Pharmacology 1 Musculoskeletal Meds

A client has been prescribed cyclobenzaprine in the treatment of painful muscle spasms accompanying a herniated intervertebral disk. The nurse should withhold the medication and question the prescription if the client had which concurrent prescriptions to take? 1.Ibuprofen 2.Furosemide 3.Valproic acid 4.Tranylcypromine

4.Tranylcypromine

The nurse employed in the ambulatory care department hears a client in the waiting room call out, "Help, fire!" The nurse rushes to the waiting room and finds the wastebasket on fire. Which is the immediate action of the nurse? 1.Confine the fire. 2.Extinguish the fire. 3.Activate the fire alarm. 4.Remove the clients from the waiting room.

4.Remove the clients from the waiting room.

A primary health care provider prescribes atenolol 0.05 g orally daily. The label on the medication bottle states, atenolol 50-mg tablets. How many tablet(s) will the nurse administer to the client? Fill in the blank.

1 mL

The nurse has reinforced client instructions regarding crutch safety. Which comment by the client would indicate a need for further teaching? 1."Crutch tips will not slip, even when wet." 2."Use of someone else's crutches is a bad idea." 3."Crutch tips should be inspected periodically for wear." 4."I need to have spare crutches and tips available."

1."Crutch tips will not slip, even when wet."

The nurse has reinforced discharge instructions to a client with multiple sclerosis who is receiving baclofen. Which statement by the client indicates an understanding of the medication? 1."I need to watch for urinary retention." 2."I need to stop the medication if diarrhea occurs." 3."If I develop fatigue, I need to notify the primary health care provider." 4."I need to restrict my fluid intake while I take this medication."

1."I need to watch for urinary retention."

A client who has had a total knee replacement tells the nurse that there is pain with extension of the knee. Which action should the nurse implement? 1.Administer an analgesic. 2.Immobilize the knee temporarily. 3.Notify the primary health care provider immediately. 4.Put the client's knee through full passive range of motion.

1.Administer an analgesic.

The nurse is caring for a client who has had a spinal fusion with insertion of hardware. The nurse should be especially concerned with which finding? 1.An oral temperature of 101° F orally 2.Complaints of discomfort during repositioning 3.Old bloody drainage outlined on the surgical dressing 4.Discomfort during coughing and deep breathing exercises

1.An oral temperature of 101° F orally

The nurse in the emergency department is caring for a client with a fractured arm. The nurse understands that which item is least likely needed before reduction of the fracture in the casting room? 1.Anesthesia consent 2.Consent for the procedure 3.Administration of an analgesic 4.Explanation of the procedure to the client

1.Anesthesia consent

The nurse is caring for a client with Paget's disease. The nurse knows that when serum calcium levels are lowered, what hormone secretion increases to release calcium to the blood? 1.Antidiuretic hormone (ADH) 2.Parathyroid hormone (PTH) 3.Follicle-stimulating Hormone (FSH) 4.Adrenocorticotropic hormone (ACTH)

1.Antidiuretic hormone (ADH)

A primary health care provider is planning to administer a skeletal muscle relaxant to a client with a spinal cord injury. The medication is going to be administered intrathecally. Which medication would the nurse expect to be prescribed and administered by this route? 1.Baclofen 2.Chlorzoxazone 3.Dantrolene sodium 4.Cyclobenzaprine hydrochloride

1.Baclofen

The nurse is discharging a client with a diagnosis of gout. Which best practice guidelines should the nurse teach the client? Select all that apply. 1.Drink plenty of fluids. 2.Avoid taking diuretics. 3.Avoid taking acetaminophen. 4.Organ meats are allowed on your diet. 5.Avoid excessive physical or emotional stress.

1.Drink plenty of fluids. 2.Avoid taking diuretics. 5.Avoid excessive physical or emotional stress.

The nurse is caring for a client with a tibial fracture who was just diagnosed with acute compartment syndrome (ACS). Which procedure does the nurse anticipate the surgeon will perform? 1.Fasciotomy 2.Arteriotomy 3.Venous thromboectomy 4.External compartment removal

1.Fasciotomy

The nurse is caring for a client diagnosed with Paget's disease. The nurse plans care knowing that this condition usually affects which bones? Select all that apply. 1.Femur 2.Skull 3.Tibia 4.Sternum 5.Shoulder 6.Vertebrae

1.Femur 2.Skull 3.Tibia 6.Vertebrae

The nurse prepares to reinforce instructions to a client who is taking allopurinol. The nurse should include which instruction in the plan? 1.Instruct the client to drink 3000 mL of fluid per day. 2.Instruct the client to take the medication on an empty stomach. 3.Inform the client that the effect of the medication will occur immediately. 4.Instruct the client that if swelling of the lips occurs, this is a normal expected response.

1.Instruct the client to drink 3000 mL of fluid per day.

The nurse is caring for a client recently diagnosed with Parkinson disease (PD). The nurse is assessing the client and knows that PD is characterized by what cardinal signs/symptoms? Select all that apply. 1.Tremor 2.Dry skin 3.Muscle rigidity 4.Postural instability 5.Orthostatic hypertension 6.Bradykinesia or akinesia (slow movement/no movement)

1.Tremor 3.Muscle rigidity 4.Postural instability 6.Bradykinesia or akinesia (slow movement/no movement)

A client has just had a cast removed and the underlying skin is yellow-brown and crusted. The nurse determines that further instructions are needed about skin care if the client makes which statement? 1."I will soak the skin and then wash it gently." 2."I need to scrub the skin vigorously with soap and water." 3."I need to apply an emollient lotion to enhance softening." 4."I need to use a sunscreen on the skin if it will be directly exposed to the sun."

2."I need to scrub the skin vigorously with soap and water."

A client with possible rib fracture has never had a chest x-ray. The nurse should tell the client which statement about the procedure? 1."The x-ray stimulates a small amount of pain." 2."It is necessary to remove jewelry and any other metal objects." 3."The client will be asked to breathe in and out during the x-ray." 4."The x-ray technologist will stand next to the client during the x-ray."

2."It is necessary to remove jewelry and any other metal objects."

The nurse is planning to teach a client with a left arm cast about measures to keep the left shoulder from becoming stiff. Which suggestion should the nurse include in the teaching plan? 1."Use a sling on the left arm." 2."Lift the left arm up over the head." 3."Lift the right arm up over the head." 4."Make a fist with the hand of the casted arm."

2."Lift the left arm up over the head."

The nurse is planning to reinforce instructions to the client about how to stand on crutches. In the instructions, the nurse should plan to tell the client to place the crutches in which position? 1.3 inches to the front and side of the client's toes 2.8 inches to the front and side of the client's toes 3.15 inches to the front and side of the client's toes 4.20 inches to the front and side of the client's toes

2.8 inches to the front and side of the client's toes

When reinforcing dietary instructions to a client with irritable bowel syndrome whose primary symptom is alternating constipation and diarrhea, the nurse should tell the client that which foods are best to include in the diet for this disorder? Select all that apply. 1.Beans 2.Apples 3.Cabbage 4.Brussels sprouts 5.Whole-grain bread

2.Apples 5.Whole-grain bread

A client in skeletal leg traction with an overbed frame is not allowed to turn from side to side. Which action by the nurse should be most useful in trying to provide good skin care to the client? 1.Having another nurse tilt the client to the side 2.Asking the client to pull up on a trapeze to lift the hips off the bed 3.Pushing down on the mattress of the bed while administering care 4.Asking the client to lift up by digging into the mattress with the unaffected leg

2.Asking the client to pull up on a trapeze to lift the hips off the bed

The nurse is preparing discharge instructions for a client receiving baclofen. Which instruction should be included in the teaching plan? 1.Restrict fluid intake. 2.Avoid the use of alcohol. 3.Stop the medication if diarrhea occurs. 4.Notify the primary health care provider (PHCP) if fatigue occurs.

2.Avoid the use of alcohol.

The nurse is caring for the client who has had skeletal traction applied to the left leg. The client is complaining of severe left leg pain. Which action should the nurse take first? 1.Provide pin care. 2.Check the client's alignment in bed. 3.Medicate the client with an analgesic. 4.Call the primary health care provider (PHCP).

