ADH Test #2

A client who has had rheumatoid arthritis (RA) for 3 years reports increasing pain and stiffness in her hands, especially in the morning. On physical examination, the nurse in the clinic should expect which of the following findings? A. anorexia B. knuckle deformity C. low-grade fever D. reddened joints

B

A client who has fracture of the right tibia has had a fiberglass cast applied. To teach the client how to observe and manage his cast extremity at home, the nurse should include which of the following instructions? A. use a blow dryer on a moderate hear setting to dry the cast after showering B. Use a cotton swab to relieve itching under the cast C. Reprot any worsening or unrelieved pain D. avoid moving the affected leg

C

A client has returned to the surgical unit after a mastectomy. The nurse is caring for the client should assist her in performing which of the following exercises on her affected side in the first postoperative day? (select all that apply) A. Squeezing a rolled washcloth B. Flexing and extending her hand C. Flexing and extending her elbow D. Rotation of her shoulder E. Hand wall climbing

A, B, C

A nurse is teaching a client at high risk for osteoporosis about dietary measures she can take to increase her calcium level. The nurse should advise the client to increase her intake of A. carrots B. spinach C. cabbage D. potatoes

B

A nurse is talking with a client who has gout. The nurse should teach the client not to drink which of the following beverages? A. Alcohol B. orange juice C. milk D. coffee

A

A Nurse is caring for a client who has a fractured femur. Which of the following techniques should the nurse use when performing a assessment of circulatory status? A. Ask the client to cough and deep-breathe B. observe the client's ability to turn himself in bed. C. Assist the client in performing biceps exercises D. Instruct the client to wiggle his toes.

D

A nurse in an urgent care center is caring for a child who has a forearm fracture. The parent tells the nurse that the provider said it was a greenstick fracture and asks what that means. The nurse should explain that: A. The bone cracked lengthwise but didn't break all the way through B. fragments of bone have splintered into the surrounding tissue C. the bone ends have been forced toward each other D. the sharp edge of the bone has broken through the skin

A

A nurse is assessing the effectiveness of the elastic bandage on the stump of a client who had a right-below-the-knee amputation. Which of the following findings should alert the nurse to a possible complication? A. Pitting edema around the stump dressing B. looseness of the stump dressing C. the dressing forming a cone shape over the stump D. Figure-eight wrapping around the stump

A

A nurse is caring for a client following a left hip arthroplasty. Which of the following should the nurse implement to prevent dislocation? A. maintain foam wedge between legs B. encourage use of elastic stockings C. monitor for shortening of the affected leg D. avoid flexing the hips more than 60 degrees

A

A nurse is caring for a client who has a cast in place for a fractured tibia. Of the following, which nursing action is the priority immediately after the provider has applied the cast? A. checking capillary refill B. discussing cast care C. managing pain D. performing range of motion

A

A nurse is caring for a client who is 1 day postoperative following spinal fusion. When assessing the client the nurse should expect which of the following findings? A. log roll the client every 2 hrs B. assist the client to sit upright in a chair for 4 hr at a time C. expect clear drainage on the spinal dressing D. elevate the client's legs when he is sitting in a chair

A

A nurse is caring for a client who is postoperative following a below-the-knee-ampuation and will soon undergo fitting for a leg prosthesis. Which of the following is an appropriate nursing intervention for this client at this time? A. wrap the stump with an elastic bandage in a figure-eight configuration B. Remove the elastic bandage and re-wrap the stump once a day C. wrap the stump with an elastic bandage in a proximal-to-distal direction D. secure the elastic bandage to the lowest joint

A

A nurse is discussing Russell's traction with a newly licensed nurse. Which of the following statements about this form of traction is appropriate? A. Russell's traction uses a sling under the knee to treat fracture of the femur B. Russell's traction uses cervical halter to decrease cervical muscle spasms C. Russell's traction uses a pelvic girdle belt to decrease lower back pain D. Russell's traction uses skeletal pins to stabilize the fracture.

