Questions

A nurse is discharging a client after a total hip replacement. What statement by the client indicates good potential for self-management? Select one: a. "I can bend down to pick something up." b. "I no longer need to do my exercises." c. "I won't wash my incision to keep it dry." d. "I will not sit with my legs crossed."

"I will not sit with my legs crossed."

A client with fibromyalgia is in the hospital for an unrelated issue. The client reports that sleep, which is always difficult, is even harder now. What actions by the nurse are most appropriate? (Select all that apply.) Select one or more: a. Allow the client uninterrupted rest time. b. Request an order for a strong sleeping pill. c. Assess the client's usual bedtime routine. d. Limit environmental noise as much as possible. e. Offer a massage or warm shower at night.

A.allow the client uninterrupted rest time C.assess the clients usual bedtime routine D. Limit environmental noise as much as possible E.offer massage or warm shower at night

A client who has had systemic lupus erythematosus (SLE) for many years is in the clinic reporting hip pain with ambulation. Which action by the nurse is best? Select one: a. Measure the range of motion in both hips. b. Notify the health care provider immediately. c. Assess medication records for steroid use. d. Facilitate a consultation with physical therapy.

C. assess med record for steriod use

A client has a leg wound that is in the second stage of the inflammatory response. For what manifestation does the nurse assess? Select one: a. Swelling and pain b. Warmth at the site c. Purulent drainage d. Noticeable rubor

C. purulent drainge

A client has an ingrown toenail. About what self-management measure does the nurse teach the client? Select one: a. Long-term antibiotic use b. Warm moist soaks c. Toenail trimming d. Shoe padding

b. Warm moist soaks

A nurse cares for a client recovering from an above-the-knee amputation of the right leg. The client reports pain in the right foot. Which prescribed medication should the nurse administer first? Select one: a. Intravenous morphine b. Oral ibuprofen c. Intravenous calcitonin d. Oral acetaminophen

c. Intravenous calcitonin

A client has fibromyalgia and is prescribed duloxetine hydrochloride (Cymbalta). The client calls the clinic and asks the nurse why an antidepressant drug has been prescribed. What response by the nurse is best? Select one: a. "Depression often accompanies fibromyalgia." b. "You will have more energy after taking this drug." c. "A little sedation will help you get some rest." d. "This drug works in the brain to decrease pain."

D. this drug works in the brain to decrease pain

A client is taking prednisone to prevent transplant rejection. What instruction by the nurse is most important? Select one: a. "Avoid large crowds and people who are ill." b. "You have a higher risk of developing cancer." c. "Take this medicine exactly as prescribed." d. "Check over-the-counter meds for acetaminophen."

a. "Avoid large crowds and people who are ill."

The clinic nurse assesses a client with diabetes during a checkup. The client also has osteoarthritis (OA). The nurse notes the client's blood glucose readings have been elevated. What question by the nurse is most appropriate? Select one: a. "Have you been taking glucosamine supplements?" b. "How much exercise do you really get each week?" c. "Are you compliant with following the diabetic diet?" d. "You're still taking your diabetic medication, right?"

a. "Have you been taking glucosamine supplements?"

A client has newly diagnosed systemic lupus erythematosus (SLE). What instruction by the nurse is most important? Select one: a. "Notify your provider at once if you get a fever." b. "Be sure you get enough sleep at night." c. "Weigh yourself every day on the same scale." d. "Eat plenty of high-protein, high-iron foods."

a. "Notify your provider at once if you get a fever."

A nurse cares for an older adult client who is recovering from a leg amputation surgery. The client states, "I don't want to live with only one leg. I should have died during the surgery." How should the nurse respond? Select one: a. "This is a big change for you. What support system do you have to help you cope?" b. "Your vital signs are good, and you are doing just fine right now." c. "Your children are waiting outside. Do you want them to grow up without a father?" d. "You will be able to do some of the same things as before you became disabled."

a. "This is a big change for you. What support system do you have to help you cope?"

What action by the perioperative nursing staff is most important to prevent surgical wound infection in a client having a total joint replacement? Select one: a. Administer preoperative antibiotic as ordered. b. Monitor the client's temperature postoperatively. c. Instruct the client to shower the night before. d. Assess the client's white blood cell count.

a. Administer preoperative antibiotic as ordered.

The nursing student studying rheumatoid arthritis (RA) learns which facts about the disease? (Select all that apply.) Select one or more: a. Antibodies lead to inflammation. b. Permanent damage is inevitable. c. It affects single joints only. d. Morning stiffness is rare. e. It consists of an autoimmune process.

a. Antibodies lead to inflammation. e. It consists of an autoimmune process.

For a person to be immunocompetent, which processes need to be functional and interact appropriately with each other? (Select all that apply.) Select one or more: a. Antibody-mediated immunity b. Cell-mediated immunity c. White blood cells d. Red blood cells e. Inflammation

a. Antibody-mediated immunity b. Cell-mediated immunity e. Inflammation

A client with Paget's disease is hospitalized for an unrelated issue. The client reports pain and it is not yet time for more medication. What comfort measures can the nurse delegate to the unlicensed assistive personnel (UAP)? (Select all that apply.) Select one or more: a. Applying a heating pad b. Providing a massage c. Referring the client to a support group d. Administering ibuprofen (Motrin) e. Using a bed cradle to lift sheets off the feet

a. Applying a heating pad b. Providing a massage

A client is distressed at body changes related to kyphosis. What response by the nurse is best? Select one: a. Ask the client to explain more about these feelings. b. Offer to help select clothes to hide the deformity. c. Explain that these changes are irreversible. d. Tell the client safety is more important than looks.

a. Ask the client to explain more about these feelings.

A client in the orthopedic clinic has a self-reported history of osteoarthritis. The client reports a low-grade fever that started when the weather changed and several joints started "acting up," especially both hips and knees. What action by the nurse is best? Select one: a. Assess the client for the presence of subcutaneous nodules or Baker's cysts. b. Reassure the client that the problems will fade as the weather changes again. c. Inspect the client's feet and hands for podagra and tophi on fingers and toes. d. Prepare to teach the client about an acetaminophen (Tylenol) regimen.

a. Assess the client for the presence of subcutaneous nodules or Baker's cysts.

