muscskeletal

A comminuted fracture is

-A comminuted fracture is one in which the bone breaks into multiple pieces or fragments.

A nurse is assessing a female client who reports severe joint pain. The nurse should identify that which of the following factors places the client at risk for gout?

-The client's use of diuretics is a risk factor for gout. Gout is a systemic disorder that affects the joints as a result of high uric acid levels in the blood. - A client who is postmenopausal is at risk for gout.

A nurse in the emergency department is caring for a client who reports pain in her left leg following a motor-vehicle crash. The client's left leg has bruising, swelling, and displacement of the bones. Which of the following actions should the nurse take first?

-The greatest risk to this client is impaired circulation to the limb from trauma and the resulting edema; therefore, the first action is to check the circulation, sensation, and movement distal to the level of the injury. If the nurse notes a weak or absent pulse distal to the injury, the limb's circulation is compromised, and immediate action is critical. -Pt needs an X-ray to confirm the nature and extent of the injury -Pt needs cold application to reduce swelling and pain from the injury -Pt needs elevation of the leg to reduce swelling and pain from the injury

A nurse is preparing a community education program about reducing the risk of osteoporosis. Which of the following pieces of information should the nurse include?

-The nurse should emphasize that regular walks are the preferred weight-bearing exercise to build and maintain strong bones. -The nurse should include in the education program that sunlight exposure is important to ensure an adequate supply of vitamin D. -Supplementation of 1 to 1.5 g of calcium in divided doses daily will help promote strong bones. -Excessive caffeine intake increases the risk of developing osteoporosis.

risk factor for osteoposrosis

-The nurse should identify anorexia nervosa as a risk factor for osteoporosis. Inadequate protein intake can lead to decreased bone density, increasing the risk of fractures. -An increased intake of phosphate-containing foods, such as carbonated beverages, is a risk factor for osteoporosis. -A lack of time outdoors in sunlight is a risk factor for osteoporosis. -Decreased estrogen or testosterone is a risk factor for osteoporosis.

A nurse is providing teaching about disease management to a client who has rheumatoid arthritis. Which of the following responses by the client indicates an understanding of the teaching?

-The nurse should instruct the client to have handrails installed in the bathroom and hall to promote safety as the disease progresses. -nurse should instruct the client to take a hot shower to decrease morning stiffness. Getting in and out of a bathtub is a safety risk for a client who has rheumatoid arthritis. -Immobility will further hinder joint movement and should be avoided. Gentle exercise of the affected extremities should be performed, even when joints are painful and inflamed. -physical therapy regimen might be required.D. The client should balance activity with rest by taking 1 or 2 naps during the day.

A nurse is teaching a client who has osteoporosis. Which of the following instructions should the nurse include in the teaching?

-The nurse should instruct the client to perform weight-bearing exercises to promote bone formation and increase strength and mobility. - The nurse should instruct the client to increase the dietary intake of calcium, vitamin D, protein, magnesium, and vitamin K to promote bone formation. -The nurse should instruct the client to apply heat to relieve discomfort. -The nurse should instruct the client to increase the calcium intake to 1.2 to 1.5 G per day.

abdominal evaluation and posture test

-client should lie supine on the table for various other procedures, such as an abdominal evaluation -examiner may ask a client to lean backward to test posture or flexibility, but the examiner needs to support the client to prevent falling.

A nurse is caring for a client who has a fractured hip and was placed in Buck's traction 4 hr ago. Which of the following actions should the nurse take?

-encourage pt to perform dorsiflexion of the affected extremity every 2 hrs to assess if pt is experiencing nerve damage. Weakness of dorsiflexion can indicate peroneal nerve damage. If this occurs, nurse should notify the provider immediately. -inspect pt's skin underneath the boot for irritation, increased swelling, and skin breakdown every 8 hours. -The weights should never be removed without a prescription from the provider. The purpose of the weights is to decrease muscle spasms as a result of the hip fracture. - The ropes of the traction should never be loosened. This can affect the traction and increase the client's muscle spasms.

manifestations of bursitis

-manifestations of bursitis or inflammation of the bursa of the joints. -Inflamed, fluid-filled sacs over the joints are manifestations of bursitis or inflammation of the bursa of the joints.

A nurse is caring for a client who is wearing a halo fixator. Which of the following interventions should the nurse implement?

-monitor Pt's VS and neuro status every 1 to 4 rs, depending on Pt's overall status. -monitor Pt's pin sites for loosening. Loosening of the pins of the halo device can place Pt's cervical or thoracic traction at risk, and provider should be notified immediately if this occurs. -check Pt's skin for redness and ensure the vest is not rubbing against Pt's skin, which can create a pressure ulcer. Nurse should check Pt's skin to ensure that it is dry and clean to prevent skin breakdown. -nurse should never hold or pull on Pt's halo device to turn or reposition Pt. This can cause misalignment and loosen the screws that are secured into Pt's skull. -nurse should never adjust the screws of Pt's halo device. The screws are inserted into the Pt's skull to ensure proper alignment while Pt's spinal cord injury heals. The provider is the only person who should make adjustments to the screws if needed.

pulm TB

-nurse should expect anorexia, fatigue, and night sweats in a Pt who has active TB. -Pulm TB causes hemoptysis and chest tightness.