A

A nurse is teaching a client who has fibromyalgia about strategies that might help reduce her symptoms. Which of the following interventions should the nurse include? A. Establish regular sleep pattern B. Avoid exercise during flare-ups C. Try jogging or running between flare-ups D. Increase calcium intake

A

A nurse is assessing a client who has a herniated cervical intervertebral disc. Which of the following should the nurse expect? (select all that apply) A. tinging in the arms B. low back pain C. shoulder pain D. hip pain E. stiff neck

A, C, E

A nurse is educating coworkers about how to minimize back pain and avoid repeated episodes of low back pain. Which of the following strategies should the nurse include? A. avoid prolonged sitting B. apply cold packs frequently C. sleep in a side-lying position with flexed knees D. sleep on a soft mattress E. try shoe insoles

A, C, E

A nurse in an urgent care center for a client who fell and injured her ankle. The ankle appears swollen and ecchymotic. While the client waits for the technician to take x-rays, which of the following are appropriate nursing interventions? (select all that apply) A. apply ice to the ankle B. encourage range of motion of the foot C. provide the client with a light snack D. apply a compression bandage E. elevate the foot

A, D, E

A client comes to the clinic reporting shoulder pain. When obtaining the client's history, the nurse suspects a rotator cuff injury. When assessing the client, the nurse expects to find which of the following? A. Alteration in the contour of the joint B. Inability to abduct the arm at the shoulder C. A negative drop arm test D. A positive Tinel's sign

B

A client returns to the surgical unit from the post anesthesia care unit in skeletal traction. The nurse should take action to correct which of the following problems with the traction setup? A. The ropes are in the center of the wheel grooves B. The weights rest against the foot of the bed C. The weights are equal on each side D. The ropes attach securely attached to the pin.

B

A nurse at an urgent care center cares for four clients with leg or foot injuries. Which of the following client reports should suggest to the nurse that the client has an ankle sprain? A. Dropping a 10 lb weight on his lower leg at the health club B. Having ankle pain after running a 10 mile race C. Twisting his foot while running bases during a baseball game D. Getting hit by another soccer player on the field

C

A nurse is caring for a client following arthroscopic knee surgery. To prevent postoperative complications, the nurse should have the client do which of the following? A. Remain on bed rest for the first 24 hr B. keep the leg in a dependent position C. apply ice to the affected area D. begin active range of motion

C

A nurse is caring for a client who is postoperative from a total hip arthroplasty. The nurse assists the client into a supine position. Which of the following actions is appropriate to prevent external rotation of the lower extremity? A. place a wedge pillow between the legs B. Place a sandbag to the lateral calf C. place a trachanter roll against the thigh D. place a footboard on the bed

C

A nurse is discussing skeletal and skin traction with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicated understanding? A. "skeletal traction has less risk for infection than skin traction" B. "clients with skin traction have more mobility than those with skeletal traction" C. "skeletal traction is more appropriate than skin traction for reducing a fracture" D. "clients with skin traction have more discomfort than those with skeletal traction"

C

A nurse is talking with a client who has a new diagnosis of gout. When the client asks the nurse how she got this disorder, the nurse should explain, in terminology the client can understand, that gout develops when: A. uric acid levels drop and calcium forms precipitates B. tophi form in the kidneys and they impair the excretion of uric acid C. the inrta-articular disposition of irate crystals cause inflammation D. articular cartilage thins, leading to splitting and fragmentation

C

A client comes to the clinic reporting wrist pain. When obtaining the client's history, the nurse suspects carpal tunnel syndrome. When assessing the client, the nurse should expect to find which of the following? A. Decreased radial pulse B. Positive Chcostek's sign C. Cool extremities D. Positive Phalen's sign

D

A client is about to start taking celecoxib (Celebrex) to treat osteoarthritis symptoms. The nurse should instruct the client to watch for and report which of the following possible indications of a serious reaction to this drug? A. Bone Pain B. Dry mouth C. polyuria D. Black, tarry stools

D

A client is about to undergo electromyography. The nurse should explain to the client that this diagnostic test in involves which of the following? A. Administration of a radioisotope 2 hr before the procedure B. Injection of a radiopaque contrast agent or air into a joint cavity C. Use of x-rays or ultrasound to approximate bone mineral density D Placement of thin needles into the muscle with recording of responses to stimuli

