Med Surg-Exam4 (MS, Mobility, Pre, Intra, Post Op)

The nurse is completing a neurovascular assessment on the patient with a tibial fracture and a cast. The feet are pulseless, pale, and cool. The patient says they are numb. What should the nurse suspect is occurring?

Compartment syndrome

A patient experiences delayed bone healing. What function does the nurse identify as helpful by electrical bone growth stimulation?

Increases the calcium uptake of bones

A school-age child with Paget's disease reports pain and swelling around the right knee after an injury 2 weeks ago that has become increasingly worse. What does the nurse suspect these findings are indicative of?

Osteosarcoma

Which joint surgery involves removing a slice of bone?

Osteotomy

The nurse is arranging discharge for a patient with a history of congestive heart failure and suggests a consultation with the palliative care team. How does palliative care differ from hospice care?

Palliative care permits the patient to receive simultaneous curative care.

A patient has clinical manifestations that indicate the presence of Paget's disease. When reviewing the laboratory results, which results confirm this diagnosis?

Elevated serum alkaline phosphatase levels

The nurse is caring for a patient with a fractured femur. Which nursing action(s) by the nurse is the priority?

Elevating the extremity. Providing analgesia as necessary. Compressing the involved extremity. Applying ice compresses to the injured area. Stopping the activity and limiting movement.

A patient is suffering from inflammation in the joints of fingers, wrists, feet, and ankles that results in painful deformity, especially in the knees. Which type of surgery is indicated as a palliative treatment for this patient?

Synovectomy

Bisphosphonates have been recommended for a patient with osteoporosis. What patient education is important for the nurse to include?

Take them 30 minutes before food or medications. Remain upright for at least 30 minutes after taking a dose. Take them with a full glass of water.

A patient arrives in the emergency department after sustaining a fall. The initial assessment reveals that the left leg is shorter than the right and externally rotated. What condition should the nurse suspect?

Hip Fracture

A nurse applies an elastic bandage to a patient's knee and provides discharge instructions after teaching the patient how to reapply the bandage. Which statement made by the patient indicates the need for further teaching?

I will leave it in place for prolonged periods."

A patient will undergo debridement of the shoulder joint. After the nurse explains the procedure, the patient asks the nurse what will be removed from the joint. How should the nurse answer?

Joint debris Osteophytes Degenerated menisci

An older adult patient is admitted with a vertebral compression fracture. For which procedure does the nurse anticipate preparing the patient?

Kyphoplasty

A patient is admitted for a fractured hip. A nurse is reviewing the medical history with the patient on admission. Which conditions does the nurse tell the patient place this patient at risk for osteoporosis?

Kidney disease Hyperthyroidism Diabetes mellitus Rheumatoid arthritis

Which body part of the patient is at risk for superior mesenteric artery syndrome when sustaining a fracture?

Vertebrae

A woman has been diagnosed with osteoporosis after fracturing a hip. Which explanation does the nurse give to the patient about this disorder?

Women have less bone mass because they have smaller frames.

A patient experiences a ligament injury to the ankle joint. Which instruction by the nurse would be most helpful to relieve edema?

Wrap an elastic bandage from proximal to distal end.

A patient with acute osteomyelitis is prescribed gentamicin. Which clinical parameter in the patient indicates that the prescription needs to be reconsidered?

serum creatinine: 3.4 mg/dL

The nurse is assessing a patient who has a traumatic leg injury. What intervention is the most important in the initial assessment?

Determine the extremity's color and temperature in the area of the injury

A patient sustains a severe hip injury with dislocation in the posterior direction. Joint aspiration reveals hemarthrosis. What condition does the nurse suspect?

Intraarticular fracture

The registered nurse teaches a student nurse about care of a patient with a fracture of the humerus, compartment syndrome, and a plaster cast in place. The student nurse provides discharge education to the patient. Which statement made by the student nurse needs correction?

"Elevate the extremity above the heart level."

A patient experiences an unstable wrist fracture. Which type of cast will be most beneficial for the patient?

Long arm cast

A patient recently diagnosed with osteoporosis is concerned about getting a bone fracture. On what preventive measures would the nurse educate the patient?

