Exam #2: Musculoskeletal
C. Sciatica
A patient complains of back pain that goes all the way down the back of the leg to her foot. The RN should document what type of pain? A. Bursitis B. Radiculopathy C. Sciatica D. Tendonitis
B. Risk for ineffective peripheral tissue perfusion
A patient had a knee replacement. The affected leg has a decreased pedal pulse. What is the priority diagnosis for this patient? A. Risk for infection B. Risk for ineffective peripheral tissue perfusion C. Unilateral neglect related to hematoma D. Disturbed kinesthetic sensory perception
C. Assess the surgical site and the affected extremity
A patient had a total hip surgery and after moving, the patient a new onset of pain occurs at the surgical site. Which is the RNs best action? A. Administer pain medication as prescribed B. Reassure the client the pain is direct result of increased activity C. Assess the surgical site and the affected extremity D. Assess the client for signs and symptoms of a systemic infection
A. Osteomyelitis
A patient has a leg ulcer which is swollen and warm to the touch. The patient should undergo diagnostic testing for which health problem? A. Osteomyelitis B. Osteomalacia C. Osteoporosis D. Septic arthritis
D. Keep an elastic compression bandage on the ankle
A patient has an ankle sprain. While providing discharge education, the RN should encourage what action? A. Apply heat for the first 24 to 48 hours after the injury B. Maintain the ankle in a dependent position C. Exercise hourly by performing rotation exercises of the ankle D. Keep an elastic compression bandage on the ankle
A. Preventing additional injury C. Providing support D. Controlling movement
A patient has had a brace prescribed to facilitate recovery. What are the potential therapeutic benefits of a brace? Select all that apply A. Preventing additional injury B. Immobilizing prior to surgery C. Providing support D. Controlling movement
A. Carpal tunnel syndrome
A patient has pain and numbness to his thumb, 1st and second finger of the right hand which is worse with work. The patient may have... A. Carpal tunnel syndrome B. Tendonitis C. Impingement syndrome D. Dupuytren contracture
C. Compartment syndrome
A patient is in a cast with pain. the RN gives medication and elevated the extremity, but the pain is still unrelieved. What is the diagnosis? A. Subcutaneous emphysema B. Skin breakdown C. Compartment syndrome D. Disuse syndrome
D. Promote the client's highest possible level of function
A patient who has had an amputation is being cared for by a multidisciplinary team. What is the primary goal of the team? A. Maximize the efficiency of care B. Ensure that the client's health care is holistic C. Facilitate the client's adjustment to a new body image D. Promote the client's highest possible level of function
B. Keep your right leg elevated above the heart level.
A patient with a right tibial fracture is being discharged home after having a cast applied. What instruction should the RN provide? A. Cover the cast with a blanket until the cast dries B. Keep your right leg elevated above the heart level. C. Use a clean object to scratch itches inside the cast. D. A foul smell from the cast is normal after the first few days.
B. Signs of neurovascular compromise
An elderly patient's hip joint is immobilized prior to surgery to correct a femoral head fracture. What is the RN's priority assessment? A. The presence of leg shortening B. Signs of neurovascular compromise C. The client's complaints of pain D. The presence of internal or external rotation
A. Increased bone mass
An older adult women's current medication regimen includes alendornate. What outcome would indicate successful treatment? A. Increased bone mass B. Resolution of infection C. Relief of bone pain D. Absence of tumor spread
C. Calcium D. Vitamin D
In an effort to prevent osteoporosis, the RN should encourage patient to ensure that they consume which nutrients? Select all that apply A. Vitamin B12 B. Calcitonin C. Calcium D. Vitamin D
D. Assess the pin insertion site every 8 hours.
RN is caring for a patient who is in traction. To prevent skin breakdown, which action should be included for this patient? A. Apply occlusive dressings to the pin sties B. Encourage the patient to push up with the elbows when repositioning C. Encourage the client to perform isometric exercises once a shift D. Assess the pin insertion site every 8 hours.
A. Improving the client's level of function
RN is planning the care of a patient who has undergone ortho surgery. What main goal should guide the RN? A. Improving the client's level of function B. Helping the client to come to terms with limitations C. Administering medications safely D. Improving the client's adherence to treatment
D. Promptly inform the primary provider
RN is unable to palpate the clients dorsalis pedis or posterior tibial pulse and the patient's foot is pale. What is the RN's most appropriate action? A. Warm the client's foot and determine whether circulation improves B. Reposition the client with the affected foot dependent C. Reassess the client's neurovascular status in 15 min D. Promptly inform the primary provider
C. Encourage the patient to avoid scratching, and give meds if itching continues
RN observes a patient using a pencil to scratch the skin under their cast. How should the nurse respond? A. Allow the patient to scratch with a pencil but tell him to be careful B. Give the patient a sterile tongue depressor to use for scratching C. Encourage the patient to avoid scratching, and give meds if itching continues D. Obtain a rx, for a sedative (lorazepam), to prevent the patient from scratching.
D. Osteomyelitis
The RN is performing frequent assessments for signs and symptoms of infection after an ortho surgery. What does the patient have a high risk of? A. Cellulitis B. Septic arthritis C. Sepsis D. Osteomyelitis
D. Reporting signs of impaired circulation
The RN is providing discharge education to a patient who is going home with a cast on his leg. What topic should the RN emphasize? A. Using crutches efficiently B. Exercising joints above and below the cast, as prescribed C. Remove the cast correctly at the end of the treatment period D. Reporting signs of impaired circulation
C. Small frame and female gender
The RN is reviewing the risks for osteoporosis with a group of recent graduates. What risk factor should be included? A. Recurrent infections and prolonged use of NSAIDS B. High alcohol intake and low body mass index C. Small frame and female gender D. Male gender, diabetes and high protein intake
A. Risk for infection
The nurse will assign priority to what nursing diagnosis for a client with an open fracture of radius? A. Risk for infection B. Risk for ineffective role performance C. Risk for perioperative positioning injury D. Risk for powerlessness
B. Compartment syndrome C. Deep vein thrombosis D. Fat embolism
The patient has been placed in traction until his femur has surgery. For what early complications should the RN monitor for? Select all that apply. A. Systemic infection B. Compartment syndrome C. Deep vein thrombosis D. Fat embolism
A. Apply ice B. Compression dressings C. Resting the affected extremity D. Elevating the injured limb
What treatment modalities are common to all of these musculoskeletal injuries? Select all that apply. A. Apply ice B. Compression dressings C. Resting the affected extremity D. Elevating the injured limb
A. Increased warmth of the calf
When assessing a client's lower limbs, what signs or symptoms is suggestive of deep vein thrombosis? A. Increased warmth of the calf B. Decreased circumference of the calf C. Loss of sensation to the calf D. Pale-appearing calf
B. An elderly client with an infected pressure ulcer in the sacral area
Which of the following patient should the nurse recognize as being the highest risk for the development of osteomyelitis? A. A middle-aged adult who takes ibuprofen daily for rheumatoid arthritis B. An elderly client with an infected pressure ulcer in the sacral area C. A 17-year-old football player who had orthopedic surgery 6 weeks prior D. An infant diagnosed with jaundice
