Musculoskeletal AAH
Which of the following client would benefit from the application of warm moist heat?
A client with chronic low back pain
A nurse is teaching a group of parent about fx. Which of following statement by a parent indicates an understanding of the teaching?
A fx. to an arm cause it to be shorter than the non-injured arm
A nurse is caring for a client who has a cast on his am after reduction of a fx. of the ulna. What is a normal finding when checking neurovascular status of the distance; extremity?
A strong pulse that is easily palpated
Which of following finding are most likely when assessing an elderly individual who fell and now presents with portable hip fx? SATA
A,. Groin pain with weight bearing B. Ecchymosis over the hip and thigh C. Muscle spams around the fx. site
A nurse is caring for a client with spica cast. Which of the following interventions involves proper skin care?
A. Check exposed areas for signs of redness or irritation B. Inspect the inside edges of the cast to look for extra pieces of cast material C. Provide regular sponge bath for this client
A nurse is admitting a client who has been immobile due to spinal-cord injury. Which of the following finding should the nurse identify as complications of immobility?
A. Contractures of the extremities B. Crackles in the lungs C. Pressure ulcers
A nurse is caring for an adolscent who has muscular dystrophy Corticosteroid. Which of follwing statements about Corticosteroid should the nurse include teaching? SATA
A. Corticosteroid help preserve respiratory functioning B. Corticosteroids slow the progression of muscle weakness C. increase muscle bulk and power. D. Corticosteroid decrease the incidence of scoliosis.
A nurse ED is caring for a child who sustained a fx. Which of the following should the nurse take?
A. Elevate the affected limb B. Assess near status frequent C. Stabilize the injury
A nurse is assessing a client with herniation of L5-S1 disk To which of the following does the nurse expect the client is most likely experience radiation of pain?
Buttocks and lower extremities
A client is in the acute phase of RA. In which order of priority should the nurse establish the following goals:
-Relieving pain -Preventing joint deformity -Preserving joint function -Maintaining usual ways of accomplishing tasks
Which of the following. would a nurse expect on assessment of a client with fat embolism syndrome after femur fx? SATA
-Restlessness and confusion -Fever -Petechail rash on the neck, chest and axilla
A nurse is to administer 10 mg of morphine to a client with 3 fx. ribs. The available concentration for this drug is 15 mg/ml How many ml should the nurse administer?
0.7 ml
A nurse has just received report for 4 clients. Which client should the nurse prioritize?
A client post surgical repair of a right tibia-fibula fx. who complains of severe pain after surgery and now has no feeling in the right foot.
A nurse is providing teaching to a client about preventing low back pain. Which of the following instruction should the nurse include in the teaching ? SATA
A. Engage in regular exercise, including walking B. Use a wide base of support when lifting objects C. Wear low heeled shoes
A nurse is caring for a client who has undergone placement of an external fixation device for a bone fx. Which of the following actions should the nurse make? SATA
A. Keep the affected extremity above hear the level of the hear B. Use a separate cotton swab for cleaning each pin C. Report increased redness at the pin sites
Nursing is caring for a school aged child who has juvenile idiopathic arthritis and is returning to school. Which of the following instructions should the nurse include regarding successful school attendance? SATA
A. Make arrangements to have a set of books at school and a set at home B. Involve the school nurse in med management C. Request an individual education plan for pt. that require extensive modifications for school
A nurse is caring for a client who requires lifting assistance. Which of following practices will nurse implement to avoid low back strain or injury? SATA
A. Obtain help if possible B. Keep the trunk in straight aligment
A nurse is planning care for a child who is in skeletal traction. Which of the following interventions should the nurse include in the plan?
A. Provide a high fiber diet B. Assess the pin sites q4hours
A nurse developing a care plan for a client with chronic osteomyelitis. Which of the following nursing diagnosis are appropriate for the client?
A. Risk for assess formation B. Pain C. Impaired physical mobility D. Fever
A nurse is providing education for a group of senior at a health fair concerning osteoporosis. Which of the following lifestyle modifications should the nurse recommend to decrease the risk of fx.?
A. weight bearing exercise, including regular walks. B. Tobacco cessation
A nurse is reviewing the medical records of a client who has osteoporosis. Which of the following finding should the nurse expect.? SATA
A> Loss in height of 5.1 cm (2 in) B. Kyphotic curve at upper thoracic spine C. Hx. of lactose intolerance
A nurse is caring for a client with developmental dysplasia of the hip. Which of the following is primary intervention for this child?
Abduction of the hip
A 12 year old is dx. with idiopathic scoliosis and is fitted with a brace. The length of time the brace must be worn varies, but as a general guideline the nurse instructs the client and her parents that the brace is usually worn until:
After the client bones have stopped growing and she is physically mature
A flight nurse arrives at. the scene of a MVA and observes that the victim has had a traumatic amputation. What action is a nursing priority?
Apply pressure to the stump with sterile gauze to prevent hemorrhage
A nurse is caring for a client who has chronic back pain and request pain medication. Which of the following actions should the nurse take first?
Ask the client to rate pain on a scale 0-10.