A client with bone cancer is hospitalized for a limb salvage procedure. How can the nurse best address the client's psychosocial needs? Select one: a. Assess the client's coping skills and support systems. b. Explain that the surgery leads to a longer life expectancy. c. Refer the client to the social worker or hospital chaplain. d. Reinforce physical therapy to aid with ambulating normally.

a. Assess the client's coping skills and support systems.

A home health care nurse is visiting a client discharged home after a hip replacement. The client is still on partial weight bearing and using a walker. What safety precautions can the nurse recommend to the client? (Select all that apply.) Select one or more: a. Buy and install an elevated toilet seat. b. Install grab bars in the shower and by the toilet. c. Step into the bathtub with the affected leg first. d. Remove all throw rugs throughout the house. e. Use a shower chair while taking a shower.

a. Buy and install an elevated toilet seat. b. Install grab bars in the shower and by the toilet. d. Remove all throw rugs throughout the house. e. Use a shower chair while taking a shower.

A nurse works in the rheumatology clinic and sees clients with rheumatoid arthritis (RA). Which client should the nurse see first? Select one: a. Client with a red, hot, swollen right wrist b. Client who reports jaw pain when eating c. Client who has a puffy-looking area behind the knee d. Client with a worse joint deformity since the last visit

a. Client with a red, hot, swollen right wrist

A client is admitted with a bone tumor. The nurse finds the client weak and lethargic with decreased deep tendon reflexes. What actions by the nurse are best? (Select all that apply.) Select one or more: a. Consult the provider about a loop diuretic. b. Institute seizure precautions for the client. c. Place the client on a 1500-mL fluid restriction. d. Assess the daily serum calcium level. e. Instruct the client to call for help out of bed.

a. Consult the provider about a loop diuretic. d. Assess the daily serum calcium level. e. Instruct the client to call for help out of bed.

A nurse is caring for a client with systemic sclerosis. The client's facial skin is very taut, limiting the client's ability to open the mouth. After consulting with a registered dietitian for appropriate nutrition, what other consultation should the nurse facilitate? Select one: a. Dentist b. Physical therapy c. Massage therapist d. Occupational therapy

a. Dentist

When assessing gait, what features does the nurse inspect? (Select all that apply.) Select one or more: a. Ease of stride b. Steadiness c. Goniometer readings d. Balance e. Length of stride

a. Ease of stride b. Steadiness d. Balance e. Length of stride

A client with chronic osteomyelitis is being discharged from the hospital. What information is important for the nurse to teach this client and family? (Select all that apply.) Select one or more: a. Eating high-protein and high-carbohydrate foods b. Keeping daily follow-up appointments c. Proper use of the intravenous equipment d. Adherence to the antibiotic regimen e. Correct intramuscular injection technique

a. Eating high-protein and high-carbohydrate foods c. Proper use of the intravenous equipment d. Adherence to the antibiotic regimen

A client is suspected to have muscular dystrophy. About what diagnostic testing does the nurse educate the client? (Select all that apply.) Select one or more: a. Electromyography b. Serum aldolase c. Muscle biopsy d. Serum creatinine kinase e. Nerve conduction studies

a. Electromyography b. Serum aldolase c. Muscle biopsy d. Serum creatinine kinase

A nurse plans care for a client who is recovering from a below-the-knee amputation of the left leg. Which intervention should the nurse include in this client's plan of care? Select one: a. Encourage range-of-motion exercises. b. Administer prophylactic antibiotics. c. Place pillows between the client's knees. d. Implement strict bedrest in a supine position.

a. Encourage range-of-motion exercises.

A client is scheduled to have a hip replacement. Preoperatively, the client is found to be mildly anemic and the surgeon states the client may need a blood transfusion during or after the surgery. What action by the preoperative nurse is most important? Select one: a. Ensure that a consent for transfusion is on the chart. b. Explain to the client how anemia affects healing. c. Teach the client about foods high in protein and iron. d. Administer preoperative medications as prescribed.

a. Ensure that a consent for transfusion is on the chart.

The nurse working in the rheumatology clinic assesses clients with rheumatoid arthritis (RA) for late manifestations. Which signs/symptoms are considered late manifestations of RA? (Select all that apply.) Select one or more: a. Felty's syndrome b. Anorexia c. Weight loss d. Joint deformity e. Low-grade fever

a. Felty's syndrome c. Weight loss d. Joint deformity

Which are steps in the process of making an antigen-specific antibody? (Select all that apply.) Select one or more: a. Recognition b. Opsonization c. Antibody-antigen binding d. Invasion e. Sensitization

a. Recognition c. Antibody-antigen binding d. Invasion e. Sensitization

A nurse notes crepitation when performing range-of-motion exercises on a client with a fractured left humerus. Which action should the nurse take next? Select one: a. Immobilize the left arm. b. Administer prescribed steroids. c. Monitor for signs of infection. d. Assess the client's distal pulse.

a. Immobilize the left arm.

A nurse teaches a client with a fractured tibia about external fixation. Which advantages of external fixation for the immobilization of fractures should the nurse share with the client? (Select all that apply.) Select one or more: a. It promotes healing. b. It increases blood supply to tissues. c. It leads to minimal blood loss. d. It decreases the risk of infection. e. It allows for early ambulation.

a. It promotes healing. e. It allows for early ambulation.

A student nurse is learning about the types of different cells involved in the inflammatory response. Which principles does the student learn? (Select all that apply.) Select one or more: a. Macrophages can participate in many episodes of phagocytosis. b. Neutrophils can only take part in one episode of phagocytosis. c. Monocytes turn into macrophages after they enter body tissues. d. Eosinophils increase during allergic reactions and parasitic invasion. e. Basophils are only involved in the general inflammatory process.

a. Macrophages can participate in many episodes of phagocytosis. b. Neutrophils can only take part in one episode of phagocytosis. c. Monocytes turn into macrophages after they enter body tissues. d. Eosinophils increase during allergic reactions and parasitic invasion.

