mobility prep u

A client presents to a health clinic complaining of several vague symptoms. As the history/physical continues, the health care provider clearly thinks the client may have myasthenia gravis. Which statements by the client would correlate with this diagnosis?

"I feel like I don't have enough energy to chew my food sometimes." "I have more energy in the morning but get worse as the day goes by." "Sometimes I have double vision."

The nurse has educated a patient with low back pain about techniques to relieve the back pain and prevent further complications. What statement by the patient shows understanding of the education the nurse provided?

"I will avoid prolonged sitting or walking."

A nurse is educating a patient newly diagnosed with Parkinson's disease. Which description would the nurse offer to describe the disease?

"It is characterized by abnormalities in movement and posture."

The home health nurse visits an older adult client and their spouse to discuss home safety prior to discharge from the hospital. What information should the nurse focus on to optimize safety?

"It's important to have good lighting and clear, even flooring surfaces." *

The nurse is caring for an 8-year-old child in traction. The client has been in an acute care setting for 2 weeks and will require an additional 10 days in the hospital. The client is showing signs of regression with thumb sucking and pleas for the now tattered baby blanket. What would be the most helpful intervention?

"Let's ask your parents to bring your friends for a visit."

The nurse is providing instructions to the client who is being prepared for skeletal traction. Which statement by the client indicates teaching was effective?

"Metal pins will go through my skin to the bone."

A new mother asks, "Why are you examining my baby's hips?" What is the nurse's best response?

"Musculoskeletal screening is important to identify anything that needs intervention."

Restoration of the integrity of myelin sheaths would likely result in a slowing or stopping of the progression of:

Amyotrophic lateral sclerosis (ALS) *

Which hormone inhibits bone reabsorption and increases calcium deposit in the bone?

Calcitonin

Which type of materials are not included in a cancellous bone?

Cartilaginous Densely calcified Compact

A client has developed osteomyelitis and asks the health care provider how the problem occurred. Which response is most accurate?

Direct contamination of an open wound

The client who had a total hip replacement was discharged home and developed acute groin pain in the affected leg, shortening of the leg, and limited movement of the fractured leg. The nurse interprets these findings as indicating which complication?

Dislocation of the hip

A client with chronic kidney disease (CKD) has developed asterixis. The nurse knows that asterixis is:

Dorsiflexion of hands and feet

The nurse is conducting a physical examination of a 10-year-old boy with a suspected neuromuscular disorder. Which finding is a sign of Duchenne muscular dystrophy?

Gowers sign

The type of fracture often seen in young children is one in which there is not complete ossification of the bone, and the bone bends and just partially breaks. What type of fracture is this?

Greenstick

An older adult client has had mobility and independence significantly impaired by the progression of rheumatoid arthritis (RA). What is the primary pathophysiologic process that has contributed to this client's decline in health?

Immunologically mediated joint inflammation

A nurse is monitoring a client post cardiac surgery. What action would help to prevent cardiovascular complications for this client?

Implement leg exercises and turn the client in bed every 2 hours.

Which assessment finding would cause the nurse to suspect compartment syndrome in the client following a bone biopsy?

Increased diameter of the calf *

The client presents with an exaggeration of the lumbar spine curve. How does the nurse interpret this finding?

Lordosis

A client with a spinal cord injury has experienced contractures and destructive changes in the joints of the lower extremities. The nurse determines which of the following is the most likely cause?

Loss of proprioception and reflex control of the muscles

Mr. Jones is admitted to the nursing unit from the emergency department with a diagnosis of hypokalemia. His laboratory results show a serum potassium of 3.2 mEq/L (3.2 mmol/L). For what manifestations should the nurse be alert?

Muscle weakness, fatigue, and dysrhythmias

What is the term used to refer to the failure of bone to heal before the process of bone repair stops?

NonunionFollowing a lengthy series of diagnostic tests, a client's chronic hip pain has been attributed to advanced osteonecrosis. What treatment is this client most likely to require?

A client who is hospitalized and receiving antiretroviral therapy has a nursing diagnosis of Risk for Injury related to weakness and dizziness. Which would be appropriate for the nurse to do?

Provide for frequent rest periods.

