Provider 1 Quiz 4

After a total knee replacement, a client is using a continuous passive motion device. The nurse concludes that teaching was effective when the client states that what is the goal of this therapy? 1 Improve joint flexion. 2 Maintain muscle tone. 3 Prevent tissue breakdown. 4 Prevent formation of a blood clot.

1

After an amputation of a limb, a client begins to experience extreme discomfort in the area where the limb once was. What is the nurse's greatest concern at this time? 1 Addressing the pain 2 Reversing feelings of hopelessness 3 Promoting mobility in the residual limb 4 Acknowledging the grieving for the lost limb

1

A nurse is caring for a client who had a total hip replacement. Which is the priority assessment when monitoring the client for hemorrhage? 1 Checking vital signs every 4 hours 2 Examining the bedding under the client 3 Measuring the circumference of the thigh 4 Observing for ecchymosis at the operative site

2

A nurse is caring for a client who had a total hip replacement. Which nursing action should be incorporated into the plan of care to prevent thrombus formation? 1 Turning the client from side to side 2 Encouraging the client to perform ankle exercises 3 Elevating the knee gatch to 15 degrees for comfort 4 Getting the client up to sit in a chair for as long as tolerated

2

The nurse is preparing an individualized teaching plan for a client with osteoarthritis. The nurse recognizes which abnormality specific to osteoarthritis? 1 Ulnar drift 2 Heberden nodes 3 Swan-neck deformity 4 Boutonnière deformity

2

While assessing a client, the nurse suspects that the client has acute osteomyelitis. Which symptoms in the client support the nurse's suspicion? Select all that apply. 1 Foot ulcer 2 Temperature of 102° F 3 Erythema of the affected area 4 Tenderness of the affected area 5 Drainage from the affected area

2,3,4

A client with a fractured head of the right femur and osteoporosis is placed in Buck extension before surgical repair. What should the nurse do when caring for this client until surgery is performed? 1 Remove the weights from the traction every 2 hours to promote comfort. 2 Turn the client from side to side every 2 hours to prevent pressure on the coccyx. 3 Raise the knee gatch on the bed every 2 hours to limit the shearing force of traction. 4 Assess the circulation of the affected leg every 2 hours to ensure adequate tissue perfusion.

4

Which nursing intervention prevents footdrop in a client with osteomyelitis? 1 Elevating the foot with the use of pillows 2 Consistently flexing the affected extremity 3 Encouraging the client to change positions 4 Neutral positioning of the foot with the use of a splint

4

Which joint surgery is used as a prophylactic measure and as a palliative treatment for clients with rheumatoid arthritis (RA)? 1 Osteotomy 2 Arthrodesis 3 Synovectomy 4 Debridement

3

A client sustains a fracture of the femur after jumping from the second story of a building during a fire. The client is placed in Buck traction until an open reduction and internal fixation is performed. The client keeps slipping down in bed. What should the nurse do to alleviate this problem? 1 Elevate the foot of the bed. 2 Shorten the rope on the weights. 3 Release the traction so the client can be repositioned. 4 Move the client toward the head of the bed every couple of hours.

1

A client with osteomyelitis has a slow rate of healing. Which factors can contribute to reduced healing in the client? Select all that apply. 1 Diabetes 2 Cataract 3 Smoking 4 Dermatitis 5 Alcoholism

1,3,5

What are the systemic manifestations of acute osteomyelitis? Select all that apply. 1 Malaise 2 Restlessness 3 Night sweats 4 Warmth at the infection site 5 Swelling at the infection site

1,2,3

Place the steps in the process of arthrocentesis in the correct sequence, as performed in a client with rheumatoid arthritis. 1. Cleanse the client's skin 2. Apply local anesthesia 3. Insert an 18-gauge or larger needle into the joint 4. Withdraw fluid from the joint 5. Inject corticosteroids by way of the intraarticular route

1,2,3,4,5

What should the nurse do to prevent deformities of the knee in a client with an exacerbation of arthritis? Select all that apply. 1 Encourage motion of the joint. 2 Maintain a knee brace on the leg. 3 Keep the client on a regimen of bed rest. 4 Maintain joints in functional alignment when resting. 5 Immobilize the joint with pillows until pain subsides.