A nurse is caring for a client who is 72 hr postoperative following an above-the-knee amputation and reports phantom limb pain. Which of the following actions should the nurse take?

-nurse should only elevate the client's residual limb above the heart level within the first 48 hr following the surgery. After that time, doing so can cause a hip or knee flexion contracture.

A nurse is caring for a client who had a below-the-knee amputation for gangrene of the right foot. The client reports sensations of burning and crushing pain in the toes of the absent right foot. Which of the following statements should the nurse make? A. "This type of pain usually decreases over time as the limb becomes less sensitive." B. "Try to look at the surgical wound as a reminder the limb is gone." C. "Use a cold compress intermittently to decrease these pain sensations." D. "Grief over the lost limb can sometimes cause denial that the limb is really gone."

A. nurse should recognize that the client is reporting phantom limb pain, a frequent complication following an amputation. The nurse should instruct the client that the sensation should decrease over time. The nurse should recognize the pain, provide treatment, and handle the limb gently to decrease the risk of triggering pain. B. This statement by the nurse does not address the client's current concerns. C. The nurse should instruct the client to use heat and massage, along with pharmacological interventions, to manage this type of pain. D. The nurse should validate the client's report of pain and treat it accordingly. The client is not exhibiting denial; therefore, this statement by the nurse is not appropriate.

nurse should provide these instructions for a client who is prescribed elbow flexion.

"Keep your arm bent at the elbow."

nurse should provide these instructions for a client who is prescribed shoulder abduction, moving the arm away from the midline of the body.

"Position your arm with the shoulder at a 90° angle."

The nurse should provide these instructions for a client who is prescribed shoulder elevation.

"Use a pillow to prop your shoulder up close to your ear."

A nurse is talking with an older adult client who has an elevated risk for osteoporosis about strategies for preventing bone loss. Which of the following instructions should the nurse provide?

-Begin a program of brisk walkingWeight-bearing exercises help maintain bone mass and prevent osteoporosis. Walking is generally a safe activity for older clients. -An adequate daily intake of calcium promotes bone strength and can help reduce the risk of osteoporosis. The recommended calcium intake for women 51 years of age or older is 1.2 G/day. For men, the r -(sparkling water) Carbonated beverages can interfere with the absorption of calcium. - Drinking alcohol excessively can cause bone loss. One alcoholic drink per day will unlikely cause significant bone loss but will not aid prevention.

A nurse is assessing a client who has osteoarthritis. The client's medical record indicates the presence of Heberden's nodes. Which of the following findings should the nurse expect?

-Hard lumps over the joints of the fingers: Heberden's nodes are hard, bony lumps or nodules in the joints of the fingers.

A nurse is caring for a client who has chronic phantom limb pain following an above-knee amputation. Which of the following medication prescriptions should the nurse verify with the provider?

-Meperidine. Opioids are more effective for residual limb pain rather than phantom limb pain. Additionally, meperidine is not recommended for chronic pain because long-term use can cause accumulation of a toxic metabolite.

risk for fibromyalgia.

-Migraine h/a and IBS a risk factor for fibromyalgia.

A nurse is planning care for a client following a total hip arthroplasty. Which of the following interventions should the nurse include in the plan?

-nurse should plan to place a pillow or a wedge between the client's legs to reduce the risk of hip dislocation. -nurse should position the client with her legs abducted to reduce the risk of hip dislocation. -The nurse should avoid internal rotation of the client's affected hip to reduce the risk of hip dislocation. -The nurse should instruct the client to avoid flexing her hip more than 90º to reduce the risk of hip dislocation.

A nurse is discussing the plan of care with a client who has osteomyelitis of an open wound on his heel. Which of the following information should nurse include?

- "Your provider might prescribe a central catheter line for long-term antibiotic therapy."Osteomyelitis is an acute or chronic bone infection. Pt will require weeks to months of IV antibiotic therapy for tx. Therefore, the nurse should discuss the need for long-term IV access for antibiotic therapy. -Cold therapy is contraindicated for a pt who has an open wound. Cold causes decreased blood flow, which can further damage the impaired tissue. -Pt is at increased risk of a fracture of the weakened bone. Therefore, tnurse should instruct the Pt to limit weight-bearing as prescribed by the provider. - The client should consume a diet high in protein to support wound healing.

A nurse is teaching a client who is on bed rest about preventing complications. Which of the following client statements indicates an understanding of the teaching?

- instruct pt to cough and deep-breathe every hr to promote lung expansion, maintain adequate gas exchange, and mobilize secretions. --instruct Pt to perform foot and ankle pump exercises every 1 to 2 hrs to reduce the risk for thrombus formation. -instruct pt to perform ROM exercises 3 to 4 times per day to reduce the risk of muscle wasting and promote mobility. - instruct Pt to change positions every 1 to 2 hours to reduce the risk of skin breakdown.