A nurse is discharging a client to a short-term rehabilitation center after a joint replacement. Which action by the nurse is most important? Select one: a. Providing a verbal hand-off report to the facility b. Ensuring the family has directions to the facility c. Answering any last-minute questions by the client d. Administering pain medication before transport

a. Providing a verbal hand-off report to the facility

A home health nurse assesses a client with diabetes who has a new cast on the arm. The nurse notes the client's fingers are pale, cool, and slightly swollen. Which action should the nurse take first? Select one: a. Raise the arm above the level of the heart. b. Apply heat to the affected hand. c. Encourage range of motion. d. Bivalve the cast to decrease pressure.

a. Raise the arm above the level of the heart.

A nurse plans care for a client who is prescribed skeletal traction. Which intervention should the nurse include in this plan of care to decrease the client's risk for infection? Select one: a. Schedule for pin care to be provided every shift. b. Do not place the traction weights on the floor. c. Release traction tension for 30 minutes twice a day. d. Wash the traction lines and sockets once a day.

a. Schedule for pin care to be provided every shift.

An emergency nurse assesses a client who is admitted with a pelvic fracture. Which assessments should the nurse monitor to prevent a complication of this injury? (Select all that apply.) Select one or more: a. Skin color b. Urinary output c. Temperature d. Pupil reaction e. Blood pressure

a. Skin color b. Urinary output e. Blood pressure

A nurse is providing education to a community women's group about lifestyle changes helpful in preventing osteoporosis. What topics does the nurse cover? (Select all that apply.) Select one or more: a. Strengthening exercises are important. b. Limit alcohol to two drinks a day. c. Cut down on tobacco product use. d. Walk 30 minutes at least 3 times a week. e. Take recommended calcium and vitamin D.

a. Strengthening exercises are important. d. Walk 30 minutes at least 3 times a week. e. Take recommended calcium and vitamin D.

An older client has returned to the surgical unit after a total hip replacement. The client is confused and restless. What intervention by the nurse is most important to prevent injury? Select one: a. Use an abduction pillow. b. Administer mild sedation. c. Keep all four siderails up. d. Restrain the client's hands.

a. Use an abduction pillow.

The nurse is working with clients who have connective tissue diseases. Which disorders are correctly paired with their manifestations? (Select all that apply.) Select one or more: a. Vasculitis causing organ damage - Rheumatoid arthritis b. Esophageal dysmotility - Systemic sclerosis c. Excess uric acid excretion - Gout d. Dry, scaly skin rash - Systemic lupus erythematosus (SLE) e. Footdrop and paresthesias - Osteoarthritis

a. Vasculitis causing organ damage - Rheumatoid arthritis b. Esophageal dysmotility - Systemic sclerosis d. Dry, scaly skin rash - Systemic lupus erythematosus (SLE)

What information does the nurse teach a women's group about osteoporosis? Select one: a. "Men actually have higher rates of the disease but are underdiagnosed." b. "For 5 years after menopause you lose 2% of bone mass yearly." c. "Women and men have an equal chance of getting osteoporosis." d. "There is no way to prevent or slow osteoporosis after menopause."

b. "For 5 years after menopause you lose 2% of bone mass yearly."

A nurse is caring for a client who is recovering from an above-the-knee amputation. The client reports pain in the limb that was removed. How should the nurse respond? Select one: a. "This type of pain is common and will eventually go away." b. "How would you describe the pain that you are feeling?" c. "Would you like to learn how to use imagery to minimize your pain?" d. "The pain you are feeling does not actually exist."

b. "How would you describe the pain that you are feeling?"

After teaching a client who is recovering from a vertebroplasty, the nurse assesses the client's understanding. Which statement by the client indicates a need for additional teaching? Select one: a. "I will monitor the puncture site for signs of infection." b. "I can drive myself home after the procedure." c. "I will remove the dressing the day after discharge." d. "I can start walking tomorrow and increase my activity slowly."

b. "I can drive myself home after the procedure."

A client receiving muromonab-CD3 (Orthoclone OKT3) asks the nurse how the drug works. What response by the nurse is best? Select one: a. "It inhibits cytokine production in most lymphocytes." b. "It increases the elimination of T lymphocytes from circulation." c. "It prevents DNA synthesis, stopping cell division in activated lymphocytes." d. "It prevents the activation of the lymphocytes responsible for rejection."

b. "It increases the elimination of T lymphocytes from circulation."

A client has rheumatoid arthritis that especially affects the hands. The client wants to finish quilting a baby blanket before the birth of her grandchild. What response by the nurse is best? Select one: a. "Let's ask the provider about increasing your pain pills." b. "Try a paraffin wax dip 20 minutes before you quilt." c. "You need to stop quilting before it destroys your fingers." d. "Hold ice bags against your hands before quilting."

b. "Try a paraffin wax dip 20 minutes before you quilt."

A client had a bunionectomy with osteotomy. The client asks why healing may take up to 3 months. What explanation by the nurse is best? Select one: a. "Your feet bear weight so they never really heal." b. "Your feet have less blood flow, so healing is slower." c. "The surrounding bones and tissue are damaged." d. "The bones in your feet are hard to operate on."

b. "Your feet have less blood flow, so healing is slower."

A nurse in the family clinic is teaching a client newly diagnosed with osteoarthritis (OA) about drugs used to treat the disease. For which medication does the nurse plan primary teaching? Select one: a. Cyclobenzaprine hydrochloride (Flexeril) b. Acetaminophen (Tylenol) c. Hyaluronate (Hyalgan) d. Ibuprofen (Motrin)

b. Acetaminophen (Tylenol)

A client with osteoporosis is going home, where the client lives alone. What action by the nurse is best? Select one: a. Refer the client to Meals on Wheels. b. Arrange a home safety evaluation. c. Ensure the client has a walker at home. d. Help the client look into assisted living.

b. Arrange a home safety evaluation.