1,4

A nurse is caring for a client who will have a below-the-knee amputation with an immediate postoperative prosthesis. The client asks the nurse the advantage of having an immediate prosthesis. What should the nurse explain is the advantage? 1 Decreases phantom limb sensations 2 Encourages a normal walking pattern 3 Reduces the incidence of wound infection 4 Allows for fitting of the prosthesis before discharge

2

The nurse is preparing to initiate intravenous antibiotic therapy for a client who developed an infection along the incision after having a total knee replacement. Before starting the first dose of intravenous antibiotics, which task should the nurse ensure has been completed? 1 Red blood cell count 2 Wound culture 3 Knee x-ray 4 Urinalysis

2

A client with a fractured hip is placed in traction until surgery can be performed. What should the nurse explain is the primary purpose of the traction? 1 Relieving muscle spasm and pain 2 Preventing contractures from developing 3 Keeping the client from turning and moving in bed 4 Maintaining the limb in a position of external rotation

1

The nurse considers that a 70-year-old female client can best limit further progression of osteoporosis by doing what? 1 Taking supplemental calcium and vitamin D 2 Increasing the consumption of eggs and cheese 3 Taking supplemental magnesium and vitamin E 4 Increasing the consumption of milk and milk products

1

Which term should the nurse use to describe bone loss greater than normal but less than that caused by osteoporosis? 1 Osteopenia 2 Osteomyelitis 3 Osteomalacia 4 Osteoarthritis

1

The nursing student is teaching a client who has undergone hip replacement surgery. Which instructions from the nursing student indicate a need for correction? Select all that apply. 1 Sit on chairs without arms. 2 Use an elevated toilet seat. 3 Cross legs at the knees or ankles. 4 Use a pillow between legs for the first 6 weeks. 5 Keep hips in a neutral, straight position when sitting.

1,3

A client has an above-the-knee amputation of the left leg because of arterial insufficiency. To prevent a hip flexion contracture, in what position should the nurse periodically place this client? 1 Prone position 2 Sitting position 3 Supine position with a pillow under the residual limb 4 Right side-lying position with a pillow between the thighs

1

A client who had a right total hip replacement is progressing from the use of a walker to the use of a cane. In which hand should the nurse teach the client to hold the cane? 1 Left hand 2 Right hand 3 Stronger hand 4 Dominant hand

1

The nurse teaches a premenopausal obese client about strategies to prevent osteoporosis. Which strategy identified by the client indicates that the teaching is effective? 1 Starts a rapid, strict weight-reduction diet 2 Joins a tennis league and practices every day 3 Takes 1200 International Units of vitamin D a day 4 Signs up for a swimming class three times a week

2

Considerations when caring for a client with a total hip replacement should include which interventions? Select all that apply. 1 Maintain the affected hip in the adduction position when moving the client out of bed. 2 Pain control should include regularly scheduled analgesics and may necessitate use of as needed medications as well. 3 The client should sit in a chair at the correct height to encourage flexion of the joint. 4 Frequent neurovascular assessment should be done distal to the surgical site and compared with the unaffected side. 5 When turning, the client should be log rolled to prevent the leg from falling forward or backward.

2,4,5

A client who had a total hip replacement is receiving continuous regional analgesia. The nurse recognizes what as the benefit of this treatment over conventional methods? 1 It is easy to adjust the dose. 2 Neuropathic pain can be relieved. 3 Systemic side effects are minimal. 4 The need for parenteral medication is prevented.

3

A client with a femoral fracture associated with osteomyelitis is immobilized for 3 weeks. The nurse assesses for the development of renal calculi. What is the rationale for the nurse's assessment? 1 The client's dietary patterns have changed since admission. 2 The client has more difficulty urinating in a supine position. 3 Lack of weight-bearing activity promotes bone demineralization. 4 Fracture healing requires more calcium, which increases total calcium metabolism.

3