. A client who has RA experiences symmetrical joint impairment.

A nurse is reinforcing teaching with a client who has osteomyelitis of an open wound on his heal. Which of the following information should nurse include? a. "You will need to apply a cold pack to the site three times per day." b. "Your provider might ask you to walk frequently to increase circulation to the area." c. "You will need to limit consumption of high-protein foods." d. "Your provider might prescribe a central catheter line for long-term antibiotic therapy."

d. "Your provider might prescribe a central catheter line for long-term antibiotic therapy." Rationale: Osteomyelitis is an acute or chronic bone infection. The client will require weeks to months of IV antibiotic therapy for treatment. Therefore, the nurse should discuss the need for long-term IV access for antibiotic therapy.

A nurse in the emergency department is preparing to discharge a client following a Grade II (moderate) ankle sprain. Which of the following instructions should the nurse plan to give to the client? a. Perform passive range-of-motion exercises of the ankle hourly b. Keep The affected extremity in a dependent position c. Wrap a loose dressing around the affected ankle d. Apply cold compresses to the extremity intermittently

d. Apply cold compresses to the extremity intermittently Rationale: Cold minimizes swelling and erythema to the affected area. Therefore, the nurse should instruct the client to apply cold compresses for no more than 20 min at a time.