Musculoskeletal Pretest

A client is ordered gentamycin 3 mg/kg/day in four divided doses. The client weighs 198 lbs. The pharmacy has provided gentamycin 80 mg per mL. How many mL would the nurse administer per dose? (Please round to the nearest tenth)

0.8 mL per dose

Which information will the nurse include when teaching a client with acute low back pain (select all that apply)? Correct! 1. Ibuprofen or acetaminophen can be used to relieve pain. 2. Symptoms of acute low back pain frequently improve in a few weeks. 3. Keep the knees straight when leaning forward to pick something up. 4. Avoid activities that require twisting of the back or prolonged sitting. 5. Sleep in a prone position with the legs extended.

1. Ibuprofen or acetaminophen can be used to relieve pain. 2. Symptoms of acute low back pain frequently improve in a few weeks. 4. Avoid activities that require twisting of the back or prolonged sitting.

Which actions will the nurse include in the plan of care when caring for a client with metastatic bone cancer of the left femur (select all that apply)? 1. Monitor serum calcium level. 2. Teach about the need for strict bed rest. 3. Support family as they discuss the prognosis of client. 4. Avoid use of sustained-release opioids for pain. 5. Support the left leg when repositioning the client.

1. Monitor serum calcium level. 3. Support family as they discuss the prognosis of client. 5. Support the left leg when repositioning the client.

Which information will the nurse include when teaching a client with acute low back pain (select all that apply)? 1. Keep the knees straight when leaning forward to pick something up. 2. Avoid activities that require twisting of the back or prolonged sitting. 3. Symptoms of acute low back pain frequently improve in a few weeks. 4. Sleep in a prone position with the legs extended. 5. Ibuprofen or acetaminophen can be used to relieve pain.

2. Avoid activities that require twisting of the back or prolonged sitting. 3. Symptoms of acute low back pain frequently improve in a few weeks. 5. Ibuprofen or acetaminophen can be used to relieve pain.

A client is ordered vancomycin 500 mg intramuscularly for osteomyelitis. The pharmacy has provided vancomycin 1 gm in 5 mL of normal saline. The nurse would administer how many mL? (Please round to the nearest tenth)

2.5 mL

A nurse receives report on the following four clients. Which client would the nurse see first? A. A 65 year old female with Pearson traction and a temperature of 39.6 (103.4) B. A 76 year old male with a cast to left radius and ulna and swelling of fingers C. A 36 year old female with bilateral bunionectomies complaining of pain D. A 48 year old male with fractured right femur and external rotation

A. A 65 year old female with Pearson traction and a temperature of 39.6 (103.4)

A client's left leg is in Buck's traction. The client complaining of burning under the traction boot and the toes on that foot are cool. What is the nurse's first action? A. Notify the health care provider B. Apply an ice pack to the boot for 15 minutes C. Remove the boot, then reapply and reassess D. Ask "What do you mean by burning?"

A. Notify the health care provider

A client with kyphosis is scheduled for a DEXA testing. The nurse will plan to A. Teach the client that DEXA is noninvasive B. Start an intravenous line C. Give an oral sedative D. Screen for shellfish allergies

A. Teach the client that DEXA is noninvasive

The nurse will determine that more teaching is needed if a client with discomfort from a bunion says, "I will A. only wear sandals, no closed-toe shoes." B. use the bunion pad to cushion the area." C. give away my high-heeled shoes." D. take ibuprofen (Motrin) if I need it."

A. only wear sandals, no closed-toe shoes."

Which intervention would be appropriate for a nurse to teach a client with a left radius fracture with a cast? A. "If your fiberglass cast gets wet, dry it with a blow dryer on the warm setting." B. "Do not place anything down the cast when itching." C. "Cover your plaster cast with plastic before taking a long bath or shower." "A foul odor emanating from the cast is normal.

B. "Do not place anything down the cast when itching."

A 21-year-old female soccer player has injured her anterior crucial ligament (ACL) and is having reconstructive surgery. The nurse knows that the client will need more teaching when the patient makes which statement? A. "I will need to wear an immobilizer and progressively bear weight on my knee." B. "I can't wait to get this done now so I can play soccer for the next tournament." C. "They will have me do range of motion with my knee soon after surgery." D. "I probably won't be able to play soccer for 6 to 8 months."

B. "I can't wait to get this done now so I can play soccer for the next tournament."

When preparing a client for discharge with an intermaxillary fixation, the nurse determines that the teaching is effective when the client states, A. "I can keep my mouth moist by sucking hard candy." B. "I may use a bulk forming laxative if my liquid diet causes constipation." C. "I could use a moist swab to clean my mouth every time I eat something." D. "I should cut the wires with the scissors if I begin to vomit."

