Workbook questions exam #4
A pt diagnosed with carpal tunnel syndrome (CTS) asks the nurse about numbness in the fingers and pain in the wrist. In responding to the pt, how would the nurse best describe CTS?
"CTS is a neuropathy that is characterized by compression of the median nerve at the wrist."
The nurse has educated a pt with low back pain about techniques to relieve the back pain and prevent further complications. What statement by the pt shows understanding of the education the nurse provided?
"I will avoid prolonged sitting or walking."
A pt tells the nurse, "I was working out and lifting weights and now I have stopped, I am flabby and my muscles have gone!" What is the best response by the nurse?
"Your muscles were in a state of hyper trophy from the weight lifting but it will persist only if the exercise is continued."
A pt is having repeated tears of the joint capsule in the shoulder, and the physician orders an arthrogram. What intervention should the nurse provide after the procedure is completed?
-Apply a compression bandage to the area -Administer a mild analgesic -Inform the pt that a clicking or crackling noise in the joint may persist for a couple of days
A pt has a cast removed after bone healing takes place. What should the nurse instruct the pt to do after the removal?
-Apply an emollient lotion to soften the skin -Control swelling with elastic bandages, as directed -Gradually resume activities and exercise
A pt with an arm cast complains of pain. What nursing interventions should the nurse provide in order to reduce the incidence of complications?
-Assess the fingers for color and temperature -Assess for a pressure sore -Determine the exact site of the pain
The nurse is caring for a pt with a pelvic fracture. What nursing assessment for a pelvic fracture should be included?
-Checking the urine for hematuria -Palpating peripheral pulses in both lower extremities -Testing the stool for occult blood
A pt shows the nurse a round, firm nodule on the wrist. The pain described as aching, with some weakness of the fingers. What treatment does the nurse anticipate assisting with?
-Corticosteroid injections -Surgical excision -Aspiration of the cyst
A pt sustains an open fracture of the left arm after an accident at the roller skating rink. What does emergency management of this fracture involve?
-Covering the area with a clean dressing if the fracture is open -Immobilizing the affected site -Splinting the injured limb
The nurse suspects "compartment syndrome" for a castes extremity. What characteristic symptoms would the nurse assess that would confirm these suspicions?
-Decreased sensory function -Excruciating pain -Loss of motion
A nurse is caring for a pt who has had an amputation. What interventions can the nurse provide to foster a positive self-image?
-Encouraging the pt to care for the residual limb -Allowing the expression of grief -Introducing the pt to local amputee support groups
A pt is diagnosed with osteomyelitis of the right leg. What signs and symptoms does the nurse recognize that are associated with this diagnosis?
-Pain -Erythema -Fever
The nurse is performing an assessment for a pt who may have peripheral neurovascular dysfunction. What signs does the patient present with that indicate circulation is impaired?
-Pale, cyanotic, or mottled color -Cool temperature of the extremity -More than 3-second capillary refill
An older adult pt had a hip replacement. When should the pt begin with assisted ambulation with a walker?
24 hours
The nurse is caring for a pt with a total hip replacement. How should the nurse allow the pt to turn?
45 degrees onto the unoperated side if the affected hip is kept abducted
The nurse is caring for a pt after arthroscopic surgery for a rotator cuff tear. The nurse informs the pt that full activity can usually resume after what period of time?
6-12 months
A pt had a total hip replacement. What recommended leg position should the nurse ensure is maintained to prevent prosthesis dislocation?
Abduction
A pt is diagnosed with osteogenic sarcoma. What lab studies should the nurse monitor for the presence of elevation?
Alkaline phosphatase
A pt had an above the knee amputation of the left leg related to complications from PVD. The nurse enters the pts room and observes the dressing and bed covers saturated with blood. What is the first action by the nurse?
Apply a tourniquet
A pt is scheduled for a procedure that will allow the physician to visualize the knee joint in order to diagnose the pts pain. What procedure will the nurse prepare the pt for?
Arthroscopy
A pt sustains a fracture of the arm. When does the nurse anticipate pendulum exercise should begin?
As soon as tolerated, after a reasonable period of immobilization
A pt stepped in a hole in the yard, causing ankle injury. The ankle is edematous and painful to palpation. How long should the nurse inform the patient that the acute inflammatory stage will last?
Between 24-48 hrs
A pt has been diagnosed with osteomalacia. What common symptoms does the nurse recognize that correlate with the diagnosis?
Bone pain and tenderness
A pt tells the physician about shoulder pain that is present even without any strenuous movement. The physician identifies a sac filled with synovial fluid. What condition should the nurse educate the patient about?
Bursitis
The nurse is caring for a pregnant pt with pregnancy-induced HTN. When assessing the reflexes in the ankle, the nurse observes the rhythmic contractions of the muscle when dorsiflexing the foot. What is this finding known as?
Clonus
The nurse is assessing the feet of a pt and observes an overgrowth of the horny layer of the epidermis. What does the nurse recognize this condition as?
Corn
A pt was climbing a ladder, slipped on a rung, and fell on the right side of the chest. X-Ray studies reveal three rib fractures, and the pt is complaining of pain with inspiration. What is the anticipated treatment for this pt?
