EAQs for Exam 3 CM: AH1

Which role would the nurse assign to unlicensed assistive personnel (UAP) in caring for a client with a cast? Select all that apply. One, some, or all responses may be correct. A) Apply ice to the cast B) Position the casted extremity above the heart level C) Mark the circumference of any drainage on the cast D) Look for clinical manifestations of compartment syndrome E) Teach range-of-motion exercises to the client and caregiver.

ANS: A and B. Apply ice to the cast and position the casted extremity above the heart level.

The nurse notes an older adult's admission orders include gentamicin for the treatment of osteomyelitis. Which laboratory report would the nurse review before beginning the medication? Select all that apply. One, some, or all responses may be correct. A) blood urea nitrogen (BUN) and creatinine B) electrolytes and urinalysis C) erythrocyte count D) blood platelet count E) serum thyroxine levels

ANS: A and B. Blood urea nitrogen (BUN) and creatinine, electrolytes and urinalysis.

Which client would the nurse provide care to first? A) Airway obstruction B) Extensive, full-thickness body burns C) Open fracture D) Closed fracture and abrasions

ANS: A) Airway obstruction

Which medication is derived from a natural source and may be prescribed for the treatment of osteoporosis? A) Calcitonin B) Raloxifene C) Clomiphene D) Bisphosphonates

ANS: A) Calcitonin

A client who has been receiving treatment for osteomyelitis reports hives, mouth sores, and bloody diarrhea. Which medication would the nurse expect to see in the client's medication administration record? A) Cefazolin B) Neomycin C) Tobramycin D) Ciprofloxacin

ANS: A) Cefazolin

A client who has severe back pain is found to have a vertebral compression fracture. Which cause of fracture would the nurse consider when planning interventions? A) collapse of the vertebral bodies B) demineralization of the spinal cord C) wear and tear of the spinous process D) bulging of the spinal cord from the vertebra

ANS: A) Collapse of the vertebral bodies

Which medication to treat osteoporosis would be contraindicated for a client who has a history of renal calculi? A) Os-cal B) Raloxifine C) Ibandronate D) Zoledronic Acid

ANS: A) Os-cal

The nurse is reviewing the history and assessment data for a client who has a total hip replacement 24 hours ago. Which complication would the nurse suspect? A) Fat embolism B) Urinary retention C) Hypovolemic shock D) Pulmonary embolism

ANS: A) fat embolism

Which clinical manifestation is consistent with Sjögren syndrome? Select all that apply. One, some, or all responses may be correct. A) Iritis B) scleritis C) Xerostomia D) baker's cyst E) Keratoconjunctivitis sicca

ANS: C and E. Xerostomia, and keratoconjunctivitis sicca

Which property would the nurse understands the medication is being used primarily for when aspirin is prescribed on a regular schedule for a client with rheumatoid arthritis? A) Analgesic B) Antipyretic C) Anti-inflammatory D) Antiatelet

ANS: C) Anti-inflammatory

A client who had an above-the-knee amputation has an elastic bandage around the residual limb. Which action would the nurse take when rewrapping the bandage? A) Apply it tightly so it does not slip off. B) Reapply it only if it slips off. C) Apply it smoothly without creases. D) Reapply it with the limb in dependent position.

ANS: C) Apply it smoothly without creases.

Which term refers to the exaggerated posterior curvature of a client's thoracic spine? A) Lordosis B) Scoliosis C) Kyphosis D) Osteoporosis

ANS: C) Kyphosis

Which clinical indicator is unique to a fat embolus? A) oliguria B) dyspnea C) petechiae D) confusion

ANS: C) Petechiae

Which factor in the client's history increases the risk for osteoporosis? A) Estrogen therapy B) Hypoparathyroidism C) Prolonged immobility D) Excessive calcium intake

ANS: C) Prolonged immobility

Which factor may have led to the development of flexion contractures in a client with osteoarthritis (OA)? A) Wearing shoes without insoles B) Elevating the legs 8-12 inches C) Using large pillows under the knees or head D) Placing a small pillow under the head in a supine position

ANS: C) Using large pillows under the knees or head

Which laboratory test would the nurse review for a client suspected of rheumatoid arthritis? A) pancreatic lipase B) Bence Jones protein C) antinuclear antibody D) alkaline phosphatase

ANS: C) antinuclear antibody

Which medication may have caused a client's admission to the hospital for treatment of a peptic ulcer, osteoporosis, and hypertension? A) Everolimus B) Azathioprine C) Mycophenolate Acid D) Methylprednisolone

ANS: D) Methylprednisolone

Colchicine 1200 mcg orally is prescribed for client with gout. Each tablet contains 0.6 mg. How many tablets will the nurse administer? Record your answer using a whole number.

