bones and shit
A client had a surgical amputation of an arm and is having a myoelectric arm applied. What does the nurse understand are the benefits of this type of device? Select all that apply.
A) Eliminates the need to wear a harness B) Terminal device looks natural C) Better function than cosmetic hand
The nurse is caring for a client experiencing rosacea. Which is the earliest symptom of the disease process?
A) Flushed facial appearance
Which of the following conditions is the cause of thickening of the nail?
A) Fungal infection
The nurse observes a client's fingernails have a concave shape. What laboratory studies should the nurse review?
A) Hemoglobin and hematocrit
When admitting a client to the hospital, what should the nurse do initially to prevent pressure sores?
A) Identify if the client is at risk for the development of pressure sores.
A client is seen in the orthopedic clinic for complaints of severe pain in the left hip. After a series of diagnostic tests, the client is diagnosed with severe degenerative joint disease of the left hip and suggested to have the hip reconstructed. What procedure will the nurse schedule the client for?
A) Left hip arthroplasty
Skin substitutes are often used after the wound is debrided and cleaned. Which of the following supports a primary purpose for the use of a skin substitute? Select all that apply.
A) Lessen potential for infection E) Slows regeneration of tissue
The nurse is caring for a client in traction that is immobile. What measures can the nurse provide to prevent further injury and potential infection and promote circulation to the area?
A) Massage bony prominences subject to pressure unless red when pressure relieved.
The nurse is discussing the new medication that a client will be taking for treatment of rheumatoid arthritis. Which disease-modifying antirheumatic drug (DMARD) will the nurse educate the client about?
A) Methotrexate (Rheumatrex)
A client is scheduled to undergo an electromyography. The nurse understands that this test is performed to evaluate which of the following?
A) Muscle weakness
The nurse is assessing the client who states a decline in muscle strength. Which is the primary source essential to allow muscle contraction? A) Myofibrils B) Sarcomeres C) Acetylcholine D) Actin and myosin
A) Myofibrils
Which of the following would indicate the need to increase fluids beyond what is recommended for fluid resuscitation?
A) Myoglobin in the urine
When caring for a client with a fracture, assessment of which of the following would be the priority?
A) Neurovascular compromise
During the assessment of a client scheduled for orthopedic surgery, the nurse discovers that the client was previously treated for the disorder. In such a case, what additional data need to be collected?
A) Occurrence of complications or problems during treatment
An instructor is describing the process of bone development. Which of the following would the instructor describe as being responsible for the process of ossification?
A) Osteoblasts
The nurse is assisting an older adult client with performing activities of daily living (ADL) and is brushing her hair. What does the nurse document as an abnormal finding?
A) Pearly white substance that is attached to the hair shaft that is not removed with brushing
A patient has had surgery to repair a fractured hip. What intervention is important for the nurse to perform when turning the client from side to side?
A) Place abductor pillows between the legs.
When assisting a client following an arthroscopy of the knee to a comfortable position, which standard is maintained?
A) Place the client's joint in a neutral position.
A client has had several diagnostic tests to determine if he has systemic lupus erythematosus (SLE). What result is very specific indicator of this diagnosis?
A) Positive Anti-dsDNA antibody test
After being exposed to smoke and flames from a house fire, which assessment finding is most important in determining care of the client?
A) Presence of soot around nasal passages
A client sustained a sprained ankle while skiing, and the physician ordered RICES. What will the nurse inform the client to do related to the physician's order upon discharge?
A) Rest, ice, compression, elevation, stabilization
A client is taking large amounts of salicylates for the treatment of bursitis of the left shoulder. The client should be aware to report which symptoms of salicylism?
A) Ringing in the ears
A client, who has sustained burns to the anterior chest and upper extremities, is brought to the burn center. During the initial stage of assessment, which nursing diagnosis is primary?
A) Risk for Impaired Gas Exchange
The school nurse is instructing a parent in the care and elimination of lice from their child's hair. The parent brings all of the products for care in a bag. Which contents are not appropriate for use?
A) Shampoo and conditioner
A client is having a cast applied for a fractured leg that extends from below the knee to the base of the toes. The foot is flexed at a right angle in a neutral position. What type of cast is the client having applied?
A) Short leg cast
A client with rheumatoid arthritis has infiltration of the lacrimal and salivary glands with lymphocytes as a result of the disease. What does the nurse understand that this clinical manifestation is?
A) Sicca syndrome
The nurse is performing a skin assessment on a client that is admitted to the hospital and observes an area over the left heel that is reddened but intact. How would the nurse stage this pressure sore?
A) Stage I
The nurse is caring for a client with a fractured tibia and fibula. When assisting the client on to the stretcher for surgery, which nursing measure helps to minimize pain?
A) Support the leg by placing a hand under the knee and under the heel.
The nurse is gathering objective data for a client at the clinic complaining of arthritic pain in the hands. The nurse observes that the fingers are hyperextended at the proximal interphalangeal joint with fixed flexion of the distal interphalangeal joint. What does the nurse recognize this deformity as?
A) Swan neck deformity
A client is diagnosed with a first-degree strain of the left ankle related to running 5 miles daily. How would the nurse differentiate the first-degree strain from other strains and sprains?
A) The client has some edema of the left ankle with muscle spasms but is able to walk without assistive devices.
