EVOLVE QUESTIONS, MS EXAM 4 ATI BOOK, MEDSURG EXAM 4 TXTBK, MS EXAM4

The nurse provides instructions to an adult office worker who has low back pain. Which statement indicates additional patient teaching is required?

"Acupuncture to the lower back would cause irreparable nerve damage."

A patient has come to the clinic with a gradual onset of pain and swelling in the left knee. The patient is diagnosed with osteosarcoma without metastasis. Chemotherapy is ordered before surgery. How would the nurse explain the reason for preoperative chemotherapy?

"Chemotherapy is being used to decrease the tumor size."

The nurse is admitting a patient who reports the new onset of lower back pain. To distinguish between the pain of a lumbar herniated disc from other causes, what is the best question for the nurse to ask the patient?

"Does the pain radiate down the buttock or into the leg?"

A patient who had a long leg cast applied this morning asks to crutch walk before dinner. Which statement explains the reason the nurse will decline the patient's request?

"Excess edema and complications are prevented when the leg is elevated for 24 hours."

A young adult soccer player has injured the anterior cruciate ligament (ACL) and is having reconstructive surgery. Which patient statement indicates more teaching is required?

"I can't wait to get this done now so I can play in the soccer tournament next month."

The nurse obtains a history from a patient with rheumatoid arthritis. The nurse would follow up on which patient statement?

"I restrict fluids to prevent edema when taking methotrexate (Rheumatrex)."

The nurse has reviewed proper body mechanics with a patient who has a history of low back pain caused by a herniated lumbar disc. Which statement indicates a need for further teaching?

"I should pick up items by leaning forward without bending my knees."

A patient with osteoporosis shows an understanding of appropriate self-care when they state

"I should remove trip hazards such as throw rugs in my house to make it safer."

When reinforcing health teaching on managing osteoarthritis (OA), which patient statement indicates additional instruction is needed?

"I should try to stay standing all day to keep my joints from becoming stiff."

A nurse is teaching a client who has systemic lupus erythematosus (SLE) about self care. Which of the following statements by the client indicates an understanding of teaching?

"I should use a mild hair shampoo"

The nurse is delivering teaching to a patient newly diagnosed with systemic lupus erythematosus (SLE). Which statement demonstrates the patient's need for further teaching about the disease?

"I'm hoping surgery will be an option for me in the future."

A patient with acute osteomyelitis asks the nurse how this problem will be treated initially. Which response by the nurse is most appropriate?

"IV antibiotics are usually required for several weeks."

A young adult patient with systemic lupus erythematosus (SLE) tells the nurse "I want to have a baby" and is "considering getting pregnant." Which response by the nurse is most appropriate?

"Infertility can result from some medications used to control your disease."

A nurse performs discharge teaching for a patient after a left hip arthroplasty using the posterior approach. Which statement indicates teaching is successful?

"Leg-raising exercises are necessary for several months."

Which statement suggests a need for the nurse to assess the patient for ankylosing spondylitis?

"My lower back pain seems to be getting worse and nothing seems to help."

A patient with history of colon cancer is diagnosed with rib fractures, and the HCP orders a bone scan. The nurse determines the patient understands teaching about the purpose of the procedure when they state

"The bone scan will see if my colon cancer may have spread."

The nurse receives a report from the licensed practical nurse (LPN/VN) about care provided to patients in the orthopedic surgical unit. It is most important for the nurse to follow up on which statement?

"The patient who had spinal surgery 3 hours ago is reporting a headache and has clear drainage on the dressing."

A nurse is teaching a client who has a new diagnosis of rheumatoid arthritis. Which of the following statements should the nurse include in the teaching?

"You can experience morning stiffness when you get out of bed"

Assessment findings that the nurse would expect in a patient with rheumatoid arthritis who has articular involvement include (select all that apply)

- metatarsal head dislocation in feet -morning stiffness lasting 60 minutes or more

A patient with osteoarthritis is scheduled for total hip arthroplasty. The nurse explains the purpose of this procedure is to (select all that apply)

- replace the joint. -improve or maintain ROM

A nurse is performing health screenings at a health fair. Which of the following clients have a risk factor of osteoporosis? (SATA)

-40 yr old client who has been taking prednisone for 4 months -45 yr old client who takes phenytoin for seizures -65 yr old client who has a sedentary lifestyle -70 ye old client who has smoked for 50 years

Which persons are at high risk for chronic low back pain? (select all that apply)

-A 63-year-old man who is a long-distance truck driver -A 30-year-old nurse who works on an orthopedic unit and smokes -A 55-year-old construction worker who is 6 ft, 2 in and weighs 250 lb -A 44-year-old female chef with prior compression fracture of the spine

A patient presents to the clinic after tripping on a curb and spraining the right ankle. Which initial care measures are appropriate? (Select all that apply.)