D

A nurse in a clinic is caring for a client who is postmenopausal and asks about medication to prevent osteoporosis. The nurse anticipates the client will be given a prescription for which of the following medications by the nurse practitioner? A. Levothyroxine (synthroid) B. Calcitonin (Miacalcin) C. Raloxifene hydrochloride ( Evista) D. Alendronate Sodium (Fosamax)

D

A nurse is assessing a client who has a left lower arm fracture. Which of the following findings indicates impaired venous return in the affected arm? A.a bounding distal pulse B. acute pain C. ecchymosis of the surrounding skin D. increasing edema

D

A nurse is caring for a client following a right total hip arthroplasty. Postoperatively the nurse should maintain the right leg in a position of A. Adduction B. External rotation C. internal rotation D. abduction

D

A nurse is providing teaching for a client who is preparing for a below the knee amputation. Which of the following statements is appropriate regarding the postoperative placement of a prothesis? " The prothesis will be in place immediately following surgery to: A. improve your ability to ambulate sooner" B. decrease the chance of phantom limb pain" C. decrease the frequency of dressing changes" D.improve the fit of prothesis"

A

A nurse is reviewing the causes of osteoporosis with a group of nursing students. The nurse should include which of the following types of medication therapy as a risk factor for osteoporosis? A. Thyroid hormones B. Anticoagulants C. NSAIDS D. Cardiac glycosides

A

A nurse is teaching a client who has rheumatoid arthritis about self-care techniques. Which of the following strategies should she include to illustrate the concept of joint protection? A. Press water from a sponge rather than wringing it. B. Lift objects instead of sliding or pushing them. C. Finish weekly household tasks within 1 or 2 days D. Engage in repetitive tasks that keep the joint mobile

A

A nurse in an urgent care center for a client who has ankle sprain. Which of the following interventions are appropriate? (select all that apply) A. rest B. movement C. heat application D. compression E. elevation

A, D, E

A nurse is caring for a client who is in Buck's traction. Which of the following nursing interventions is appropriate? (select all that apply) A. monitor peripheral pulses in the affected extremity B. position weights against the foot of the bed C. Adjust the prescribed weights every shift D. Examine the skin under the traction splint E. Assess the temperature of the affected extremity

A, D, E

A nurse is assessing a client who has Paget's disease of the bone. Which of the following findings should the nurse expect. (select all that apply) A. cranial enlargement B. skeletal pain C. Waddling gait D. cold extremities E. vision deficits

A,B,C

An occupational health nurse is instructing workers at an industrial facility in emergency procedures in the event of a traumatic amputation. Which of the following guidelines should the nurse included for preserving the amputated part for possible surgical reattachment? (select all that apply) A. wrap the part in a dry sterile gauze B. place the severed end of the part into crushed ice C. put the severed part in a dry, waterproof bag D. Wrap the covered part in an elastic bandage E. prevent contact of the severed part with water

A,C, E

A client tells the nurse at the clinic that she thinks she might be developing rheumatoid arthritis because she has some stiffness in her joints. Which other early manifestation of RA should the nurse expect to find when she assesses the client? A. muscle atrophy B. fatigue C. Temporomandibular joint pain D. decreased range of motion

B

A nurse assessing a client who has multiple fractures in his left leg notes increasing edema. Because this is often the firth sign of a serious complication of fractures, the nurse should suspect which of the following? A. Fat embolism syndrome B. acute compartment syndrome C. pulmonary embolism D. osteomyelitis

B

A nurse assigns a assistive personnel to apply a footplate to the bed of a client who has his left leg in Buck's traction. The nurse correctly explains that the purpose of this action is to? A. anchor the traction B. prevent foot drop C. keep the client from sliding down in bed D. prevent pressure a reals on the foot

B

A nurse caring for a client who has a femur fracture suspects fat embolism syndrome. Which of the following is the nurse's earliest warning that this complication is developing? A. petechiae B. confusion C. tachycardia D. crackles

B

A nurse is assessing an older adult client who has a hip fracture. Which of the following findings should the nurse expect? A. Leg lengthening B. External rotation C. Muscle flaccidity D. Leg abduction