The emergency room nurse is reporting the location of a fracture to the client's primary care physician. When stating the location of the fracture on the long shaft of the femur, the nurse would be most correct to state which terminology locating the fractured site?
A) The fracture is on the diaphysis.
A client arrives in the emergency room complaining of severe pain in her left hip after falling out of the bed. What indication upon assessment does the nurse recognize as a dislocated left hip? Select all that apply
A) The left leg is shorter than the right. B) Limited range of motion of the left hip. D) The skin of the lower left leg is pale.
The nurse is triaging a client over the phone who states having a contact dermatitis rash. Which treatment option of over-the-counter preparations does the nurse suggest for the client? Select all that apply.
A) Topical antihistamines C) Hydrocortisone cream D) Moisturizing cream E) Lanolin based
Chapter 65 A young college student recently had her tongue and lip pierced. She has developed a superinfection of candidiasis from the antibacterial mouthwash. Which of the following would be the correct recommendation for her?
A) Use an antifungal mouthwash or salt water.
Which of the following actions should a nurse perform to help reduce the accumulation of debris within the burn wound?
A) Use powder-free sterile gloves.
A client has a fractured jaw sustained in an automobile accident and has had the fracture surgically reduced and immobilized with a wire loop. What should the nurse ensure is present at the client's bedside in case of vomiting?
A) Wire cutters
A client is experiencing muscle weakness in the upper extremities. The client raises an arm above the head but then loses the ability to maintain the position. Muscular dystrophy is suspected. Which diagnostic test would evaluate muscle weakness or deterioration?
B) An electromyography
The initial treatment of rosacea includes which of the following?
B) Antibiotics
Which medication classification is prescribed when allergy is a factor causing the skin disorder?
B) Antihistamines
A client was playing softball and was hit in the right ankle by the ball sustaining a contusion. What is the first action taken to help alleviate pain and swelling?
B) Apply a cold pack to the ankle.
Which of the following causes odor in perspiration?
B) Bacteria on the skin
The nurse is caring for a newly admitted client to an orthopedic unit. Which of the following nursing actions is helpful in reducing client anxiety? Select all that apply.
B) Be confident in action and instructions. C) Speak quietly and in simple terms. D) Relieve discomfort as able. E) Be attentive to client needs.
A client has been prescribed an antibiotic to treat a bacterial skin infection. What should the nurse inform the client is most important to do when taking the medication?
B) Be sure to complete the prescription even if the infection appears to resolve.
Which of the following is a disadvantage of surgical debridement?
B) Bleeding
A client is experiencing symptoms that are suspected to be related to systemic lupus erythematosus. What cutaneous symptom occurs in about 50% of clients affected by this disease?
B) Butterfly-shaped rash on the face over the bridge of the nose and cheeks
The nurse is assessing the capillary refill on a client who has a new, lower extremity cast. Which documented finding provides the best evidence of an abnormality?
B) Capillary refill within 4 seconds
Which of the following symptoms is anticipated when caring for a client with herpes zoster? Select all that apply.
B) Client states pain and itchiness. D) Rash appears first as vesicles then crusts. E) A secondary skin infection can begin.
A client was playing softball and dislocated four of his fingers when diving for a ball. The physician manipulated the fingers into alignment and applied a splint to maintain alignment. What type of procedure does the nurse document this as?
B) Closed reduction
A client comes to the emergency department complaining of localized pain and swelling of his lower leg. Ecchymotic areas are noted. History reveals that the client got hit in the leg with a baseball bat. Which of the following would the nurse suspect as most likely?
B) Contusion
The nurse is caring for a client who sustained rib fractures in an automobile accident. What symptoms does the nurse recognize as a complication of rib fractures and should immediately be reported to the physician?
B) Crackles in the lung bases
A client has a cast applied to the leg for treatment of a tibia fracture and also has a wound on the leg that requires dressing changes due to drainage. For what should the nurse prepare the client?
B) Cutting a cast window
Which of the following would lead a nurse to suspect that a client has a rotator cuff tear?
B) Difficulty lying on affected side
The nurse is caring for a client who is experiencing discomfort following a tongue piercing. Which instruction is most helpful?
B) Eat soft foods.
A client is complaining of severe pain in the left great toe. What lab studies that the nurse reviews indicate that the client may have gout?
B) Elevated uric acid levels
A client is complaining of severe pain in the left great toe. What lab studies that they nurse reviews indicate that the client may have gout? A) Elevated white blood count?
B) Elevated uric acid levels
A nurse is caring for a client experiencing an exacerbation of plaque psoriasis. The nurse assesses the area and documents a proliferation of which cell type?
B) Epidermal
Which is the primary nursing intervention in the care of a client with burns exceeding 20% of total body surface area?
B) Fluid resuscitation
During a routine checkup, a nurse observes the client's skin to be tight and shiny. Which of the following is the correct indication of this sign?
B) Fluid retention
The physician orders a 24-hour urine test for a client on a medical unit. At what time would the nurse document the start of the specimen collection?
B) From the time of the first morning void to 24 hours later
Which type of skin graft is more comparable in appearance to normal skin?
B) Full-thickness graft
A client with a burn injury is in acute stress. Which of the following complications is prone to develop in this client?
B) Gastric ulcers
A client has a cast that extends from below the elbow to the palmar crease and is secured around the base of the thumb. The thumb is also casted. The nurse identifies this as which type of cast?