A nurse is assessing a client who has a fractured left femur and is in skeletal traction. Which of the following findings should the nurse report to the provider?

- nurse should identify chest petechiae as an indication of fat embolism syndrome. pts who have fractures of the long bones such as the femur are at increased risk of fat emboli. Fat emboli typically occur 12 to 48 hrs after the injury when fat droplets from the marrow enter into the systemic circulation and are deposited in the lungs. nurse should immediately notify the provider bc pt could progress to acute resp failure. - Ecchymosis of the thigh, serous drainage at the pin site (monitor for purulent drainage mean infection), and muscle spasm in the left leg are an expected finding for a client who has a fractured left femur.

A nurse is preparing a client for a bone scan. Which of the following statements indicates that the client understands the pre-procedure teaching?

-"A special camera will scan the bones in my entire body." -"I'll have to drink a lot of water to help get the radiation out of my body." -"I understand the radiation is harmless, and I don't have to worry about it." -A bone scan is a radionuclide procedure that allows viewing of the entire skeleton. - It is less common than other diagnostic tests but is still useful for identifying hairline fractures and some malignancies. -pt should drink plenty of fluids to promote urinary excretion of the radioactive material. -Reassure Pt that the radioactive material is not dangerous bc it deteriorates quickly in the body and exits via urine and stool. -Increased absorption of contrast material indicates bone disease and disorders.

A nurse is teaching a group of clients at a senior center about the risk factors for osteoporosis. Which of the following statements should the nurse include in the teaching?

-"Extended periods of immobility increase your risk of osteoporosis." Osteoporosis is a disorder of weakened bones due to a loss of bone mass and a change in bone structure. Immobility can result in osteoporosis; therefore, weight-bearing exercise, such as walking, can help prevent osteoporosis. -Prolonged exposure to sunlight does not increase the risk of developing osteoporosis. Appropriate amounts of sun exposure increase vitamin D levels, which increases the absorption of calcium. -Eating large amounts of protein can result in more calcium loss through the kidneys. -The chronic use of steroid medications increases the risk of osteoporosis.

A nurse is providing discharge teaching to a client who has osteoarthritis. Which of the following instructions should the nurse include?

-"Rest frequently after periods of activity."The joint pain in osteoarthritis is caused by deterioration of the synovial membranes and often worsens after activity. Rest usually helps relieve the pain, so performing activities at a comfortable pace with periods of rest is appropriate. -The client should perform exercise consistently on both good and bad days. -The client should perform exercise immediately after applying heat to painful joints. -The client should not use a large pillow under the knees or head bc this can lead to contractures. A small pillow should be placed under the head or neck when lying down.

A nurse is preparing a client for magnetic resonance imaging (MRI) of the spine. Which of the following pieces of information should the nurse give the client prior to the procedure?

-"You can have a mild sedative before the procedure."Some clients need mild sedation, especially when using an older closed MRI machine. Clients can feel claustrophobic and anxious as they slowly pass through what seems like a tunnel. -client will have to lie supine and still for 45 to 60 min. -MRI can be unsafe for clients who have pacemakers or stents. -There is no exposure to radiation during an MRI.

A nurse is caring for a client with a hip fracture who has Buck's extension traction in place. Which of the following pieces of information should the nurse give the client about this type of traction?

-"You'll have considerably less pain with the traction in place." -"The traction will help decrease muscle spasms." -"The weights act as a pulling force to keep your leg and hip still." (Pain is usually more severe without the traction. Buck's extension traction uses weights to help decrease muscle spasms. Typically, 2.3 to 5.5 kg (5 to 10 lb) of force helps stabilize the hip and leg preoperatively.) -Buck's extension traction is for short-term stabilization of a hip fracture prior to surgery (so not for week or so) -The weights must stay suspended at all times and should not touch the floor.

A nurse is preparing to care for a client who is in balanced skeletal traction to stabilize a femur fracture. Which of the following actions should the nurse include in the client's plan of care?

-A pt who is immobile is at risk of constipation; encourage a diet high in fluid and fiber to promote gi function. -Active ROM of the unaffected limbs is encouraged to prevent muscle wasting; however, active ROM of a limb in traction is not feasible, as the traction apparatus limits mobility. -Once the weights are in place, the nurse should not remove them. -The nurse should plan to inspect the pt's pin sites at least every 8 to 12 hours due to the risk of infection.

A nurse is preparing a client for an electromyogram (EMG). Which of the following statements indicates that the client understands the pre-procedure teaching?

-An EMG shows electrical activity within the muscles during contraction. It is useful for discriminating between muscular dysfunction and nerve dysfunction. -An EMG is a diagnostic procedure that can help the provider plan future interventions -Fasting is not required for an EMG. However, Pt should avoid caffeine for at least 3 hrs prior to the procedure bc an EMG requires pt to refrain from movement. -Pt will most likely not receive any premed or sedation bc the provider will require cooperation during the procedure.