2.Check the client's alignment in bed.

The nurse is caring for a client admitted with fat embolism syndrome (FES). Which are some of the early manifestations of this syndrome? Select all that apply. 1.Fever 2.Dyspnea 3.Petechiae 4.Hypoxemia 5.Tachypnea 6.Decreased level of consciousness

2.Dyspnea 4.Hypoxemia 5.Tachypnea

The nurse is caring for a client who just been prescribed alendronate. Which conditions contraindicate this medication being given to the client? Select all that apply. 1.Liver failure 2.Hypocalcemia 3.Cardiac disease 4.Poor renal function 5.Irritable bowel syndrome (IBS) 6.Gastroesophageal reflux disease (GERD)

2.Hypocalcemia 4.Poor renal function 5.Irritable bowel syndrome (IBS) 6.Gastroesophageal reflux disease (GERD)

A client has had skeletal traction applied to the right leg and has an overhead trapeze available for use. The nurse should monitor which area as a high-risk area for pressure and breakdown? 1.Scapulae 2.Left heel 3.Right heel 4.Back of the head

2.Left heel

A client with skeletal traction applied to the right leg complains to the nurse about severe right leg pain in spite of being medicated with a prescribed analgesic. Which action should the nurse take? 1.Provide pin care. 2.Notify the registered nurse. 3.Remove some of the traction weights. 4.Find out when the next dose of the prescribed analgesic can be given.

2.Notify the registered nurse.

A client is complaining of skin irritation from the edges of a cast applied the previous day. The nurse should plan for which intervention? 1.Massaging the skin at the rim of the cast 2.Petaling the cast edges with adhesive tape 3.Using a rough file to smooth the cast edges 4.Applying lotion to the skin at the rim of the cast

2.Petaling the cast edges with adhesive tape

The nurse is repositioning the client who has returned to the nursing unit following internal fixation of a fractured right hip. How should the nurse plan to position the client? 1.Trochanter roll to prevent abduction while turning 2.Pillow to keep the right leg abducted during turning 3.Pillow to keep the right leg adducted during turning 4.Trochanter roll to prevent external rotation while turning

2.Pillow to keep the right leg abducted during turning

The nurse is evaluating the pin sites of a client in skeletal traction. The nurse would be least concerned with which finding? 1.Inflammation 2.Serous drainage 3.Pain at a pin site 4.Purulent drainage

2.Serous drainage

A client has a newly fractured fibula that is plaster casted in the emergency department. Because the client will need to use crutches, the nurse plans to teach the client which crutch-walking gait before discharge? 1.Two-point gait 2.Three-point gait 3.Swing-through gait 4.Four-point alternate gait

2.Three-point gait

A client who is scheduled for surgery and who is to be placed in skeletal traction says to the nurse, "I'm not sure if I want to have this skeletal traction or if the skin traction would be best to stabilize my fracture." Based on the client's statement, the nurse should make which response to the client? 1."There is no reason to be concerned. I have seen lots of these procedures." 2."Skeletal traction is much more effective than skin traction in your situation." 3."You have concerns about skeletal versus skin traction for your type of fracture?" 4."Your fracture is very unstable. You will die if you don't have this surgery performed."

3."You have concerns about skeletal versus skin traction for your type of fracture?"

A postoperative client received a spinal anesthetic. The client has not experienced pain because the anesthetic has not yet worn off. The nurse should monitor the client closely for pain and provide the client with which instruction? 1."I will be bringing your pain medication at 10:00 pm." 2."You will not feel pain because of the spinal anesthesia." 3."You will need to let me know when you start to get feeling back in your legs." 4."You will not be able to take pain medication until you have been up to the bathroom."

3."You will need to let me know when you start to get feeling back in your legs."

A client is receiving a maintenance dose of oral dantrolene sodium for the treatment of spasticity. The nurse reviews the medication record, expecting which dose to be prescribed? 1.50 mg daily 2.100 mg daily 3.100 mg twice daily 4.200 mg four times daily

3.100 mg twice daily

The nurse is providing care to a client with this type of cast. (Refer to figure.) The nurse documents that the client has which type of cast?View Figure 1.A long leg cast 2.A short leg cast 3.A hip spica cast 4.A body jacket cast

3.A hip spica cast

A client is treated in the primary health care provider's office for a sprained ankle. Before sending the client home, the nurse plans to reinforce instructions to the client about which item to avoid in the next 24 hours? 1.Resting the foot 2.Applying an Ace wrap 3.Applying a heating pad 4.Elevating the ankle on a pillow while sitting or lying down

3.Applying a heating pad

The nurse is caring for a client who has developed compartment syndrome from a severely fractured arm. The client asks the nurse how this can happen. How should the nurse explain compartment syndrome? 1.A bone fragment has injured the nerve supply in the area. 2.An injured artery causes impaired arterial perfusion through the compartment. 3.Bleeding and swelling cause increased pressure in an area that cannot expand. 4.The fascia expands with injury, causing pressure on underlying nerves and muscles.

3.Bleeding and swelling cause increased pressure in an area that cannot expand.

The nurse is preparing to collect data from a client who has sustained a pelvic fracture following a motor vehicle crash. The nurse reviews the primary health care provider's (PHCP) prescriptions and notes that the PHCP has prescribed a pelvic (skin) sling. The nurse prepares to place the client in which device? Refer to figure.View Figure 1.A 2.B 3.C 4.D

3.C

The nurse is giving the client with a left leg cast crutch-walking instructions using the three-point gait. The client is allowed to touch down the affected leg. How should the nurse teach the client to use the crutches? 1.Crutches and then both legs simultaneously 2.Crutches and the right leg, then advance the left leg 3.Crutches and the left leg, then advance the right leg 4.Left leg and right crutch, then right leg and left crutch

3.Crutches and the left leg, then advance the right leg

The nurse is monitoring a client receiving baclofen for side effects related to the medication. Which should indicate that the client is experiencing a side effect? 1.Polyuria 2.Diarrhea 3.Drowsiness 4.Muscular excitability

3.Drowsiness

The nurse is caring for a client diagnosed with Paget's disease. What abnormal laboratory values would the nurse specifically monitor in a client with Paget's disease? Select all that apply. 1.Decreased potassium 2.Elevated serum calcium 3.Elevated serum amylase 4.Increased creatine kinase (CK-MM) 5.Elevated serum alkaline phosphatase (ALP) 6.Elevated 24-hour urinary hydroxyproline level

3.Elevated serum amylase 5.Elevated serum alkaline phosphatase (ALP) 6.Elevated 24-hour urinary hydroxyproline level

A nursing instructor asks a nursing student about the risk factors associated with osteoporosis. The instructor determines that the student needs further teaching if the student states that which is an associated risk factor? 1.Postmenopausal age 2.Family history of osteoporosis 3.High-calcium diet consumption 4.Long-term use of corticosteroids

3.High-calcium diet consumption

The nurse is caring for a comatose client at risk for fat embolism because of a fractured femur and pelvis sustained in a fall. Which finding does the nurse identify as early signs/symptoms of possible fat embolism? 1.Decreased heart rate and increased restlessness 2.Decreased heart rate and decreased respiratory rate 3.Increased heart rate and adventitious breath sounds 4.Increased heart rate and increased oxygen saturation

3.Increased heart rate and adventitious breath sounds

A client with a herniated intervertebral lumbar disk complains of a knifelike, stabbing pain in the lower back, as well as pain radiating into the right buttock. The nurse interprets that the sharp, stabbing pain is probably a result of which reason? 1.Pressure on the spinal cord 2.Pressure on the spinal nerve root 3.Muscle spasm in the area of the herniated disk 4.Excess cerebrospinal fluid production in the area

3.Muscle spasm in the area of the herniated disk

A client has been placed in Buck's extension traction. Which technique provided by the nurse will provide countertraction? 1.Using a footboard 2.Providing an overhead trapeze 3.Slightly elevating the foot of the bed 4.Slightly elevating the head of the bed

3.Slightly elevating the foot of the bed

A client is receiving baclofen for muscle spasms caused by a spinal cord injury. The nurse monitors the client, knowing that which is a side effect of this medication? 1.Muscle pain 2.Hypertension 3.Slurred speech 4.Photosensitivity

3.Slurred speech

The nurse prepares to care for a client with inflamed joints and plans to use which item to maintain proper positioning for the inflamed joints? 1.Footboards 2.Large pillows 3.Small pillows 4.Soft mattress

3.Small pillows

The nurse reinforces cast application instructions to a client who is going to have a plaster cast applied. The nurse determines that the client needs further teaching if the client makes which statement about the casting? 1.The cast will give off heat as it dries. 2.The cast edges may be trimmed with a cast knife. 3.The client may bear weight on the cast in 30 minutes. 4.A stockinette will be placed over the leg area to be casted.