B

A nurse is caring for a client who has just undergone insertion of a femoral head prosthesis. The nurse should instruct the client to avoid which of the following activities? A. Placing a large pillow between legs when turning B. putting on shoes and socks C. using a raised toilet seat D. using a walker

B

A nurse is caring for a client who is 1 day postoperative following hip open reduction with internal fixation. It is 0830 and the client will begin physical therapy at 0900. Which of the following is an appropriate nursing intervention for this client at this time? A. Assist the client out of the bed into the wheelchair B. Identify the client's pain level and medicate if needed C. Teach the client which positions to avoid during PT D. Complete the client's usual morning care

B

A nurse is giving discharge instructions to a client who had an internal repair of a right hip fracture. The nurse knows that the teaching has been effective when the client tells her that he will rest during the day sitting on which of the following pieces of furniture? A. a reclining chair with a ottoman B. a straight-backed chair with an elevated seat C. a couch with plush cushions D. a rocking chair with a curved back

B

A nurse is giving instructions to a client who had a surgical correction of hallux valgus ( a bunion). Which of the following should the nurse include? A. Expect the foot to be numb for several days postoperatively B. Rest frequently with the foot elevated C. Expect the foot to take at least 3 weeks to heal D. Walk primarily on the heel to relieve pressure on the toes

B

A nurse is planning care for a client who is postoperative from a total hip arthroplasty. Which of the following is appropriate to include in the plan of care? A. Instruct the client to avoid movement of the affected leg B. Prevent hip flexion of the affected extremities C. Position the lower extremities so that they are touching D. Ensure that the client's heels are touching the bed

B

A nurse is talking with a client who has a new diagnosis of acute bursitis in her right shoulder. Which of the following self-care strategies should the nurse recommend? A. Range of motion exercises B. Intermittent ice and heat C. Elevation of right arm D. Corticoid steroid therapy

B

An older adult client on an orthopedic unit has an intracapsular fracture of the right hip following a fall. The client is in Buck's extension traction and will have hip prosthesis surgery in the morning. The nurse should tell the client that this type of traction helps. A. Reduce the fracture B. relieve muscle spasms C. Maintain alignment of the pins D. allow supported movement of the extremities

B

A nurse is caring for a client who is 2 days postoperative following an above the knee-ampuation. Which of the following is an appropriate nursing intervention for this client at this time? A. elevate the foot of the bed B. encourage sitting up as much as possible C. elevate the stump on a pillow D. Have the client lie prone several times a day

D

A client comes to the clinic reporting chronic low back pain. He asks the nurse to recommend specific exercises for him. Which of the following activities should the nurse suggest? A. tennis B. canoeing C. Swimming D. archery

C

A client who has undergone a right below- the- knee ampuation due to trauma now has a prosthetic limb. When teaching the client about prosthesis and stump care, the nurse should include which of the following instructions? A. Keep the prosthesis in direct contact with the residual limb B. Apply a moisturizing lotion or oil to the stump daily C. Dry the prosthesis socket completely before applying to the limb. D. Expect some skin irritation from the prosthesis.

C

A client is admitted to the rehabilitation unit following a spinal cord injury that resulted in paraplegia. After a week on the unit, the nurse notes that the client is withdrawn and increasingly resistant to rehabilitative efforts by the staff. Which of the following actions should the nurse take? A. Inform the client that privileges are related to participation in therapy. B. Limit visiting hours until the client begins to participate in therapy. C. Allow the client to control the timing and frequency of the therapy. D. Establish a plan of care with the client with mutually set attainable goals.

D

A nurse in a provider's office is talking with a client for whom the provider is considering arthroplasty. When the client asks the nurse what this procedure will do for him, the nurse should explain that the purpose of the procedure is to do which of the following? A. Assess the extent of joint damage B. Fuse a joint and reduce pain C. Prevent further joint damage D. replace the joint and improve function

D

A nurse is completing discharge instructions with a client following hospitalization for an acute onset of gout. Which of the following client statements should indicate to the nurse that the client understands the treatment regimen? A. "I will closely follow a high-purine diet" B. " I will limit my fluid intake to 1 liter per day" C. " I will take one enteric-coated aspirin every day" D. " I will drink only one beer, at most, a night"

D