-Administer antinflammatory medication. -Compress the ankle using an elastic bandage. -Rest and elevate the ankle above the heart.

A nurse is providing information to a client who has osteoarthritis of the hip and knee. Which of the following information should the nurse include in the information? (SATA)

-Apply heat to joints to alleviate pain -Reduce the amount of exercise done on days with increased pain -Active range of motion is more effective than passive

A patient with longstanding Raynaud's phenomenon currently reports red spots on the hands, forearms, palms, face, and lips. Which additional findings would the nurse expect? (Select all that apply.)

-Calcinosis -Sclerodactyly -Difficulty swallowing -Skin thickening below the elbow and knee

A nurse is providing teaching for a client who has a history of low back injury. Which of the following instructions should the nurse give to the client to prevent future problems with low back pain? (SATA)

-Engage in regular exercise including walking -Create a smoking cessation plan -Wear low heeled shoes

A nurse is caring for a client who has rheumatoid arthritis. Which of the following laboratory tests are used to diagnose this disease? (SATA)

-Erythrocyte sedimentation rate (ESR) -Antinuclear antibody (ANA) titer -WBC count

A nurse is assessing a client who has osteoarthritis of the knees and fingers. Which of the following manifestations should the nurse expect to find? (SATA)

-Herberden's nodes -Enlarged joint size -Limp when walking

A nurse is teaching a client how to manage an external fixation device upon discharge. Which of the following statements by the client indicates understanding? (SATA)

-I will clean the pins more often if drainage from the pins increases -I will use a separate cotton swab for each pin -I will report loosening of the pins to my doctor -I will report increased redness at the pin sites

A nurse is assessing a client who had an external fixation device applied 2 hr ago for a fracture of the left tibia and fibula. Which of the following findings is a manifestation of compartment syndrome? (SATA)

-Intense pain when the client's left foot is passively moved -Hard, swollen muscle in the client's left leg -Burning and tingling of the client's left foot

A patient with acute osteomyelitis is being discharged on antibiotic therapy. What would the nurse include in the teaching plan? (select all that apply)

-It is important to finish all the antibiotics even if you feel better. -You will need to schedule periodic through bone scans and ESR testing. -Signs such as fever and night sweats may be present but are usually not severe. -Contact the HCP if signs of infection such as pain and swelling at the site occur.

A nurse is admitting an adult client who has suspected osteoporosis. Which of the following findings are risk factors for osteoporosis? (SATA)

-Loss in height of 2 inches -BMI of 18 -Kyphotic curve at upper thoracic spine -History of lactose intolerance

A patient with fibromyalgia has pain at 12 of the 18 identified tender sites, including the neck, upper back, and knees. The patient reports nonrefreshing sleep, depression, and anxiety when dealing with multiple tasks. Which treatments would be included in the plan of care? (Select all that apply.)

-Massage therapy -Low-impact aerobic exercise -Relaxation strategy (biofeedback) -Antiseizure drug pregabalin (Lyrica) -Serotonin reuptake inhibitor (e.g., sertraline [Zoloft])

A nurse is reviewing the plan of care for a client who has systemic lupus erythematosus (SLE). The client reports fatigue, joint tenderness, swelling, and difficulty urinating. Which of the following laboratory findings should the nurse anticipate?

-Postive ANA titer -2+ urine protein -Elevated BUN

A nurse assesses a patient with joint pain and stiffness who was diagnosed with stage III rheumatoid arthritis (RA). Which additional characteristics would the nurse expect? (Select all that apply.)

