MS2 Exam 3 Review Questions
A client in the emergency department is being treated for a wrist fracture. The client asks why a splint is being applied instead of a cast. What is the best response by the nurse?
"A splint is applied when more swelling is expected at the site of injury."
During a routine physical examination on an older female client, a nurse notes that the client is 5 feet, 3/8 inches (1.6 m) tall. The client states, "How is that possible? I was always 5 feet and 1/2? (1.7 m) tall." Which statement is the best response by the nurse?
"After menopause, the body's bone density declines, resulting in a gradual loss of height."
A client is treated in the emergency department for acute muscle strain in the left leg caused by trying a new exercise. During discharge preparation, the nurse should provide which instruction?
"Apply ice packs for the first 24 to 48 hours, then apply heat packs."
A client diagnosed with carpal tunnel syndrome (CTS) asks the nurse about numbness in the fingers and pain in the wrist. What is the best response by the nurse?
"CTS is a neuropathy that is characterized by compression of the median nerve at the wrist."
A nurse is teaching a client who was recently diagnosed with carpal tunnel syndrome. Which statement should the nurse include?
"Ergonomic changes can be incorporated into your workday to reduce stress on your wrist."
The nurse is collaborating with the health care provider on a plan of care for a 54-year-old male client with osteomyelitis of the left femur secondary to uncontrolled type 1 diabetes. Click to highlight the prescriptions for care that the nurse should anticipate for this client.
-perform neurovascular checks of lower extremities every 8 hours -administer IV antibiotics based on culture and sensitivity report -administer ibuprofen 400 mg orally three times daily, as needed for pain -make referral to dietitian to discuss nutrition for healing and blood glucose control -provide education on self blood glucose monitoring and insulin administration
A client has undergone grafting following a burn injury. The nurse understands that the first dressing change at the site of an autograft is performed how soon after the surgery?
2 to 5 days after surgery
The client displays manifestations of compartment syndrome. What treatment will the nurse expect the client to be scheduled for?
A fasciotomy
In an industrial accident, a client who weighs 155 lb (70 kg) sustained full-thickness burns over 40% of his body. He's in the burn unit receiving fluid resuscitation. Which finding shows that the fluid resuscitation is benefiting the client?
A urine output consistently above 40 ml/hour
The nurse is caring for a patient with extensive bullous lesions on the trunk and back. Prior to initiating skin care, what is a priority for the nurse to do?
Administer analgesic pain medication.
A client is admitted with acute osteomyelitis that developed after an open fracture of the right femur. When planning this client's care, the nurse should anticipate which measure?
Administering large doses of I.V. antibiotics as ordered
The nurse is assigned to care for a client who has had a total knee arthroplasty yesterday. What type of pharmacologic therapy does the nurse anticipate administering to this client to prevent complications related to the surgery?
Anticoagulation therapy
A client has been diagnosed with shingles. Which of the following medication classifications will reduce the severity and prevent development of new lesions?
Antiviral
The nurse is preparing a client for a surgical procedure that will allow visualization of the extent of joint damage of the knee for a client with rheumatoid arthritis and also obtain a sample of synovial fluid. What procedure will the nurse prepare the client for?
Arthroscopy
Which action would be most important postoperatively for a client who has had a knee or hip replacement?
Assisting in early ambulation.
The orthopedic surgeon has prescribed balanced skeletal traction for a client. What advantage is conferred by balanced traction?
Balanced traction allows for greater patient movement and independence than other forms of traction.
A nurse is reviewing a client's activities of daily living prior to discharge from total hip replacement. The nurse should identify what activity as posing a potential risk for hip dislocation?
Bending down to put on socks
A group of students is reviewing information about cast composition in preparation for a discussion on the advantages and disadvantages of each. The students demonstrate understanding of the topic when they cite which of the following as an advantage of a plaster cast?
Better molding to the client.
Which cleansing solution is the most effective for use in completing pin site care?