B) Gauntlet cast
The physician's office nurse is tracking pediatric growth data. As the nurse evaluates trends in assessment findings, which is expected? A) The central canal narrows, causing limited bone reabsorption. B) Height increases are noted on gender specific growth charts. C) Serum blood calcium levels increases through puberty. D) The client states more strength in the extremities.
B) Height increases are noted on gender specific growth charts.
A client has just undergone a leg amputation. The nurse would closely monitor the client for which of the following during the immediate postoperative period?
B) Hematoma
Which of the following is a true statement regarding psoriasis?
B) It is characterized by patches of redness covered with silvery scales.
Which of the following information regarding the transmission of lice would the nurse identify as a myth?
B) Lice can jump from one individual to another.
The nurse and nursing assistant are moving a client who slid down in the chair. What does the nurse encourage the assistant to avoid shearing when moving the client to a higher position in the chair?
B) Lift the client, do not slide them.
When providing initial assessment to a client who has suffered an electrical burn, which assessment finding will provide the most important data?
B) Location of entry and exit wounds
A young child is being evaluated for area of burn involvement. The nurse knows the most accurate method of assessing the total body surface area is through the use of which assessment tool?
B) Lund and Browder method
The nurse is working on an orthopedic floor caring for a client injured in a football game. The nurse is reviewing the client's chart noting that the client has previously had an injured tendon. The nurse anticipates an injury between the periosteum of the bone and which of the following? A) Joint B) Muscle C) Ligament D) Cartilage
B) Muscle
Which type of debridement occurs when nonliving tissues sloughs away from uninjured tissues?
B) Natural
Which of the following advice should the nurse give a client with a furuncle to prevent the spread of the infection?
B) Never pick or squeeze a furuncle.
The nurse is caring for a client with an external fixator that requires pin care twice a day. The nurse observes that there is a new purulent drainage around one of the pins. What intervention should the nurse anticipate doing?
B) Obtaining a culture
The nurse is assisting with an examination of a client suspected of having carpal tunnel syndrome. The physician has the patient flex the wrist for 30 seconds and percusses the median nerve. The client complains of pain and numbness when this is done. What does the nurse know this positive sign is documented as?
B) Phalen's sign
Treatment of melanoma includes which of the following?
B) Radical excision
A nurse is monitoring a client diagnosed with Lyme disease. Which finding would suggest that the disease is in the early stages?
B) Red macule or papule
A client is diagnosed with systemic lupus erythematosus (SLE). Which of the following would be most appropriate for the nurse to use to evaluate the client' s stage of disease?
B) Review the client's medical record.
When caring for the client with a new tattoo, which nursing diagnosis is of highest priority?
B) Risk for Infection
An older adult client is being seen in the dermatology clinic for lesions on the hands and forearm. The client is concerned that he has melanoma and wants to be evaluated. The nurse documents the lesions as small, brown lesions of the hands and forearms. What type of benign lesions are these characteristic of?
B) Senile lentigines
A client undergoes an invasive joint examination of the knee. The nurse would closely monitor the client for which of the following?
B) Serous drainage
The nurse is caring for a patient with a fractured right femur who is not a candidate to repair the femur immediately. What intervention should the nurse anticipate the physician will order to relieve muscle spasm and pain until surgery is performed?
B) Skin traction
The nurse is changing a brief for a client that has been incontinent of stool and observes an area over the left trochanter that is reddened and in the center of the area is a shallow skin tear. The nurse takes a picture of the wound for the chart. How will the nurse stage this ulcer?
B) Stage II
An adult is swinging a small child by the arms, and the child screams and grabs his left arm. It is determined in the emergency department that the radial head is partially dislocated. What is this partially dislocated radial head documented as?
B) Subluxation
A client is receiving treatment for rheumatoid arthritis but states that he is allergic to eggs. What medication would the client not be able to receive?
B) Synvisc
A client has been prescribed nonsteroidal anti-inflammatory medications for treatment of carpal tunnel syndrome. What should the nurse be sure to include when educating the client about taking this medication?
B) Take the medication with food.
A client has been treated for migraine headaches for several months and comes to the clinic stating he is getting no better. The nurse is talking with the client and hears an audible click when the client is moving his jaw. What does the nurse suspect may be happening?
B) Temporomandibular disorder
A client experiences a musculoskeletal injury that involves the structure that connects a muscle to the bone. The nurse understands that this injury involves which of the following?
B) Tendon
The nurse is caring for a client with a suspicious lesion on the client's head. The lesion is sore and resembles basal cell carcinoma. Which client finding is a risk factor for developing skin cancer?
B) The client has androgenetic alopecia.
1. Chapter 66 A nurse is required to monitor the effectiveness of fluid resuscitation in a client who is being treated for burns. Which of the following assessments would indicate the success of the fluid resuscitation?
B) The client's urinary output is 0.3 to 0.5 mL/kg/hour.
A client is coming to the office to have a growth removed by the doctor. The client asks "What does cryosurgery do to the growth?" What is the correct response?
B) Through the application of extreme cold, the tissue is destroyed.
Which is the primary reason for placing a client in a horizontal position while smothering flames are present?
B) To keep fire and smoke from airway
When performing pin care, which of the following would be most appropriate?
B) Use an applicator only once. C) Gently remove crusts around pin sites.
