Med Surg Test #3 -- Musculoskeletal and Endocrine

What postoperative instruction should the nurse give to the client scheduled for a subtotal thyroidectomy? A) How to support the head with the hands when turning in bed B) Coughing should be avoided to prevent pressure on the incision C) Head and neck will need to remain immobile until the incision heals D) Any tingling around the lips or in the fingers after surgery is expected and temporary

A

A patient with a pelvic fracture should be monitored for: A) Changes in urine output B) Abdominal petechiae C) A palpable lump in the buttock D) A sudden increase in blood pressure

A) Changes in urine output -- pelvic fx can cause severe injury to abdominal organs; the nurse should assess bowel and urinary elimination, and distal neuromuscular status

A patient screened for diabetes at a clinic has a fasting plasma glucose level of 120 mg/dL. Which statement by the nurse is best? A) You will develop Type II diabetes within 5 years. B) You are at an increased risk for developing diabetes C) The test is normal, and diabetes is not a problem D) The laboratory test result is positive for type 2 diabetes

B

Phosomax is prescribed for a patient with osteoporosis. The nurse teaches the patient that: A) Drug must be taken with food to decrease GI side effects B) Bisphosphonates prevent calcium from being taken from the bones C) Lying down after taking the drug prevents lightheadedness and dizziness D) Taking the drug with milk enhances the absorption of calcium from the bowel

B

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 to the patient that ORIF is indicated when... A) The patient is unable to tolerate prolonged immobilization B) The patient cannot tolerate the surgery for a closed reduction C) A temporary cast would be too unstable to provide normal mobility D) Adequate alignment cannot be obtained by other nonsurgical methods

D) Adequate alignment cannot be obtained by other nonsurgical methods

A patient with Type I diabetes calls the clinic with complaints of nausea, vomiting, and diarrhea. It is MOST important that the nurse advise the patient to: A) Withhold the regular dose of insulin B) Drink cool fluids with high glucose content C) Check the blood glucose level every 2-4 hours D) Use a less strenuous form of exercise than usual until the illness resolves

C

The nurse plans a class for patients who have newly diagnosed Type II DM. Which goal is MOST appropriate? A) Make all patients responsible for the management of their disease. B) Involve the family and significant others int eh care of these patients. C) Enable the patients to become active participants in the management of their disease D) Provide the patients with as much information as soon as possible to prevent complications

C

Which patient would be at the greatest risk for developing osteoporosis? A) 73 year old man; 5 alcoholic drinks per week; limits sun exposure to prevent reoccurrence of skin cancer B) 84 year old man; recently diagnosed with hypothyroidism; has been prescribed Synthroid C) 69 year old woman; renal transplant 5 years ago; has been taking prednisone to prevent organ rejection D) 55 year old woman; recently had a hysterectomy with bilateral removal of ovaries; has refused estrogen therapy

C

The nurse is caring for a patient who just returned to the surgical unit following a thyroidectomy. The nurse is most concerned if which is observed? A) The patient complains of increased thirst B) The patient reports a sore throat when swallowing C) The patient supports her head when moving in bed D) The patient makes harsh, vibratory sounds when breathing

D

A client with diabetes is learning to mix regular insulin and NPH insulin in the same syringe. The nurse determines that additional teaching is needed when the client does what? A) Withdraws the NPH dosage into the syringe first B) Injects air equal to the NPH dose in the NPH vial first C) Removes any air bubbles after withdrawing the first insulin D) Adds air equal to the insulin dose into the regular vial and withdraws the dose

A

A patient with osteoarthritis is scheduled for a THA. The nurse explains that the purpose of this procedure is too... (select all that apply) A) To fuse the joint B) to replace the joint C) to prevent further damage D) to improve or maintain range of motion E) to decrease the amount of destruction in the joint

B, D

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 complains fo increasing pain in the affected leg and foot that is not relieved by loosening of the elastic bandage. The most important action by the nurse is to: A) To elevate the leg on 2 pillows B) To apply ice over the fracture site C) To notify the healthcare provider D) To perform neurovascular assessment of the foot

D) To perform neuromuscular assessment of the foot