3.The client may bear weight on the cast in 30 minutes.

The nurse is evaluating a client in skeletal traction. When evaluating the pin sites, the nurse would be most concerned with which finding? 1.Redness around the pin sites 2.Pain on palpation at the pin sites 3.Thick, yellow drainage from the pin sites 4.Clear, watery drainage from the pin sites

3.Thick, yellow drainage from the pin sites

The nurse is reinforcing discharge instructions for a client who underwent left total knee replacement (TKR) with insertion of a metal prosthesis. Which statement by the client indicates the need for further teaching? 1."I need to report bleeding gums or tarry stools." 2."I need to report fever, redness, or increased pain." 3."I need to tell my other doctors about the metal implant." 4."I don't need to be worried if the shape of my knee changes."

4."I don't need to be worried if the shape of my knee changes."

The nurse is discharging a client who had conventional open back surgery. Which comment by the client indicates a need for further teaching? 1."I plan to restrict or limit my driving." 2."I will avoid bending and twisting at the waist." 3."I'll go for a walk every day, but I won't take the dog." 4."I'll be careful not to lift anything heavier than 20 pounds."

4."I'll be careful not to lift anything heavier than 20 pounds."

The nurse has reinforced instructions to the client returning home after arthroscopy of the knee. The nurse determines that the client understands the instructions if the client makes which statement? 1."I can resume regular exercise tomorrow." 2."I will stay off of the leg entirely for the rest of the day." 3."I need to refrain from eating food for the remainder of the day." 4."I'll report fever or site inflammation to the primary health care provider."

4."I'll report fever or site inflammation to the primary health care provider."

The nurse is teaching a male client with osteomalacia about this disorder. Which comment by the client indicates a need for further teaching? 1."I need to take high doses of vitamin D." 2."Calcification does not occur to harden my bones." 3."Vitamin D helps calcium to be absorbed in my small intestines." 4."This condition is primarily due to my lack of calcium and testosterone."

4."This condition is primarily due to my lack of calcium and testosterone."

A client is experiencing an acute exacerbation of bursitis. The nurse encourages the client to avoid which least likely helpful measure until the current episode is resolved? 1.Resting the joint 2.Applying moist heat 3.Elevation of the joint 4.Active intermittent range of motion

4.Active intermittent range of motion

The nurse has a prescription to get the client out of bed to a chair on the first postoperative day after total knee replacement. The nurse plans to do which to protect the knee joint? 1.Obtain a walker to minimize weight bearing by the client on the affected leg. 2.Apply an Ace wrap around the dressing, and put ice on the knee while sitting. 3.Lift the client to the bedside chair, leaving the continuous passive motion (CPM) machine in place. 4.Apply a knee immobilizer before getting the client up, and elevate the client's surgical leg while sitting.

4.Apply a knee immobilizer before getting the client up, and elevate the client's surgical leg while sitting.

The nurse is caring for a client with osteoarthritis. The nurse collects data, knowing that which is a sign/symptom associated with this disorder? 1.Morning stiffness 2.Positive rheumatoid factor 3.An elevated sedimentation rate 4.Dull aching pain in the affected joints

4.Dull aching pain in the affected joints

The nurse has a prescription to place a client with a herniated lumbar intervertebral disk on bed rest to minimize the pain. The nurse plans to put the bed in which position? 1.Flat with the knee gatch raised 2.In semi-Fowler's position with the foot of the bed flat 3.In high-Fowler's position with the foot of the bed flat 4.In semi-Fowler's position with the knee gatch slightly raised

4.In semi-Fowler's position with the knee gatch slightly raised

The nurse is preparing a plan of care for a client in skeletal leg traction with an over bed frame. Which nursing intervention should be included in the plan of care to assist the client with positioning in bed? 1.Use the assistance of four nurses to reposition the client. 2.Place a draw sheet under the client for pulling the client up in bed. 3.Encourage the client to pull up by pushing with the unaffected leg on the bed mattress. 4.Place a trapeze on the bed to provide a means for the client to lift the hips off the bed.

4.Place a trapeze on the bed to provide a means for the client to lift the hips off the bed.

The nurse is caring for a client who sustained multiple fractures in a motor vehicle accident 12 hours ago. The client develops severe dyspnea, tachycardia, and mental confusion, and the nurse suspects fat embolism. Which is the nurse's initial action? 1.Reassess the vital signs. 2.Perform a neurological assessment. 3.Place the client in a supine position. 4.Place the client in a Fowler's position.

4.Place the client in a Fowler's position.

A client with a hip fracture asks the nurse why Buck's extension traction is being applied before surgery. The nurse's response is based on the understanding that Buck's extension traction has which primary function? 1.Allows bony healing to begin before surgery 2.Provides rigid immobilization of the fracture site 3.Lengthens the fractured leg to prevent severing of blood vessels 4.Provides comfort by reducing muscle spasms and provides fracture immobilization

4.Provides comfort by reducing muscle spasms and provides fracture immobilization

A client is fearful about having an arm cast removed. Which action by the nurse would be the most helpful? 1.Telling the client that the saw makes a frightening noise 2.Reassuring the client that no one has had an arm lacerated yet 3.Stating that the hot cutting blades cause burns only very rarely 4.Showing the client the cast cutter and explaining how it works

4.Showing the client the cast cutter and explaining how it works

The nurse is preparing to reinforce instructions to a client regarding how to safely use crutches. Before initiating the teaching, the nurse collects data on the client. Which priority data should be included? 1.The client's fear related to the use of the crutches 2.The client's feelings about the restricted mobility 3.The client's understanding of the need for increased mobility 4.The client's vital signs, muscle strength, and previous activity level

4.The client's vital signs, muscle strength, and previous activity level

Morphine 8 mg IM has been prescribed by the primary health care provider. The medication label reads morphine 4 mg/mL. The nurse should prepare how many milliliters to administer the correct dose? Fill in the blank.

2 mL

The nurse has given medication instructions to a client beginning therapy with carisoprodol. The nurse determines that the client understands the effects of the medication if the client makes which statement? 1."I can expect muscle spasticity as a side effect." 2."I need to avoid alcohol while taking this medication." 3."I can drive on city streets, but would avoid highway driving." 4."I can take a missed dose when remembered, regardless of when the next dose is due."

2."I need to avoid alcohol while taking this medication."

A client is complaining of pain underneath a cast in the area of a bony prominence. Which should the nurse anticipate? 1.The cast will be bivalved. 2.A window will be cut in the cast. 3.The cast will be replaced with an air splint. 4.Extra padding will be put over this area of the cast.

2.A window will be cut in the cast.

The nurse receives a client in the surgical unit who was transferred from the post anesthesia care unit. The nurse checks the client for which data first? 1.A patent airway 2.Surgical dressing 3.Adequate urine output 4.Orientation to the surroundings

1.A patent airway

The nurse notes that meloxicam is prescribed for a client. The nurse knows that what are the specific actions of this medication? Select all that apply. 1.Analgesic 2.Antipyretic 3.Antiemetic 4.Antibacterial 5.Antihypertensive 6.Anti-inflammatory

1.Analgesic 2.Antipyretic 6.Anti-inflammatory

The nurse is caring for a client with muscle spasticity characterized by heightened muscle tone, spasm, and loss of dexterity caused by multiple sclerosis. Which centrally acting skeletal muscle relaxants might be prescribed for this client? Select all that apply. 1.Baclofen 2.Diazepam 3.Ibuprofen 4.Dantrolene 5.Trazadone

1.Baclofen 2.Diazepam 4.Dantrolene

A primary health care provider's prescription reads "ketorolac 30 mg intramuscular every 6 hours as needed." The medication label reads "ketorolac 15 mg/mL." The nurse prepares to administer how many milliliters to the client? Fill in the blank.