When the area of burn is irregular in shape and is scattered over multiple areas of the body, which is the best method for the nurse to obtain a quick assessment of the total body surface area of the burn?
B) Use client's palm size
Which nursing action would the nurse do first when caring for a client's new tattoo?
B) Wash your hands prior to gloving.
The nurse is preparing to assess Phalen's sign. Which of the following would the nurse identify as indicative of a positive indicator for this sign?
B) Wrist flexion for 30 seconds causes pain and numbness.
The nurse is reviewing the diagnostic test findings of a client with rheumatoid arthritis. Which of the following would the nurse expect to find?
C) Elevated erythrocyte sedimentation rate
A professional tennis player comes to the orthopedic clinic and informs the nurse that he is having pain that radiates down the forearm and is unable to grasp the racket firmly. What does the nurse suspect is occurring with the client?
C) Epicondylitis
A client presents with a full-thickness burn to the anterior chest. The leathery skin is tight, making breathing difficult. The nurse anticipates which treatment management technique in the care of this client?
C) Escharotomy
A client with a fracture develops compartment syndrome that requires surgical intervention. The nurse would most likely prepare the client for which of the following?
C) Fasciotomy
The nurse is providing client education on growth and development throughout the life span. When stating periods of most rapid bone growth, which period is the nurse most correct to state?
C) From birth through puberty
Skin grafts are necessary for which of the following burns?
C) Full thickness
A client has been diagnosed with temporomandibular disorder and has not been able to eat. What suggestion can the nurse make to modify the diet so that the client will be able to eat?
C) Have the client eat soft rather than coarse food.
Radiographic evaluation of a client's fracture reveals that a bone fragment has been driven into another bone fragment. The nurse identifies this as which type of fracture?
C) Impacted
A client is diagnosed with carpal tunnel syndrome. Which of the following assessment findings would the nurse expect?
C) Inability to flex index and middle fingers
A client enters the walk-in clinic stating that there is an itchy, red, warm, raised rash on the left forearm. The nurse documents when the rash developed and what the client was doing when it appeared. Allergic dermatitis is diagnosed. Which instruction is most important to prevent further problems?
C) Instruct on eliminating further allergen exposure.
A client with ankylosing spondylitis has a stooped position and is being positioned in the bed prior to the nurse taking vital signs. The nurse listens to the client's lungs after positioning. What finding does the nurse hear when listening to lung sounds?
C) Lung sounds are diminished in the apical area.
The nurse is working in the emergency department interacting with clients of various disease processes and injuries. When completing a head-to-toe assessment, which standard assessment technique is most important?
C) Maintain standard precautions throughout the exam.
The nurse is caring for a client who has a deficiency in the formation of cartilage in joints. Which essential substance is absent?
C) Matrix
The nurse is caring for a client with questionable lice infestation. The nurse is using a bright light focused on an area of the head to confirm the presence of lice. In which manner is it easiest to differentiate nits from dandruff?
C) Nits are difficult to move from hair shafts.
The nurse is administering a medication to a client who is suffering from pain related to partial thickness burns. The medication will interrupt the sensation and transmission of pain stimuli. What type of receptors will this medication block?
C) Nociceptors
A family member is caring for an older adult client with osteomalacia in the home. When the home health nurse comes to evaluate the client, what should be a focus point of the visit?
C) Observing for safety hazards that could be a fall risk
Which of the following is a dermatophyte infection of the fingernails or toes?
C) Onychomycosis
A nurse is caring for a client with an undiagnosed bone disease. When instructing on the normal process to maintain bone tissue, which process transforms osteoblasts into mature bone cells?
C) Ossification and calcification
A client is informed that he has a benign bone tumor but is the type of tumor that may become malignant. What type of tumor does the nurse know that this is characteristic of?
C) Osteoclastoma
The nurse is demonstrating how to perform range-of-motion (ROM) exercises for a patient with tendinitis of the wrist. What intervention can the nurse encourage the client to use in order to decrease discomfort when performing the exercises?
C) Perform the exercises with the hand and wrist under warm water.
A nurse is required to care for a client with facial burns who is prescribed the open method treatment. Which of the following nursing interventions should a nurse perform?
C) Place a bed cradle or sheets over the client.
The nurse knows that inflammatory response following a burn is proportional to the extent of injury. Which factor presents the greatest impact on the ability to modify the magnitude and duration of the inflammatory response in a client with a burn?
C) Preexisting conditions
The nurse is caring for a client who had an amputation of the left leg above the knee. What position can the nurse place the client in several times per day to promote stump extension and prevent contractures?
C) Prone
Which nursing instruction is most important to stress when teaching on calcium intake?
C) Provide age-related calcium intake recommendations.
The nurse is caring for a client who experienced a crushing injury of the lower extremities. Which of the following symptoms is essential to be reported to the physician?
C) Pulselessness
Which of the following would a nurse encourage a client with gout to limit?
C) Purine-rich foods
33. A client has a boil that is located in the left axillary area and is elevated with a raised border, and filled with pus. How would the nurse document this type of lesion?
C) Pustule
Which of the following is the cause of shingles?
C) Reactivated virus
The physician orders an opioid analgesic for a client with a traumatic injury. The nurse would monitor the client closely for which of the following as the priority?
