NUR 1215 Immobility

Which would be contraindicated as a component of self-care activities for the client with a cast? 1. Cover the cast with plastic to insulate it 2. Cushioning rough edges of the cast with tape 3. Elevate the casted extremity to heart level frequently 4. Do not attempt to scratch the skin under a cast

1. Cover the cast with plastic to insulate it

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? 1. Cutting of a bivalve cast 2. Cutting a cast window 3. Removal of the cast 4. Insertion of an external fixator

2. Cutting a cast window

An important nursing assessment, post fracture, is to evaluate neurovascular status. Therefore, the nurse should check for: 1. Crepitus. 2. Shortening and deformity. 3. Capillary refill. 4. Swelling and discoloration.

3. Capillary refill

The primary nursing intervention that will control swelling while treating a musculoskeletal injury is: 1. Apply cold (moist or dry). 2. Immobilize the injured area. 3. Elevate the affected area. 4. Apply an elastic compression bandage.

3. Elevate the affected area.

Which nursing diagnosis takes highest priority for a client with a compound fracture? 1. Imbalanced nutrition: Less than body requirements related to immobility 2. Impaired physical mobility related to trauma 3. Infection related to effects of trauma 4. Activity intolerance related to weight-bearing limitations

3. Infection related to effects of trauma

Assessment of a client reveals signs and symptoms of Paget's disease. Which of the following would be most likely? 1. Skull narrowing 2. Lordosis 3. Long bone bowing 4. Upright gait

3. Long bone bowing

Following a total knee replacement, the surgeon orders a continuous passive motion (CPM) device. The client asks about the purpose of this treatment. What is the best response by the nurse? 1 "CPM increases range of motion of the joint." 2. "CPM strengthens the muscles of the leg." 3 "CPM delivers analgesic agents directly into the joint." 4. "CPM prevents injury by limiting flexion of the knee."

1. "CPM increases range of motion of the joint."

A client is being discharged home with a long arm cast. What education should the nurse include to prevent disuse syndrome in the arm? 1. Use of isometric exercises 2. Proper use of a sling 3. Repositioning the arm in the cast 4. Abduction and adduction of the shoulder

1. Use of isometric exercises

A client with a right leg fracture is returning to the orthopedist to have the cast removed. During cast removal, it is important for the nurse to assure: 1. the client that he or she won't be cut. 2. that the cast cutter blade is new. 3. that pedal pulses are present. 4. that the leg will be as good as new.

1. the client that he or she won't be cut.

A client has severe osteoarthritis in the left hip and is having surgery to replace both articular surfaces of the hip. What type of surgical procedure will the nurse prepare the client for? 1. Arthrodesis 2. Hemiarthroplasty 3. Total arthroplasty Osteotomy

3. Total arthroplasty

The nurse is assisting a client with removing shoes prior to an examination and observes that the client has a flexion deformity of several toes on both feet of the proximal interphalangeal (PIP) joints. What can the nurse encourage the client to do? 1. Bind the toes so that they will straighten. 2. Do active range of motion on the toes. 3. Have surgery to fix them. 4. Wear properly fitting shoes.

4. Wear properly fitting shoes.

A client has undergone a leg amputation. What teachings should the nurse offer such a client to prevent abduction deformity? Select all that apply. 1. Advise the client to use a trochanter roll. 2. Advise the client to adduct the stump so it presses against the other leg when the client is lying on the stomach. 3. Advise the client to use antiembolism stockings on both legs. 4. Advise the client to place pillows between the legs.

1. Advise the client to use a trochanter roll. 2. Advise the client to adduct the stump so it presses against the other leg when the client is lying on the stomach.