B. "I may use a bulk forming laxative if my liquid diet causes constipation."

A client recently started an exercise regimen that includes running three to four miles a day. The client tells a nurse the pain is so intense that it is limiting the ability to run. An appropriate response by the nurse is, A. "You should have x-rays of your lower legs to be sure you do not have stress fractures of your femur." B. "Improper running shoes can cause tibial inflammation. What kind of shoes are you wearing?" C. "Soft surfaces stress the lower leg. Are you running on a hard surface?" D. "You should use speed walking rather than running in your exercise regimen because it is less traumatic."

B. "Improper running shoes can cause tibial inflammation. What kind of shoes are you wearing?"

A client who has had an open reduction and internal fixation (ORIF) of a hip fracture tells the nurse that he is ready to get out of bed for the first time. Which action should the nurse take? A. Use a mechanical lift to transfer the patient from the bed to the chair. B. Check the postoperative orders for the client's weight-bearing status. C. Delegate the transfer of the client to nursing assistive personnel (NAP). D. Avoid administration of pain medications before getting the client up.

B. Check the postoperative orders for the client's weight-bearing status.

A client with a comminuted fracture of the right femur has Buck's traction in place while waiting for surgery. To assess for pressure areas on the client's back and sacral area and to provide skin care, a nurse should A. Turn the client partially to each side with the assistance of another nurse. B. Have the client lift the buttocks by bending and pushing with the left leg. C. Loosen the traction and have the client turn onto the unaffected side. D. Place a pillow between the client's legs and turn gently to each side.

B. Have the client lift the buttocks by bending and pushing with the left leg.

A client with acute osteomyelitis of the left femur is hospitalized for regional antibiotic irrigation. Which intervention will be included in the initial plan of care? A. Assisted weight-bearing ambulation B. Immobilization of the left leg C. Positioning the left leg in flexion D. Quadriceps-setting exercise repetitions

B. Immobilization of the left leg

The client is brought to the emergency department after a car accident and has a femur fracture. What nursing intervention should the nurse implement to prevent a fat embolus in this client? A. Administer enoxaparin (Lovenox). B. Immobilize the fracture preoperatively C. Provide range-of-motion exercises D. Apply sequential compression boots.

B. Immobilize the fracture preoperatively

A client is admitted to the floor after having a laminectomy with spinal fusion. Of the following maneuvers the client may use to avoid pain, which is unsafe? A. Log rolling B. Sitting in semi-Fowlers position C. Placing a pillow between the legs D. Lying flat in bed

B. Sitting in semi-Fowlers position

An assessment finding for a 55-year-old client that alerts the nurse to the presence of osteoporosis is A. the presence of bowed legs. B. a measurable loss of height. C. the aversion to dairy products. D. a statement about frequent falls.

B. a measurable loss of height.

Following laminectomy with a spinal fusion to treat a herniated disc, a client reports numbness and tingling of the right lower leg. The first action that the nurse should take is to A. check the vital signs for indications of hemorrhage. B. check the chart for preoperative assessment data. C. report the patient's complaint to the surgeon. D. turn the client to the side to relieve pressure on the right leg.

B. check the chart for preoperative assessment data.

An appropriate nursing intervention for a client who has acute low back pain and muscle spasms is to teach the client to A. twist gently from side to side to maintain range of motion in the spine. B. keep the head elevated slightly and flex the knees when resting in bed. C. avoid the use of cold packs because they will exacerbate the muscle spasms. D. keep both feet flat on the floor when prolonged standing is required.

B. keep the head elevated slightly and flex the knees when resting in bed.

A 20 year old baseball pitcher has had an arthroscopic repair of a rotator cuff injury performed in same day surgery. When the nurse plans postoperative teaching for the client, which information will be included? A. "The doctor will use the drop-arm test to determine the success of the procedure." B. "Leave the shoulder immobilizer on for the first few days to minimize pain." C. "You have an appointment with a physical therapist for tomorrow." D. "Ask your coach to find a different position to play on the baseball team."

C. "You have an appointment with a physical therapist for tomorrow."

A female client with a long-standing history of rheumatoid arthritis has sought care because of increasing stiffness in her right knee that has culminated in complete fixation of the joint. The nurse would document the presence of which of the following problems? A. Contracture B. Atrophy C. Ankylosis D. Kyphosis

C. Ankylosis

A nurse is providing postoperative care for a college student who has undergone a knee arthroscopy for tendon repair. The client is scheduled to be discharged in a few hours and plans to return to the college dormitory and spend the weekend there before returning to class in two days. What is most important for the nurse to include in the client's discharge plan? A. Instruct the client to restrict activities for at least several days. B. Arrange for a taxi to return the client to the dormitory. C. Ask the client who is available in the dormitory that could provide assistance. D. Suggest the client spend the weekend in a motel near the hospital.