Coughing and deep breathing with pillow splinting
A pt comes to the clinic complaining of low back pain radiating down to the left leg. After diagnostic studies rule out any pathology, the physician orders a serotonin-norepinephrine reuptake inhibitor (SNRI). Which medication does the nurse anticipate educating the pt about?
Duloxetine (Cymbalta)
A pt sustained an open fracture of the femur 24 hrs ago. While assessing the pt, the nurse observes the pt is having difficulty breathing, and oxygen saturation decreases to 88% from a previous 99%. What does the nurse understand is likely occurring with this pt?
Fat emboli
The nurse is caring for a pt postoperatively following orthopedic surgery. The nurse assesses an oxygen saturation of 89%, confusion, and a rash on the upper torso. What does the nurse suspect is offering with this pt?
Fat emboli syndrome
A pt has had a stroke and is unable to move the right upper and lower extremity. During assessment the nurse picks up the arm and it is limp and without tone. How would the nurse document this finding?
Flaccidity
The nurse is very concerned about the potential debilitating complication of peroneal nerve injury. What symptom does the nurse recognize as a result of that complication?
Footdrop
A pt in pelvic traction needs circulatory status assessed. How should the nurse assess for a positive Homans' sign?
Have the pt extend each leg and dorsiflex each foot to determine if pain or tenderness is present in the lower leg
While riding a bicycle on a narrow road, the patient was hit from behind and thrown into a ditch, sustaining a pelvic fracture. What complications does the nurse know to monitor for that are common to pelvic fractures?
Hemorrhage and shock
The nurse is caring for a pt with bone metastasis from a primary breast cancer. The pt complains of muscle weakness and nausea and is voiding large amounts frequently. Cardiac dysrhythmias are observed on the telemetry monitor. What should the nurse suspect based on these clinical manifestations?
Hypercalcemia
The nurse is monitoring a pt who sustained an open fracture of the left hip. What type of shock should the nurse be aware can occur with this type of injury?
Hypovolemic
A pt has suffered a femoral shaft fracture in an industrial accident. What is an immediate nursing concern for this pt?
Hypovolemic shock
The nurse is caring for a patient who is sustained an open fracture of the right femur in an automobile accident. What does the nurse understand is the most serious complication of an open fracture?
Infection
The nurse is performing an assessment on an older adult pt and observes the pt has an increased forward curvature of the thoracic spine. What does the nurse understand this finding as?
Kyphosis
The nurse assesses a pt after a total right hip arthroplasty and observes a shortening of the extremity, and the pt complains of severe pain in the right side of the groin. What is the priority action of the nurse?
Notify the physician
A pt comes to the clinic and informs the nurse of numbness, tingling, and a burning sensation in the arm from the elbow down to the fingers. What type of symptom would this be documented as?
Paresthesia
A pt had hand surgery to correct a Dupuytren's contracture. What nursing intervention is a priority postoperatively?
Performing hourly neurovascular assessments for the first 24 hours
A pt has a long leg cast applied. Where does the nurse understand a common pressure problem may occur?
Peroneal nerve
The nurse is caring for a pt who had a total hip replacement. What lethal postoperative complication should the nurse closely monitor for?
Pulmonary embolism
The nurse is educated the pt with low back pain about the proper way to lift objects. What muscle should the nurse encourage the pt to maximize?
Quadriceps
A pt has a fracture of the right femur sustained in an automobile accident. What process of fracture healing does the nurse understand will occur with this patient?
Reactive phase, reparative phase, remodeling phase
The hospice nurse is assigned to care for a pt with metastatic bone cancer who wants to remain at home. What is the therapeutic goal in the care for this pt?
Relieve pain and discomfort while promoting quality of life
A pt has a fracture that is being treated with open rigid compression plate fixation devices. How will the progress of bone healing be monitored?
Serial x-rays
A pt arrives in the ED with a suspected bone fracture of the right arm. How does the nurse expect the pt to describe the pain?
Sharp and piercing
A pt stepped on an acorn while walking barefoot in the backyard and developed an infection progressing to osteomyelitis. What microorganism does the nurse understand is most often the cause of the development of osteomyelitis?
Staphylococcus aureus
A pt is having low back pain. What position can the nurse suggest to relieve this discomfort?
Supine, with the knees slightly flexed and the head of the bed elevated 30 degrees
A pt had a total left hip arthroplasty. What clinical manifestation would indicate to the nurse that the prosthesis is dislocated?
The left leg is internally rotated
After a bone density test, an older adult female pt tells the nurse, "I don't understand why I have osteoporosis because I eat well and take my calcium." What does the nurse understand is the reason the pt may have osteoporosis?
The loss is from withdrawal of estrogen and a decrease in activity levels.
The nurse assesses soft subcutaneous nodules along the line of the tendons in a pts hand and wrist. What does this finding indicate to the nurse?
The pt has rheumatoid arthritis
The nurse suspects that a pt with an arm cast has developed a pressure ulcer. Where should the nurse assess for the presence of the ulcer?
Ulna styloid
A pt falls while skiing and sustains a supracondylar fracture. What does the nurse know is the most serious complication of a supracondylar fracture of the humerus?
Volkmann's ischemic contracture