The nurse on the postoperative inpatient unit assesses a client after a total hip replacement. The client's surgical leg is visibly shorter than the other one and the client reports extreme pain. While a co-worker calls the surgeon, what action by the nurse is best? Select one: a. Try to place the affected leg in abduction. b. Assess neurovascular status in both legs. c. Elevate the affected leg and apply ice. d. Prepare to administer pain medication.

b. Assess neurovascular status in both legs.

A nurse delegates care of a client in traction to an unlicensed assistive personnel (UAP). Which statement should the nurse include when delegating hygiene care for this client? Select one: a. "Provide pin care by using alcohol wipes to clean the sites." b. "Inspect the client's skin when performing a bed bath." c. "Ensure that the weights remain freely hanging at all times." d. "Remove the traction when re-positioning the client."

c. "Ensure that the weights remain freely hanging at all times."

A client has been diagnosed with rheumatoid arthritis. The client has experienced increased fatigue and worsening physical status and is finding it difficult to maintain the role of elder in his cultural community. The elder is expected to attend social events and make community decisions. Stress seems to exacerbate the condition. What action by the nurse is best? Select one: a. Suggest the client give up the role of elder. b. Assess the client's culture more thoroughly. c. Discuss options for performing duties. d. See if the client will call a community meeting.

b. Assess the client's culture more thoroughly.

The nurse is working with a client who has rheumatoid arthritis (RA). The nurse has identified the priority problem of poor body image for the client. What finding by the nurse indicates goals for this client problem are being met? Select one: a. Has a positive outlook on life b. Attends meetings of a book club c. Takes medication as directed d. Uses assistive devices to protect joints

b. Attends meetings of a book club

A school nurse is conducting scoliosis screening. In screening the client, what technique is most appropriate? Select one: a. Sitting upright with arms outstretched b. Bending forward from the hips c. Walking across the room and back d. Walking with both eyes closed

b. Bending forward from the hips

The nurse sees several clients with osteoporosis. For which client would bisphosphonates not be a good option? Select one: a. Client who recently fell and has vertebral compression fractures b. Client with a spinal cord injury who cannot tolerate sitting up c. Hypertensive client who takes calcium channel blockers d. Client with diabetes who has a serum creatinine of 0.8 mg/dL

b. Client with a spinal cord injury who cannot tolerate sitting up

A client takes celecoxib (Celebrex) for chronic osteoarthritis in multiple joints. After a knee replacement, the health care provider has prescribed morphine sulfate for postoperative pain relief. The client also requests the celecoxib in addition to the morphine. What action by the nurse is best? Select one: a. Teach the client that, since morphine is stronger, celecoxib is not needed. b. Consult with the health care provider about administering both drugs to the client. c. Tell the client he or she should not take both drugs at the same time. d. Inform the client that the celecoxib will be started when he or she goes home.

b. Consult with the health care provider about administering both drugs to the client.

The nurse on an inpatient rheumatology unit receives a hand-off report on a client with an acute exacerbation of systemic lupus erythematosus (SLE). Which reported laboratory value requires the nurse to assess the client further? Select one: a. White blood cell count: 4400/mm3 b. Creatinine: 3.9 mg/dL c. Platelet count: 210,000/mm3 d. Red blood cell count: 5.2/mm3

b. Creatinine: 3.9 mg/dL

A client is having a myelography. What action by the nurse is most important? Select one: a. Position the client flat after the procedure. b. Ensure that informed consent is on the chart. c. Reinforce the dressing if it becomes saturated. d. Assess serum aspartate aminotransferase (AST) levels.

b. Ensure that informed consent is on the chart.

A nursing student studying the musculoskeletal system learns about important related hormones. What information does the student learn? (Select all that apply.) Select one or more: a. Thyroxine stimulates estrogen release. b. Estrogens stimulate osteoblastic activity. c. Calcitonin increases serum calcium levels. d. Parathyroid hormone stimulates osteoclastic activity. e. A lack of vitamin D can lead to rickets.

b. Estrogens stimulate osteoblastic activity. e. A lack of vitamin D can lead to rickets.

A nurse works with several clients who have gout. Which types of gout and their drug treatments are correctly matched? (Select all that apply.) Select one or more: a. Allopurinol (Zyloprim) - Acute gout b. Febuxostat (Uloric) - Chronic gout c. Colchicine (Colcrys) - Acute gout d. Indomethacin (Indocin) - Acute gout e. Probenecid (Benemid) - Chronic gout

b. Febuxostat (Uloric) - Chronic gout c. Colchicine (Colcrys) - Acute gout d. Indomethacin (Indocin) - Acute gout e. Probenecid (Benemid) - Chronic gout

A client with systemic lupus erythematosus (SLE) was recently discharged from the hospital after an acute exacerbation. The client is in the clinic for a follow-up visit and is distraught about the possibility of another hospitalization disrupting the family. What action by the nurse is best? Select one: a. Offer to talk to the family and educate them about SLE. b. Help the client create backup plans to minimize disruption. c. Explain to the client that SLE is an unpredictable disease. d. Tell the client to remain compliant with treatment plans.

b. Help the client create backup plans to minimize disruption.

The student nurse is learning about the functions of different antibodies. Which principles does the student learn? (Select all that apply.) Select one or more: a. IgD is present in the highest concentrations in mucous membranes. b. IgA is found in high concentrations in secretions from mucous membranes. c. IgE is associated with antibody-mediated hypersensitivity reactions. d. IgG comprises the majority of the circulating antibody population. e. IgM is the first antibody formed by a newly sensitized B cell.

b. IgA is found in high concentrations in secretions from mucous membranes. c. IgE is associated with antibody-mediated hypersensitivity reactions. d. IgG comprises the majority of the circulating antibody population. e. IgM is the first antibody formed by a newly sensitized B cell.