-Increase exposure to sunlight to at least 20 minutes a day -Conduct weight-bearing exercises, such as tennis or walking -Eat foods such as cottage cheese, sardines, and turnip greens

A patient who receives Medicaid is being moved from one care setting to another. What is required?

A care transition plan

The nurse assists in performing annual well visits for four patients. Which patient is least likely to develop overuse syndrome?

A football player

A nurse is examining a patient who is in a body jacket brace. The patient states that the brace is applied too tightly. What findings in the patient may indicate that the brace is too tightly applied?

Abdominal pain, Nausea, vomiting, Increased abdominal pressure

A patient with intervertebral disc damage caused by lumbar spinal stenosis is undergoing treatment and reports bladder incontinence and constant back pain. The nurse prepares the patient for what outpatient procedure?

An interspinous process decompression system

When going to the hospital, which forms should patients be encouraged to bring with them in case end-of-life care becomes an ethical or legal issue?

Advance directive

Which legal document is a written statement of a chronic illness patient's wishes regarding medical care?

Advanced directive

Which condition in a patient indicates that he or she is an ideal candidate for an osteotomy?

Ankylosing spondylitis

The nurse is administering an intravenous infusion of zoledronic acid to a patient being treated for osteoporosis. How often should the nurse inform the patient they will be receiving this medication?

Annually from the time of the last infusion

What do the psychologic responses to grief include?

Anxiety Sadness Depression

The nurse is caring for a comatose patient admitted following cardiopulmonary arrest. The patient is intubated, mechanically ventilated, and receiving vasopressors to maintain the pulse and blood pressure. The nurse knows a clinical diagnosis of brain death requires what?

Apnea Comatose or unresponsive Absence of brainstem reflexes

Which surgery is considered to be the most appropriate in a patient with osteoarthritis and complete loss of function in the knee joint?

Arthroplasty

When performing the physical examination of a patient, how should the nurse assess the function of the peroneal nerve?

Assess dorsiflexion of the foot Assess sensation in the dorsal part of the foot between the first and second toes.

A nurse is caring for a patient with reported fracture of the tibia. A plaster cast has been applied to the patient. What interventions are important for the care of the cast during the drying period and immediately thereafter?

Avoid direct pressure on the cast. Handle the cast gently with an open palm. Place several strips of tape over the rough edges.

A patient is admitted to the nursing unit with a history of a herniated lumbar disc and lower-back pain. The nurse would suspect which causative factor of increasing pain?

Bending forward

The nurse is providing discharge teaching to a patient after a stress fracture of the foot. Which drug does the nurse inform the patient would increase the risk for osteoporosis?

Betamethasone Calcium carbonate

What are the closed sacs lined with synovial membrane that contain a small amount of synovial fluid that are located at sites of friction in the joints?

Bursae

The nurse recommends taking calcium supplements to a patient with osteoporosis. Which supplement does the nurse recommend?

Calcium carbonate

An older adult patient with hyperlipidemia is also at a high risk for the development of osteomalacia. Which medication prescribed for the hyperlipidemia should the nurse question that increases this risk for the patient?

Cholestyramine

A nurse is taking care of a patient with a cast on the right leg maintained in external traction. However, during the routine examination, the nurse finds that the patient has compartment syndrome. What measures should a nurse take in the management of this patient?

Cut the cast in half. Reduce external traction weight. Remove or loosen any bandage.

A patient is suspected of having fat emboli after a fractured hip. What assessment data gathered by the nurse are indicative of this condition?

Decreased platelet count Prolonged prothrombin time Pulmonary infiltration on chest radiograph

Which condition does the nurse anticipate if a patient experiences a severe injury to the ligament around the humerus bone?

Dislocation

The nurse is planning the care of an older adult patient being treated for Paget's disease. What nursing actions should be included in the plan of care?

Encourage physical therapy. Encourage the patient to wear a corset brace.

What will goals of a palliative care management plan include?

Enhancing the quality of life Providing relief of symptoms Providing care that does not hasten death or shorten life

Which complication is being addressed when the nurse assists the patient with physical therapy exercises following shoulder surgery?

Fibrosis

The nurse is caring for a pediatric patient who has Duchenne muscular dystrophy. Which treatment strategies would be beneficial for the child?