C) Respiratory depression
The nurse is caring for clients with spinal deformities. Which type of deformity would the nurse prioritize as having the most significant consequences on the respiratory system?
C) Scoliosis
The client is admitted with full-thickness burn to the forearm. Which is the most accurate interpretation made by the nurse?
C) Skin grafting will be necessary.
The nurse is caring for a client in the long-term care facility that was living in their home with a family member caring for them. The family member states that they had a difficult time getting the client to eat or drink and he developed a "bed sore." The nurse observes a serous drainage covering the dressing and a 2 × 2 cm crater that is 0.5 cm deep. What stage does the nurse document this pressure sore as?
C) Stage III
The nurse is preparing a client to have his cast cut off after having it for 6 weeks to treat a fracture tibia. What should the nurse inform the client prior to the cast being removed?
C) The skin may be covered with a yellowish crust that will shed in a few days.
A client arrives at the orthopedic clinic and informs the nurse that he thinks he has another stress fracture of the right foot. The physician orders an x-ray with negative results. What does the nurse understand that these negative results can mean?
C) The stress fracture may not be seen on x-ray for a few weeks.
Which of the following superficial fungal infections begin in the skin between the toes and spreads to the soles of the feet?
C) Tinea pedis
A client has severe osteoarthritis in the left hip and is having surgery to replace both articular surfaces of the hip. What type of surgical procedure will the nurse prepare the client for?
C) Total arthroplasty
The nurse is caring for a female with progressive hair loss. When instructing the client on typical considerations to promote hair growth, which would be restricted in the client's care?
C) Use of finasteride (Propecia)
A client is recovering from a fractured hip. The nurse would suggest that the client increase intake of which of the following to facilitate calcium absorption from food and supplements?
C) Vitamin D
The nurse is working at a podiatrist's office. Which assessment finding is characteristic to the acquisition of onychomycosis in women?
C) Wearing artificial nails
A client is a passenger in a vehicle that was hit in the rear by another vehicle. The client is complaining of pain in the neck from the head rapidly moving forward and then back against the headrest. What type of injury does the nurse suspect the client sustained in the accident?
C) Whiplash injury
A client is a passenger in a vehicle that was hit in the rear by another vehicle. The client is complaining of pain in the neck from the head rapidly moving forward and then back against the headrest. What type of injury does the nurse suspect the client sustained in the accident?
C) Whiplash injury
Which of the following would the nurse expect to assess as the most common finding associated with fibromyalgia?
C) Widespread chronic pain
A client is scheduled for a joint replacement surgery. Which action would be most important?
C) Withhold administration of aspirin before the surgery.
A client in skeletal traction has a nursing diagnosis of Impaired Tissue Integrity: Related to puncture wound; pins. What expected outcome would be appropriate for this client?
C) Wounds heal without infection.
A client sustains an injury to the left ankle when he fell down three steps. There was immediate swelling and pain from the injury, and the client was taken to the local emergency department. What initial test does the nurse anticipate the physician will order to rule out a fracture?
C) X-ray
The nurse is caring for a client diagnosed with herpes zoster. Which statement, by the client, needs further clarification by the nurse?
D) "Once I get the infection, I cannot get it again."
A client has severe psoriasis and is scheduled to receive photochemotherapy. The client is to take psoralen methoxsalen prior to exposure to the ultraviolet A. When is the client informed that the medication should be taken?
D) 1 to 2 hours prior to the procedure
A client suffered a fractured femur during a football game. The client asks how long until the bone is back to its former structural strength. What should the client be informed?
D) 12 months
A client with diabetes punctured his foot with a broken acorn in the yard. Within a week, the client developed osteomyelitis of the foot. The client was admitted for IV antibiotic therapy. How long does the nurse anticipate the client will receive IV antibiotics?
D) 3 to 6 weeks
A client calls the clinic and tells the nurse that he was bitten by a tick and is afraid he has Lyme disease. How long does the nurse understand that the tick must be attached to have Lyme disease?
D) 36 to 48 hours
An emergency department nurse is evaluating a client with partial-thickness burns to the entire surfaces of both legs. Based on the rule of nines, what is the percentage of the body burned?
D) 36%
A client is having cryosurgery to remove a growth on the leg. How long will the client be informed that healing will take?
D) 4 to 6 weeks
A patient has sustained a left femur fracture in a skiing accident. When is the nurse aware that the complication of a fat emboli typically occurs and should be monitored for closely?
D) 48 to 72 hours
A client has had a knee replacement and will be discharged in the morning. What does the nurse understand the goal for bending the knee is by discharge?
D) 90°
A client has a rash on the arm that has been treated with an antibiotic without eradicating the rash. What type of examination can be used to determine if the rash is a fungal rash using ultraviolet light?
D) A Wood's light examination
A client arrives at the orthopedic physician's office stating knee pain sustained while playing soccer. A history and physical assessment is completed. The knee appears reddened with edema. Which other diagnostic testing would the nurse anticipate?
D) An arthroscopy
A client comes to the clinic 2 days after sustaining a sprain to the left ankle. What intervention can the nurse encourage the client to perform that will help improve circulation?
D) Applying heat
The nurse is caring for a geriatric client with thin, chapped, itchy skin. Which nursing intervention should the nurse alter in the plan of care?