A client comes to the family medicine clinic and reports joint pain and stiffness. The nurse is asked to assess the client for Heberden's nodules. What assessment technique is correct? Select one: a. Palpate the client's abdomen for tenderness. b. Inspect the client's distal finger joints. c. Palpate the client's upper body lymph nodes. d. Perform range of motion on the client's wrists.

b. Inspect the client's distal finger joints.

The nurse understands that which type of immunity is the longest acting? Select one: a. Artificial active b. Natural active c. Natural passive d. Inflammatory

b. Natural active

After a total knee replacement, a client is on the postoperative nursing unit with a continuous femoral nerve blockade. On assessment, the nurse notes the client's pulses are 2+/4+ bilaterally; the skin is pale pink, warm, and dry; and the client is unable to dorsiflex or plantarflex the affected foot. What action does the nurse perform next? Select one: a. Document the findings and monitor as prescribed. b. Notify the surgeon or anesthesia provider immediately. c. Increase the frequency of monitoring the client. d. Palpate the client's bladder or perform a bladder scan.

b. Notify the surgeon or anesthesia provider immediately.

A nurse cares for a client with a fractured fibula. Which assessment should alert the nurse to take immediate action? Select one: a. Feeling cold while lying in bed b. Numbness in the extremity c. Swollen extremity at the injury site d. Pain of 4 on a scale of 0 to 10

b. Numbness in the extremity

A client is admitted with a large draining wound on the leg. What action does the nurse take first? Select one: a. Give pain medications if needed. b. Obtain cultures of the leg wound. c. Insert an intravenous line. d. Administer ordered antibiotics.

b. Obtain cultures of the leg wound.

A client has a bone density score of -2.8. What action by the nurse is best? Select one: a. Scheduling another scan in 6 months b. Planning to teach about bisphosphonates c. Asking the client to complete a food diary d. Scheduling another scan in 2 years

b. Planning to teach about bisphosphonates

A nurse is caring for four clients. After the hand-off report, which client does the nurse see first? Select one: a. Client with suspected bone tumor who just returned from having a spinal CT b. Post-microvascular bone transfer client whose distal leg is cool and pale c. Client with osteoporosis and a bone fracture who requests pain medication d. Client with osteoporosis and a white blood cell count of 27,000/mm3

b. Post-microvascular bone transfer client whose distal leg is cool and pale

The student nurse learns that the most important function of inflammation and immunity is which purpose? Select one: a. Preventing any entry of foreign material b. Providing protection against invading organisms c. Regulating the process of self-tolerance d. Destroying bacteria before damage occurs

b. Providing protection against invading organisms

The client's chart indicates genu varum. What does the nurse understand this to mean? Select one: a. Fluid accumulation b. Knock-kneed c. Bow-legged d. Spinal curvature

c. Bow-legged

A nurse is assessing a client for acute rejection of a kidney transplant. What assessment finding requires the most rapid communication with the provider? Select one: a. Blood urea nitrogen (BUN) of 18 mg/dL b. Urine output of 340 mL/8 hr c. Creatinine of 3.9 mg/dL d. Cloudy, foul-smelling urine

c. Creatinine of 3.9 mg/dL

The nurse is caring for a client with systemic sclerosis (SSc). What comfort measures can the nurse delegate to the unlicensed assistive personnel (UAP)? (Select all that apply.) Select one or more: a. Inspect the skin and note any areas of ulceration. b. Remind the client to elevate the head of the bed after eating. c. Keep the room at a comfortably warm temperature. d. Collaborate with a registered dietitian for appropriate foods. e. Place a foot cradle at the end of the bed to lift sheets.

b. Remind the client to elevate the head of the bed after eating. c. Keep the room at a comfortably warm temperature. e. Place a foot cradle at the end of the bed to lift sheets.

An emergency department nurse triages a client with diabetes mellitus who has fractured her arm. Which action should the nurse take first? Select one: a. Immobilize the arm by splinting the fractured site. b. Remove the medical alert bracelet from the fractured arm. c. Cover any open areas with a sterile dressing. d. Place the client in a supine position with a warm blanket.

b. Remove the medical alert bracelet from the fractured arm.

After teaching a client with a fractured humerus, the nurse assesses the client's understanding. Which dietary choice demonstrates that the client correctly understands the nutrition needed to assist in healing the fracture? Select one: a. Baked fish with orange juice and a vitamin D supplement b. Roast beef with low-fat milk and a vitamin C supplement c. Bacon, lettuce, and tomato sandwich with a vitamin B supplement d. Vegetable lasagna with a green salad and a vitamin A supplement

b. Roast beef with low-fat milk and a vitamin C supplement

The nurse is assessing four clients with musculoskeletal disorders. The nurse should assess the client with which laboratory result first? Select one: a. Serum aspartate aminotransferase (AST): 26 units/L b. Serum phosphorus: 2 mg/dL c. Serum alkaline phosphatase (ALP): 108 units/L d. Serum calcium: 10.2 mg/dL

b. Serum phosphorus: 2 mg/dL

The nurse working in the orthopedic clinic knows that a client with which factor has an absolute contraindication for having a total joint replacement? Select one: a. Urinary tract infection b. Severe osteoporosis c. Needs multiple dental fillings d. Over age 85

b. Severe osteoporosis

A hospitalized client's strength of the upper extremities is rated at 3. What does the nurse understand about this client's ability to perform activities of daily living (ADLs)? Select one: a. The client is unable to perform ADLs alone. b. The client is able to perform ADLs but not lift some items. c. No difficulties are expected with ADLs. d. The client would need near-total assistance with ADLs.

b. The client is able to perform ADLs but not lift some items.

The nurse working in the rheumatology clinic is seeing clients with rheumatoid arthritis (RA). What assessment would be most important for the client whose chart contains the diagnosis of Sjögren's syndrome? Select one: a. Renal function studies b. Visual acuity c. Oxygen saturation d. Abdominal assessment

b. Visual acuity

A nurse is teaching a client with psoriatic arthritis about the medication golimumab (Simponi). What information is most important to include? Select one: a. "Stay upright for 1 hour after taking this drug." b. "You may double the dose if pain is severe." c. "Avoid large crowds or people who are ill." d. "This drug may cause your hair to fall out."

c. "Avoid large crowds or people who are ill."