A nurse is preparing a client who is scheduled to have an arthroscopy the following day. Which of the following statements indicates that the client understands the pre-procedure teaching?

-An arthroscopy helps with diagnosing musculoskeletal disorders such as RA osteoarthritis, and internal joint injuries. -Pt has to be able to flex the knee at least 40° so the surgeon can insert the arthroscope into the joint space. -An arthroscopy typically requires ambulatory or same-day surgery. Activity restrictions are likely; however, Pt is allowed to ambulate after anesthesia recovery, most likely with crutches. -Pt might have several incisions that are typically about 0.6 cm (0.24 in) long.

foods with vitamins

-Bananas are a good source of potassium and can reduce bone loss. - Broccoli is a good source of vitamin C, which is important for bone matrix formation. -Green leafy vegetables are a good source of vitamin K. However, green leafy vegetables contain oxalic acid, which decreases calcium absorption.

A nurse is caring for a client who is postoperative following a total knee arthroplasty and has been prescribed a continuous passive motion (CPM) machine and PCA. The client tells the nurse, "I am in so much pain." Which of the following actions should the nurse take first?

-Before the nurse can formulate a plan of action, implement a nursing intervention, or notify a provider of a change in pt's status, the nurse must first collect adequate data from pt. Assessing or collecting additional data will provide the nurse with the knowledge to make an appropriate decision. Therefore, the first action the nurse should take is to acquire further data by asking the client to describe the characteristics of the pain. -nurse should remind the client to push the button for the PCA device to promote the pt's understanding of the PCA and to facilitate consistent pain control -nurse should discuss activities pt may use to distract from the pain to provide nonpharmacological pain relief measures -nurse should stop the CPM machine briefly to apply a cold pack to the client's knee to help reduce edema of the joint as a nonpharm pain relief measure

A nurse is caring for a client who has a fractured right hip. Which of the following types of traction should the nurse expect the client to have prior to hip arthroplasty surgery?

-Buck's traction is used prior to hip arthroplasty to maintain alignment and prevent muscle spasms prior to surgery. -Balanced skeletal traction is used to stabilize fractures of the femur or pelvis, not the hip. Skeletal traction involves the surgical insertion of pins, tongs, wires, or screws; this is sometimes used to stabilize long bone and vertebral fractures. -A pelvic belt is used to treat back pain and does not provide traction prior to hip arthroplasty. -A pelvic sling is used to stabilize pelvic fractures, not hip fractures.

A nurse in the emergency department is preparing to discharge a client following a Grade II (moderate) ankle sprain. Which of the following instructions should the nurse plan to give to the client?

-Cold minimizes swelling and erythema to the affected area. Therefore, the nurse should instruct the client to apply cold compresses for no more than 20 minutes at a time. -Perform passive ROM exercises of the ankle hourly. -Instruct pt to elevate the extremity to decrease swelling (not dependent position). -Instruct pt to apply a compression dressing to decrease swelling of the affected area.

nurse is assessing a client who has a new diagnosis of osteoarthritis. Which of the following findings should the nurse expect?

-Crepitus, a grating sound, is an expected finding with clients who have osteoarthritis as loosened bone and cartilage move around in the fluid inside the joint. -Decreased range of motion is an expected finding with clients who have osteoarthritis because the client's pain limits movement. -Rheumatoid arthritis causes many systemic manifestations, including low-grade fever, weakness, anorexia, and paresthesias. -Spongy joint tissue is an expected finding with rheumatoid arthritis, which is an inflammatory disease, not a degenerative disease.

fluoride, vitamin A, phosphorus deficeincy disease

-Dental caries can result from a deficiency in fluoride. Fluoride does not contribute to bone health. - Deficiency of vitamin A can cause problems with vision, tooth decay, impaired digestion, and decreased immune function. - Phosphorus deficiency is rare. This mineral regulates acid-base balance in the body and is a component of RNA and DNA. It does not contribute to bone health.

A nurse is providing post-procedural teaching to a client who had a diagnostic knee arthroscopy. Which of the following statements indicates that the client understands the nurse's instructions?

-Following a diagnostic arthroscopy, the client should keep the leg elevated for 12 to 24 hours to help reduce pain and swelling. -Pt should take a mild analgesic prescribed by the provider to relieve pain. Aspirin can increase the risk of bleeding. -Pt should apply ice intermittently for the first 24 hours. -Pt should adhere to short-term activity restrictions.

A nurse is caring for a client who has osteoporosis and a new prescription for calcium supplements. Which of the following foods should the nurse recommend to promote calcium absorption?

-Fortified milk provides 2.45 mcg of vitamin D, which promotes calcium absorption from the gastrointestinal tract. Adults up to age 70 need 600 international units of vitamin D per day and 800 international units thereafter. Therefore, fortified milk is a good source of vitamin D.