A nurse is caring for 6 year old client with greenstick fx. of the femur who has returned to ED after immobilization and casting. The mother stares that the child is in intense pain even when leg elevated and the child has taken an NSAID for relief of pain. What is the priority nursing action?
Assess limb color and pulses.
A nurse is caring for a client who is post-op lumbar laminectomy. Which of the following is appropriate when caring for this client?
Assist with repositioning by using the draw sheet and logrolling the client.
A nurse is assisting a client to ambulate on the first fay after a knee replacement. The nurse is using a gait belt, and is the only person assisting the client.. As soon as they enter the hallway, the client legs slides out from under him and he begins to fall. What is the most appropriate action for he n nurse to take?
Assume a wide stance and use her body to break the clients fall.
Match each bone describe below with the correct classification of bone type? 1. Scapula 2. Vertebra 3. Femur 4. Sternum 5. Humerus 6. Mandible A. Long bone B. Flat bone C. Irregular bone
BCABAC
Which best describes placement of spica cast?
Cast applied from chest to thigh or knees
A nurse is providing discharge instruction to the guardian of an infant who has developmental hip dysplasia and has a newly applied plaster spica cast. Which of. the following instructions should the nurse include?
Check the temp. of the infant toes every hours for at least the first 24 hours.
A nurse is assessing a client who has HIV. Which finding should the nurse identify as a manifestation of HIV associated muscle wasting?
Diminished strength
A nurse is providing teaching to a client with chronic low back pain on non-pharmacological pain modalities of pain relief that use which of the following strategies?
Distraction
A nurse is caring for a client has RA. The nurse should identify that which of the following labs test are used to diagnosis this disease? SATA
ESR ANA C-reactive protein
A nurse is developing a POC for a 4 year old child who has cerebral palsy. Which of the following actions should the nurse include?
Evaluate the child need for referral to speech-language therapist.
A nurse is caring for a client admitted a day earlier after repair of femur fx. who is agitated and SOB. Physical examination reveals petechiae on the chest and abdomen. Which of the following is most likely cause if these symptoms?
Fat embolism
Assessing the client using the bulge sign would most likely check which type of injury?
Fluid in the knee joint
In which situation would this type of device most likely be used?
For an unstable, comminuted fx.
Your client has just arrived at E.D. via ambulance with an open fx. of the arm that is accompanied by excessive tissue, nerves and vascular damage. What grade open fx. does the client have?
Grade III
A nurse is for a 6 month old infant who is scheduled for a lumbar puncture. Which of the following action should the nurse take?
Hold the infant chin to his chest to his chest and knees to his abdomen during procedure.
A client presents to the clinic with a cast on the upper extremity after a fracture of the distal humerus. Which of the following statements id the most urgent priority for assessment?
I can't extend my finger today.
A nurse is teaching a client with RA about how to manage the fatigue associated with RA. Which statement indicates the client understands how to manage the fatigue?
I schedule afternoon rest period for myself in addition to sleeping 10 hrs @ night
The nurse is discharging a baby with clubfoot who has had a cast applied. The nurse should provide additional teaching to the parents if they state:
I should use a pillow to elevate my child foot as she sleeps.
A nurse is assessing a client complaining of moderate low back pain after gardening. Which of the following statements is true?
Id salicylate is prescribed, the client should be informed of possible SE (tinnitus) that may indicate toxicity
A nurse in the E.D. is caring for a client with spinal cord injury. Which interventions should nurse prioritize?
Immobilize the client head and neck
A nurse is providing information about capsaicin cream to a client who has osteoarthritis. Which of the following information should the nurse include in the teaching?
Inspect for skin irruption and cuts prior to application
A nurse is caring for a client with a cast after reduction of tibial fx. The nurse understands that which of the following is a symptom of compartment syndrome?
Intense muscle pain, numbness, burning and feeling of tight muscles
The nurse is caring for a client with a new plaster cast on his L arm. Which of the following will the nurse NOT include in teaching this client about cast care?
Keep the arm below the level of your heart.
A nurse is caring for a teenager who broke his femur in a motorcycle accident. He has a full length cast on the injured leg and is to avoid weight bearing on the injured leg for 8 weeks. Before discharged, client demonstrates correct use of the crutches when he:
Leads with the "good" while going up the stairs, keeping the "bad" leg out behind
Which of the follow should the nurse assess in a client dx. osteoarthritis?
Local joint pain.
A nurse is assessing a client who presents in the E.D. complaining of low back pain which he describes as extremity severe. Which of the following does the nurse understand when assessing the client pain?
Localized pain described as throbbing or aching is typical of nociceptive pain.
A nurse is caring for a client who is in perimenopause. Which of the following example of long term change that may develop after menopause?
Loss of bone tissue
A nurse is creating a POC who has a fx. femur and is in buck traction. Which of the following interventions should the nurse include?
Maintain the affected leg in extended position?
A nurse is caring for a client in Buck's traction after a femur fracture. When repositioning the client toward the head of bed, which of the following should the nurse do?
Maintain the same degree of traction tension while repositioning the client.
A nurse in the ICU is caring for a client who has been sedated on a mechanical ventilator for 10 days. Which of the following is hazard associated with immobility?