2

The nurse is completing the health history of a client admitted to the hospital with osteoarthritis. Which joint would the nurse expect the client to report as having been involved first? Select all that apply. One, some, or all responses may be correct. A) hips B) knees C) ankles D) shoulders E) metacarpals

ANS: A and B. Hips and knees.

A client sustains a crushing injury to the lower left leg, and a below-the-knee amputation is performed. For which common clinical manifestation of a pulmonary embolus would the nurse assess for in this client? Select all that apply. One, some, or all responses may be correct. A) Sharp chest pain B) acute onset of dyspnea C) Pain in the residual limb D) absence of the popliteal pulse E) blanching of the affected extremity

ANS: A and B. Sharp chest pain and acute onset of dyspnea.

Which client statement supports the nurse's conclusion that teaching about osteoporosis was effective? A) "I know that certain illnesses can affect my body's calcium level." B) " I think I can eat all the calcium I need rather than taking medication." C) " I will begin to actively monitor my risk for this disease after menopause." D) " I'm glad that drinking a little wine every day is advised to maintain calcium levels."

ANS: A) " I know that certain illnesses can affect my body's calcium level."

A client who had an above-the-knee amputation (AKA) has a pressure dressing on the end of the residual limb. The client asks, "Why do I have to have this tight dressing on my leg?" Which response would the nurse provide? A) "It decreases the swelling of the area." B) "It decreases the formation of scar tissue." C) "It prevents the formation of blood clots." D) "It reduces phantom limb pain."

ANS: A) "It decreases the swelling of the area."

Which foot disorder is caused by continual pressure over bony prominences? A) corn B) wart C) hammertoe D) hallux rigidus

ANS: A) Corn

A client has closed fractures of the right femur and tibia with multiple soft-tissue contusions. Which action would the nurse plan to take? A) Perform a neurovascular assessment of the extremity. B) Reassure the client that these injuries are not that serious. C) Gather equipment needed for the application of skeletal traction. D) Prepare the client for a surgical reduction of the injured extremity.

ANS: A) Perform a neurovascular assessment of the extremity.

Which complication would the nurse conclude is being experienced by a client who takes four 325-mg tablets for buffered aspirin four times a day for severe arthritis and complains of dizziness and ringing in the ears? A) Salicylate toxicity B) Allergic reaction C) Withdrawal symptoms D) Aspirin tolerance

ANS: A) Salicylate toxicity

For which purpose is a goniometer used? A) To assess range of motion B) To reduce phantom limb sensation C) To prevent hip flexion contractures D) To immobilize a joint during fracture

ANS: A) To assess range of motion.

Which positioning would the nurse plan for a client after a total hip arthroplasty? A) Use a pillow to keep the legs abducted. B) Evaluate the client's affected limb on a pillow. C) Turn the client using the log-rolling technique. D) Place a trochanter roll along the lower leg.

ANS: A) Use a pillow to keep the legs abducted.

A client admitted with a femur fracture 24 hours ago becomes confused. Which action would the nurse take first? A) assess for petechiae. B) administer oxygen. C) check for bilateral foot warmth and pedal pulses. D) Request that the healthcare provider change the pain medication.

ANS: A) assess for petechiae.

Which finding would support the nurse's suspicion that a client has fat embolism syndrome (FES)? Select all that apply. One, some, or all responses may be correct. A) lipid cells in the urine B) PaO2 value of 58 mm Hg C) hematocrit value of 30% D) prothrombin time of 12 seconds E) platelet count of 160,000/mcL

ANS: A, B, and C. Lipid cells in the urine, PaO2 value of 58 mm Hg, hematocrit value of 30%.