Chlorhexidine
Which assessment findings would the nurse expect to find in the client with osteomyelitis?
Column B
A client comes to the emergency department and reports localized pain and swelling in the lower leg. Ecchymotic areas are noted. History reveals that the client got hit in the leg with a baseball bat. What will the nurse most likely suspect?
Contusion
A client is brought to the emergency department after being struck with a baseball bat on the upper arm while diving for a pitched ball. Diagnostic tests reveal that the humerus is not broken but that the client has suffered another type of injury. What type of injury would the physician likely diagnose?
Contusion
Which of the following is a term used to describe a soft tissue injury produced by a blunt force?
Contusion
What clinical manifestation would the nurse expect to find in a client who has had osteoporosis for several years?
Decreased height
The client diagnosed with osteosarcoma is scheduled for a surgical amputation. Which nursing diagnosis would be a priority for this client compared with other surgical clients?
Disturbed body image
Which term refers to a flexion deformity caused by a slowly progressive contracture of the palmar fascia?
Dupuytren's contracture
A client with arterial insufficiency undergoes below-knee amputation of the right leg. Which action should the nurse include in the postoperative care plan?
Elevating the stump for the first 24 hours
Which nursing intervention is appropriate for a client with a closed-reduction extremity fracture?
Encourage participation in ADLs
A teenage client is brought to the clinic by a parent and reports pain in the arm. The client is a member of a high school crew team and practices for 2 ½ hours every day after school. Which of the following would the nurse suspect?
Epicondylitis
A nurse practitioner administers first aid to a patient with a deep partial-thickness burn on his left foot. The nurse describes the skin involvement as the:
Epidermis and a portion of deeper dermis.
A client with a fracture develops compartment syndrome that requires surgical intervention. What treatment will the nurse would most likely prepare the client for?
Fasciotomy
A client is brought to the ED with burns exceeding 20% of total body surface area. Which is the primary nursing intervention in the care of this client?
Fluid resuscitation
Dupuytren contracture causes flexion of which area(s)?
Fourth and fifth fingers
The nurse is developing a plan of care for a client with toxic epidermal necrolysis (TEN) or Stevens-Johnson syndrome. Which action should the nurse include?
Frequently inspect the oral cavity.
When assessing a client with partial-thickness burns over 60% of the body, which finding should the nurse report immediately?
Hoarseness of the voice
The nurse is caring for a patient who sustained a full-thickness burn to his arm when he was scalded with boiling water. How did the nurse determine that the patient's burns are full-thickness burns?
Identification by the destruction of the dermis and epidermis
Which skin condition is caused by staphylococci, streptococci, or multiple bacteria?
Impetigo
Which type of fracture involves a break through only part of the cross-section of the bone?
Incomplete
Which nursing diagnosis takes highest priority for a client with a compound fracture?
Infection related to effects of trauma
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.
A client asks the nurse what psoriasis is. What is the best answer?
It is characterized by patches of redness covered with silvery scales.
A client who has injured a hip in a fall cannot place weight on the leg and is in significant pain. After radiographs indicate intact yet malpositioned bones, what repair would the physician perform?
Joint manipulation and immobilization
Assessment of a client reveals signs and symptoms of Paget's disease. Which of the following would be most likely?
Long bone bowing
Which area of the spinal column is subject to the greatest mechanical stress and degenerative changes?
Lower lumbar
A client has sustained a long bone fracture and the nurse is preparing the client's care plan. Which of the following should the nurse include in the care plan?
Monitor temperature and pulses of the affected extremity.
Which of the following is the analgesic of choice for burn pain?
Morphine sulfate
The nurse determines which statement reflects current research regarding the utilization of nonpharmacological measures in the management of burn pain?
Music therapy may provide reality orientation, distraction, and sensory stimulation.
Which type of debridement occurs when nonliving tissue sloughs away from uninjured tissues?