-Presence of nodules -Subluxation of joints without fibrous ankylosis

A nurse is working in an outpatient clinic is assessing a client who has rheumatoid arthritis (RA). The client reports increased joint tenderness and swelling. Which of the following findings should the nurse expect? (SATA)

-Recent influenza -Decreased range of motion -Pain at rest

A nurse is planning discharge teaching on home safety for an adult client who has osteoporosis. Which of the following information should the nurse include in the teaching? (SATA)

-Remove throw rugs in walkways -Use prescribed assistive devices -Remove clutter from the environment -Maintain lighting of doorway areas

Teach the patient with fibromyalgia the importance of limiting intake of which foods? (select all that apply)

-Sugar -Alcohol -Caffeine

A nurse is discussing gout with a client who is concerned about developing the disorder. Which of the following findings should the nurse identify as risk factors for this disease? (SATA)

-diuretic use -obesity -cardiovascular disease

A patient who ran his first marathon had heel pain that would not resolve and was diagnosed with calcaneus stress fracture. The nurse will teach the patient to (select all that apply)

-rest and refrain from running. -wear a shoe heel pad when ambulating. -apply ice to the heel and take NSAIDs as directed by HCP.

The nurse is caring for patients in a primary care clinic. Which patient is most at risk to develop osteomyelitis caused by Staphylococcus aureus?

A patient with type 1 diabetes and stage 4 pressure injury

The patient developed acute gout while hospitalized for a heart attack. Because the patient takes aspirin for its antiplatelet effect, what would the nurse recommend to prevent future attacks of gout?

Administration of allopurinol

A nurse is assessing a client who has a new diagnosis of systemic lupus erythematosus (SLE). Which of the following findings should the nurse expect?

Alopecia

A nurse is assessing a client who has a casted compound fracture of the femur. Which of the following findings is a manifestation of a fat embolus?

Altered mental status

A nurse is completing discharge teaching to a client who has a wound debridement for osteomyelitis. Which of the following information should the nurse include?

Antibiotic therapy should continue for 3 months

The patient with frostbite on the distal toes of both feet is scheduled for amputation of the damaged tissue. Which assessment finding or diagnostic study is most objective in determining tissue viability?

Arteriogram showing blood vessels

The nurse is admitting a patient with a history of a herniated lumbar disc and low back pain. Which action would likely aggravate the pain?

Bending or lifting

The nurse is caring for a patient hospitalized with a herniated lumbar disc and an exacerbation of chronic bronchitis. Which breakfast choice would be most appropriate for the patient to select from the breakfast menu?

Bran muffin

A nurse in the emergency department is planning care for a client who has a right hip fracture Which of the following immobilization devices should the nurse anticipate in the plan of care?

Buck's traction

The public health nurse is providing community education to increase the number of people who seek care after a tick bite. What information would the nurse provide to people at risk for tick bites?

Check for an enlarging reddened area with a clear center.

Which drug would the nurse prepare to administer to the patient with acute gout?

Colchicine

Which drug would the nurse plan to administer to the patient with Sjögren syndrome with the goal of improving symptoms of dry eyes?

Cyclosporine (Restasis)

The nurse completes an admission history for a patient with osteoarthritis scheduled for total knee arthroplasty. Which response is expected when asking the patient the reason for admission?

Debilitating joint pain

A nurse is working with a patient with osteoarthritis. Which description of the disorder would be included in the teaching plan?

Degeneration of articular cartilage in synovial joints

The nurse is caring for a patient with bilateral knee osteoarthritis (OA). Which measure would the nurse recommend to slow disease progression?

Eat a well-balanced diet to maintain a healthy body weight.

The nurse teaches a patient with gouty arthritis about food that may be consumed on a low-purine diet. The patient's choice of which food item indicates an understanding of the instructions?

Eggs

A patient who has low back pain from a herniated lumbar disc is having muscle spasms. Which nursing intervention would be most appropriate?

Elevate the head of the bed 20 degrees and flex the knees.

A patient has a plaster cast applied to the right arm for a Colles' fracture. Which nursing action is most appropriate?

Elevate the right arm on 2 pillows for 24 hours.

The nurse determines that a patient recovering from left total knee arthroplasty has impaired physical mobility from decreased muscle strength. What nursing intervention is appropriate?

Encourage isometric quadriceps-setting exercises at least 4 times a day.