Which life-threatening wound is treated with hyperbaric oxygen therapy? Select all that apply. One, some, or all responses may be correct. A) Burns B) skin cancer C) osteomyelitis D) diabetic ulcers E) myocardial infarction

ANS: A, C, D (Burns, osteomyelitis, diabetic ulcers.)

Which factors contribute to development of osteoporosis in female clients? Select all that apply. One, some, or all responses may be correct. A) Cigarette smoking B) Moderate Exercise C) Use of street drugs D) Familial Predisposition E) Inadequate intake of dietary calcium

ANS: A, D, and E. Cigarette smoking, familial predisposition, inadequate intake of dietary calcium.

Which action would the nurse take when providing care for a client who has compartment syndrome? Select all that apply. One, some, or all responses may be correct. A) assist with splitting the cast B) Monitor urine output C) evaluate pain using a pain scale D) apply splints to the injured part E) Place cold compresses on the affected area

ANS: A,B and C. Assist with splitting the cast, monitor urine output, evaluate pain using a pain scale.

The nurse is teaching a client about dietary control of gout. Which statement made by the client indicates successful learning? A) "I will avoid eating eggs." B) "I will avoid eating shellfish." C) "I will avoid eating fried poultry." D) "I will avoid eating cottage cheese."

ANS: B) "I will avoid eating shellfish."

Which client is most at risk for osteoporosis? A) A nonsmoking 60-year-old woman, BMI 27.1 B) A 66-year-old white woman, BMI 18, who is a paralegal. C) A 68-year-old black woman, BMI 23.3, a retired receptionist D) A 62-year-old woman, BMI 23.2, takes calcium carbonate every day.

ANS: B) A 66-year-old white woman, BMI 18, who is a paralegal.

The client with a fractured femur is being prepared for surgery. The client develops a sudden onset of cyanosis, tachycardia, dyspnea, and restlessness. Which action would the nurse take first? A) Call the health care provider. B) Administer Oxygen by mask. C) Obtain an Oxygen saturation level. D) Maintain the client in a semi-Fowler position.

ANS: B) Administer oxygen by mask.

Which nursing intervention is correct for a client in skeletal traction? A) Add and remove weights as the client desires. B) Assess the pin sites at least every shift and as needed. C) Ensure that the knots in the rope are tied to the pulley. D) Perform range of motion to joints proximal and distal to the fracture at least once a day.

ANS: B) Assess the pin sites at least every shift and as needed.

Which medication would the health care provider prescribe to treat the acute attack of gout and prevent future attacks? A) Ibuprofen B) Colchicine C) Probenecid D) Allopurinol

ANS: B) Colchicine

Which client with complications of fracture would the nurse expect may be treated with a fasciotomy? A) Acute respiratory distress syndrome B) Compartment syndrome C) Venous thromboembolism D) Fat embolism syndrome

ANS: B) Compartment syndrome

Which clinical manifestations would the nurse expect when a client experiences fat embolism syndrome (FES)? A) Nausea B) Dyspnea C) Orthopnea D) Paresthesia

ANS: B) Dyspnea

Which finding would the nurse expect to identify in a client who has osteoarthritis that would not be present in clients with rheumatoid arthritis? A) Ulnar drift B) Heberden nodes C) Swan-neck deformity D) Boutonnière deformity

ANS: B) Heberden nodes

Which factor explains why a client who experiences an acute episode of rheumatoid arthritis has swollen finger joints? A) Urate crystals in the synovial tissue B) Inflammation in the joint's synovial lining C) Formation of bony spurs on the joint surfaces D) Deterioration and loss of articulation cartilage joints

ANS: B) Inflammation in the joint's synovial lining.

Which action would the nurse take in caring for a client after surgical placement of an external fixator on the client's leg? A) Cleanse the pin sites with alcohol several times a day. B) Perform a neurovascular assessment of the lower extremities. C) Ambulate the client with partial weight bearing on the affected leg. D) Maintain placement of an abduction pillow between the client's legs.

ANS: B) Perform a neurovascular assessment of the lower extremities.