A nurse is caring for a client who has a pelvic fracture. The client reports sudden shortness of breath, stabbing chest pain, and feelings of doom. This client is experiencing which of the following complications?

-Immobility following musculoskeletal trauma places the client at an increased risk of pulmonary embolus. -Pt might also exhibit tachycardia and chest petechiae and have a decreased SaO2. The nurse should notify the rapid response team immediately.

A nurse is assessing a client who has several risk factors for osteoporosis. Which of the following findings indicates that the client requires further evaluation for this disorder?

-Lower back pain is common among Pts who have osteoporosis, especially when they lift, stoop, or bend. Back pain and tenderness that cause movement restriction might indicate vertebral compression fractures, which are the most common type of fracture resulting from osteoporosis. - Leg cramps are not a symptom of osteoporosis. A variety of imbalances such as deficiencies of calcium and magnesium can cause muscle cramps. - Stress incontinence is not a symptom of osteoporosis. Weakening of the bladder neck supports as a result of childbirth or anatomical damage to the urethral sphincter cause this disorder. - Abdominal distention is not a symptom of osteoporosis. It can be a sign of gi disorders such as irritable bowel syndrome and intestinal obstruction.

A nurse is assessing a client who has rheumatoid arthritis. Which of the following findings should the nurse expect?

-Pt who has rheumatoid arthritis can experience inflammation in the hand joints that can make them susceptible to deformity from daily use. Ulnar deviation, or lateral deviation of the fingers, can occur from opening jars and other similar motions. -Compression fractures of the spine are more common in clients who have osteoporosis.

A home health nurse is performing an assessment on a client who is 1 week postoperative following a total knee replacement. Which of the following statements by the client indicates an understanding of the teaching?

-Pt will receive a prescription for a walker, cane, or crutches to promote ambulation following a total knee replacement. -A blood thinner such as warfarin is typically prescribed to a client following joint surgery to prevent the development of a deep-vein thrombosis (DVT). The client should continue to take the medication until able to ambulate again and the provider decides the medication is no longer needed. -A pillow should not be placed under the client's knee, as this can promote a contracture of the knee joint, making full extension difficult. - A CPM machine will be continued for a client who is going home following a total knee replacement. A CPM machine is used to increase the range of motion of the knee following surgery, and the client should continue to use the machine until physical therapy has been discontinued by the provider.

A nurse is determining a client's risk of developing osteoporosis. The nurse should identify which of the following as risk factors for bone loss?

-Small body frame. Females have a higher risk of developing osteoporosis than males. Other risk factors include family history, low body mass index. -Consuming inadequate levels of calcium and vitamin D, smoking, and ingesting high amounts of alcohol or caffeine also increase the risk of developing osteoporosis. -HTN does not specifically contribute to osteoporosis risk. Common osteoporosis comorbidities include hyperthyroidism and DM - Caucasian and Asian ethnicities are associated with a higher risk of developing osteoporosis.

A nurse is teaching a client with arthritis who is experiencing joint pain that impairs mobility. Which of the following instructions should the nurse include?

-The nurse should instruct the client to apply heat to the joints prior to exercising to increase mobility and reduce pain. -The nurse should instruct the client to avoid resistance exercise because it can cause joint injury when joints are soft and inflamed. - The nurse should instruct the client to use assistive devices when walking to promote independence and increase mobility. -The nurse should instruct the client to perform active exercises when possible to increase mobility.

A nurse is caring for a client who had a fiberglass cast placed on her left arm several hours ago and now reports itching under the cast. Which of the following actions should the nurse plan to take?

-The nurse should provide relief for this client's itching by blowing air into the cast using a hair dryer on a cool setting or an empty 60 mL plunger syringe. -Cast bivalving is used relieve pressure when a cast becomes too tight on the affected extremity - The nurse should instruct the client not to place any foreign object under the cast to prevent injury to the skin. -The nurse should avoid using heat on a casted extremity because this can increase edema.

A nurse is providing preoperative teaching for a client who is scheduled for total knee arthroplasty. Which of the following statements by the client indicates an understanding of the teaching?

-The purpose of elastic stockings is to prevent venous thromboembolism, which is a common complication following orthopedic surgery. -A continuous passive motion (CPM) machine is usually prescribed for a few hours at a time, several times a day. Not all clients are prescribed CPM therapy following total knee arthroplasty. -pt's pain will be initially addressed with epidural or patient-controlled analgesia and supplemented by other analgesic medications, including NSAIDs. -instruct pt to begin leg exercises while in bed during the immediate postop period, including heel pumps and quadriceps-setting exercises.

sphenoid, occipital, frontal bone

-The sphenoid bone forms part of the face. - The occipital bone is in the back of the skull. - The frontal bone is in the front of the skull.

A nurse is preparing a client who is postoperative following total hip arthroplasty for discharge. Which of the following statements indicates that the client understands the instructions?