The nurse is reinforcing health teaching about osteoporosis with a patient admitted to the hospital. What would the nurse explain to the patient?

Even with a family history of osteoporosis, the calcium loss from bones can be slowed by increased calcium intake and exercise.

The patient brought to the emergency department after a car accident is diagnosed with a femur fracture. What nursing intervention would the nurse implement at this time to decrease risk of a fat embolus?

Immobilize the fracture preoperatively.

A nurse is providing dietary teaching about calcium rich foods to a client who has osteoporosis. Which of the following foods should the nurse include in the instructions?

Kale

The nurse is caring for a patient with osteoarthritis scheduled for total left knee arthroplasty. Preoperatively, the nurse assesses for which contraindication to surgery?

Left knee infection

The home care nurse visits a patient with Parkinson's disease who fell while walking this morning. What observation is of most concern to the nurse?

Left leg externally rotated and shorter than the right leg

A patient underwent amputation below the knee on the left leg after a traumatic accident. Which intervention would the nurse include in the plan of care?

Lie prone with hip extended for 30 minutes 4 times per day.

The nurse is caring for a patient admitted to the nursing unit with osteomyelitis of the tibia. When completing a focused assessment, which finding would the nurse expect?

Localized pain and warmth

A patient is diagnosed with Paget's disease. Which finding would indicate improvement in the condition?

Lower serum alkaline phosphatase

The nurse is completing discharge teaching with a patient who is recovering from a right total hip arthroplasty by posterior approach. Which patient action indicates further instruction is needed?

Maintains hip in adduction and internal rotation.

During a health screening event, which assessment finding in an older adult would alert the nurse to the possible presence of osteoporosis?

Measurable loss of height

The nurse is caring for a patient placed in Buck's traction before open reduction and internal fixation of a left hip fracture. Which care can be delegated to the LPN/VN?

Monitor pain intensity and administer prescribed analgesics.

A patient with breast cancer is admitted for severe back pain related to a vertebral compression fracture. Laboratory values include serum potassium of 4.5 mEq/L, serum sodium of 144 mEq/L, and serum calcium of 14.3 mg/dL. Which signs and symptoms would the nurse expect the patient to exhibit?

Nausea, vomiting, and altered mental status

A patient with a fracture of the proximal left tibia in a long leg cast reports of severe pain and a prickling sensation in the left foot. The toes on the left foot are pale and cool. Which nursing action is a priority?

Notify the health care provider immediately.

The nurse is admitting a patient who is scheduled for knee arthroscopy related to osteoarthritis (OA). Which finding would the nurse expect when examining the patient's knees?

Pain with joint movement

A nurse is caring for a client who has systemic lupus erythematosus (SLE) and is experiencing an episode of Raynaud's phenomenon. Which of the following findings should the nurse anticipate?

Pallor of toes with cold exposure

A patient hospitalized with osteomyelitis has an order for bed rest with bathroom privileges and elevation of the affected foot on 2 pillows. The nurse would place the highest priority on which intervention?

Perform frequent position changes and range-of-motion (ROM) exercises.

A nurse is providing care for a client who has a vertebroplasty of the thoracic spine. Which of the following actions should the nurse take?

Place the client in a supine position

Which nursing intervention is most appropriate when turning a patient after spinal surgery?

Placing a pillow between the patient's legs and turning the body as a unit

Four patients have been newly diagnosed with connective tissue disorders. The nurse is concerned with safety issues and interstitial lung involvement for the patient with which diagnosis?

Polymyositis

The nurse is caring for a patient who had a left total knee arthroplasty to relieve the pain of severe osteoarthritis. What care would be expected postoperatively?

Progressive leg exercises to obtain 90-degree flexion

A nurse is providing information about capsaicin cream to a client who reports continuous knee pain from osteoarthritis. Which of the following information should the nurse include in the discussion?

Put on gloves before applying the cream to other parts of the body

A nurse is assessing the recent health history of a patient with osteoarthritis (OA). Which activity pattern would the nurse recommend?

Regular exercise program of walking

When the patient is diagnosed with muscular dystrophy, what information would the nurse include in the teaching plan?

Remain active to prevent skin breakdown and respiratory complications.

The nurse determines diet teaching for a patient with osteoporosis has been successful when the patient selects which meal as highest in calcium?