Which factor would the nurse recognize as a cause of neck pain in a client? A) Headache B) Poor posture C) Low body weight D) Sedentary lifestyle

ANS: B) Poor posture

Which information from the client's history would the nurse identify as a risk factor for developing osteoporosis? A) Takes estrogen therapy B) Receives long-term steroid therapy C) Has a history of hypoparathyroidism D) Engages in strenuous physical activity

ANS: B) Receives long-term steroid therapy

Which diagnostic study is used to determine bone density? A) Diskogram B) Standard x-ray C) computed tomography scan (CT) D) magnetic resonance imaging (MRI)

ANS: B) Standard x-ray

Which response would the nurse provide a client when asked the purpose for using Buck traction before surgery? A) To reduce the fracture. B) To immobilize the fracture. C) To maintain abduction of the leg. D) To eliminate rotation of the femur.

ANS: B) To immobilize the fracture.

A client returns from surgery, after a right below-the-knee amputation, with the residual limb straight, but elevated on a pillow to prevent edema. In which position would the nurse place the client after the first postoperative day? A) Any position, as long as the residual limb remains immobilized. B) Turn client to the prone position for 15-20 minutes at least three times a day. C) For short periods, position the client in the right side-lying position. D) Maintain elevation of the residual limb for a total of 3 days.

ANS: B) Turn client to the prone position for 15-20 minutes at least three times a day.

Which assessment findings would the nurse identify in a client with clinical manifestations of rheumatoid arthritis (RA)? Select all that apply. One, some, or all responses may be correct. A) Obesity and asymmetric joint disease B) development of antinuclear antibodies C) inflammatory disease pattern D) Bilateral involvement of metacarpophalangeal joints E) disease process involving the distal interphalangeal joints F) disease in the weight-bearing joints and hands

ANS: B, C, and D. Development of anti-nuclear antibodies, inflammatory disease pattern, bilateral involvement of metacarpophalangeal joints.

Which dietary suggestion would the nurse provide while teaching a group of geriatric female clients who have reduced amounts of circulating estrogen? A) "include fish in your diet." B) "include fruits in your diet." C) "include yogurt in your diet." D) "include legumes in your diet."

ANS: C) "Include yogurt in your diet."

Which information with the nurse include in the teaching session about care of residual limb to client body below-the-elbow amputation? A) " wear a sling to bed every night." B) " Apply skin lotion and massage it at least twice a day." C) " wash and dry the residual limb at least once a day." D) " Soak the residual limb in warm water for 30 minutes each day."

ANS: C) "Wash and dry the residual limb at least once a day."

A client has a right-above-the-knee amputation after trauma sustained in a work-related accident. Upon awakening from surgery, the client states, "What happened to me? I don't remember a thing." Which is the nurses best response? A) " tell me what you think happened." B) " you will remember more as you get better." C) " you were in a work-related accident this morning." D) " it was necessary to amputate your leg after the accident."

ANS: C) "You were in a work-related accident this morning."

A client with a femoral fracture and osteomyelitis is immobilized for three weeks. Which rationale explains the nurses plan to assess for the development of renal calculi? A) The client's dietary patterns have changed since admission. B) The client has more difficulty urinating in a supine position. C) lack of weight-bearing activity promotes bone demineralization. D) Fracture healing requires more calcium, which increases calcium metabolism.

ANS: C) Lack of weight-bearing activity promotes bone demineralization.

A client reports pain, weakness, and numbness in the neck, back, and shoulders after working long hours at a computer. Which condition found in the client's electronic medical record is congruent with those symptoms? A) Bursitis B) Menuscus injury C) Repetitive strain injury (RSI) D) Carpal tunnel syndrome (CTS)

ANS: C) Repetitive strain injury (RSI)

Which surgery is used as a prophylactic measure and as a palliative treatment for clients with rheumatoid arthritis (RA)? A) Osteotomy B) Arthrodesis C) Synovectomy D) Debridement

ANS: C) Synovectomy

Which food selection by the client with osteoporosis indicates that the nurse's dietary instruction was effective? A) Red meat B) Coffee C) Turnip Greens D) Wheat bran

ANS: C) Turnip greens

Which part of the client's body would the nurse assess to identify osteoporotic changes? A) Long bones B) Facial bones C) Vertebral column D) Joints of the hands

ANS: C) Vertebral column

A thin 24-year-old woman who runs 10 miles each week asks the nurse for advice about preventing osteoporosis. Which vitamin would the nurse recommend? A) Vitamin E B) Vitamin B C) Vitamin D D) Vitamin C

ANS: C) Vitamin D

The nurse finds a client on the floor, crying for help, with signs of a hip fracture. Which action would the nurse take first? A) administer pain medication. B) Place the affected extremity in traction. C) immobilize the affected extremity. D) notify the primary healthcare provider on call.