2 mL

Dantrolene sodium is prescribed for a client experiencing flexor spasms, and the client asks the nurse about the action of the medication. The nurse responds knowing that which is the therapeutic action of this medication? 1.Depresses spinal reflexes 2.Acts directly on the skeletal muscle to relieve spasticity 3.Acts within the spinal cord to suppress hyperactive reflexes 4.Acts on the central nervous system (CNS) to suppress spasms

2.Acts directly on the skeletal muscle to relieve spasticity

The nurse is caring for a client being treated for fat embolus after multiple fractures. Which data indicate to the nurse a favorable resolution of the fat embolus? 1.Minimal dyspnea 2.Clear chest x-ray 3.Oxygen saturation 85% 4.Arterial oxygen level of 78 mm Hg

2.Clear chest x-ray

A primary health care provider prescribes auranofin for a client with rheumatoid arthritis. Which data would indicate to the nurse that the client is experiencing toxicity related to the medication? 1.Joint pain 2.Constipation 3.Ringing in the ears 4.Complaints of a metallic taste in the mouth

4.Complaints of a metallic taste in the mouth

Penicillin G procaine 1 million units intramuscularly, has been prescribed for the child with a throat infection. The child's weight is 62 pounds. The safe pediatric dosage for a child that weighs greater than 60 pounds is 600,000 to 1,200,000 units daily. Which should the nurse determine about the medication dosage? 1.The dosage is too low. 2.The dosage is too high. 3.The dosage is within the safe range. 4.There is not enough information to determine the safe dosage.

3.The dosage is within the safe range.

A client is taking large doses of acetylsalicylic acid for rheumatoid arthritis. The nurse tells the client to report which signs/symptoms of ototoxicity? 1.Dizziness, tinnitus, purpura 2.GI bleeding, ecchymosis, tinnitus 3.Tinnitus, hearing loss, dizziness, ataxia 4.Gastrointestinal (GI) upset, hematuria, dizziness

3.Tinnitus, hearing loss, dizziness, ataxia

A client has just had an application of a nonplaster cast. What are some of the synthetic materials used for nonplaster casts? Select all that apply. 1.Rayon 2.Nylon 3.Neoprene 4.Fiberglass 5.Polyester-cotton knit

4.Fiberglass 5.Polyester-cotton knit

The nurse is reviewing medications with the client receiving colchicine for the treatment of gout. The nurse determines that the medication is effective if the client reports a decrease in which? 1.Headaches 2.Blood glucose 3.Blood pressure 4.Joint inflammation

4.Joint inflammation

A licensed practical nurse (LPN) is reviewing laboratory results for a client taking dantrolene sodium. The LPN should suggest that the registered nurse notify the primary health care provider if which finding is noted on the laboratory report sheet? 1.Creatinine 0.6 mg/dL 2.Platelet count 290,000 mm3 3.Blood urea nitrogen 9 mg/dL 4.Lactate dehydrogenase (LDH) 600 units/L

4.Lactate dehydrogenase (LDH) 600 units/L

The nurse is providing instructions to a client with a diagnosis of rheumatoid arthritis (RA) who is receiving acetylsalicylic acid 5 g orally daily. Which statement by the client would indicate an understanding of the instructions? 1."A slow pulse might indicate a reaction to the medication." 2."If I have joint pain, I need to notify the primary health care provider." 3."If I have discomfort with exercise, I need to stop the medication." 4."I should notify the primary health care provider if I get any ringing in my ears."

4."I should notify the primary health care provider if I get any ringing in my ears."

A client with multiple sclerosis is receiving dantrolene for relief of muscle spasticity. When would this medication be discontinued if there is no relief of spasticity? 1.10 days 2.2 weeks 3.5 weeks 4.2 months

4.2 months

Allopurinol has been prescribed for a client with chronic tophaceous gout. The nurse explains to the client that what condition can occur during the first few months of treatment? 1.Leukemia 2.Myeloid metaplasia 3.Polycythemia vera 4.Acute gouty arthritis

4.Acute gouty arthritis

The nurse is preparing to assist a client of Orthodox Jewish faith with eating lunch. A kosher meal is delivered to the client. Which nursing action is appropriate when assisting the client with the meal? 1.Unwrapping the eating utensils for the client 2.Replacing the plastic utensils with metal utensils 3.Carefully transferring the food from paper plates to glass plates 4.Allowing the client to unwrap the utensils and prepare his own meal for eating

4.Allowing the client to unwrap the utensils and prepare his own meal for eating

A licensed practical nurse (LPN) is reviewing the medical record of a newly assigned client and notes that the client is receiving cyclobenzaprine hydrochloride for the treatment of muscle spasms. The LPN questions the prescription if which disorder is noted in the admission history? 1.Hypothyroidism 2.Chronic bronchitis 3.Recurrent pneumonia 4.Angle-closure glaucoma

4.Angle-closure glaucoma

A client with multiple sclerosis is receiving diazepam, a centrally acting skeletal muscle relaxant. Which data would indicate that the client is experiencing a side effect related to this medication? 1.Headache 2.Drowsiness 3.Urinary retention 4.Increased salivation

2.Drowsiness

Which fluids are identified as insensible fluid losses? Select all that apply. 1.Sweat 2.Sputum 3.Nasogastric tube output 4.Output from Jackson-Pratt drain 5.Urine output from indwelling catheter

1.Sweat 2.Sputum

A client is receiving diazepam for its skeletal muscle relaxant effects. The nurse would monitor this client for which side effect of this medication? 1.Headache 2.Incoordination 3.Urinary retention 4.Increased salivation

2.Incoordination

A client is being discharged after application of a plaster leg cast. The nurse determines that the client understands proper care of the cast if the client makes which statement? 1."I need to avoid getting the cast wet." 2."I will use my fingertips to lift and move the leg." 3."I need to cover the casted leg with warm blankets." 4."I can use a padded coat hanger end to scratch under the cast."

1."I need to avoid getting the cast wet."

The nurse is assisting in caring for a client who has sustained a nasal fracture. The nurse monitors for which priority finding specifically related to this injury? 1.Leakage of clear fluid from the nose 2.Inability to breathe through one nare 3.Hematoma formation around the eyes 4.Edema noted around the nose and eyes

1.Leakage of clear fluid from the nose

The nurse is caring for a client with osteoporosis who is being discharged with instructions to take calcium with vitamin D. Which instructions should the nurse give the client about taking this medication? Select all that apply. 1."Take a third of the daily dose at bedtime." 2."Increase fluid intake, unless medically contraindicated." 3."Take the medication with 6 to 8 ounces of water to help dissolve it." 4."You will need to have your blood tested for calcium every month." 5."You can get a slight fever with this medication, so check your temperature every day." 6."After taking this medication for 6 months, you won't have to worry about having any more fractures."

1."Take a third of the daily dose at bedtime." 2."Increase fluid intake, unless medically contraindicated." 3."Take the medication with 6 to 8 ounces of water to help dissolve it."

The nurse caring for a client with a neurological disorder is assisting in planning care to maintain nutritional status. The client has had a swallowing study done that shows the client is at risk for aspiration and is able to feed self. The nurse should review which interventions with the unlicensed assistive personnel (UAP)? Select all that apply. 1.Add the prescribed thickener to liquids. 2.Have the client sitting up at 45 degrees. 3.Follow each swallow of food with a sip of water. 4.Observe client for episodes of coughing or choking. 5.Take the client for a walk before the meal to provide stimulation.

1.Add the prescribed thickener to liquids. 4.Observe client for episodes of coughing or choking.

The nurse is caring for a client following total hip replacement who has a wound suction drain in place. At the end of the 8-hour shift, the nurse empties 45 mL of drainage from the wound-suction device. Based on this amount of drainage, which action is appropriate? 1.Document the findings. 2.Place the leg in a flat position. 3.Check the client's blood pressure. 4.Immediately notify the registered nurse.