D) Applying lanolin ointment
The nurse is preparing a client for a surgical procedure that will allow visualization of the extent of joint damage of the knee for a client with rheumatoid arthritis and also obtain a sample of synovial fluid. What procedure will the nurse prepare the client for?
D) Arthroscopy
Which of the following skin substitutes is a nylon-silicone membrane coated with a rotein derived from pig tissue?
D) Biobrane
The nurse is caring for a client who has had emphysema for 10 years. When performing a fingernail assessment, what does the nurse anticipate the client's nails will be documented as?
D) Clubbing
A client sustained a stable fracture of the cervical spine and is having skeletal traction applied. What type of traction does the nurse educate the client about?
D) Crutchfield tongs
A female client comes to the clinic and tells the nurse, "I am getting all these little hairs on my chin. I never had them before I turned 50." What does the nurse understand is the cause of the terminal hairs on the face?
D) Decreased ratio of estrogen to androgen hormones
A client is receiving treatment for a head injury. Which of the following would the nurse do related to positioning to reduce the risk of further injury?
D) Elevate the client's head slightly while keeping the neck neutral.
A 68-year-old female client who had a total hip replacement is to be discharged because her healing is almost complete. Which of the following would be most important for this client
D) Exploring factors related to the client's home environment
The nurse is reporting on the results of client blood work to the oncoming nurse. Upon reviewing the data, it is noted that the client has an elevated uric acid level. Which inflammatory process would the nurse screen for on shift rounds?
D) Gout
A client with scabies has been prescribed a scabicide. Which of the following advice should the nurse give the client before beginning the treatment?
D) Have a thorough bath.
A client informs the nurse that he has been diagnosed with degenerative joint disease of the fingers but now has these bumps on his fingers that don't hurt. The nurse observes bony nodules on the distal interphalangeal joints. What type of "bumps" does the nurse understand these are?
D) Heberden's nodes
Following a serious thermal burn, which complication will the nurse take action to prevent first?
D) Hypovolemia
A client suffered a subtrochanteric hip fracture after falling out of the bed. What complication should the nurse monitor closely for related to this type of fracture?
D) Hypovolemic shock
Which stage of a pressure sore is exhibited by deeply ulcerated tissue, exposing muscle and bone?
D) IV
A client is having traction applied to a fractured left lower extremity prior to surgery. What outcomes does the nurse expect from the application of the traction for the client? Select all that apply.
D) Immobilization of the left leg will be maintained.
When caring for a client in a prenatal clinic who has history of acne vulgaris, which client medication would the nurse advise against?
D) Isotretinoin (Accutane)
The nurse is preparing a client for a hip replacement with the use of porous-coated cementless joint components. What does the nurse know is the benefit of this type of component?
D) It allows the bone to grow into the prosthesis and securely fix the joint replacement in place.
A client has a wart on the left knee but wants to try an over-the-counter medication to dissolve the wart. What type of solution would the nurse educate the client about?
D) Keratolytics
Chapter 63 A client with degenerative joint disease asks the nurse for suggestions to avoid unusual stress on the joints. Which suggestion would be most appropriate?
D) Maintain good posture.
Which of the following pigments influences hair color?
D) Melanin
A client with metastatic bone cancer sustained a left hip fracture without injury. What type of fracture does the nurse understand occurs without trauma or fall?
D) Pathologic fracture
While assessing a client with onychocryptosis, which of the following is evident if the tissue is infected?
D) Purulent drainage and an odor
A client with osteoporosis is prescribed a selective estrogen receptor modifier (SERM) as treatment. The nurse would identify which drug as belonging to this class?
D) Raloxifene (Evista)
A client had a dislocated shoulder, and when healing, the client had insufficient deposits of collagen during the repair stage. What complication is the nurse aware can occur from this lack of collagen?
D) Recurrent dislocations
Chapter 62 A client has a history of dislocations of the same joint. The nurse understands that this is most likely due to an insufficient deposit of collagen during the healing process leading to which of the following?
D) Reduced tensile strength
The nurse is providing education to the client with multiple burns and lists the options for skin grafting and application techniques. Which is the primary benefit for using an autograft slit graft versus other types of grafts?
D) Rejection is unlikely.
A client is brought to the emergency department by a softball team member who states the client and another player ran into each other, and the client is having severe pain in the right shoulder. What symptoms of a fractured clavicle does the nurse recognize?
D) Right shoulder slopes downward and droops inward.
The pediatric nurse is instructing a young athlete and parent regarding tinea pedis. Which nursing advice best decreases frequent attacks?
D) Rotate shoe use.
The nurse is caring for a client who has had a fracture reduction using a cast. Which of the following would be most important for the nurse to assess?
D) Sensation and mobility status
The home health nurse is going to visit a client w is being cared for by family members in the home that has a pressure ulcer. The nurse is going to change the dressing and observe the healing status. The wound is 6 × 7 cm and 2 cm deep and exposes muscle. What does the nurse document this wound as?
D) Stage IV
A client is diagnosed with osteomyelitis. This is most commonly caused by which of the following?
D) Staphylococcus aureus
An explosion of a fuel tanker has resulted in melting of clothing on the driver and extensive full-body burns. The client is brought into the emergency department alert, denying pain, and joking with the staff. Which is the best interpretation of this behavior?
D) The client has experienced partial-thickness burns.
The nurse is assessing four clients in the skin clinic for skin cancer. Which client is of highest risk for skin cancer?