Natural
A client with superficial burns on the face and deep partial-thickness burns on the neck and chest is undergoing treatment and is anxious to know about skin grafting. For which of the following areas can skin grafting be suggested?
Neck and chest
A nurse is admitting a client to the unit who presented with a lower extremity fracture. What signs and symptoms would suggest to the nurse that the client may have a peroneal nerve injury?
Numbness and burning of the foot
Elderly clients who fall are most at risk for which injuries?
Pelvic fractures
A patient had hand surgery to correct a Dupuytren's contracture. What nursing intervention is a priority postoperatively?
Performing hourly neurovascular assessmentsfor the first 24 hours
Which of the following presents with an onset of heel pain with the first steps of the morning?
Plantar fasciitis
A client brought to the emergency department has been exposed to smoke and flames from a house fire. What assessment finding is most important to the nurse in determining care of the client?
Presence of soot around nasal passages
The nurse is caring for a client who underwent a total hip replacement yesterday. What should the nurse do to prevent dislocation of the new prosthesis?
Protect the affected leg from internal rotation.
A nurse assesses a client with dry, rough, scaly skin without lesions on the legs. The client reports itching in the affected area. What skin assessment would the nurse document?
Pruritus
Photochemotherapy has been used as a treatment for which of the following skin disorders?
Psoriasis
The nurse is caring for a patient who had a total hip replacement. What lethal postoperative complication should the nurse closely monitor for?
Pulmonary embolism
A nurse is giving instructions to a client who's going home with a leg cast. Which teaching point is most critical?
Reporting signs of impaired circulation
A nurse is planning the care of a client who will require a prolonged course of skeletal traction. When planning this client's care, the nurse should prioritize interventions related to what risk nursing diagnosis?
Risk for Impaired Skin Integrity
With repeated reactions of contact dermatitis, which of the following can occur?
Secondary bacterial infection
An elderly client's hip joint is immobilized prior to surgery to correct a femoral head fracture. What is the nurse's priority assessment?
Signs of neurovascular compromise
Which is an inaccurate principle of traction?
Skeletal traction is interrupted to turn and reposition the client.
The client is admitted with full-thickness burns to the forearm. Which is the most accurate interpretation made by the nurse?
Skin grafting will be necessary.
A patient is having low back pain. What position can the nurse suggest to relieve this discomfort?
Supine, with the knees slightly flexed and the head of the bed elevated 30 degrees
The health care team is caring for a client with osteomalacia. It has been determined that the osteomalacia is caused by malabsorption. What treatment should the nurse anticipate?
Supplemental calcium and increased doses of vitamin D
A client has been treated for migraine headaches for several months and comes to the clinic reporting no improvement. The nurse is talking with the client and hears an audible click when the client is moving the jaw. What does the nurse suspect may be happening?
Temporomandibular disorder
A nurse is teaching a client about preventing osteoporosis. Which teaching point is correct?
The recommended daily allowance of calcium may be found in a wide variety of foods.
A client is coming to the office to have a growth removed by the doctor. The client asks "What does cryosurgery do to the growth?" What is the correct response?
Through the application of extreme cold, the tissue is destroyed
Which term describes a fungal infection of the scalp?
Tinea capitis
To treat a client with acne vulgaris, the physician is most likely to order which topical agent for nightly application?
Tretinoin (retinoic acid [Retin-A])
A client is being treated for acne vulgaris. What warning must be given to this client regarding the application of benzoyl peroxide?
Use gloves with application.
The nurse teaches the client with a high risk for osteoporosis about risk-lowering strategies, including which action?
Walk or perform weight-bearing exercises outdoors
The nurse is helping to set up Buck's traction on an orthopedic client. How often should the nurse assess circulation to the affected leg?
Within 30 minutes, then every 1 to 2 hours
As the first priority of care, a patient with a burn injury will initially need:
a patent airway established.