The nurse is caring for a client with a hip fracture. The physician orders the client to start taking a bisphosphonate. Which medication would the nurse document as given? 1. Alendronate 2. Raloxifene 3. Teriparatide 4. Denosumab

1. Alendronate

A client with an arm cast reports pain. What nursing interventions should the nurse provide in order to reduce the incidence of complications? Select all that apply. 1. Assess the fingers for color and temperature. 2. Administer a prescribed analgesic to promote comfort and allay anxiety. 3. Assess for a pressure sore 4. Determine the exact site of the pain. 5. Cut the cast with a cast saw

1. Assess the fingers for color and temperature. 3. Assess for a pressure sore 4. Determine the exact site of the pain.

A nurse is caring for a client in skeletal leg traction. Which nursing assessment findings indicate the client has met expected outcomes? Select all that apply. 1. Capillary refill less than 3 seconds 2. Repositions self with trapeze 3. Peripheral pulses +2 bilaterally 4. Right calf warm and swollen 5. Elbows are free of skin breakdown

1. Capillary refill less than 3 seconds 2. Repositions self with trapeze 3. Peripheral pulses +2 bilaterally 5. Elbows are free of skin breakdown

Arthrodesis is: 1. fusion of a joint (most often the wrist or knee) for stabilization and pain relief. 2. total reconstruction or replacement of a joint (most often the knee or hip) with an artificial joint to restore function and relieve pain. 3. replacement of one of the articular surfaces in a joint, such as the femoral head but not the acetabulum. 4. cutting and removal of a wedge of bone (most often the tibia or femur) to change the bone's alignment, thereby improving function and relieving pain.

1. fusion of a joint (most often the wrist or knee) for stabilization and pain relief.

A client diagnosed with a right ulnar fracture asks why the cast needs to go all the way up the arm. What is the best response by the nurse? 1. "This allows for the strength in the arm to remain consistent." 2. "The joint above the fracture and below the fracture must be immobilized." 3. "When a spica cast is ordered, the arm must be immobilized." 4. "The method allows for the fastest healing time and the greatest mobility."

2. "The joint above the fracture and below the fracture must be immobilized."

A client comes to the emergency department complaining of localized pain and swelling of his lower leg. Ecchymotic areas are noted. History reveals that the client got hit in the leg with a baseball bat. Which of the following would the nurse suspect as most likely? 1. Fracture 2. Contusion 3. Sprain 4. Strain

2. Contusion

The nurse is very concerned about the potential debilitating complication of peroneal nerve injury. What symptom does the nurse recognize as a result of that complication? 1. Permanent paresthesias 2. Foot drop 3. Deep vein thrombosis (DVT) 4. Infection

2. Foot drop

Which term refers to a fracture in which one side of a bone is broken and the other side is bent? 1. Spiral 2. Greenstick 3. Avulsion 4. Oblique

2. Greenstick

A patient in pelvic traction needs circulatory status assessed. How should the nurse assess for a positive Homans' sign? 1. Have the patient extend both hands while the nurse compares the volume of both radial pulses. 2. Have the patient extend each leg and dorsiflex each foot to determine if pain or tenderness is present in the lower leg. 3. Have the patient plantar flex both feet while the nurse performs the blanch test on all of the patient's toes. 4. Have the patient squeeze the nurse's hands with his or her hands to evaluate any difference in strength.

2. Have the patient extend each leg and dorsiflex each foot to determine if pain or tenderness is present in the lower leg.

A nurse notices a client lying on the floor at the bottom of the stairs. The client is alert and oriented and denies pain other than in the arm, which is swollen and appears deformed. After calling for help, what should the nurse do? 1. Place the client in a sitting position. 2. Immobilize the client's arm. 3. Help the client walk to the nearest nurses' station. 4. Raise the client's arm above the heart.

2. Immobilize the client's arm.

The nurse assesses a client after total right hip arthroplasty and observes a shortening of the extremity. The client reports severe pain in the right side of the groin. What is the priority action of the nurse? 1. Apply Buck's traction. 2. Notify the health care provider. 3. Externally rotate the extremity. 4. Bend the knee and rotate the knee internally.

2. Notify the health care provider.

A client with a short arm cast is suspected to have compartment syndrome. What actions should the nurse include in the plan of care? Select all that apply. 1. Elevate the arm above the heart. 2. Prepare to remove the cast. 3. Provide support to the injured extremity. 4. Assess neurovascular status every 8 hours. 5. Apply ice to extremity.

2. Prepare to remove the cast. 3. Provide support to the injured extremity.

Which principle applies to the client in traction? 1. Weights should rest on the bed. 2. Skeletal traction is never interrupted. 3. Knots in the ropes should touch the pulley. 4. Weights are removed routinely.