ANS: C) immobilize the affected extremity.

Which action by a client who requires an above-the-knee amputation for peripheral arterial disease best indicates emotional readiness for the surgery? A) Explains the goals of the procedure B) displays few signs of anticipatory grief C) Participates in learning perioperative care D) Verbalizes acceptance of permanent dependency needs

ANS: C) participates in learning perioperative care

The nurse is assessing a client with arthritis. Which statement made by the client indicates a precipitating factor? A) " The pain is usually present in my fingers and knees." B) " I observed swelling and redness near the pain area." C) " I feel the pain in each and every joint of my hands and legs." D) " I run for 30 minutes every day; this exercise increases my pain."

ANS: D) "I run for 30 minutes every day; this exercise increases my pain."

Which response would the nurse give to a client taking ibuprofen for rheumatoid arthritis who asks the nurse if acetaminophen can be substituted? A) "Yes, both are antipyretics and have the same effect." B) "Acetaminophen irritates the stomach more than ibuprofen does." C) "Acetaminophen is the preferred treatment for rheumatoid arthritis." D) "Ibuprofen has anti-inflammatory properties, and acetaminophen does not."

ANS: D) "Ibuprofen has anti-inflammatory properties, and acetaminophen does not."

Which instruction will the nurse provide to a client with type 2 diabetes who develops gout when teaching about the administration of allopurinol? A) "Allopurinol masks symptoms of hypoglycemia." B) "Increase your oral hypoglycemic medications." C) "Increase attention to diabetic foot care." D) "Monitor blood glucose levels more frequently."

ANS: D) "Monitor blood glucose levels more frequently."

Which nursing intervention would the nurse include in the plan of care for an older adult client with decreased bone density? A) Teaching the client isometric exercises B) advising the client to take a warm shower C) providing supportive armchairs to the client D) Demonstrating weight-bearing exercises to the client

ANS: D) Demonstrating weight-bearing exercises to the client

After completing physical assessments and review of laboratory data, which client with the nurse identify as having findings consistent with rheumatoid arthritis? A) uric acid 8.5 mg/dL B) c-reactive proteins (CRP) 800 mcg/dL C) anti-deoxyribonucleic acid (DNA) antibody 90 IU/mL D) Erythrocyte sedimentation rate (ESR) 65mm/Hour

ANS: D) ESR of 65mm/Hour

Which action would the nurse instruct the unlicensed assistive personnel (UAP) to perform to prevent hip dislocation in a client recovering from a total hip arthroplasty via posterior approach? A) Raise heels off the bed. B) Change positions slowly. C) Use a gait belt during ambulation. D) Insert abduction pillow between legs.

ANS: D) Insert abduction pillow between legs.

Which definition would the nurse use to explain osteoporosis? A) It is avascular necrosis B) It is caused by pathological fractures C) It is hyperplasia of osteoblasts. D) It involves a decrease in bone substance.

ANS: D) It involves a decrease in bone substance.

Which type of diet with the nurse expect the primary healthcare provider to prescribe for a client diagnosed with rheumatoid arthritis? A) Salt-free, low-fiber diet B) High-calorie, low-cholesterol diet C) High-protein diet with minimal calcium D) Regular diet with vitamins and minerals

ANS: D) Regular diet with vitamins and minerals

While assessing an immobilized client, the nurse notes that the client has shortened muscles over a joint, preventing full extension. Which is this condition known as? A) osteoarthritis B) osteoporosis C) muscle atrophy D) contracture

ANS: D) contracture

A client with osteoarthritis (OA) reports experiencing painful back muscle spasms. Which medication would the nurse administer? A) tramadol B) hyaluronate C) Diclofenac Epolamine patch D) cyclobenzaprine hydrochloride

ANS: D) cyclobenzaprine hydrochloride