Which is not one of the general nursing measures employed when caring for the client with a fracture?
cranial nerve assessment
A client has a burn on the leg related to an engine fire. When the burn area was assessed, it was determined that the client felt no pain in the area and that it appeared leathery. How would the nurse document the depth of burn injury this client has?
full thickness (third degree)
The classic lesions of impetigo manifest as
honey-yellow crusted lesions on an erythematous base.
The nurse is educating a client with low back pain on proper lifting techniques. The nurse recognizes that the education was effective when the client
places the load close to the body.
Which type of burn is similar to a sunburn?
superficial partial thickness
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 patient is diagnosed with osteomyelitis of the right leg. What signs and symptoms does the nurse recognize that are associated with this diagnosis? (Select all that apply.)
-Pain -Erythema -Fever
Which intervention should the nurse implement with the client who has an external fixator? Select all that apply.
-Perform pin care as ordered. -Supervise the client during transfers. -Perform neurovascular assessment. -Inspect pin sites for signs of infection.
A nurse is caring for a client with osteomyelitis. What complication should the nurse consider that the client is at risk to develop?
Bone abscess formation
Which medication directly inhibits osteoclasts, thereby reducing bone loss and increasing bone mass density (BMD)?
Calcitonin
Which of the following inhibits bone resorption and promotes bone formation?
Calcitonin
An older adult female has a bone density test that reveals severe osteoporosis. What does the nurse understand can be a problem for this client due to the decrease in bone mass and density?
Compression fractures
A client has a cast applied to the leg for treatment of a tibia fracture and also has a wound on the leg that requires dressing changes due to drainage. For what should the nurse prepare the client?
Cutting a cast window
The nurse is asked to explain to the client the age-related processes that contribute to bone loss and osteoporosis. What is the nurse's best response?
Decrease in estrogen
The nurse is assessing a client's skin when the client points out a mole. The nurse brings the mole to the physician's attention when which characteristic is noted?
Diameter exceeding 6 mm
Which of the following disorders results in widespread hemorrhage andmicrothrombosis with ischemia?
Disseminated intravascular coagulation (DIC)
In which deformity does the great toe deviate laterally?
Hallux valgus
A client is brought to the emergency department after injuring the right arm in a bicycle accident. The orthopedic surgeon tells the nurse that the client has a greenstick fracture of the arm. What does this mean?
One side of the bone is broken and the other side is bent.
A client is brought to the emergency department by a softball team member who states the client and another player ran into each other, and the client is having severe pain in the right shoulder. What symptoms of a fractured clavicle does the nurse recognize?
Right shoulder slopes downward and droops inward.
The community health nurse is assessing the risk factors for osteoporosis in a female client at a health fair. For each assessment finding, click to specify if the finding is a risk factor for osteoporosis or is not a risk factor for osteoporosis.
Risk factors for Osteoporosis: -66 years of age -Asian heritage -postmenopausal status -takes fluticasone inhaler for asthma Not a risk factor for Osteoporosis: -large frame -Nonsmoker -alcohol intake of 3 drinks/week -walks 2 miles, 3 days/week
Which of the following musculoskeletal injuries is manifested by acromioclavicular joint pain?
Rotator cuff tears
Which term refers to an injury to ligaments and other soft tissues surrounding a joint?
Sprain
A nurse is caring for a client who's experiencing septic arthritis. This client has a history of immunosuppressive therapy and the immune system is currently depressed. Which assignment is the most appropriate for the nurse caring for this client?
The nurse is caring for this client on the intensive care unit.
A client recently received lip and tongue piercings and subsequently developed a superinfection of candidiasis from the antibacterial mouthwash. What would the nurse recommend for this client?
Use an antifungal mouthwash or salt water.
The nurse is instructing the parents of a child with head lice. Which statement should the nurse include?
Use shampoo with piperonyl butoxide.
A client with low back pain is being seen in the clinic. In planning care, which teaching point should the nurse include?