1.Document the findings.

The nurse is caring for a client who had a total knee replacement and was put on a continuous passive motion (CPM) machine in the postanesthesia care unit (PACU). What are some of the actions the nurse needs to monitor to operate this machine? Select all that apply. 1.Ensure that the machine is well padded. 2.Assess the client's response to the machine. 3.When the machine is not in use, store it on the floor. 4.Check the cycle and range-of-motion settings once a day. 5.Turn off the machine while the client is having a meal in bed. 6.Make sure that the joint being moved is properly positioned on the machine.

1.Ensure that the machine is well padded. 2.Assess the client's response to the machine. 5.Turn off the machine while the client is having a meal in bed. 6.Make sure that the joint being moved is properly positioned on the machine.

The nurse is assessing a client recently diagnosed with rheumatoid arthritis. Besides joint inflammation, what are some early systemic sign/symptoms of this disease that the nurse expects to assess? Select all that apply. 1.Fatigue 2.Anemia 3.Weakness 4.Weight loss 5.Paresthesias 6.Low-grade fever

1.Fatigue 3.Weakness 5.Paresthesias 6.Low-grade fever

The clinic nurse is teaching a client who has just been diagnosed with osteoporosis about nutritional therapy. Which comment by the client indicates a need for further teaching? 1."I will avoid excessive amounts of alcohol." 2."I'm glad I can still drink as much coffee as I want." 3."I must make sure I include fruits and vegetables in my daily diet." 4."I need to make sure I have adequate amounts of calcium and vitamin D."

2."I'm glad I can still drink as much coffee as I want."

A client has had surgery to repair a fractured left hip. The nurse plans to use which important item when repositioning the client from side to side in the bed? 1.Bed pillow 2.Abductor splint 3.Adductor splint 4.Overhead trapeze

2.Abductor splint

A client with a 4-day-old lumbar vertebral fracture is experiencing muscle spasms. The nurse avoids using which intervention in an effort to relieve the spasm? 1.Heat 2.Cold 3.Analgesics 4.Prescribed intermittent traction

2.Cold

A client with multiple sclerosis is receiving baclofen. The nurse monitoring this client should look for which outcome to indicate a primary therapeutic response from the medication? 1.Decreased nausea 2.Decreased muscle spasms 3.Increased muscle tone and strength 4.Increased range of motion of all extremities

2.Decreased muscle spasms

The nurse is assigned to care for a client with a peripheral intravenous (IV) infusion. The nurse is providing hygiene care to the client and should avoid which while changing the client's hospital gown? 1.Using a hospital gown with snaps at the sleeves 2.Disconnecting the IV tubing from the catheter in the vein 3.Checking the IV flow rate immediately after changing the hospital gown 4.Putting the bag and tubing through the sleeve, followed by the client's arm

2.Disconnecting the IV tubing from the catheter in the vein

A client with a history of spinal cord injury is receiving baclofen for muscle spasms. The nurse determines that the client is experiencing a side effect of this medication if the client experiences which sign/symptom? 1.Muscle pain 2.Drowsiness 3.Hypertension 4.Photosensitivity

2.Drowsiness

A primary health care provider writes a prescription to apply a heating pad to a client's back. The nurse implements the prescription and avoids which action? 1.Setting the heating pad on a low setting 2.Placing the heating pad under the client 3.Assessing the skin integrity frequently for signs of burns 4.Assessing the heating pad periodically for proper electrical function

2.Placing the heating pad under the client

The nurse reinforces dietary instructions to a client at risk for hypokalemia about the foods high in potassium that should be included in the daily diet. The nurse determines the client has understood if the client plans to include which foods in the diet? Select all that apply. 1.Apples 2.Raisins 3.Kiwifruit 4.Bananas 5.Pineapple 6.Canned peaches

2.Raisins 3.Kiwifruit 4.Bananas

A client has been taught to use a walker to aid in mobility following internal fixation of a hip fracture. The nurse determines that the client is using the walker incorrectly if which action is noted? 1.The client holds the walker using the handgrips. 2.The client advances the walker with reciprocal motion. 3.The client leans forward slightly when advancing the walker. 4.The client supports body weight on the hands while advancing the weaker leg.

2.The client advances the walker with reciprocal motion.

The nurse is caring for a client with a long bone fracture who is at risk for fat embolism. The nurse specifically monitors for the early signs of this complication by checking which criteria? Select all that apply. 1.The client's renal system 2.The client's mental status 3.The client's mobility status 4.The client's respiratory function 5.The client's cardiovascular system

2.The client's mental status 4.The client's respiratory function

The nurse is caring for a recently admitted client with painful muscle spasms due to a traumatic injury. Besides drug therapy, what are some of the physical measures the nurse expects will be prescribed for this client? Select all that apply. 1.Limiting fluids 2.Whirlpool baths 3.Physical therapy 4.Muscle relaxants 5.Application of hot compresses 6.Immobilization of the affected muscle

2.Whirlpool baths 3.Physical therapy 6.Immobilization of the affected muscle

Carisoprodol is been prescribed for a client to relieve muscle spasms. The client is being discharged and the nurse is instructing the client and family about the medication. What comment by the client indicates a need for further teaching? 1."I will avoid alcohol." 2."I know this medication is only used for short periods, such as 2 to 3 wks. 3."I'm glad there are no withdrawal problems when I stop taking this medication. 4."I must avoid tasks that require alertness and movement skills until my response to the medication is okay."

3."I'm glad there are no withdrawal problems when I stop taking this medication.

An antihypertensive medication has been prescribed for a client with hypertension. The client tells the nurse that she would like to take an herbal substance to help lower her blood pressure. Which statement by the nurse is most important to provide to the client? 1."Herbal substances are not safe and should never be used." 2."I will teach you how to take your blood pressure so that it can be monitored closely." 3."You will need to talk to your primary health care provider (PHCP) before using an herbal substance." 4."If you take an herbal substance, you will need to have your blood pressure checked frequently."

3."You will need to talk to your primary health care provider (PHCP) before using an herbal substance."

A primary health care provider instructs a client with rheumatoid arthritis to take ibuprofen. The nurse reinforces the instructions, knowing that the normal adult dose for this client is which? 1.100 mg orally twice a day 2.200 mg orally twice a day 3.400 mg orally 3 times a day 4.1000 mg orally 4 times a day

3.400 mg orally 3 times a day

The nurse is providing care for a client following a bone biopsy. Which action by the nurse is unnecessary in the care of this client? 1.Elevating the limb for 24 hours 2.Monitoring vital signs every 4 hours 3.Administering intramuscular opioid analgesics 4.Monitoring the site for swelling, bleeding, hematoma

3.Administering intramuscular opioid analgesics

The nurse is administering an intravenous dose of methocarbamol to a client with multiple sclerosis. For which adverse effect should the nurse monitor? 1.Tachycardia 2.Rapid pulse 3.Bradycardia 4.Hypertension

3.Bradycardia

A client has several fractures of the lower leg and has been placed in an external fixation device. The client is upset about the appearance of the leg, which is very edematous. The nurse determines that the client is experiencing which problem? 1.Feelings of isolation 2.Inability to tolerate activity 3.Concerns about body image 4.Inability to physically move about

3.Concerns about body image

A client diagnosed with rheumatoid arthritis (RA) has been started on medication therapy with hydroxychloroquine. The nurse reinforces teaching with this client regarding the most serious adverse effect of this medication? 1.Liver disease 2.Kidney failure 3.Retinal damage 4.Esophageal irritation and necrosis

3.Retinal damage

An adult client with severe muscle spasticity is receiving intrathecal baclofen (ITB). The nurse knows that what adverse effects may occur if the medication is suddenly withdrawn. Select all that apply. 1.Fatigue 2.Sedation 3.Seizures 4.Dizziness 5.Hallucinations

3.Seizures 5.Hallucinations

The nurse is teaching a client how to walk with a cane. Which information should the nurse include? Select all that apply. 1.The cane is placed on the affected side. 2.A quad-cane provides a narrower base for the cane. 3.The cane should create no more than 30 degrees of flexion of the elbow. 4.The top of the cane should be parallel to the greater trochanter of the femur. 5.A straight leg cane is used if the client only needs minimal support for an affected leg.