Sardine (3 oz) sandwich on whole wheat bread, 1 cup of fruit yogurt, and 1 cup of skim milk

A nurse is caring for a client who received a lower back injury during a fall and describes sharp pain in the back and down the left leg. In which of the following positions should the nurse place the client to decrease pain?

Semi-Fowler's with a pillow under the knees

When caring for a patient after lumbar spinal surgery, the nurse would immediately report which finding to the HCP?

The patient has loss of sensation to the perineum, buttocks, inner thighs, and back of the legs.

Which nursing intervention is appropriate for a patient with Sjögren's syndrome?

Use lubricating eyedrops frequently.

An injured soldier who underwent left leg amputation has been reporting shooting pain and heaviness in the left leg. What action may help resolve symptoms long-term?

Using mirror therapy

The nurse is planning health promotion teaching for a patient with asthma who has low back pain from herniated lumbar disc. What activity would the nurse include in an individualized exercise plan for the patient?

Walking

A patient with osteoporosis shows an understanding of appropriate self-care when they state a. "I should remove trip hazards such as throw rugs in my house to make it safer." b. "I am not using the cane my HCP recommended. I don't want to look that old!" c. "I can continue to go downhill skiing as long as I'm careful and don't ever fall." d. "I need to take up running to help strengthen my bones. Walking is just not enough."

a. "I should remove trip hazards such as throw rugs in my house to make it safer."

A patient with OA asks the nurse if he could try glucosamine and chondroitin for symptom management. How would the nurse respond? a. "Results of research have been mixed and most medical groups do not recommend their use." b. "Most patients find these supplements helpful for relieving athritis pain and improving mobility." c. "These supplements are a fad that have not been shown to reduce pain or increase joint mobility" d. "High dosages of these supplements are needed for the patient to receive any benefit in treating OA."

a. "Results of research have been mixed and most medical groups do not recommend their use."

Which persons are at high risk for chronic low back pain? (select all that apply) a. A 63-year-old man who is a long-distance truck driver b. A 30-year-old nurse who works on an orthopedic unit and smokes c. A 55-year-old construction worker who is 6 ft, 2 in and weighs 250 lb d. A 44-year-old female chef with prior compression fracture of the spine e. A 28-year-old female yoga instructor who is 5 ft, 6 in and weighs 130 lb

a. A 63-year-old man who is a long-distance truck driver b. A 30-year-old nurse who works on an orthopedic unit and smokes c. A 55-year-old construction worker who is 6 ft, 2 in and weighs 250 lb d. A 44-year-old female chef with prior compression fracture of the spine

A patient withracute osteomyelitis is being discharged on antibiotic therapy. What would the nurse include in the teaching plan? (select all that apply) a. It is important to finish all the antibiotics even if you feel better. b. You will need to schedule periodic bone scans and ESR testing. c. If the infection comes back, you must contact the HCP to schedule surgery. d. Signs such as fever and night sweats may be present but are usually not severe. e. Contact the HCP if signs of infection such as pain and swelling at the site Occur.

a. It is important to finish all the antibiotics even if you feel better. b. You will need to schedule periodic bone scans and ESR testing. d. Signs such as fever and night sweats may be present but are usually not severe. e. Contact the HCP if signs of infection such as pain and swelling at the site Occur.

What would the nurse include in the teaching plan for the patient with SLE? a. Ways to avoid exposure to sunlight b. Ways to increase dietary protein and carbohydrate intake c. The need for genetic counseling before planning a family d. The use of nonpharmacologic pain interventions instead of analgesics

a. Ways to avoid exposure to sunlight

A patient with a humeral fracture is returning for a 4-week checkup. The nurse explains that initial evidence of healing on x-ray is indicated by a. formation of callus. b. complete bony union. c. hematoma at the fracture site. d. presence of granulation tissue.

a. formation of callus.

The nurse determines that teaching about management of osteoarthritis of the feet and hands has been effective when the patient says: a. "I will be careful to avoid crowds and people with infections." b. "I can use heat to relieve the stiffness when I wake up in the morning." c. "I should exercise my hands every day, especially if they are painful and inflamed." d. "I should avoid the use of glucosamine as it does not have any therapeutic value."

b. "I can use heat to relieve the stiffness when I wake up in the morning."