Use the large muscles of the leg when lifting items.
A client with a musculoskeletal injury is instructed to alter the diet. The objective of altering the diet is to facilitate the absorption of calcium from food and supplements. Considering the food intake objective, which food item should the nurse encourage the client to include in the diet?
Vitamin D-fortified milk
Which may occur if a client experiences compartment syndrome in an upper extremity?
Volkmann's contracture
A client who has fallen and injured a hip cannot place weight on the leg and is in significant pain. After radiographs indicate intact but malpositioned bones, what would the physician diagnose?
dislocation
A client has sustained a right tibial fracture and has just had a cast applied. Which instruction should the nurse provide in client cast care?
"Keep your right leg elevated above heart level."
On a visit to the family health care provider, a client is diagnosed with a bunion on the lateral side of the great toe at the metatarsophalangeal joint. Which statement should the nurse include in the teaching session?
"Some bunions are congenital; others are caused by wearing shoes that are too short or narrow."
A nurse is planning discharge instructions for the client with osteomyelitis. What instructions should the nurse include in the discharge teaching?
"You will receive IV antibiotics for 3 to 6 weeks."
Which instruction should the nurse include when teaching the client following hip replacement surgery? (Select all that apply.)
-"Place pillows between your legs when you lay on your side." -"Avoid bending forward when sitting in a chair." -"Use a raised toilet seat and high-seated chair."
The nurse notes that a client is scheduled for a procedure to apply a skin graft. For which reason will the nurse consider this a form of reconstructive surgery? Select all that apply.
-Cover loss of skin after a burn injury -Close a surgical wound -After excision of a skin tumor
A client received burns to his entire back and left arm. Using the Rule of Nines, the nurse can calculate that he has sustained burns on what percentage of his body?
27%
Which term refers to a graft derived from one part of a client's body and used on another part of that same client's body?
Autograft
A patient has stepped in a hole in the yard, causing an ankle injury. The ankle is edematous and painful to palpation. How long should the nurse inform the patient that the acute inflammatory stage will last?
Between 24 and 48 hours
What food can the nurse suggest to the client at risk for osteoporosis?
Broccoli
Which medication directly inhibits osteoclasts, thereby reducing bone loss and increasing BMD?
Calcitonin (Miacalcin)
An important nursing assessment, post fracture, is to evaluate neurovascular status. Therefore, the nurse should check for:
Capillary refill.
While the nurse is performing a physical assessment, the client reports numbness, tingling, and pain when the nurse percusses lightly over the median nerve. What should this assessment indicate to the nurse?
Carpal tunnel syndrome
Which medication classification may be used for contact dermatitis?
Corticosteroids
A patient in pelvic traction needs circulatory status assessed. How should the nurse assess for a positive Homans' sign?
Have the patient extend each leg and dorsiflex each foot to determine if pain or tenderness is present in the lower leg.
A nurse is preparing to discharge a client from the emergency department after receiving treatment for an ankle sprain. While providing discharge education, the nurse should encourage what action?
Keep an elastic compression bandage on the ankle.
A client visits an orthopedic specialist because of pain beginning in the low back and radiating behind the right thigh and down below the right knee. The doctor suspects a diagnosis of sciatica. The nurse knows that the origin of the pain is between which intervertebral disks?
L4, L5, and S1
The nurse and nursing assistant are moving a client who slid down in the chair. What does the nurse encourage the assistant to avoid shearing when moving the client to a higher position in the chair?
Lift the client, do not slide them
A client with carpal tunnel syndrome has had limited improvement with the use of a wrist splint. The nurse knows that which procedure will show the greatest improvement in treatment for this client?
Open nerve release
A client's fracture was reduced by surgically exposing the bone and realigning it. What type of treatment does the nurse identity this as?
Open reduction
The nurse is caring for a patient who sustained a major burn. What serious gastrointestinal disturbance should the nurse monitor for that frequently occurs with a major burn?