-To prevent dislocation, Pt must avoid flexing to 90° at the waist. -Using a device that allows the client pick up objects from the floor without bending will help avoid this type of flexion. -Pt should cleanse the hip incision with soap and water every day. -Pt should perform straight-leg raises, ankle pumps, and other exercises as recommended by the physical therapist (no bent leg exercise). -goal of physical therapy is to help Pt resume usual activities. Typically, clients use a walker first and then a cane before the final transition to ambulation without an assistive device.

A nurse in an acute care clinic is talking with a client who reports that the osteoarthritis pain in her knees is increasing each day. The client wants to discuss non-pharmacological approaches to help relieve her pain. Which of the following interventions should the nurse suggest?

-Warm packs or warm soaks (e.g. in a bath or hot tub) are often effective for relieving arthritic pain, should plan for a temp just a little warmer than body temp for optimal comfort. -Pt should eat a well-balanced diet, including the recommended daily allowance of protein. This promotes gradual weight loss or maintenance of a healthy weight. -Pt should rest her joints in their functional position. She should avoid using large pillows to support her knee joints bc they can result in flexion contractures. -pt should sleep for 8 to 10 hrs per night and rest for another 1 to 2 hrs during the day.

A nurse is teaching a client who is postoperative following a right hip arthroplasty. Which of the following images indicates the position the nurse should teach the client to take when sitting in a chair?

-avoid crossing the affected leg over the center of the body to avoid hip dislocation. -instruct the client to sit with the hips at a 90° angle with the knees slightly lower than the hips to avoid hip dislocation. -instruct the client to avoid sitting with the knees higher than the hips to avoid hip dislocation. -instruct the client to avoid leaning forward over the knees to avoid hip dislocation.

nurse is providing discharge instructions for a client who is postoperative following inner maxillary fixation with wiring. Which of the following pieces of information should the nurse include?

-cut the wiring if emesis occurs. The wires are left in place until the fracture is healed. To preserve the client's airway, the nurse should instruct the client to have wire cutters available to cut the wiring immediately if emesis occurs. The client should return to the provider as soon as possible for re-wiring. -The nurse should encourage the client to consume adequate protein and calories for wound healing. Small, frequent meals can prevent nausea - The nurse should instruct the client to report any irritation in the oral cavity to the provider. -The nurse should instruct the client to consume a liquid diet for 1 to 4 weeks postoperatively.

A nurse is caring for a client who is 72 hr postoperative following an above-the-knee amputation. Which of the following actions should the nurse take?

-nurse should assist the client into a prone position for 20 to 30 minutes every 3 to 4 hours following an amputation to reduce the risk of flexion contractures. -nurse should avoid elevation of the residual limb for 72 hours following an amputation because this position increases the client's risk of flexion contractures. -nurse should reapply a bandage to the residual limb every 4 to 6 hours to assist in preparation for a prosthetic limb. -nurse should apply bandages to the residual limb in a distal-to-proximal direction to prevent restriction of blood flow.

A nurse is teaching a client who has a cast on his left arm to treat a forearm fracture. Which of the following statements indicates that the client understands the teaching?

-nurse should emphasize the importance of doing neurovascular checks and notifying the provider of any unexpected findings, such as temperature variances. -client should not insert any objects under the cast to relieve itching. Instead, the client can try blowing cool air from a blow dryer under the cast to relieve itching. - The client should elevate his arm to reduce swelling. Some providers prescribe ice packs for the first 24 to 48 hours, which might also help reduce swelling. - Tingling can indicate compartment syndrome, a complication that involves increased pressure within the fascia leading to reduced circulation to the area. It can also mean the cast is too tight. The client should report this finding to the provider immediately.

A nurse is caring for a client who is in skeletal traction following a femur fracture. On entering, the nurse finds that the client has slid toward the foot of the bed, and the traction weight is resting on the floor. Which of the following actions should the nurse take?

-nurse should ensure that traction weight is hanging freely. Pt can use an overhead trapeze bar to move up in bed, or the nurse can assist Pt while making sure to maintain proper alignment of the extremity. (Have the client use a trapeze to pull himself up while ensuring the weight hangs freely) -nurse should not remove the weight without a prescription, as this could interfere with the correct alignment of the extremity. -nurse should ensure the traction ropes are on the pulley. Lifting the rope displaces the weight and can interfere with the correct alignment of the extremity. -nurse should not lift the weight without a prescription bc this could interfere with the correct alignment of the extremity.

A nurse is caring for a client immediately following application of a plaster cast. The nurse should monitor for and report which of the following findings as an indication of compartment syndrome?

-nurse should identify paresthesias as a finding of compartment syndrome. Compartment syndrome involves the compression of nerves and blood vessels in an enclosed space, leading to impaired blood flow and nerve damage. Other findings include numbness, tingling, weakness, and pain that does not respond to medication. -nurse should expect the cast to feel hot immediately following application due to a chemical reaction in the casting materials. - nurse should identify pruritus as an indication of possible cast irritation and implement measures to provide relief. -nurse should expect a new plaster cast to feel damp and have a musty odor for 24 to 72 hours until drying is complete.