A nurse cares for a client placed in skeletal traction. The client asks, "What is the primary purpose of this type of traction?" How should the nurse respond? Select one: a. "This treatment will prevent future complications and back pain." b. "This type of traction minimizes damage as a result of fracture treatment." c. "Skeletal traction will assist in realigning your fractured bone." d. "Traction decreases muscle spasms that occur with a fracture."

c. "Skeletal traction will assist in realigning your fractured bone."

A nurse teaches a client about prosthesis care after amputation. Which statements should the nurse include in this client's teaching? (Select all that apply.) Select one or more: a. "A prosthetist will clean your inserts for you each month." b. "Your prosthetic is good for work but not for exercising." c. "The device has been custom made specifically for you." d. "Make sure that you wear the correct liners with your prosthetic." e. "I have scheduled a follow-up appointment for you."

c. "The device has been custom made specifically for you." d. "Make sure that you wear the correct liners with your prosthetic." e. "I have scheduled a follow-up appointment for you."

A nurse coordinates care for a client with a wet plaster cast. Which statement should the nurse include when delegating care for this client to an unlicensed assistive personnel (UAP)? Select one: a. "Turn the client every 3 to 4 hours to promote cast drying." b. "Assess distal pulses for potential compartment syndrome." c. "Use a cloth-covered pillow to elevate the client's leg." d. "Handle the cast with your fingertips to prevent indentations."

c. "Use a cloth-covered pillow to elevate the client's leg."

A trauma nurse cares for several clients with fractures. Which client should the nurse identify as at highest risk for developing deep vein thrombosis? Select one: a. A 36-year old female with type 2 diabetes and fractured ribs b. A 55-year-old woman prescribed aspirin for rheumatoid arthritis c. A 74-year-old man who smokes and has a fractured pelvis d. An 18-year-old male athlete with a fractured clavicle

c. A 74-year-old man who smokes and has a fractured pelvis

A nurse cares for a client who had a long-leg cast applied last week. The client states, "I cannot seem to catch my breath and I feel a bit light-headed." Which action should the nurse take next? Select one: a. Ask the client to take deep breaths. b. Auscultate the client's lung fields anteriorly and posteriorly. c. Administer oxygen to keep saturations greater than 92%. d. Check the client's blood glucose level.

c. Administer oxygen to keep saturations greater than 92%.

A nurse assesses an older adult client who was admitted 2 days ago with a fractured hip. The nurse notes that the client is confused and restless. The client's vital signs are heart rate 98 beats/min, respiratory rate 32 breaths/min, blood pressure 132/78 mm Hg, and SpO2 88%. Which action should the nurse take first? Select one: a. Re-position to a high-Fowler's position. b. Assess response to pain medications. c. Administer oxygen via nasal cannula. d. Increase the intravenous flow rate.

c. Administer oxygen via nasal cannula.

A client has been advised to perform weight-bearing exercises to help minimize osteoporosis. The client admits to not doing the prescribed exercises. What action by the nurse is best? Select one: a. Suggest other exercises the client can do. b. Instruct the client to increase calcium. c. Ask the client about fear of falling. d. Tell the client to try weight lifting.

c. Ask the client about fear of falling.

A client is in the internal medicine clinic reporting bone pain. The client's alkaline phosphatase level is 180 units/L. What action by the nurse is most appropriate? Select one: a. Teach the client about ibuprofen (Motrin). b. Facilitate an oncology workup. c. Assess the client for leg bowing. d. Instruct the client on fluid restrictions.

c. Assess the client for leg bowing.

A client had an arthroscopy 1 hour ago on the left knee. The nurse finds the left lower leg to be pale and cool, with 1+/4+ pedal pulses. What action by the nurse is best? Select one: a. Notify the provider of the findings immediately. b. Document the findings in the client's chart. c. Assess the neurovascular status of the right leg. d. Elevate the left leg on at least two pillows.

c. Assess the neurovascular status of the right leg.

A clinic nurse is working with an older client. What assessment is most important for preventing infections in this client? Select one: a. Teaching hand hygiene to prevent the spread of microbes b. Instructing the client to wash minor wounds carefully c. Assessing vaccination records for booster shot needs d. Encouraging the client to eat a nutritious diet

c. Assessing vaccination records for booster shot needs

A nurse assesses a client with a cast for potential compartment syndrome. Which clinical manifestations are correctly paired with the physiologic changes of compartment syndrome? (Select all that apply.) Select one or more: a. Tingling - A release of histamine b. Pallor - Increased blood blow to the area c. Cyanosis - Anaerobic metabolism d. Edema - Increased capillary permeability e. Unequal pulses - Increased production of lactic acid

c. Cyanosis - Anaerobic metabolism d. Edema - Increased capillary permeability e. Unequal pulses - Increased production of lactic acid

A nurse plans care for a client who is recovering from open reduction and internal fixation (ORIF) surgery for a right hip fracture. Which interventions should the nurse include in this client's plan of care? (Select all that apply.) Select one or more: a. Push the client's patient-controlled analgesia button. b. Use pillows to encourage subluxation of the hip. c. Elevate heels off the bed with a pillow. d. Re-position the client every 2 hours. e. Ambulate the client on the first postoperative day.

c. Elevate heels off the bed with a pillow. d. Re-position the client every 2 hours. e. Ambulate the client on the first postoperative day.

