Neuromusculoskeletal System

The nurse is caring for a client with a spinal cord injury that has paraplegia. The nurse can expect which major problem early in the recovery period? 1.Bladder control 2.Nutritional intake 3.Quadriceps setting 4.Use of aids for ambulation

1.Bladder control

A client is admitted to the hospital with a suspected brain tumor. Based on the history of loss of equilibrium and coordination, the nurse suspects the tumor is located in the: 1.Cerebellum 2.Parietal lobe 3.Basal ganglia 4.Occipital lobe

1.Cerebellum

A client is admitted to the hospital with the diagnosis of Parkinson disease. What medication should the nurse expect the health care provider to prescribe to relieve the client's physiological responses to this disease? 1.Levodopa (l-Dopa) 2.Isocarboxazid (Marplan) 3.Dopamine (Intropin) 4.Pyridoxine (vitamin B6)

1.Levodopa (l-Dopa)

When a disaster occurs, the nurse may have to first treat mass hysteria that is indicated by what response? 1.Panic 2.Coma 3.Euphoria 4.Depression

1.Panic

A nurse uses a dull object to stroke the lateral side of the underside of a client's left foot and moves upward to the great toe. What reflex is the nurse testing? 1.Moro 2.Babinski 3.Stepping 4.Cremasteric

2.Babinski

A client returns from the post-anesthesia care unit after a right rotator cuff repair. What should the nurse do when performing a neurovascular assessment? 1.Monitor for a pulse deficit. 2.Obtain hourly blood pressure readings. 3.Assess for capillary refill in the nail beds. 4.Place the shoulder through range of motion

3.Assess for capillary refill in the nail beds.

A nurse is teaching a client with a diagnosis of open-angle glaucoma. The nurse explains that the chief aim of treatment is to: 1.Rest the eye 2.Dilate the pupil 3.Control the intraocular pressure 4.Prevent secondary infections

3.Control the intraocular pressure

A client is admitted to the hospital after sustaining a head injury. The nurse monitors for the most reliable sign of increased intracranial pressure, which is a slow: 1.Rise in respiratory rate 2.Narrowing of pulse pressure 3.Decrease in the level of consciousness 4.Increase in the diastolic blood pressure

3.Decrease in the level of consciousness

A client is treated with lorazepam (Ativan) for status epilepticus. What effect of lorazepam does the nurse consider therapeutic? 1.Slows cardiac contractions. 2.Dilates tracheobronchial structures. 3.Depresses the central nervous system (CNS). 4.Provides amnesia for the convulsive episode

3.Depresses the central nervous system (CNS).

A client who is receiving radiation therapy for bone cancer lives alone and works full time. What should the nurse encourage this client to do? 1.Perform regularly scheduled aerobic activity daily. 2.Take a leave of absence from work when receiving therapy. 3.Include rest periods during the day while receiving radiation. 4.Continue the activities usually performed before becoming ill

3.Include rest periods during the day while receiving radiation.

The nurse is monitoring a client with a severe head injury for signs and symptoms of increasing intracranial pressure. Which finding is most indicative of increasing intracranial pressure? 1.Polyuria 2.Tachypnea 3.Increased restlessness 4.Intermittent tachycardia

3.Increased restlessness

The nurse is caring for a client with arthritis. The client asks, "Can I take Tylenol instead of aspirin? Aspirin irritates my stomach." The nurse explains that acetaminophen (Tylenol): 1.Lacks anticoagulant action 2.Has the same action as aspirin 3.Lacks an anti-inflammatory action 4.Has more severe side effects than aspirin

3.Lacks an anti-inflammatory action

An x-ray film indicates that an older client has a fractured femur. The client asks the nurse, "Will I be able to walk again?" What is the best response by the nurse? 1."I have no idea because only time will tell." 2."You only broke a bone. It could have been worse." 3."You'll walk again. This is a common issue in older people." 4."Tell me more about your concerns about being able to walk."

4."Tell me more about your concerns about being able to walk."

The spouse of a client with an intracranial hemorrhage asks the nurse, "Why aren't they administering an anticoagulant?" How should the nurse respond? 1."It is contraindicated because bleeding will increase." 2."If necessary it will be started to enhance circulation." 3."If necessary it will be stated to prevent pulmonary thrombosis." 4."It is inadvisable because it masks the effects of the hemorrhage."

1."It is contraindicated because bleeding will increase."

Which medication should the nurse anticipate the health care provider will prescribe to relieve the pain experienced by a client with rheumatoid arthritis? 1.Acetylsalicylic acid (Aspirin) 2.Hydromorphone (Dilaudid) 3.Meperidine (Demerol) 4.Alprazolam (Xanax)

1.Acetylsalicylic acid (Aspirin)

After an amputation of a limb, a client begins to experience extreme discomfort in the area where the limb once was. The nurse's greatest concern at this time is: 1.Addressing the pain 2.Reversing feelings of hopelessness 3.Promoting mobility in the residual limb 4.Acknowledging the grieving for the lost limb

1.Addressing the pain

After cataract surgery, a client reports feeling nauseated. How can the nurse help to relieve the nausea? 1.Administer the prescribed antiemetic drug. 2.Provide some dry crackers for the client to eat. 3.Explain that this is expected following surgery. 4.Teach how to breathe deeply until the nausea subsides.