A nurse in the emergency department is assessing a client who was in a motor-vehicle crash 2 days ago and sustained fractures of his tibia, ulna, and several ribs. The client is now disoriented to time and place and has a SaO2 of 87%. The nurse notes generalized petechiae on the client's skin. Which of the following complications should the nurse suspect?

-nurse should identify the triad of neurological changes, petechial rash, and hypoxemia as findings of fat embolism syndrome. Risk factors include multiple fractures and a fracture of a long bone. Male clients are also at greater risk. The manifestations occur when fat globules occlude small blood vessels.

A nurse is discussing the difference between rheumatoid arthritis (RA) and osteoarthritis with a newly licensed nurse. Which of the following pieces of information should the nurse include about osteoarthritis?

-nurse should identify unilateral joint involvement as a finding of osteoarthritis. A client who has RA experiences symmetrical joint impairment. -nurse should identify aging as a risk factor that causes degenerative changes in osteoarthritis. RA is an autoimmune disease in which the body's immune system attacks itself. -nurse should expect an increased erythrocyte sedimentation rate for a client who has osteoarthritis. -Osteoarthritis is limited to the joints. RA is a systemic autoimmune disease, involving other body organs.

A nurse is providing discharge teaching for a client who had a left total hip arthroplasty. Which of the following client statements indicates the teaching was effective?

-nurse should instruct the client to avoid crossing the legs at the knees or ankles because this can result in the dislocation of the femoral head. -client should be instructed to notify the provider of potential complications such as leg swelling, pain or redness. This can be an indication of deep vein thrombosis. - client should inspect the surgical incision site daily for redness and warmth. This can be an indication of infection following surgery -client should avoid bending at the hip to pick up objects on the floor and should not flex the hip more than 90°. This can cause dislocation of the hip following surgery.

A nurse is providing teaching for a client following a below-the-knee amputation. Which of the following pieces of information should the nurse include in the teaching?

-nurse should instruct the client to lie in a prone position for 20 to 30 minutes every 3 to 4 hours. This prevents the client from developing contractures while in bed. -nurse should instruct the client to sleep on a firm mattress following the procedure to prevent the development of contractures. -nurse should instruct the client to push down the residual limb while in bed. This prepares the limb for the prosthetic and reduces the incidence of phantom pain. - nurse should instruct the client to wrap the residual limb in an elastic bandage to assist with shrinking the limb and preparing for the prosthesis. The bandage should be wrapped in a figure-8 pattern from a distal to proximal direction. The bandages should be reapplied every 4 to 6 hours or more often if loose.

A nurse is assessing a client who is 48 hr postoperative following open reduction and internal fixation of a fractured tibia. Which the following findings should the nurse report to the provider?

-nurse should monitor for and report manifestations of compartment syndrome following internal fixation. Therefore, the nurse should contact the provider immediately if the client's toes are cold to the touch. -nurse should identify serous drainage from the pin sites and pink to red tissue at the fixator insertion sites as an expected finding during the first 2 to 3 days following the procedure. -As part of measuring capillary refill, the nurse should press the nail bed long enough to produce a blanching appearance. Therefore, the nurse does not need to report this finding. -open reduction muscle spasms are expected?

A nurse is caring for a client who is 3 days postoperative following a right total hip arthroplasty. While transferring to a chair, the client cries out in pain. The nurse should assess the client for which of the following manifestations of dislocation of the hip prosthesis?

-nurse should monitor the client for shortening of the affected leg as an indication of dislocation of the prosthesis. Other findings include increased hip pain, an inability to move the extremity, and rotation of the hip internally or externally.

A nurse is caring for a client who is scheduled to undergo surgery to repair an open hip fracture. In which of the following positions should the nurse plan to place the client postoperatively?

-nurse should plan to place the client with the leg abducted on the affected side postoperatively. Adduction or external rotation of the leg will cause the hip to dislocate. -Adduction of the client's leg will cause the hip to dislocate, requiring further surgery. - External rotation of the client's leg will cause the hip to dislocate, requiring further surgery. -Flexion of the client's hip at 90° or greater will cause the hip to dislocate, requiring further surgery.

A nurse is caring for a client who is 3 days postoperative following a below-the-knee amputation. Which of the following actions should the nurse take?

-nurse should rewrap the client's residual limb with a pressure bandage 3 times daily. This keeps the bandage taught, which ensures the residual limb will shrink. Rewrapping the bandage also allows the nurse to check the skin for redness or skin breakdown. - The nurse should turn the client every 2 hours while in bed to prevent contractures and increase the range of motion of the client's extremities. The nurse should turn the client slowly to prevent muscle spasms.

A nurse is assessing a client's skeletal system. The nurse should be in which of the following positions to screen the client for scoliosis?

-nurse should stand behind the client, who is bent over at the waist, to inspect the symmetry of the scapula and curvature of the spine from the posterior view. These are essential components of a scoliosis screening.