A client is scheduled for a bone biopsy. What action by the nurse takes priority? Select one: a. Administering the preoperative medications b. Answering any questions about the procedure c. Ensuring that informed consent is on the chart d. Showing the client's family where to wait

c. Ensuring that informed consent is on the chart

A client is started on etanercept (Enbrel). What teaching by the nurse is most appropriate? Select one: a. Using heat on the injection site b. Taking the medication with food c. Giving subcutaneous injections d. Having a chest x-ray once a year

c. Giving subcutaneous injections

A nurse is providing community education about preventing traumatic musculoskeletal injuries related to car crashes. Which group does the nurse target as the priority for this education? Select one: a. Older adult women b. Middle-aged men c. High school football team d. High school homeroom class

c. High school football team

A client with rheumatoid arthritis (RA) has an acutely swollen, red, and painful joint. What nonpharmacologic treatment does the nurse apply? Select one: a. Wax dip b. Splints c. Ice packs d. Heating pad

c. Ice packs

A nurse is working with a community group promoting healthy aging. What recommendation is best to help prevent osteoarthritis (OA)? Select one: a. Get plenty of calcium. b. Engage in weight-bearing exercise. c. Lose weight if needed. d. Avoid contact sports.

c. Lose weight if needed.

A nurse reviews prescriptions for an 82-year-old client with a fractured left hip. Which prescription should alert the nurse to contact the provider and express concerns for client safety? Select one: a. Patient-controlled analgesia (PCA) with morphine sulfate b. Ibuprofen elixir every 8 hours for first 2 days c. Meperidine (Demerol) 50 mg IV every 4 hours d. Percocet 2 tablets orally every 6 hours PRN for pain

c. Meperidine (Demerol) 50 mg IV every 4 hours

An older client's serum calcium level is 8.7 mg/dL. What possible etiologies does the nurse consider for this result? (Select all that apply.) Select one or more: a. Good dietary intake of calcium and vitamin D b. Potential for metastatic cancer or Paget's disease c. Normal age-related decrease in serum calcium d. Possible occurrence of osteoporosis or osteomalacia e. Recent bone fracture in a healing stage

c. Normal age-related decrease in serum calcium d. Possible occurrence of osteoporosis or osteomalacia

A nurse cares for an older adult client with multiple fractures. Which action should the nurse take to manage this client's pain? Select one: a. Morphine 4 mg intravenous push every 2 hours PRN for pain b. Meperidine (Demerol) injections every 4 hours around the clock c. Patient-controlled analgesia (PCA) pump with morphine d. Ibuprofen (Motrin) 600 mg orally every 4 hours PRN for pain

c. Patient-controlled analgesia (PCA) pump with morphine

A client has a possible connective tissue disease and the nurse is reviewing the client's laboratory values. Which laboratory values and their related connective tissue diseases (CTDs) are correctly matched? (Select all that apply.) Select one or more: a. Elevated sedimentation rate - Rheumatoid arthritis b. Lowered albumin - Indicative only of nutritional deficit c. Positive rheumatoid factor - Possible kidney disease d. Elevated antinuclear antibody (ANA) - Normal value; no connective tissue disease e. Positive human leukocyte antigen B27 (HLA-B27) - Reiter's syndrome or ankylosing spondylitis

c. Positive rheumatoid factor - Possible kidney disease e. Positive human leukocyte antigen B27 (HLA-B27) - Reiter's syndrome or ankylosing spondylitis

An older client is scheduled to have hip replacement in 2 months and has the following laboratory values: white blood cell count: 8900/mm3, red blood cell count: 3.2/mm3, hemoglobin: 9 g/dL, hematocrit: 32%. What intervention by the nurse is most appropriate? Select one: a. Teach the client about foods high in iron. b. Tell the client that all laboratory results are normal. c. Prepare to administer epoetin alfa (Epogen). d. Instruct the client to avoid large crowds.

c. Prepare to administer epoetin alfa (Epogen).

A client has a continuous passive motion (CPM) device after a total knee replacement. What action does the nurse delegate to the unlicensed assistive personnel (UAP) after the affected leg is placed in the machine while the client is in bed? Select one: a. Assess the distal circulation in 30 minutes. b. Remind the client to do quad-setting exercises. c. Raise the lower siderail on the affected side. d. Change the settings based on range of motion.

c. Raise the lower siderail on the affected side.

The nurse is caring for a client using a continuous passive motion (CPM) machine and has delegated some tasks to the unlicensed assistive personnel (UAP). What action by the UAP warrants intervention by the nurse? Select one: a. Placing padding in the machine per request b. Keeping controls in a secure place on the bed c. Storing the CPM machine under the bed after removal d. Checking to see if the machine is working

c. Storing the CPM machine under the bed after removal

The nurse working with clients who have autoimmune diseases understands that what component of cell-mediated immunity is the problem? Select one: a. CD4+ cells b. Cytotoxic T cells c. Suppressor T cells d. Natural killer cells

c. Suppressor T cells

A nurse assesses a client with a fracture who is being treated with skeletal traction. Which assessment should alert the nurse to urgently contact the health provider? Select one: a. Blood pressure increases to 130/86 mm Hg b. Capillary refill is less than 3 seconds c. Traction weights are resting on the floor d. Oozing of clear fluid is noted at the pin site

c. Traction weights are resting on the floor

A nurse is caring for a client after joint replacement surgery. What action by the nurse is most important to prevent wound infection? Select one: a. Monitor the client's temperature every 4 hours. b. Culture any drainage from the wound. c. Use aseptic technique for dressing changes. d. Assess the client's white blood cell count.

c. Use aseptic technique for dressing changes.

The nurse is teaching a client with gout dietary strategies to prevent exacerbations or other problems. Which statement by the nurse is most appropriate? Select one: a. "Have 10 to 12 ounces of juice a day." b. "Never eat hard cheeses or sardines." c. "Liver is a good source of iron." d. "Drink 1 to 2 liters of water each day."

d. "Drink 1 to 2 liters of water each day."

A client recently diagnosed with systemic lupus erythematosus (SLE) is in the clinic for a follow-up visit. The nurse evaluates that the client practices good self-care when the client makes which statement? Select one: a. "I try not to use cosmetics that contain any type of sunblock." b. "Since I can't be exposed to the sun, I have been using a tanning bed." c. "Since I tend to sweat a lot, I use a lot of baby powder." d. "I always wear long sleeves, pants, and a hat when outdoors."

d. "I always wear long sleeves, pants, and a hat when outdoors."