A patient with newly diagnosed SLE asks the nurse how the disease will affect her life. What is the nurse's best response? a. "You can plan to have a near-normal life, since SLE rarely causes death." b. "It is hard to say because the disease is so variable in its severity and progression." c. "Life span is shortened in people with SLE, but the disease can be controlled with long-term corticosteroid use." d. "Most people with SLE have alternating periods of remissions and exacerbations that rapidly progress to permanent organ damage."

b. "It is hard to say because the disease is so variable in its severity and progression."

During assessment of the patient diagnosed with fibromyalgia, what would the nurse expect the patient to report in addition to widespread pain? a. Generalized muscle twitching and spasms b. Nonrestorative sleep with resulting fatigue c. Profound and progressive muscle weakness that limits ADLs d. Widespread musculoskeletal pain that is accompanied by inflammation and fever

b. Nonrestorative sleep with resulting fatigue

What would the nurse teach the patient with OA to preserve function and the ability to perform activities of daily living (ADLs)? a. Avoid exercise that involves the affected joints. b. Plan and organize task performance to be less stressful to joints. c. Maintain normal activities during an acute episode to prevent loss of function. d. Use mild analgesics to control symptoms when performing tasks that cause pain.

b. Plan and organize task performance to be less stressful to joints.

Alendronate (Fosamax) is prescribed for a patient with osteoporosis. The nurse teaches the patient that. a. the drug must be taken with food to prevent Gl side effects. b. bisphosphonates prevent calcium from being taken from the bones. c. lying down after taking the drug prevents light-headedness and dizziness. d. taking the drug with milk enhances the absorption of calcium from the bowel.

b. bisphosphonates prevent calcium from being taken from the bones.

In assessing the joints of a patient with osteoarthritis, the nurse understands that Heberden nodes a. are often red, swollen, and tender. b. indicate osteophyte formation at the DIP joints. c. are the result of pannus formation at the PIP joints. d. occur from deterioration of cartilage caused by proteolytic enzymes.

b. indicate osteophyte formation at the DIP joints.

A patient is scheduled for total ankle replacement. The nurse should tell the patient that after surgery he should avoid

bearing weight on the affected leg for 6 weeks.

Which patient would be at greatest risk for developing osteoporosis? a. 73-year-old man who has 5 alcoholic drinks per week and limits sun exposure to prevent recurrence of skin cancer. b. An 84-year-old man who has recently been diagnosed with hypothyroidism and is prescribed levothyroxine (Synthroid). c. A 69-vear-old woman who had a renal transplant 5 years ago and has been taking prednisone to prevent organ rejection. d. A 55-year-old woman who recently had a hysterectomy with bilateral salpingo-oophorectomy and refuses estrogen therapy.

c. A 69-vear-old woman who had a renal transplant 5 years ago and has been taking prednisone to prevent organ rejection.

A 70-year-old patient is being evaluated for symptoms of RA. What would the nurse recognize as the major problem in the management of RA in the older adult? a. RA is usually more severe in older adults. b. Older patients are not as likely to comply with treatment regimens. c. Drug interactions and toxicity are more likely to occur with multidrug therapy. d. Laboratory and other diagnostic tests are not effective in identifying RA in older adults.

c. Drug interactions and toxicity are more likely to occur with multidrug therapy.

What is an ominous sign of advanced SLE? a. Proteinuria from early glomerulonephritis b. Anemia from antibodies against blood cells c. Dysrhythmias from fibrosis of the atrioventricular node d. Cognitive dysfunction from immune complex deposit in the brain

c. Dysrhythmias from fibrosis of the atrioventricular node

What would the nurse check when assessing the patient with early to moderate RA? a. Hepatomegaly b. Heberden's nodes c. Spindle-shaped fingers d. Crepitus on joint movement

c. Spindle-shaped fingers

The nurse suspects a neurovascular problem based on assessment of a. exaggerated strength with movement b. increased redness and heat below the injury c. decreased sensation distal to the fracture site d. purulent drainage at the site of an open fracture.

c. decreased sensation distal to the fracture site

A patient with a comminuted fracture of the tibia is to have an open reduction with internal fixation (ORIF) of the fracture. The nurse explains that ORIF is indicated when a. the patient cannot tolerate prolonged immobilization. b. the patient cannot tolerate the surgery for a closed reduction. c. other nonsurgical methods cannot achieve adequate alignment. d. a temporary cast would be too unstable to provide normal mobility.

c. other nonsurgical methods cannot achieve adequate alignment.

