NCLEX Part 2 Muscholoskeletal System

A client has a fiberglass -nonplaster- cast applied to the lower leg. The client asks the nurse when he will be able to walk on the cast. The nurse replies that the client will be able to bear weight on the cast within

20-30 minutes

A plaster cast can tolerate weight bearing once it is dry which varies from?

24-72 hours

A client with a 4-day old lumbar vertebral fracture experiencing muscle spasms. The nurse avoids using which of the following in an effort to relieve the spasm a. analgesics b.cold c.heat d.prescribed intermittent traction

The use of cold because cold is only applied to a site for the first 24 hourse after an injury

A client is being transferred to the nursing unit from the postanesthesia care unit following spinal fusion with rod insertion. THe nurse would prepare to transfer the client from the stretcher to the bed by using what

a slider board and the assistance of four people

A client has just undergon spinal fusion after suffering a heniated lumbar disk. THe nurse would avoid what in the room

an overhead trapeze because it use could promote twisting of the spine after surgery

A nurse has an order to get the client out of bed to a chair on the first postoperative day after total knee replacement. The nurse plans to do which of the following to protect the knee joint

apply a knee immobilizer before getting the client up and elevate the client's surgical leg while sitting

A client who has had a right total knee replacement asks the nurse how long the right leg must be kept in the contiuous passive motion (CPM) maching. The nurse's response is based on the understanding that the device should be used

as much as the client can tolerate it

Following arthocopy the client is instructed to do what

avoid excessive use of the joint for several days, to elevate the knee while sitting, to avoid twisting the knee, and to return to the physcician for follow up in about 7 days. Ice is applied to the affected joint for pain and swelling. Administer analgesics as ordered

A nurse is caring for the client who has developed compartment syndrom from a severely fractured arm. The client asks the nurse how this can happen. The nurse response is based on what understanding

compartment syndrom is caused by bleeding and swelling within a compartment lined by fascia which does the expand.

A nurse is giving the client with a left leg cast crutch walking instruction using the three-point gait. The client is allowed touch-down of the affected leg. The nurse tells the client to advance the:

crutches and the left leg, then advance the right leg

A client has had sugery to repair a fractured left hip. The nurse plans to use which of the following important items when repositioning the client from side to side in the bed

following surgery to repair a fractrued hip, an abductor splint is used to maintain teh affected extremity in god alignment. An overhead tapeze and bed pillow are also use, but they are not PRIORITY item to be used

A nurse has an order to place a client with a herniated lumbar intervertebral disk on the bedrest to minimize the pain. The nurse plans to put the bed?

in semi-fowler's position with the knee gatch slighlty raised

If a nurse supects a fat embolim the initial action of the nurse is what?

initial action is to place the client in a fowler's position

A nurse is caring for a client following a total hip replacement. The client has been diagnosed with iron deficiency enemia. The nurse instructs the client to increase intake of what

meat, liver, other organ meats, blackstrap molasses and oysters

A client undergone fasciotomy to treat compartment syndrome of the leg. THe nurse would expect that which type of wound care will be prescribed for the fasiotomy site

mosit, sterile saline dressing. After 3-5 days when perfusion is adequate and edema subsides, the wound is debrided and closed

What is the earlies symptom of compartment syndrom

paresthesia (numbness and tingling in the fingers)

A nurse is caring for a client diagnoses with Paget's disease. The nurse plans care, knowing that this condition usually affect which bones?

paget's disease usually affects the axial skelton especially the vertebrae and skull. Besides the vertebra and skull, the pelvis, femur, and tibia are other common sites of the disease.

The stiffness and joint pain that occurs in osteoarthritis increase with what?

pain increases with activity and is relieved by rest

A client who has had a total knee replacement tells the nurse that there is pain with extension of the knee. The nurse should do what

pain with knee extension is a common compaint after knee replacement.The nurse should encourage client to keep the knee extended and administer analgesics PRN

A nurse is repostitioning the client who has returned to the nursing unit following internal fixation of a fractured right hip. The nurse plans to use what

pillow to keep the right leg abducted druing turning

A nurse is caring for a client who had above the knee amputation 2 days ago. THe residual limb was wrapped with an elastic compression bandage that has fallen off. THe nurse immediately does what

rewraps the residual limb with an elastic compression bandgae otherwise excessive edema will rapidly form

An older cient is brought to the ER department via ambulance after sustaining a fall. An x-ray indicates that the client sustained a femoral neck fracture(hip fracture). The nurse would expect to note that following inspection of the client's leg

shorteing of the affected leg, adduction, and external rotation. The client may also report slight groin pain or pain in the medial side of the kneww

A client has been placed in Buck's extension traction. The nurse can provide for countertraction by

slighlty elevating the foot of the bed

A client with right sided weakness needs to learn how to use a cane. The nurse plans to teach the client to position the cane by holding it with the:

the client is taught to hold the can on the opposite side of weakness. Left hand and 6 inches lateral to the left foot

A throarcolumbosacral orthosis (TLSO) is applied when

the device (back brace) is applied in the morning before getting out of bed. The back brace is fitted to the client. THe closures should be secure but not overly looses or tight. A layer of clothing is worn between the orthosis and the skin

A nurse is caring for a client with a diagnosis of gout. Which of the following laboratory values would the nurse expect to note in the client

uric acid level of 8mg/dl gout is diagnosed by the prsence of persisitent hyperuricmia, with the uric acid level higher than 7mg/dl. Additionally uric acid in an aspirated sample of synovial fluid confirms the diagnosis

A patient with osteomalacia (softening of bone tissue characterized by inadequate mineralization of osteoid) is deficient in what vitamin

vitamin D