A phone triage nurse speaks with a client who has an arm cast. The client states, "My arm feels really tight and puffy." How should the nurse respond? Select one: a. "This is normal. A new cast will often feel a little tight for the first few days." b. "Elevate your arm on two pillows and get ice to apply to the cast." c. "Continue to take ibuprofen (Motrin) until the swelling subsides." d. "Please come to the clinic today to have your arm checked by the provider."

d. "Please come to the clinic today to have your arm checked by the provider."

An emergency department nurse cares for a client who sustained a crush injury to the right lower leg. The client reports numbness and tingling in the affected leg. Which action should the nurse take first? Select one: a. Increase the IV flow rate. b. Apply oxygen by nasal cannula. c. Loosen the traction. d. Assess the pedal pulses.

d. Assess the pedal pulses.

A nursing student learning about antibody-mediated immunity learns that the cell with the most direct role in this process begins development in which tissue or organ? Select one: a. Tonsils b. Spleen c. Thymus d. Bone marrow

d. Bone marrow

A nurse sees clients in an osteoporosis clinic. Which client should the nurse see first? Select one: a. Client taking ibandronate (Boniva) who cannot remember when the last dose was b. Client taking calcium with vitamin D (Os-Cal) who reports flank pain 2 weeks ago c. Client taking risedronate (Actonel) who reports occasional dyspepsia d. Client taking raloxifene (Evista) who reports unilateral calf swelling

d. Client taking raloxifene (Evista) who reports unilateral calf swelling

The nurse in the rheumatology clinic is assessing clients with rheumatoid arthritis (RA). Which client should the nurse see first? Select one: a. Client taking etanercept (Enbrel) with a red injection site b. Client with a blood glucose of 190 mg/dL who is taking steroids c. Client taking celecoxib (Celebrex) and ranitidine (Zantac) d. Client with a fever and cough who is taking tofacitinib (Xeljanz)

d. Client with a fever and cough who is taking tofacitinib (Xeljanz)

A nurse is assessing an older client and discovers back pain with tenderness along T2 and T3. What action by the nurse is best? Select one: a. Encourage the client to use ibuprofen (Motrin). b. Have the client perform hip range of motion. c. Place the client in a rigid cervical collar. d. Consult with the provider about an x-ray.

d. Consult with the provider about an x-ray.

A client has been on dialysis for many years and now is receiving a kidney transplant. The client experiences hyperacute rejection. What treatment does the nurse prepare to facilitate? Select one: a. Monoclonal antibody therapy b. High-dose steroid administration c. Plasmapheresis d. Dialysis

d. Dialysis

A client in a nursing home refuses to take medications. She is at high risk for osteomalacia. What action by the nurse is best? Select one: a. Give the client daily vitamin D injections. b. Hide vitamin D supplements in favorite foods. c. Plan to serve foods naturally high in vitamin D. d. Ensure the client gets 15 minutes of sun exposure daily.

d. Ensure the client gets 15 minutes of sun exposure daily.

A client has a metastatic bone tumor. What action by the nurse takes priority? Select one: a. Elevate the extremity and apply moist heat. b. Administer pain medication as prescribed. c. Place the client on protective precautions. d. Handle the affected extremity with caution.

d. Handle the affected extremity with caution.

A hospitalized client is being treated for Ewing's sarcoma. What action by the nurse is most important? Select one: a. Educating the client on the disease and its treatment b. Assessing and treating the client for pain as needed c. Providing emotional support for the client and family d. Handling and disposing of chemotherapeutic agents per policy

d. Handling and disposing of chemotherapeutic agents per policy

A client is getting out of bed into the chair for the first time after an uncemented hip replacement. What action by the nurse is most important? Select one: a. Use a footstool to elevate the client's leg. b. Provide socks so the client can slide easier. c. Tell the client full weight bearing is allowed. d. Have adequate help to transfer the client.

d. Have adequate help to transfer the client.

A nurse assesses a client with a pelvic fracture. Which assessment finding should the nurse identify as a complication of this injury? Select one: a. Hypertension b. Constipation c. Infection d. Hematuria

d. Hematuria

The nurse working in an organ transplantation program knows that which individual is typically the best donor of an organ? Select one: a. Same-sex sibling b. Child c. Parent d. Identical twin

d. Identical twin

A nurse assesses a client with a rotator cuff injury. Which finding should the nurse expect to assess? Select one: a. Referred pain to the shoulder and arm opposite the affected shoulder b. Inability to maintain adduction of the affected arm for more than 30 seconds c. Shoulder pain that is relieved with overhead stretches and at night d. Inability to initiate or maintain abduction of the affected arm at the shoulder

d. Inability to initiate or maintain abduction of the affected arm at the shoulder

A client with rheumatoid arthritis (RA) is on the postoperative nursing unit after having elective surgery. The client reports that one arm feels like "pins and needles" and that the neck is very painful since returning from surgery. What action by the nurse is best? Select one: a. Assist the client to change positions. b. Document the findings in the client's chart. c. Encourage range of motion of the neck. d. Notify the provider immediately.

d. Notify the provider immediately.

A nurse cares for a client in skeletal traction. The nurse notes that the skin around the client's pin sites is swollen, red, and crusty with dried drainage. Which action should the nurse take next? Select one: a. Apply an antibiotic ointment and a clean dressing. b. Request a prescription to decrease the traction weight. c. Cleanse the area, scrubbing off the crusty areas. d. Obtain a prescription to culture the drainage.

d. Obtain a prescription to culture the drainage.

The nurse knows that hematopoiesis occurs in what part of the musculoskeletal system? Select one: a. Collagen matrix b. Cancellous tissue c. Yellow marrow d. Red marrow

d. Red marrow

An older adult has a mild temperature, night sweats, and productive cough. The client's tuberculin test comes back negative. What action by the nurse is best? Select one: a. Recommend a pneumonia vaccination. b. Tell the client to rest and drink plenty of fluids. c. Teach the client about viral infections. d. Treat the client as if he or she has tuberculosis (TB).

d. Treat the client as if he or she has tuberculosis (TB).