D) The client with scar tissue
The home health nurse is caring for a client with scabies. When instructing on the proper procedure to wash preworn contaminated clothing, which nursing instruction is essential?
D) Use hot water throughout wash cycle.
The nurse is instructing the client on the correct toenail trimming technique when having onychocryptosis. Which instruction, made by the nurse, is best?
D) Use nail clippers allowing the ends of the nails to be longer.
The nurse is assisting a client with removing shoes prior to an examination and observes that the client has a flexion deformity of several toes on both feet of the proximal interphalangeal (PIP) joints. What can the nurse encourage the client to do?
D) Wear properly fitting shoes.
Following a burn, the nurse understands that the focused management of which burn zone is of greatest concern?
D) Zone of stasis
The nurse is assessing the client following orthopedic surgery for a deep vein thrombosis. When performing this assessment, the nurse is most correct to perform which movement?
C) Dorsiflexion
The spouse of a victim, who was struck by lightning, asks the nurse why the areas involved seems so small but the damage is extensive. Which is the best explanation from the nurse?
A) Electrical burns usually follow an internal path.
Plantar warts may be treated with which of the following modalities?
C) Electrodesiccation
A client is suspected to have Lyme disease and has a red macule at the site of the tick bite with a bull's-eye rash with round rings surrounding the center. In addition, the client has a severe headache with neck stiffness. What stage of Lyme disease is the client experiencing?
A) Early stage 1
A client has delayed bone healing in a fractured right humerus. What should the nurse prepare the client for that promotes bone growth?
A) Electrical stimulation
A client is instructed to take an oral calcium preparation with vitamin D daily for the prevention of osteoporosis. What statement made by the client demonstrates understanding of the medication instructions?
A) "I can't take the medication with my other medication."
A client is seen in the emergency department for an injury acquired from falling off of a bicycle and fracturing the arm. The client also has a long laceration that has beens utured in the same area. The client asks the nurse why a splint is applied and not a cast. What is the best explanation by the nurse?
A) "We will need to monitor the status of the laceration to be sure it does not get infected."
A client with suspected osteomalacia has a fractured tibia and fibula. What test would give a definitive diagnosis of osteomalacia?
A) A bone biopsy
The nurse is providing instruction to a client newly diagnosed with herpes zoster. Which two medications does the nurse anticipate to reduce pain and severity of disease symptoms?
A) Acyclovir and prednisone
An older adult client slipped on an area rug at home and fractured the left hip. The client is unable to have surgery immediately and is having severe pain. What interventions should the nurse provide for the patient to minimize energy loss in response to pain?
A) Administer prescribed analgesics around-the-clock.
An older adult client is prescribed a topical antifungal medication to treat a skin infection. The client comes back to the clinic in 7 days and informs the nurse that the treatment was not effective. What does the nurse know can occur in the older adult client with topical drugs?
A) Age-related changes to the skin could decrease the absorption of topical drugs.
A client is scheduled for a total left knee arthroplasty in 2 weeks. When would the best time for postoperative nursing management begin?
A) Before surgery
A group of students are reviewing information about cast composition in preparation for a discussion on the advantages and disadvantages of each. The students demonstrate understanding of the topic when they cite which of the following as an advantage of a plaster cast?
A) Better molding to the client
The nurse is assigned to care for a client who has had an open reduction and internal fixation of a fractured right femur 2 days ago. The nurse is listening to the client's lungs and, when moving the gown, observes petechial hemorrhages on the skin of the chest. What is the first action by the nurse?
A) Call the physician to inform them of the findings.
A client has joined a rowing team and has been enjoying the activity for approximately 1 month. The client comes to the clinic for a routine physical examination and shows the nurse the hands, which are observed to have thickened areas in several areas. What does the nurse recognize these are in response to the repeated friction of the oars?
A) Calluses
One major antimicrobial used in the treatment of burns is silver sulfadiazine (Silvadene) ointment. When providing instructions for the use of silver sulfadiazine (Silvadene), which teaching measure should be stressed?
A) Cleanse skin prior to application.
Which zone consists of the area where the injury is most severe and deepest?
A) Coagulation
A client sustains a fractured right humerus in an automobile accident. The arm is edematous, the client states that he cannot feel or move his fingers, and the nurse does not feel a pulse. What condition should the nurse be concerned about that requires emergency measures?
A) Compartment syndrome
A client arriving at the emergency department is diagnosed with a dislocation. Assessment would most likely reveal which of the following? Select all that apply.
A) Complaint of a popping sound C) Swelling D) Pain
A client is admitted to the emergency room after being hit by a car while riding a bicycle. The client sustained a fracture of the left femur, and the bone is protruding through the skin. What type of fracture does the nurse recognize requires emergency intervention?
A) Compound
The school nurse is instructing a group of high school students on the considerations with tattooing and body piercing. Which instruction would be included in the discussion? Select all that apply. A) Cosmetic pigment is approved by the Federal Food, Drug, and Cosmetic Act. C) Infection is a potential complication of tattoos and piercings. E) Tattoo is injected into the dermal layer of the skin.
A) Cosmetic pigment is approved by the Federal Food, Drug, and Cosmetic Act. C) Infection is a potential complication of tattoos and piercings. E) Tattoo is injected into the dermal layer of the skin.