C. Ask the client who is available in the dormitory that could provide assistance.

A client is admitted to the hospital. X-rays reveal a fractured tibia and a fiberglass cast is applied. Which of the following nursing action would be most important after the cast is in place? A. Helping the client to ambulate B. Arranging physical therapy C. Assessing capillary refill D. Discussing cast care with the client

C. Assessing capillary refill

A 50-year-old client is reporting a sore shoulder after raking the yard. The nurse should suspect which problem? A. Sprained ligament B. Fasciitis C. Bursitis D. Achilles tendonitis

C. Bursitis

When counseling an older client about ways to prevent fractures, which information would the nurse include? A. Tacking down scatter rugs in the home B. Occasional weight bearing exercise will improve muscle and bone strength C. Buy shoes that provide good support and are comfortable to wear D. Most falls happen outside the home

C. Buy shoes that provide good support and are comfortable to wear

A checkout clerk in a grocery store has muscle and tendon tears that have become inflamed, causing pain and weakness in the left hand and elbow. The nurse recognizes these symptoms are related to A. Muscle spasms B. Carpal tunnel syndrome C. Repetitive strain injury D. Meniscus injury

C. Repetitive strain injury

nurse observes a client doing all these activities after having a hip replacement surgery. Which client action requires that the nurse intervene immediately? A. The client uses crutches with a swing to gait. B. The client bends over the sink while brushing the teeth. C. The client leans over to pull shoes and socks on. D. The client sits straight up on the edge of the bed.

C. The client leans over to pull shoes and socks on.

Following x-rays of an injured wrist, the client is informed that it is badly sprained. In teaching the client to care for the injury, the nurse would instruct the client to A. Wear an elastic compression bandage continuously. B. Apply a heating pad to reduce muscle spasms. C. Use pillows to keep the arm elevated above the heart D. Take acetaminophen and ibuprofen every 2 hours for pain

C. Use pillows to keep the arm elevated above the heart

A client suffered an injury to the left shoulder. To identify any abnormalities of cartilage and soft tissue damage a nurse should expect the client to be evaluated with A. a bone scan. B. an arthrogram. C. magnetic resonance imaging. D. standard x-rays.

C. magnetic resonance imaging.

Which intervention would be appropriate for a nurse to teach a client with a left radius fracture with a cast? A. "If your fiberglass cast gets wet, dry it with a blow dryer on the warm setting." B. "A foul odor emanating from the cast is normal." You Answered C. "Cover your plaster cast with plastic before taking a long bath or shower." D. "Do not place anything down the cast when itching."

D. "Do not place anything down the cast when itching."

A 19-year-old male client has a plaster cast applied to the right upper extremity for a Colles' fracture after a skateboarding accident. Which action, if taken by the nurse, is the most appropriate? A. Place arm in a sling to prevent movement of the right shoulder. B. Apply heating pad to reduce muscle spasms and pain. C. Limit movement of the thumb and fingers on the right hand. D. Elevate the right arm on two pillows for 24 hours.

D. Elevate the right arm on two pillows for 24 hours.

The nurse is caring for a client with osteoarthritis who is about to undergo total left knee arthroplasty. The nurse assesses the client carefully to be sure that there is no evidence of what in the preoperative period? A. Pain B. Left knee instability C. Left knee ankylosis D. Left knee edema and erythema

D. Left knee edema and erythema

The home care nurse visits a 74-year-old man diagnosed with Parkinson's disease who fell while walking this morning. What observation is of most concern to the nurse? A. Stooped posture with a shuffling gait and slow movements B. 2 × 6 cm right calf abrasion with sanguineous drainage C. Mild pain and minimal swelling of the right ankle and foot D. Left leg externally rotated and shorter than the right leg

D. Left leg externally rotated and shorter than the right leg

A client is seen at the urgent care center following a blunt injury to the left knee. The knee is grossly swollen and very painful, but the skin in intact. During an arthrocentesis on the client's knee, the nurse would expect the aspirated fluid to appear A. White, thick and ropelike B. Straw colored C. Purulent and thick D. Sanginous

D. Sanginous

After an abve the knee amputation of the right leg a client reports pain in the right foot. A nurse should inform the client that phantom limb pain is the result of A. tactile illusions asscoiated with severed blood vessels. B. an unconcious phenomenon to aid with grieving over the lost body part. C. hallucinations secondary to emothional symptoms associated with the distress of amputation. D. nerve endings in the limb are still intact and react to stimuli.

D. nerve endings in the limb are still intact and react to stimuli.

A client with osteoarthritis uses non-steroidal anti-inflammatories (NSAID's) to decrease pain and inflammation. A nurse teaches the client that common side effects of these drugs include A. allergic reactions, fever and oral lesions. B. fluid retention, hypertension and bruising. C. decrease in bleeding time and blood dyscrasias. D. skin rashes, gastric irritation, and headache.

D. skin rashes, gastric irritation, and headache.