Muscular atrophy
A nurse is caring for a clieny who has just had a plaster cast applied after a fx. of the ulna. Which of the following is the most appropriate nursing interverntion?
Observe edges of the cast to ensure they do not cut the skin
Which of the following finding should a nurse prioritize for immediate action when assessing a client 1 day after a cast was placed on a reduced fx. of the tibia?
Paresthesias and pallor
A nurse is caring for a child who has a new dx. of Marfan syndrome. What should the nurse prioritize in the d/c teaching for the parents?
Participation in contact sport be avoided.
X-ray films reveal that a client has a closed fracture of the right femur and tibia. Multiple soft-tissue contusions are also present. What is the most important next step in intervention?
Perform a neurovascular assessment of the extremity
A Provider order gold salts with RA. For which of the following serious side effect will the client monitoring?
Persistent diarrhea
A nurse is caring for a new client in PACU after amputation of the left leg. Which of the following is the priority nursing action in the immediate post-op period?
Place a surgical tourniquet at the bedside
A nurse is caring for a client who has undergone total hip replacement and is now in PACU. Which of the following is an elect of post-op provided by the nurse for client whoas post-op hip replacement?
Place pillow between the client legs
A nurse is teaching the parents of a newborn about treatment measures for their newborn's plagiocephaly. Which of the following instructions should the nurse include?
Place the prescribed helmet on your baby head for 23 hours a day
The nurse is caring for an elderly man who has hip pain r/t to RA. The client is practicing appropriate self-care activities when the client chooses to sit in which of the following chairs?
Straight-backed chair with an elevated seat
Two nurses are assisting a client with one-sided weakness to move up in bed. Which of the following describe the correct procedure with respect to optimal body mechanics?
Position the nurses on either side of the bed with their feet apart, gather the pull sheet close to the client, turn toward the head of the bed, and then move the client up.
A nurse is preparing discharge education for a client with type 2 DM and RA with a new prescription for prednisone. Which of the following will the nurse include in teaching?
Prednisone suppresses the inflammatory process but doesn't cure the disease.
A nurse is caring for a child who is suspected of having Legg-Calve-Perthes disorder? The nurse should anticipate a prescription for which of the following diagnostic procedures?
Radiographs
A nurse is caring for client who has undergone chest surgery. Which of the following rehab measures should the nurse stress to prevent shoulder ankylosis?
Raise the arm on the affected side over the head
A nurse is caring for a client with OA who is receiving an injection of hydrocortisone into knee joint. Which of the following does the nurse understand is the most significant reason for this treatment?
Reduce inflammation caused by arthritis
A client with ankylosing spondylitis is discouraged because of his inability to continue working as a carpenter w/o severe pain. He has received a new prescription for etanercept. Which of the following nursing diagnosis is the priority for this client with regard to the new prescription?
Risk for infection
A nurse is teaching the guardian of a toddler who has development dysplasia of the hip about care of the toddler hip spica cast. The guardian ask why Pavlik harness is not being used. Which of the following response should the nurse make?
The Plavik harness is used for infants less than 6 months of age.
After knee arthroscopy, then client has a SCD. Which of following should the nurse include in this client care?
d/c the SCD when the client is ambulatory
A client with a dx. of polyarteritis nodosa asks the nurse for information about this disorder? What information should the nurse include in her response?
The disorder is considered one of hypersensitivity and the exact cause is unknown
A nurse is teaching the parent of a child who has a growth hormone deficiency. Which go the following statements should the nurse make?
This disorder will not affect your child ability to gain weight
A nurse places a hand roll for a client who has paralysis of the right hand and arm after a stroke. Which best describes the purpose of a hand roll?
To prevent contracture in the hand
A nurse is preparing a staff in service about developmental dysplasia of the hip in preschoolers. Which of the assessments should the nurse include?
Trendelenburg sign
A charge nurse notice that a nursing assistant is lifting a client from the bed to the chair, in an errect position with straight stiffened knee. Which of the following is a appropriate by the nurse?
Use this observation to re-educate the staff member about the center of gravity
A nurse is caring for a client who was admitted to the unit during the previous shift, after undergoing an orthopedic procedure to repair a fx. ankle. The client has been in bed but now ask the nurse to assist with transfer to a chair. Which of the following should the nurse do first?
Verify the surgeon prescription for activity for this client.
Which of the following nursing instructions should be given to a 13 year old female with scoliosis who is discharged with a thoracolumborsacral orthosis (TLSO) brace?
Wear a cotton t-shirt underneath the brace
Which go the following conditions would be an indication for gallow traction?
Weight less than 12 kg.
A client with RA is undergoing assessment for joint pain and swelling. Which of the following chemical mediators are responsible for the client inflammatory process?
a. Leukotriene b. Prostaglandin c. Histamine d. Bradykinin
A nurse is assessing an infant who has a spina bifida cystic (myelomenigocele) located below the second lumbar vertebrae. Which of the following finding should the nurse expect?
a. Partial paralysis of lower extremities b. Sensory deficits
Which of the following is a low-risk activity that the nurse can include in a discussion with a client who complains of stress and back pain?
relaxation techniques