3.The cane should create no more than 30 degrees of flexion of the elbow. 4.The top of the cane should be parallel to the greater trochanter of the femur. 5.A straight leg cane is used if the client only needs minimal support for an affected leg.

The nurse has given a client instructions on how to do active range-of-motion exercises on her contracted right hand. The nurse determines that the client understands the rationale for this procedure when the client makes which statement? 1."I'm doing this, so I can go home soon." 2."It hurts, but things always have to hurt at my age." 3."If I don't do this, that therapist gets really angry at me." 4."I'm doing these exercises so I can begin to fasten my buttons and dress myself again."

4."I'm doing these exercises so I can begin to fasten my buttons and dress myself again."

The nurse is caring for a client with a fractured tibia and fibula. Eight hours after a long leg cast was applied, the client began to report an increase in pain level even after administration of the prescribed dose of opioid analgesic. Which is the initial nursing action? 1.Elevate the casted leg. 2.Contact the primary health care provider. 3.Administer another dose of pain medication. 4.Check the neurovascular status of the toes on the casted leg.

4.Check the neurovascular status of the toes on the casted leg.

This morning a client sustained a right proximal fibula and tibia fracture that was casted in a long leg plaster cast. During evening rounds, the nurse notes that the right lower extremity capillary refill is greater than 3 seconds and the toes are edematous and dusky. The client states that the pain medication is not working anymore and that the right foot feels like it is asleep. The nurse analyzes the data and determines that the client's signs/symptoms are indicative of which complication? 1.Fat embolism 2.Venous thrombosis 3.Volkmann's thrombosis 4.Compartment syndrome

4.Compartment syndrome

The nurse is assigned to care for a client with multiple traumas who is admitted to the hospital. The client has a leg fracture, and a plaster cast has been applied. In positioning the casted leg, the nurse should perform which intervention? 1.Keep the leg in a level position. 2.Elevate the leg for 3 hours, and put it flat for 1 hour. 3.Keep the leg level for 3 hours, and elevate it for 1 hour. 4.Elevate the leg on pillows continuously for 24 to 48 hours.

4.Elevate the leg on pillows continuously for 24 to 48 hours.

The nurse has provided instructions to a client with a herniated lumbar disk about proper body mechanics and other items pertinent to low back care. The nurse determines that the client needs further teaching if the client verbalizes which action should be done? 1.Increase fiber and fluids in the diet. 2.Bend at the knees to pick up objects. 3.Strengthen the back muscles by swimming or walking. 4.Get out of bed by sitting straight up and swinging the legs over the side of the bed.

4.Get out of bed by sitting straight up and swinging the legs over the side of the bed.

The nurse is discussing primary prevention measures to clients regarding osteoporosis. The nurse plans to tell the clients that which is a primary prevention measure? 1.Selecting shoes that have firm nonskid soles 2.Applying nonskid strips on areas that get wet 3.Installing telephones in several rooms of the house 4.Maintaining body weight at or above minimum recommended levels

4.Maintaining body weight at or above minimum recommended levels

The nurse is providing postprocedure instructions to a client returning home after arthroscopy of the shoulder. The nurse should reinforce which client instruction? 1.Resume regular full activity the following day. 2.Do not eat or drink anything until the following morning. 3.Keep the shoulder completely immobilized for the rest of the day. 4.Report to the registered nurse the development of fever or redness and heat at the site.

4.Report to the registered nurse the development of fever or redness and heat at the site.

The nurse is caring for a client who had an above-the-knee amputation 2 days ago. The residual limb was wrapped with an elastic compression bandage that has fallen off. The nurse should immediately perform which action? 1.Apply ice to the site. 2.Call the primary health care provider. 3.Apply a dry sterile dressing and elevates it on one pillow. 4.Rewrap the residual limb with an elastic compression bandage.

4.Rewrap the residual limb with an elastic compression bandage.

The nurse is one of several people who witness a vehicle hit a pedestrian at a fairly low speed on a small street. The individual is dazed and tries to get up, and the leg appears fractured. The nurse should plan to perform which action? 1.Try to manually reduce the fracture. 2.Assist the person with getting up and walking to the sidewalk. 3.Leave the person for a few moments to call an ambulance. 4.Stay with the person and encourage the person to remain still.

4.Stay with the person and encourage the person to remain still.

A primary health care provider has given a prescription for dietary iron supplements to the client with osteoporosis who has an iron deficiency anemia. The nurse suggests that the client do which to enhance compliance with therapy? 1.Decrease fluid intake. 2.Decrease dietary fiber. 3.Chew the tablet thoroughly. 4.Take the medication following a meal.

4.Take the medication following a meal.

Alendronate is prescribed for a client with osteoporosis and the nurse is providing instructions for the administration of the medication. Which instruction should the nurse reinforce? 1.Take the medication at bedtime. 2.Take the medication in the morning with breakfast. 3.Lie down for 30 minutes after taking the medication. 4.Take the medication with a full glass of water after rising in the morning.

4.Take the medication with a full glass of water after rising in the morning.

A client who is learning to use a cane is afraid it will slip with ambulation, causing a fall. What should the nurse tell the client to provide greater reassurance? 1.Canes prevent falls, not cause them. 2.The physical therapist will determine if the cane is inadequate. 3.The cane would help break a fall, even if the client does slip. 4.The cane has a flared tip with concentric rings to provide stability.

4.The cane has a flared tip with concentric rings to provide stability.

The nurse is caring for a client who was admitted to the hospital with a fractured right femur sustained from a fall 5 hours ago. The client's plan of care includes interventions related to monitoring for signs/symptoms of fat embolism. The nurse provides appropriate care by performing which action? 1.Monitoring for signs of dyspnea 2.Monitoring the client's temperature regularly 3.Maintaining external rotation of the right leg 4.Educating the client to report paresthesia of the right lower leg

1.Monitoring for signs of dyspnea

A client with a left arm fracture complains of severe, diffuse pain that is unrelieved with pain medication. Based on these findings the nurse should take which action? 1.Notify the registered nurse. 2.Reassess the client in 30 minutes. 3.Check to see whether it is time for more pain medication. 4.Encourage the client to continue with active range-of-motion exercises to the left arm.

1.Notify the registered nurse.

The nurse is caring for a client recently diagnosed with secondary gout. Secondary gout involves hyperuricemia (excessive uric acid in the blood) caused by another disease or factor. Which diseases or factors make clients more at risk for acquiring this condition? Select all that apply. 1.Older clients 2.Obese people 3.Client with liver disease 4.Postmenopausal women 5.Clients from poor economic communities 6.Clients with cardiovascular health problems

1.Older clients 2.Obese people 4.Postmenopausal women 6.Clients with cardiovascular health problems

An elderly client is brought to the emergency department via ambulance after sustaining a fall. An x-ray indicates that the client sustained a femoral neck fracture. The nurse is collecting data from the client and knows that which disease processes increase the older adult's risk for hip fractures? Select all that apply. 1.Osteoporosis 2.Foot disorders 3.Bony metastases 4.Carpal tunnel syndrome 5.Diminished visual acuity 6.Changes in cardiac function

1.Osteoporosis 2.Foot disorders 3.Bony metastases 6.Changes in cardiac function

An older client with advanced Alzheimer's disease is placed in balanced suspension traction, and the primary health care provider expects to internally fixate the client's femur in 1 week. Based on this information, the nurse determines that the priority relates to addressing which client problem? 1.Risk for constipation 2.Impaired tissue integrity 3.Risk for activity intolerance 4.Disturbed thought processes

1.Risk for constipation

A client is complaining of low back pain with radiation down the left posterior thigh. The nurse continues to collect data from the client to see if the pain is worsened or aggravated with which action? 1.Applying heat 2.Bending or lifting 3.Taking ibuprofen 4.Maintaining bed rest

2.Bending or lifting

The nurse is caring for a client with diabetes mellitus who is scheduled to have a right below-knee amputation. The nurse assesses which factors that can put this client at risk for amputation? Select all that apply. 1.Psoriasis 2.Bony deformity 3.Limited joint mobility 4.Peripheral neuropathy 5.Peripheral vascular disease 6.History of skin ulcers or previous amputation

2.Bony deformity 3.Limited joint mobility 4.Peripheral neuropathy 5.Peripheral vascular disease 6.History of skin ulcers or previous amputation

The nurse is caring for a client who has had an open reduction with internal fixation (ORIF) with a posterior approach. The client has been prescribed hip precautions. The nurse plans to implement which activities in the care of the client? Select all that apply. 1.Ensure the client doesn't bend the hips beyond 120 degrees. 2.Ensure the client doesn't sit or stand for long periods of time. 3.Ensure the client engages in rigorous exercise to maintain strength. 4.Ensure the client doesn't cross the legs past the midline of the body. 5.Ensure the client uses assistive/adaptive devices with activities of daily living.