A client has been started on an antipsychotic medication and is exhibiting muscle stiffness of the arms, slowness of gait, and tremors. Which extrapyramidal syndrome (EPS) is the client displaying?

Pseudoparkinsonism

Which symptom is unique to amyotrophic lateral sclerosis (ALS) and is not observed in multiple sclerosis (MS)?

Respiratory muscle impairment

The joint capsule consists of an outer fibrous layer and an inner synovium. What does the inner synovium do to facilitate movement?

Secretes synovial fluid

A client has started on interferon beta for treatment of multiple sclerosis. What should the nurse include in the teaching?

The medication will be given by subcutaneous injection. This drug can reduce symptoms but will not alter disease activity. Interferon beta alters your immune response. *

A 41-year-old woman has been diagnosed as having a loose body of cartilage in her left knee. What data would be most likely to lead clinicians to this diagnosis?

The woman experiences intermittent, painful locking of her joint.

A nurse is teaching a client with a long leg cast how to use crutches properly while descending a staircase. The nurse should tell the client to transfer body weight to the unaffected leg, and then:

advance both crutches.

To help minimize calcium loss from a hospitalized client's bones, the nurse should

encourage the client to walk in the hall.

The nurse enters the room to do an initial assessment on a client with a fracture of the femoral head. What would be the expected findings on the affected limb?

shortening of the affected extremity with external rotation

Following a tonsillectomy, a client returns to the medical-surgical unit. The client is lethargic and reports having a sore throat. In which position should the nurse place the client?

side-lying

An obese client has returned to the unit after receiving electroconvulsive therapy (ECT). A nurse requests assistance in moving the client from the stretcher to the bed. Which direction should the nurse give to a nurse who volunteers to help?

"Obtain the sliding board or two other people to assist us."

A client recovering from lumbar surgery is fitted for a contour splint. What should the nurse explain to the client about this device?

"The splint immobilizes the body part in a functional position."

Which client is most likely to benefit from treatment with an antiparkinsonism agent?

A client who has a medication-induced movement disorder

Clients diagnosed with myasthenia gravis have a decrease in which receptor?

Acetylcholine

An elderly female client who has dizziness and osteoporosis fell at home and fractured her hip. She underwent surgical intervention for repair of the fractured hip and is now being discharged to a subacute care facility. In the comeback phase of the Trajectory Model of Chronic Illness, the nurse

Acknowledges the client's achievement when she walks to the bedside commode with her walker *

The nurse moves a client's arm from an outstretched position to a position at the side of his body. What is the term used to describe this type of body movement?

Adduction

While taking a client history, which finding may lead the nurse to suspect the client is at risk for developing osteonecrosis?

Bone marrow ischemia due to radiation therapy for cancer *

The cerebellum, separated from the cerebral hemispheres by the tentorium cerebelli, lies in the posterior fossa of the cranium. What is one of the functions of the cerebellum?

Coordinates smooth and accurate movements of the body *

Regarding the pathophysiology of Parkinson disease, which statement is true?

Degeneration of the nigrostriatal dopamine neurons occurs.

A client who has been lying prone reports shortness of breath and a sensation of choking. Into which position will the nurse place the client?

Fowler's

The unlicensed assistive personnel (UAP) tells the nurse that a client is very confused and trying to get out of bed without assistance. What is the appropriate action by the nurse?

Initiate use of a bed alarm.

Which intervention should the nurse implement with the client who has undergone a hip replacement?

Instruct the client to avoid internal rotation of the leg.

When assessing a client with rheumatoid arthritis, which statement about joint involvement is most accurate?

Involvement is symmetric and polyarticular, initially starting in the adult client's fingers, hands, and wrists.

A client's family member asks the nurse, "What is a conversion disorder?" Which is the best response by the nurse?

It involves unexplained, usually sudden, deficits in sensory or motor function. *

Following a lengthy series of diagnostic tests, a client's chronic hip pain has been attributed to advanced osteonecrosis. What treatment is this client most likely to require?

Joint replacement surgery

The nurse is caring for a client with a spica cast. What is the nurse's priority intervention?

Keep the cast clean and dry.

The nurse is caring for a client during the postoperative period. The client was prescribed thigh high antiembolism stockings and pneumatic compression devices for prevention of deep vein thrombosis. Assessment data reveal +3 pitting edema to the lower extremities bilaterally. What is the priority action by the nurse?