Fitting for an orthotic jacket Prescribing corticosteroid therapy

A nurse is caring for a patient with a fractured femur. The health care provider finds that the patient has fat embolism syndrome. What treatment (or treatments) of fat embolism syndrome should the nurse anticipate for this patient?

Fluid resuscitation Correction of acidosis Fracture immobilization

A patient has a mandibular fracture from an accident, and there is prominent swelling around it. What are the important nutritional measures that need to be followed in the postoperative stages?

Give prune juice to drink. Administer bulk-forming laxatives. Include liquid protein supplements.

A patient is hospitalized with severe bleeding in the leg. An x-ray exam of the leg reveals that the periosteum is intact across the fracture and that the bone is still in alignment. What type of fracture does the patient have?

Greenstick fracture

The nurse is assessing a patient with a painful deformity of the great toe with swelling of the bursa and formation of callus over the bony enlargement. What condition does the nurse suspect from these findings?

Hallux valgus

The nurse is caring for a patient following lumbar fusion. What nursing interventions should the nurse perform for this patient?

Monitor peripheral neurologic signs. Report severe headache to the surgeon. Assess extremity circulation.

The nurse is caring for a patient with a fracture who has a Buck's traction boot in place. Which complication is prevented by the use of the boot?

Muscle Spasms

A patient experiences a nondisplaced fracture. What condition can potentially displace the fracture in the patient?

Muscle spasm

The nurse is assessing a patient who is taking alendronate for osteoporosis. What should the nurse inform the patient to be aware of when taking this medication?

Must be taken with a full glass of water

A patient is prescribed teriparatide. What information is accurate for the nurse to include in the patient's education related to medication frequency and route of administration?

Once a day, subcutaneously

After a motor vehicle crash, a patient has a dislocated right hip joint, and the bone is exposed in the right thigh. What type of fracture should the nurse document?

Open, Displaced, Comminuted

A person who has recently lost a family member has powerful feelings of anger, guilt, and fear. The nurse notices that the person yearns and starts searching for the dead person. Which state of grief does the nurse identify in the person according to the grief wheel model?

Protest

The nurse reviews a patient's advanced directive form. What is the purpose of the advanced directive?

Provide instructions about future medical care and treatments if the patient becomes unable to communicate

The nurse is caring for a patient who underwent left total knee arthroplasty and has a new prescription to be "up in the chair today before noon." What action should the nurse take to protect the knee joint while carrying out the prescription?

Put on a knee immobilizer before moving the patient in and out of bed and keep the surgical leg elevated while sitting.

A patient fell from a 20-foot height onto the right elbow. The radiograph revealed a fracture in the middle third of the right humerus, with sharp edges. What are the structures that may be at risk of damage due to the sharp edges of broken bone in this patient?

Radial Nerve Brachial artey

A patient has been prescribed vitamin D 3 and vitamin D 2 supplements for treatment of osteomalacia. What does the nurse determine is the primary goal of treatment for this patient?

Recalcification of the bones

A patient is prescribed bisphosphonates for the treatment of Paget's disease. What outcome does the nurse expect from the administration of this medication?

Reduction in bone resorption

When the patient is diagnosed with muscular dystrophy, what information should the nurse include in the teaching about this disorder?

Remaining active will prevent skin breakdown and respiratory complications or distress

A patient with osteomyelitis in the left femur has been receiving gentamicin therapy for two weeks. During a follow up visit, which patient statement indicates that the treatment should be discontinued?

Ringing in the ears

The nurse is reviewing the bone density score for a patient that is suspected of having osteopenia. Which score does the nurse determine will confirm this suspicion?

T-score below -2.5

What is impingement syndrome?

The entrapment of soft tissue structures under the coracoacromial arch of the shoulder

The nurse assesses a patient in the preoperative holding area before total hip arthroplasty (THA). The nurse discusses the expected hospital course with the patient and family. Which are important points to discuss with the patient and family before surgery?

The presence of any skin infections Ensuring the procurement of home services Pain tolerance and management preferences Previous medical diagnoses and complications

The nurse is caring for an older patient with primary osteosarcoma of the distal femur. What does the nurse recognize about this diagnosis?

This malignancy often is associated with prior radiation

A patient asks the nurse for nonsurgical methods to relieve pain caused by hammer toe. What is the best response by the nurse?

Use a metatarsal arch support.