A nurse is caring for a client following a hip arthroplasty. The nurse places an abduction pillow on the client for which of the following purposes?

-nurse should use an abd pillow to prevent dislocation of the new hip joint. nurse should place the wedge-shaped pillow between pt's legs to prevent add beyond the midline of the body during position changes or pt movement, which can lead to subluxation or total dislocation of the hip joint. -If pt is at risk for plantar flexion resulting in foot drop, the nurse should place a foot cradle at the foot of the bed to raise the bed linens off the feet. - The nurse should use regular bed pillows to keep the client's heels off the bed to prevent shearing and skin breakdown. - The nurse should use regular pillows and rolled blankets to position the client off the operative site while in bed.

A nurse is preparing a client for discharge who is postoperative following a conventional lumbar disk excision. Which of the following statements indicates that the client understands the nurse's instructions?

-pt should apply heat to the back to relax the paraspinal muscles and reduce spasms. -Pt will have to limit daily stair climbing but should start daily walking right away. - Pt may take up to 6 weeks to heal following a laminectomy. Pt should resume activities gradually over that time to prevent spasms of the muscles near the spine. - Driving adds flexion strain to the back. Pt should avoid driving until the spine has healed, which typically takes up to 6 weeks.

A nurse is teaching a client who had an amputation of the left lower leg 3 days ago. Which of the following statements indicates that the client understands how to care for the incision and his left upper leg?

-pt should not use any lotions or powder on the residual limb. -pt should not elevate the residual limb on pillows in the first 24 to 48 hours after the procedure bc this can lead to hip or knee flexion contractures. -pt should lie prone 3 or 4 times per day for 20 to 30 minutes. This position will help reduce the risk of developing hip flexion contractures. - The amputation will have removed any gangrenous tissue. Foul-smelling drainage indicates infection. The client should report this finding to the provider immediately.

A nurse is caring for a client who is postoperative following a lumbar disk excision. Which of the following interventions should the nurse include in the client's plan of care?

=client should receive instructions about logrolling preoperatively. The nurse may need to engage other staff members in assisting with logrolling to maintain proper alignment of the client's spine at all times postoperatively =The client's knees should be in a position of slight flexion to help relax the back muscles. =Except while defecating, the client should avoid sitting in the immediate postoperative period. = Urinary retention is an indication of neurological deterioration following a laminectomy. The nurse should report this finding to the surgeon immediately.

A nurse is caring for a client who is postoperative following shoulder surgery. The client has a prescription to keep the affected arm adducted. Which of the following instructions should the nurse share with the client?

Adduction means to position toward the midline of the body. Therefore, the nurse should provide these instructions to explain the provider's prescription

Dupuytren's disease.

Dupuytren's disease: progressive flexion contracture of the palmar fascia affecting the middle, fourth, or fifth fingers describes Dupuytren's disease.

compound fracture,

In a compound fracture, the sharp edge of the bone breaks through the skin.

In a compression fracture

In a compression fracture, a loading force to the long axis of a bone collapses the bone. This is common with vertebral fractures.

depressed fracture

In a depressed fracture, the force of the injury drives the bone fragments inward. This is common with skull and facial fractures.

In a spiral fracture

In a spiral fracture, the break twists around the bone's shaft.

In an avulsion fracture

In an avulsion fracture, a tendon and its attachment have pulled away a fragment of bone.

In an impacted fracture

In an impacted fracture, the force of the injury drives one fragment of bone into another fragment of bone.

A nurse is providing nutrition education to a client who has osteomalacia. The nurse should identify that this condition is caused by a deficiency in which of the following nutrients?

Osteomalacia, a softening of the bones due to defective bone mineralization, results from a deficiency of vitamin D.

PPneumonia

The nurse should expect a productive cough and pleural pain as findings of pneumonia, which is a complication of immobility following pelvic fracture.

Pneumothorax

The nurse should expect tracheal deviation and absent breath sounds on the affected side for a client experiencing tension pneumothorax, which is a complication of chest trauma or MECHanical VENTilation.

The nurse should suspect avascular bone necrosis

The nurse should suspect avascular bone necrosis as a long-term complication for a client who reports pain and limited movement. Radiographs of the extremity will reveal loss of bone structure.

The nurse should suspect hypovolemic shock in a client who experiences

The nurse should suspect hypovolemic shock in a client who experiences hypotension following extreme fluid loss, as with uncontrolled bleeding, dehydration, or severe edema.

thrombophlebitis manifestation

The nurse should suspect thrombophlebitis for a client who reports redness and warmth over the involved vein, along with extremity pain.

A nurse is caring for a client who has a depressed skull fracture of the bone that makes up the larger part of the upper and side wall of the cranium. This fracture is located on which of the following bones?

The parietal bones form the larger part of the upper and side wall of the cranium.

greenstick fracture

With a greenstick fracture, there is an incomplete break in the bone. One side of the bone usually splinters, while the other side is bent but intact. This type of fracture is common in children because their bones are more flexible than those of an adult.