2. Skeletal traction is never interrupted.

Which may occur if a client experiences compartment syndrome in an upper extremity? 1. Whiplash injury 2. Volkmann's contracture 3. Callus 4. Subluxation

2. Volkmann's contracture

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? 1. "I will lie prone with my legs slightly elevated." 2. "I will bend at the waist when I am lifting objects from the floor." 3. "I will avoid prolonged sitting or walking." 4. "Instead of turning around to grasp an object, I will twist at the waist."

3. "I will avoid prolonged sitting or walking."

A client who has sustained a fracture reports an increase in pain and decreased function of the affected extremity. What will the nurse suspect? 1. Infection 2. Pulmonary embolism 3. Avascular necrosis 4. Hypovolemic shock

3. Avascular necrosis

A client has Paget's disease. An appropriate nursing diagnosis for this client is: 1. Risk for infection 2. Delayed wound healing 3. Risk for falls 4. Fatigue

3. Risk for falls

What term refers to a flexion deformity caused by a slowly progressive contracture of the palmar fascia? 1. Callus 2. Hammertoe 3. Hallux valgus 4. Dupuytren contracture

4. Dupuytren contracture

Which term refers to a flexion deformity caused by a slowly progressive contracture of the palmar fascia? 1. Callus 2. Hammertoe 3. Hallux valgus 4. Dupuytren's contracture

4. Dupuytren's contracture

A nurse would most likely expect the need for open reduction for a client with which of the following? 1. Closed fracture 2. Little bone separation 3. Soft tissue free of bone ends 4. Joint fracture

4. Joint fracture

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? 1. C3, C4, and L1 2. L1, L2, and L4 3. L2, L3, and L5 4. L4, L5, and S1

4. L4, L5, and S1

A nurse is caring for a client who recently underwent a total hip replacement. What is the best action by the nurse for client care? 1. Ease the client onto a low toilet seat. 2. Allow the client's legs to be crossed at the knees when out of bed. 3. Use soft chairs when the client is sitting out of bed. 4. Limit hip flexion of the client's hip when the client sits up.

4. Limit hip flexion of the client's hip when the client sits up.

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? 1. Client complains of tingling and numbness in the right shoulder. 2. Right shoulder is elevated above the left. 3. Client complains of pain in the unaffected shoulder. 4. Right shoulder slopes downward and droops inward.

4. Right shoulder slopes downward and droops inward.

Which nursing diagnosis is a priority for a client with a traumatically amputated lower extremity? 1. Impaired skin integrity related to effects of the injury 2. Anticipatory grieving related to the loss of a limb 3. Disturbed body image related to changes in the structure of a body part 4. Risk for injury related to amputation

4. Risk for injury related to amputation The priority diagnosis for this client is Risk for injury related to amputation. Patient safety takes priority. Amputation typically causes an unsteady gait until the client receives physical therapy and learns to ambulate safely. Impaired skin integrity, Anticipatory grieving, and Disturbed body image are also appropriate for a client presenting with a traumatic amputation of an extremity, but Risk for injury is the priority nursing diagnosis.

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? 1. Wound packing 2. Wound irrigation 3. Vitamin supplements 4. Surgical debridement

4. Surgical debridement

In chronic osteomyelitis, antibiotics are adjunctive therapy in which situation? 1. Wound packing 2. Wound irrigation 3. Vitamin supplements 4. Surgical debridement

4. Surgical debridement

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? 1. The nurse caring for this client is also caring for four other immunosuppressed clients on the medical floor. 2. The nurse caring for this client is also caring for four clients receiving chemotherapy for cancer treatment on the oncology floor. 3. The nurse caring for this client is also caring for two other immunosuppressed clients on the medical intensive care unit. 4. The nurse is caring for this client on the intensive care unit.

4. The nurse is caring for this client on the intensive care unit. This client is critically ill; the diagnosis and immunosuppression place the client at a high risk for infection. The most appropriate place for this client is in an intensive care unit, where the nurse can focus exclusively on health promotion. This client shouldn't be on the oncology floor. This client requires close monitoring. The nurse caring for this client shouldn't also be caring for other clients who may require frequent interventions.