2.Ensure the client doesn't sit or stand for long periods of time. 4.Ensure the client doesn't cross the legs past the midline of the body. 5.Ensure the client uses assistive/adaptive devices with activities of daily living.

The nurse is evaluating the client's use of a cane for left-sided weakness. The nurse should intervene and correct the client if the nurse observed that the client performed which action? 1.Holds the cane on the right side 2.Moves the cane when the right leg is moved 3.Leans on the cane when the right leg swings through 4.Keeps the cane 6 inches out to the side of the right foot

2.Moves the cane when the right leg is moved

The nurse has provided instructions to a client in an arm cast about the signs/symptoms of compartment syndrome. The nurse determines that the client understands the information if the client states to report which early symptom of compartment syndrome? 1.Cold, bluish fingers 2.Numbness and tingling in the fingers 3.Pain that increases when the arm is dependent 4.Pain that is relieved only by an opioid analgesic

2.Numbness and tingling in the fingers

The nurse is caring for a client who has a cast applied to the left lower leg. On data collection, the nurse notes the presence of skin irritation from the edges of a cast. Which nursing intervention is appropriate? 1.Contact the primary health care provider. 2.Petal the cast edges with adhesive tape. 3.Massage the skin at the edges of the cast. 4.Place a small face cloth in the cast around the edges of the cast.

2.Petal the cast edges with adhesive tape.

The nurse is caring for a client with a diagnosis of osteoarthritis. Which actions would be least helpful for the client? 1.Gentle regular exercise 2.A warm bath or shower early in the day 3.Increasingly vigorous and high-impact exercise 4.An individualized program of pain medication administration

3.Increasingly vigorous and high-impact exercise

A client has Buck's extension traction applied to the right leg. The nurse should plan which intervention to prevent complications of the device? 1.Giving pin care once a shift 2.Massaging the skin of the right leg with lotion every 8 hours 3.Inspecting the skin on the right leg at least once every 8 hours 4.Releasing the weights on the right leg for range-of-motion exercises daily

3.Inspecting the skin on the right leg at least once every 8 hours

A client has a fiberglass (nonplaster) cast applied to the lower leg. The client asks the nurse when he will be able to walk on the cast. How should the nurse correctly respond to this question? 1.In 24 hours 2.In 48 hours 3.In approximately 8 hours 4.Within 20 to 30 minutes of application

4.Within 20 to 30 minutes of application

Cyclobenzaprine is prescribed for a client to treat muscle spasms, and the nurse is reviewing the client's record. Which disorder would indicate a need to contact the primary health care provider (PHCP) regarding the administration of this medication? 1.Glaucoma 2.Emphysema 3.Hyperthyroidism 4.Diabetes mellitus

1.Glaucoma

Which factors contribute to the problem of stress incontinence? Select all that apply. 1.Obesity 2.Sneezing 3.Nulliparity 4.Performing Kegel exercises 5.Voiding at frequent intervals

1.Obesity 2.Sneezing

The nurse is caring for a client who has been prescribed cold pack applications to the right lower extremity. The nurse plans to collect which data specifically associated with this therapy before the initiation of therapy? Select all that apply. 1.Pedal pulses 2.Capillary refill 3.Color of the extremity 4.Temperature of the skin 5.Condition of the toenails 6.Presence of numbness

1.Pedal pulses 2.Capillary refill 3.Color of the extremity 4.Temperature of the skin 6.Presence of numbness

The nurse is caring for a client who was just admitted with a diagnosis of fractured right femur. What are some of the acute complications the nurse needs to assess for? Select all that apply. 1.Crush syndrome 2.Ischemic necrosis 3.Fat embolism syndrome 4.Arterial thromboembolism 5.Acute compartment syndrome (ACS) 6.Hemorrhage and hypovolemic shock

1.Crush syndrome 3.Fat embolism syndrome 5.Acute compartment syndrome (ACS) 6.Hemorrhage and hypovolemic shock

Several laboratory tests are prescribed for a client, and the nurse reviews the results of the tests. Which laboratory test results should the nurse report? Select all that apply. 1.Platelets 35,000 mm3 (35 × 109/L) 2.Sodium 150 mEq/L (150 mmol/L) 3.Potassium 5.0 mEq/L (5.0 mmol/L) 4.Segmented neutrophils 40% (0.40) 5.Serum creatinine, 1 mg/dL (88.3 mcmol/L) 6.White blood cells, 3000 mm3 (3.0 × 109/L)

1.Platelets 35,000 mm3 (35 × 109/L) 2.Sodium 150 mEq/L (150 mmol/L) 4.Segmented neutrophils 40% (0.40) 6.White blood cells, 3000 mm3 (3.0 × 109/L)

The nurse is caring for a client with gout who is taking colchicine. The client has been instructed to restrict the diet to low-purine foods. Which food would the nurse instruct the client to avoid while taking this medication? 1.Spinach 2.Scallops 3.Potatoes 4.Ice cream

2.Scallops

A client has undergone fasciotomy to treat compartment syndrome of the leg. Which type of wound care should the nurse anticipate will be prescribed for the fasciotomy site? 1.Dry, sterile dressings 2.Hydrocolloid dressings 3.Moist, sterile saline dressings 4.Half-strength povidone-iodine dressings

3.Moist, sterile saline dressings

The nurse is caring for the client who has skeletal traction applied to the left leg. The client complains of severe left leg pain. The nurse checks the client's alignment in bed and notes that proper alignment is maintained. Which action should the nurse take next? 1.Provide pin care. 2.Medicate the client. 3.Notify the registered nurse. 4.Remove 2 pounds of weight from the traction.

3.Notify the registered nurse.

The client has been on treatment for rheumatoid arthritis for 3 weeks. Which is most important for the nurse to check during the administration of etanercept? 1.The injection site for itching and edema 2.The white blood cell counts and platelet counts 3.A metallic taste in the mouth and a loss of appetite 4.Whether the client is experiencing fatigue and joint pain

2.The white blood cell counts and platelet counts

The nurse in the primary health care provider's office is measuring vital signs on a postoperative client who underwent mastectomy of her right breast 2 weeks ago. The client tells the nurse that she is very concerned because she has numbness in the area of the surgery and along the inner side of the arm from the armpit to the elbow. Which statement is appropriate for the nurse to tell the client? 1."These sensations are signs of a complication." 2."These sensations probably will be permanent." 3."These sensations lessen over several months and usually are gone after 1 year." 4."It is nothing to worry about because women who have this type of surgery experience this problem."

3."These sensations lessen over several months and usually are gone after 1 year."

A client has been diagnosed with functional incontinence. Which interventions are most appropriate to care for this type of incontinence? Select all that apply. 1.Schedule toileting every 2 hours. 2.Modify clothing for easy removal. 3.Assess environment for obstacles. 4.Decrease fluid intake to 1500 mL/day. 5.Obtain prescription for catheterization to eliminate embarrassment. 6.Set up schedule of cues such as mealtimes, awakening, and bedtime.

1.Schedule toileting every 2 hours. 2.Modify clothing for easy removal. 3.Assess environment for obstacles. 6.Set up schedule of cues such as mealtimes, awakening, and bedtime.