Paralytic ileus
A nurse is caring for a client following foot surgery. Which nursing intervention is most important for the nurse to include in the nursing care plan?
Perform neuromuscular assessment every hour.
The nurse is educating the patient with low back pain about the proper way to lift objects. What muscle should the nurse encourage the patient to maximize?
Quadriceps
Which term refers to a disease of a nerve root?
Radiculopathy
A nurse formulates a nursing diagnosis of Impaired physical mobility for a client with full-thickness burns on the lower portions of both legs. To complete the nursing diagnosis statement, the nurse should add which "related-to" phrase?
Related to circumferential eschar
A client with chronic osteomyelitis has undergone 6 weeks of antibiotic therapy. The wound appearance has not improved. What action would the nurse anticipate to promote healing?
Surgical debridement
Morton neuroma is exhibited by which clinical manifestation?
Swelling of the third (lateral) branch of the median plantar nerve
A provider prescribes a subcutaneous anabolic agent for an older adult client to prevent fractures associated with osteoporosis. What is the most likely prescribed drug?
Teriparatide
A nurse is required to monitor the effectiveness of fluid resuscitation in a client who is being treated for burns. Which of the following assessments would indicate the success of the fluid resuscitation?
The client's urinary output is 0.5 to 1 mL/kg/hour.
Which is not a guideline for avoiding hip dislocation after replacement surgery.
The hip may be flexed to put on clothing such as pants, stockings, socks, or shoes.
An elite high school football player has been diagnosed with a shoulder dislocation. The client has been treated and is eager to resume his role on his team, stating that he is not experiencing pain. What should the nurse emphasize during health education?
The importance of adhering to the prescribed treatment and rehabilitation regimen
Which of the following was formerly called a bunion?
Hallux valgus
A client has low back pain and the healthcare provider needs to rule out the presence of a tumor. Which diagnostic procedure would the nurse anticipate to be ordered for the client?
Bone scan
A nurse is caring for a client with eczema. Which medication would be prescribed when an allergy is a factor causing the skin disorder?
Chlorpheniramine
Which assessment findings would the nurse expect to find in the postoperative client experiencing fat embolism syndrome?
Column B
A client is admitted to the emergency room after being hit by a car while riding a bicycle. The client sustained a fracture of the left femur, and the bone is protruding through the skin. What type of fracture does the nurse recognize requires emergency intervention?
Compound
The nurse is assessing the feet of a patient and observes an overgrowth of the horny layer of the epidermis. What does the nurse recognize this condition as?
Corn
Which would be contraindicated as a component of self-care activities for the client with a cast?
Cover the cast with plastic to insulate it
The nurse in an orthopedic clinic is caring for a new client. What sign or symptom would lead a nurse to suspect that a client has a rotator cuff tear?
Difficulty lying on affected side
After undergoing surgery the previous day for a total knee replacement, a client states, "I am not ready to ambulate yet." What should the nurse do?
Discuss the complications that the client may experience if there is lack of cooperation with the care plan.
A nurse is planning the care of a client with osteomyelitis that resulted from a diabetic foot ulcer. The client requires a transmetatarsal amputation. When planning the client's postoperative care, which of the following nursing diagnoses should the nurse most likely include in the plan of care?
Disturbed Body Image
The client with osteoarthritis is seen in the clinic. Which assessment finding indicates the client is having difficulty implementing self-care?
Has a weight gain of 5 pounds
A person suffers leg burns from spilled charcoal lighter fluid. A family member extinguishes the flames. While waiting for an ambulance, what should the burned person do?
Have someone assist him into a bath of cool water, where he can soak intermittently while waiting for emergency personnel.
A healthcare provider asks a nurse to test a client for Tinel's sign to diagnose carpal tunnel syndrome. What should the nurse do to perform this assessment?
Have the client hold the palm of the hand up while the nurse percusses over the median nerve.