An older adult client is brought to the emergency department with the complaint that he became overheated while sitting in the sun. The client states, "But I wasn't even perspiring!" What occurs with the older adult that decreases spontaneous sweating and makes him vulnerable to heat?
A) Decrease in the number of eccrine glands
A client is receiving treatment for an acute episode of gout with colchicine. The nurse is administering the medication every 2 hours. What should the nurse be sure the client communicates so that the drug can be temporarily stopped? Select all that apply.
A) Diarrhea C) Intestinal cramping E) Nausea and vomiting
Chapter 64 A client on a prescribed medication for a skin disorder visits the clinic complaining of a skin rash. Which of the following would explain the client's condition?
A) Drug allergy
A patient is scheduled for hip replacement surgery in a month. Which statement made by the client demonstrates understanding for the preoperative instructions?
B) "I will stop taking my aspirin prior to my surgery."
The nurse is caring for a client who had a surgical amputation of the left leg related to complication from diabetes. The client asks the nurse, "If my leg is really gone, then why am I having such bad pain?" What is the best response by the nurse?
B) "It is called phantom pain and may come and go."
Following a burn to a large area of the body, the client receives an Oasis porcine graft. Which statement by the client indicates an understanding of the use of this grafting material?
B) "This graft will not become a permanent part of my skin."
The nurse is assessing a client in the clinic and observes a fine skin rash over the arms and trunk. What question is a priority that the nurse asks related to the rash?
B) "What medication are you taking?"
A nurse is preparing a presentation for a health class about ways to ensure bone health, including the need for an adequate calcium intake. The participants are high school- aged girls. The nurse would encourage them to consume adequate calcium to maximize peak bone mass by which age?
B) 30 to 35 years
The nurse is required to design a teaching plan for a client with a ruptured Achilles tendon. Which of the following would the nurse emphasize?
B) Activity restrictions
During the recovery of an extensive burn, the client is complaining about wearing the tight-fitting custom garment. Which is the best response by the nurse?
C) "A snug fit is needed to minimize scarring and overgrowth of skin."
A manufacturing plant has exploded, and the nurse is assigned to triage burn victims as they arrive to the hospital. Which is the most important question for the nurse to ask prior to the arrival of victims?
C) "Are the burns associated with chemicals used in the plant?"
The nurse is caring for a middle-aged female client who is experiencing premenopausal symptoms. Which client statement indicates the need for further teaching? A) "I like to take a brisk walk in the morning.
C) "Bone resorption slows with aging due to a decrease in estrogen levels."
The nurse is planning care for a client with a musculoskeletal injury. Which nursing diagnosis would be the highest priority?
C) Acute Pain
The nurse is caring for a client with rheumatoid arthritis who suffers with chronic pain in the hands. When would be the best time for the nurse to perform range-of-motion exercises?
C) After the client has had a warm paraffin hand bath
Chapter 60 Which of the following factors would the nurse need to keep in mind about the focus of the initial history when assessing a new client with a musculoskeletal problem?
C) Any chronic disorder or recent injury
Initial first aid rendered at the scene of a fire includes preventing further injury through heat exposure. Which intervention could contribute to tissue hypoxia and necrosis and therefore should be avoided?
C) Application of ice
Chapter 61 A client's cast is removed. The client is worried because the skin appears mottled and is covered with a yellowish crust. What advice should the nurse give the client to address the skin problem?
C) Apply lotions and take warm baths or soaks.
A client is scheduled to have an x-ray examination of his shoulder in which the synovial fluid will be aspirated and sent to the laboratory for analysis. This will be followed by administration of a contrast medium and x-rays. The nurse understands that the client will be undergoing which of the following?
C) Arthrogram
The orthopedic nurse is caring for a client diagnosed with a fracture of the radius. When the nurse is considering all of the various types of bone fractures, which bone type is most anticipated?
C) Cancellous
The nurse is caring for a client who was involved in an automobile accident and sustained multiple trauma. The client has a Volkmann's contracture to the right hand. What objective data does the nurse document related to this finding
C) Clawlike deformity of the right hand without ability to extend fingers
The nurse is working with community groups. At which of the following locations would the nurse anticipate a possible scabies outbreak?
C) College dormitory
An older adult female has a bone density test that reveals severe osteoporosis. What does the nurse understand can be a problem for this client due to the decrease in bone mass and density?
C) Compression fractures
A client has an elevated temperature. The nurse is applying a cool compress to his forehead. This is an example of which of the following types of heat loss?
C) Conduction
The nurse is caring for a client prescribed oral griseofulvin for treatment of a fungal toenail infection. Which instruction, by the nurse, is essential in understanding the treatment plan?
C) Continue medication regimen for several weeks.
Which of the following are benefits that support the use of a closed method wound care in the management of a client with burns? Select all that apply.
C) Creates antimicrobial barrier E) Discourages hypertrophic scarring
The nurse is employed at a long-term care facility caring for geriatric clients. Which assessment finding is characteristic of an age-related change?
C) Depressive symptoms
Which suggestion would be most important to give a client who has a mild case of bunions?
C) Don proper footwear.
Which of the following would the nurse use to determine that a client is exhibiting signs and symptoms of chronic osteomyelitis?
Which of the following would the nurse use to determine that a client is exhibiting signs and symptoms of chronic osteomyelitis? A) High fever B) Persistent draining sinus