A client is admitted to the hospital with complaints of back spasms. The client states, "I have been taking 2 or 3 aspirin every 4 hours for the past week, and it hasn't helped my back." Aspirin intoxication is suspected. Which complaint would indicate aspirin intoxication? 1.Tinnitus 2.Constipation 3.Photosensitivity 4.Abdominal cramps

1.Tinnitus

The nurse is evaluating goal achievement for a client in traction with impaired physical mobility. The nurse determines that the client has not successfully met all of the goals formulated if which outcome is noted? 1.Intact skin surfaces 2.Bowel movement every 5 days 3.Equal calf measurements bilaterally 4.Active range of motion (ROM) of uninvolved joints

2.Bowel movement every 5 days

The nurse caring for a male client with a diagnosis of gastrointestinal (GI) bleeding reviews the client's laboratory results and notes a hematocrit level of 30%. Which action should the nurse take? 1.Report the abnormally low level. 2.Report the abnormally high level. 3.Inform the client that the laboratory result is normal. 4.Place the normal report in the client's medical record.

1.Report the abnormally low level.

The client has been taking medication for rheumatoid arthritis for 3 weeks. During the administration of etanercept, it is most important for the nurse to collect which data? 1.The white blood cell and platelet counts 2.A metallic taste in the mouth, with a loss of appetite 3.Whether the client is experiencing fatigue and joint pain 4.Whether the client is experiencing itching and edema at the injection site

1.The white blood cell and platelet counts

Which intervention should be contraindicated in the postprocedure care of the client following a bone biopsy of the left arm? 1.Monitor vital signs every 4 hours. 2.Administer oral analgesics as needed. 3.Place the left arm in a dependent position for 24 hours. 4.Monitor the site for swelling, bleeding, and hematoma formation.

3.Place the left arm in a dependent position for 24 hours.

An older client with rheumatoid arthritis has been instructed by the primary health care provider to take acetaminophen 3000 mg to 4000 mg daily. Which laboratory test needs to be monitored on this client? 1.A lipoprotein panel 2.Liver function test (LFTs) 3.Kidney function tests (KFTs) 4.Complete blood count (CBC)

2.Liver function test (LFTs)

A client has been started on cyclobenzaprine for the management of muscle spasms in the cervical spine. The client is experiencing drowsiness, dizziness, and dry mouth. The nurse interprets these signs/symptoms as which response? 1.These are the common side effects of this medication. 2.These effects represent an allergic reaction to the medication. 3.These effects are related to the problem with the cervical spine. 4.These effects are dose-related; the client should cut the medication dose in half.

1.These are the common side effects of this medication.

A client is being given a transcutaneous electrical nerve stimulation (TENS) unit to use for relief of chronic pain. Which instructions should the nurse reinforce to the client about the TENS unit? Select all that apply. 1.Using this unit will help relieve the pain. 2.Hospitalization is required for this treatment. 3.The unit works after attaching electrodes to the skin. 4.The unit needs to be prescribed by the primary health care provider. 5.The unit will decrease the amount of pain medication needed. 6.The electrodes attached to the unit are placed on the skin around the area of pain.

1.Using this unit will help relieve the pain. 3.The unit works after attaching electrodes to the skin. 4.The unit needs to be prescribed by the primary health care provider. 5.The unit will decrease the amount of pain medication needed. 6.The electrodes attached to the unit are placed on the skin around the area of pain.

The nurse is reinforcing discharge instructions to a client receiving baclofen. Which should the nurse include in the instructions? 1.Restrict fluid intake. 2. Avoid the use of alcohol 3.Stop the medication if diarrhea occurs. 4.Notify the primary health care provider (PHCP) if fatigue occurs.

2. Avoid the use of alcohol

A client with multiple sclerosis is receiving diazepam, and the home care nurse reinforces instructions to the client regarding the side effects of the medication. The nurse tells the client that which is a side effect of this medication? 1.Insomnia 2.Incoordination 3.Inability to urinate 4.Increased salivation

2.Incoordination

A client has sustained a closed fracture and has just had a cast applied to the affected arm. The client is complaining of intense pain. The nurse has elevated the limb, applied an ice bag, and administered an analgesic, which was ineffective in relieving the pain. The nurse interprets that this pain may be caused by which condition? 1.Infection under the cast 2.The anxiety of the client 3.Impaired tissue perfusion 4.The newness of the fracture

3.Impaired tissue perfusion

The nurse witnesses a client sustain a fall and suspects that the client's leg may be fractured. Which action is the priority? 1.Take a set of vital signs. 2.Call the radiology department. 3.Immobilize the leg before moving the client. 4.Reassure the client that everything will be fine.

3.Immobilize the leg before moving the client.

A client with a left arm fracture exhibits loss of sensation in the left fingers, pallor, slow refill, and diminished left radial pulse. The licensed practical nurse (LPN) should take which action? 1.Administer an analgesic. 2.Notify the registered nurse. 3.Check the circulation again in 30 minutes. 4.Provide range-of-motion exercises to the fingers of the left hand.

2.Notify the registered nurse.

The nurse is preparing to give a bed bath to an immobilized client with tuberculosis (TB). The nurse should plan to wear which items when performing this care? 1.Surgical mask and gloves 2.Particulate respirator, gown, and gloves 3.Particulate respirator and protective eyewear 4.Surgical mask, gown, and protective eyewear

2.Particulate respirator, gown, and gloves

The nurse is reinforcing instructions to the client with a below-the-knee amputation (BKA) with regard to measures to protect the residual limb. The nurse would be sure to include which point in discussions with the client? 1.Put a clean nylon sock on the residual limb daily. 2.Use a mirror to inspect all areas of the residual limb. 3.Toughen the skin of the residual limb by rubbing it with alcohol. 4.Apply lotion daily to prevent cracking of the skin of the residual limb.

2.Use a mirror to inspect all areas of the residual limb.

A client receives a prescription for methocarbamol, and the nurse reinforces instructions to the client regarding the medication. Which client statement should indicate a need for further teaching? 1."My urine may turn brown or green." 2."This medication is prescribed to help relieve my muscle spasms." 3."If my vision becomes blurred, I don't need to be concerned about it." 4."I need to call my doctor if I experience nasal congestion from this medication."

3."If my vision becomes blurred, I don't need to be concerned about it."

A film-coated form of diflunisal has been prescribed for a client for the treatment of chronic rheumatoid arthritis. The client calls the clinic nurse because of difficulty swallowing the tablets. Which initial instruction should the nurse reinforce to the client? 1."Crush the tablets and mix them with food." 2."Open the tablet and mix the contents with food." 3."Swallow the tablets with large amounts of water or milk." 4."Notify the primary health care provider for a medication change."

3."Swallow the tablets with large amounts of water or milk."

A client is diagnosed with cancer and is told that surgery followed by chemotherapy will be necessary. The client states to the nurse, "I have read a lot about complementary therapies. Do you think I should try any?" The nurse should respond by making which appropriate statement? 1."I would try anything that I could if I had cancer." 2."No, because it will interact with the chemotherapy." 3."Tell me what you know about complementary therapies." 4."You need to ask your primary health care provider about it."

3."Tell me what you know about complementary therapies."

Baclofen is prescribed for a client with a spinal cord injury who is experiencing muscle spasms, and the nurse prepares a list of the associated side effects of the medication and reviews the list with the client. Which side effect identified by the client indicates a need for further teaching? 1.Tremors 2.Slurred speech 3.Nasal congestion 4.Photosensitivity

4.Photosensitivity

The nurse administers an injection to a client with a diagnosis of acquired immunodeficiency syndrome (AIDS). After administering the medication, the nurse should dispose of the used needle by which method? 1.Asking the client to recap the needle 2.Placing the needle and syringe in a puncture-resistant container 3.Recapping the needle before placing it in a puncture-resistant container 4.Laying the needle and syringe on the bedside table and carefully recapping the needle

2.Placing the needle and syringe in a puncture-resistant container

Colchicine is prescribed for a client with a diagnosis of gout. The nurse reviews the client's medical history in the health record, knowing that the medication would be contraindicated in which disorder? 1.Myxedema 2.Renal failure 3.Hypothyroidism 4 .Diabetes mellitus

2.Renal failure