1.Administer the prescribed antiemetic drug.

An older client with dementia of the Alzheimer's type is residing in a nursing home. When in bed, the client consistently is found sleeping in the semi-Fowler position. What area of the client's body does the nurse determine is at the greatest risk for developing a pressure ulcer? 1.Sacrum 2.Scapulae 3.Ischial spine 4.Greater trochanter

1.Sacrum

After a cervical neck injury, a client is placed in a halo fixation device with a body cast. A statement that indicates that the client's concern about body image has been resolved successfully is: 1."I hate having everyone else do things for me." 2."I've gotten used to the brace. I may even miss it when it's gone." 3."I've been keeping my daily calories low in an attempt to lose weight." 4."I can't get to sleep. However, I make up for it in the morning by sleeping later."

2."I've gotten used to the brace. I may even miss it when it's gone."

A client is admitted to the hospital after having a tonic-clonic seizure. The client has a two-year history of a seizure disorder, but the seizures have been well controlled by phenytoin (Dilantin) for the last six months. The client says to the nurse, "I am so upset. I didn't think I was going to have more seizures." Which is the best response by the nurse? 1."Did you forget to take your medication?" 2."You are worried about having more seizures?" 3."You must be under a lot of stress right now." 4."Don't be too concerned because your medication needs to be increased."

2."You are worried about having more seizures?"

A client who just has been diagnosed with primary open-angle glaucoma (POAG) refuses therapy. The nurse reinforces that it is important for the client to seek treatment because if POAG is left untreated it may lead to: 1.Cataracts 2.Blindness 3.Retinal detachment 4.Blurred distance vision

2.Blindness

A client is admitted to the hospital with weakness in the right extremities and speech that is slightly slurred. A diagnosis of brain attack (CVA) is suspected. During the first 24 hours after symptom onset, the priority nursing intervention is to: 1.Assess the temperature 2.Evaluate motor status 3.Monitor blood pressure 4.Obtain a urinalysis

2.Evaluate motor status

A client is admitted to the hospital with weakness in the right extremities and a slight difficulty with speech. Vital signs are within expected limits. What is the priority nursing action during the first 24 hours? 1.Taking the client's temperature. 2.Evaluating the client's motor status. 3.Obtaining the client's urine for a urinalysis. 4.Monitoring the client's blood pressure for hypertension.

2.Evaluating the client's motor status

A client experiences an acute episode of rheumatoid arthritis. The nurse observes that the client's finger joints are swollen. The nurse concludes that this swelling most likely is related to: 1.Urate crystals in the synovial tissue 2.Inflammation in the joint's synovial lining 3.Formation of bony spurs on the joint surfaces 4.Escaped fluid from the capillaries that increases interstitial fluids

2.Inflammation in the joint's synovial lining

When making rounds, a nurse observes a client who is experiencing a seizure. What should the nurse do? 1.Hyperextend the client's neck 2.Move obstacles away from the client 3.Restrain the client's body movements 4.Attempt to place an airway in the client's mouth

2.Move obstacles away from the client

Clients who have casts applied to an extremity must be monitored for complications. The most significant complication for which the nurse should assess the client's extremity is: 1.Warmth 2.Numbness 3.Skin desquamation 4.Generalized discomfort

2.Numbness

A client has paraplegia as a result of a motorcycle accident. What is the reason the nursing care plan should include turning the client every one to two hours? 1.Maintain comfort 2.Prevent pressure ulcers 3.Prevent flexion contractures of the extremities 4.Improve venous circulation in the lower extremities

2.Prevent pressure ulcers

A nurse is monitoring a client who is having a computed tomography (CT) scan of the brain with contrast. Which response indicates that the client is having an untoward reaction to the contrast medium? 1.Pelvic warmth 2.Feeling flushed 3.Shortness of breath 4.Salty taste in the mouth

3.Shortness of breath

After an automobile collision, a client who sustained multiple injuries is oriented to person and place but is confused as to time. The client complains of a headache and drowsiness, but assessment reveals that the pupils are equal and reactive. Which nursing action takes priority? 1.Moving the client as little as possible 2.Preparing the client for mannitol administration 3.Stimulating the client to maintain responsiveness 4.Monitoring the client for increasing intracranial pressure

4.Monitoring the client for increasing intracranial pressure

A client who has a long leg cast for a fractured bone is to be discharged from the emergency department. When discussing pain management, the nurse should advise the client to take the prescribed as needed oxycodone and acetaminophen (Percocet): 1.Just as a last resort 2.Before going to sleep 3.As the pain becomes intense 4.When the discomfort begins

4.When the discomfort begins