Measure client's thighs and calves to ensure the antiembolism stockings are the correct size

A client is asked to stand with feet together, eyes open, and hands by the sides. Then the client is asked to close the eyes while the nurse observes for a full minute. What assessment is the nurse performing?

Proprioception

A client is having a cast applied for a fractured leg that extends from below the knee to the base of the toes. The foot is flexed at a right angle in a neutral position. What type of cast is the client having applied?

Short leg cast

A client has been taking neuroleptic medications for many years as a treatment for schizophrenia. The client is exhibiting tongue protrusion, facial grimacing, and excessive blinking. These manifestations are characteristic of which side effect?

Tardive dyskinesia

A Jewish couple that is trying to conceive ask the nurse if they should receive genetic counseling. The nurse is aware that an autosomal recessive disorder that causes a deficiency in hexosaminidase A may be present. What disorder should the couple be tested for?

Tay-Sachs disease

A client has had a total knee replacement and is receiving care that includes learning to walk with a walker. What level of prevention is most applicable to this client?

Tertiary prevention *

An infant has a rare autosomal recessive disorder, ataxia-telangiectasia, that has recently been diagnosed. Which developmental milestone assists in diagnosing this disorder?

The child is beginning to walk.

During physiology class, the instructor asks students to explain the pathology behind development of multiple sclerosis. Which student gave the most accurate description?

The demyelination and subsequent degeneration of nerve fibers and decreased oligodendrocytes, which interfere with nerve conduction

The home care nurse is making a home visit to a 51-year-old female client with a longstanding diagnosis of multiple sclerosis. The nurse knows that the muscle wasting and weakness associated with the disease process is ultimately manifested as a failure of what normal process in muscle tissue?

Thick myosin and thin actin filaments sliding over each other.

The nurse suspects idiopathic scoliosis in a client based on which assessment finding?

Uneven shoulders or iliac crest

The nurse is performing passive range-of-motion exercises with a client who suffered an ischemic stroke 2 weeks ago and has hemiparesis. The client says, "What is the point of doing these exercises if I will never be able to use that arm again?" What should the nurse include when responding to the client?

We want to ensure your shoulder joint remains flexible while you recover. You may still regain use of this arm, and these exercises may help with this recovery. These exercises help to prevent painful shoulder complications after a stroke.

A client returns to the doctor's office for evaluation 6 weeks after a tibial fracture. Which assessment indicates the potential for nonunion?

X-ray shows minimal calcification at the fracture.

A client recovering from surgery to repair a fracture of the tibia and fibula of the left leg is reporting increased pain at the site. What sign must the nurse be alert to that would indicate compromised circulation to the leg?

increased edema in the toes of the affected leg

Smooth muscle contractions are typically characterized as:

involuntary.

An infant was born with facial nerve paralysis that occurred with delivery. As the infant ages, it becomes apparent that the facial muscles affected by the nerve damage are not moving. Seeking surgical repair, the family asks why the damage to the child's face is not being repaired by the body. The health care provider states that neurons (connected to the facial muscles) are highly specialized cells that:

lose their ability to proliferate once development of the nervous system is complete. *

The nurse is performing passive range-of-motion exercises with a client on a rehabilitation unit. The nurse takes the client's right hand and touches the thumb to each finger. Later, the nurse documents this range-of-motion activity as

opposition.

Which therapeutic exercise is done by the nurse without assistance from the client?

passive

A client has a history of dislocations of the same joint. The nurse understands that this is most likely due to an insufficient deposit of collagen during the healing process, leading to:

reduced tensile strength.

A nurse is caring for a client who has been receiving treatment for schizophrenia with chlorpromazine for the past year. It would be essential for the nurse to monitor the client for:

tardive dyskinesia.

The nurse is caring for a client with knee high antiembolism stockings. Which assessment finding does the nurse prioritize as needing notification of the healthcare provider?

unilateral swelling

The nurse is caring for a child diagnosed with Duchenne muscular dystrophy and notes the presence of a Gower sign on the assessment form. What action by the child would support this assessment?

when on the floor, rising to the knees and pressing the hands against the ankles, knees, and thighs to stand