The nurse would monitor a patient with a pelvic fracture for

changes in urine output.

What is most likely to cause the pain experienced in the later stages of OA? a. Crepitation b. Bouchard's nodes c. Heberden's nodes d. Bone surfaces rubbing together

d. Bone surfaces rubbing together

A patient is undergoing diagnostic testing for symptoms of polyarthralgia, fatigue, and hair loss. Laboratory results include the presence of anti-DINA, antinuclear antibodies, and anti-Smith in the blood. The nurse recognizes that these findings are most likely to be related to which diagnosis? a. Systemic sclerosis b. Rheumatoid arthritis c. Chronic fatigue syndrome d. Systemic lupus erythematosus

d. Systemic lupus erythematosus

What would the nurse teach the patient with fibromyalgia? a. Rest the muscles as much as possible to avoid triggering pain. b. Plan night-time sleep and naps to obtain 12 to 14 hours of sleep a day. c. Try using food supplements, such as glucosamine and chondroitin, for pain relief. d. Use techniques, such as meditation and cognitive behavioral therapy, to manage stress.

d. Use techniques, such as meditation and cognitive behavioral therapy, to manage stress.

Assessment findings that the nurse would expect in a patient with rheumatoid arthritis who has articular involvement include? a. bamboo-shaped fingers b. noninflammatory pain in large joints c. asymmetric involvement of small joints d. morning stiffness lasting 60 minutes or more

d. morning stiffness lasting 60 minutes or more

The nurse provides counseling to a family of a patient with Duchenne muscular dystrophy with the knowledge that a. patients are usually female. b. all daughters of a carrier will be carriers. c. genetic testing can help determine treatment. d. only males can pass the gene to their offspring.

d. only males can pass the gene to their offspring.

A patient with a stable, closed humeral fracture has a temporary splint with bulky padding applied with an elastic bandage. The nurse suspects early compartment syndrome when the patient has a. increasing edema of the limb. b. muscle spasms of the lower arm. c. bounding pulse at the fracture site. d. pain when passively extending the fingers.

d. pain when passively extending the fingers.

A plaster splint is applied with an elastic bandage to the leg of a patient with a fractured tibia in preparation for open reduction and internal fixation. The patient reports increasing pain in the affected leg and foot that is not relieved by loosening of the elastic bandage. The 1st action by the nurse is to: a. elevate the leg on 2 pillows. b. notify the health care provider. c. apply an ice bag over the fracture site. d. perform neurovascular assessment of the foot.

d. perform neurovascular assessment of the foot.

The nurse suspects a neurovascular problem based on assessment of

decreased sensation distal to the fracture site.

A patient with a humeral fracture is returning for a 4-week checkup. The nurse explains that initial evidence of healing on x-ray is indicated by

formation of callus.

The nurse teaches the patient with an above-the-knee amputation that the residual limb should not be routinely elevated because this position promotes

hip flexion contracture.

In assessing the joints of a patient with osteoarthritis, the nurse understands that Heberden nodes

indicate osteophyte formation at the DIP joints.

The nurse provides counseling to a family of a patient with Duchenne muscular dystrophy with the knowledge that

only males can pass the gene to their offspring.

A patient with a comminuted fracture of the tibia is to have an open reduction with internal fixation (ORIF) of the fracture. The nurse explains that ORIF is indicated when

other nonsurgical methods cannot achieve adequate alignment.

A patient with a stable, closed humeral fracture has a temporary splint with bulky padding applied with an elastic bandage. The nurse suspects early compartment syndrome when the patient has

pain when passively extending the fingers.

The nurse should teach the patient with ankylosing spondylitis the importance of

regularly exercising and maintaining proper posture.

In teaching a patient with systemic lupus erythematosus about the disorder, the nurse knows the pathophysiology includes

the production of a variety of autoantibodies directed against components of the cell nucleus.

The nurse in urgent care suspects an ankle sprain when a patient describes

twisting his ankle while running bases during a baseball game.