| These | Questions | Are | All | Musculoskeletal |
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Answer B is correct. The client has an open fracture. The priority would be to cover the wound and prevent further contamination. Manual traction should not be attempted, so answer A is incorrect. Swelling usually occurs with a fracture, making answer C a
The nurse is caring for a client after a motor vehicle accident. The client has a fractured tibia, and bone is noted protruding through the skin. Which action is of priority?
A.Provide manual traction above and below the leg. B.Cover the bone area with a |
Answer C is correct. The client with joint hip replacement should avoid adduction of the legs and flexion of the hips greater than 90 degrees to ensure continued placement of the prosthetic joint. It is recommended for these clients to use recliners for s
PHYSICAL CHALLENGE
The nurse at an orthopedic joint clinic is assisting with the preparation of preoperative teaching for clients scheduled for total hip replacement surgery. Which would be included in the teaching plan? A.Avoid sitting in a recliner B |
D. Complaints of numbness and tingling in toes of affected leg
Explanation: Numbness and tingling indicate nerve ischemia and edema, suggesting development of compartment syndrome.
Which assessment findings would cause the nurse to suspect compartment syndrome after casting of the leg?
a) Warm, pink foot and ability to move toes of affected leg b) Low-grade fever, dyspnea, tachycardia, and crackles c) Increased capillary refill an |
C. the main effect of corticosteroids is to suppress inflammation. However, this same effect is also one of the main setback of corticosteroid therapy suppression of the inflammatory response also decreases the immune response making the patient susceptib
A patient with rheumatoid arthritis asks the nurse why she is taking Prednisone (Deltasone) the nurse best response would be that it:
a) enhance the immune system b) increase bone density c) decrease inflammation d) reduce peripheral edema |
C. wet sterile saline dressing
The fasciotomy site is not sutured but is left open to relieve pressure and edema. The site is covered with wet sterile saline dressings. After 3 to 5 days, when perfusion is adequate and edema subsides, the wound is debrid
A client has undergone fasciotomy to treat compartment syndrome of the leg. The nurse prepares to provide which type of wound care to the fasciotomy site?
a) dry sterile dressings b) hydrocolloid dressings c) wet sterile saline dressings d) one-half stre |
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Answer A is correct. This test is used to check for paresthesia in the median nerve. An abnormal result would be paresthesia within 60 seconds of performing the test. Answer B is incorrect because it is another test used in which the nurse taps over the m
A client is being evaluated for carpal tunnel syndrome. The nurse is observed asking the client to place the backs of her hands together and flex them at the same time. Which assessment is the nurse performing?
A.Phalen’s maneuver B.Tinel’s sign C.Kernig |
Answer C is correct. The Transcutaneous electrical nerve stimulation (TENS) unit is applied for pain relief. This is the only option that actually does anything about the pain the client is experiencing. Answers A, B, and D might help the pain, but answe
A client with a below-the-knee amputation is experiencing phantom limb pain. Which action by the nurse would be most effective in relieving the pain?
A.Acknowledging the presence of the pain B.Elevating the stump on a pillow C.Applying a transcutaneous n |
Answer is A. Homans sign is when the nurse flexes the ankle back wards. If there is a sharp pain in the patients calf that is indicative of a DVT.
Which of the following would the nurse use as the best method to assess for the development of deep vein thrombosis in a client with a spinal cord injury?
a. Homan's sign c. Tenderness b. Pain d. Leg girth |
A. Keeping a pillow between the client's legs at all times
Explanation: After hip pinning, the client must keep the affected leg abducted at all times; placing a pillow between the legs reminds the client not to cross the legs and to keep the leg abducte
PHYSICAL CHALLENGE
A client undergoes hip-pinning surgery to treat an intertrochanteric fracture of the right hip. The nurse should include which intervention in the postoperative care plan? a) Keeping a pillow between the client's legs at all times b) |
The part of the bed under an area in traction is usually elevated to aid in countertraction. For the client in Buck's extension traction (which is applied to a leg), the foot of the bed is elevated. An overhead trapeze or footboard is not used to provide
A nurse is caring for a client who has been placed in Buck's extension traction. The nurse provides for countertraction to reduce shear and friction by:
a) using a footboard b) providing an overhead trapeze c) slightly elevating the foot of the bed d) sl |
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B. You will receive IV antibiotics for 3 to 6 weeks."
Treatment of osteomyelitis requires IV antibiotics for 3 to 6 weeks.
PHYSICAL CHALLENGE
The nurse is planning discharge instructions for the client with osteomyelitis. What instructions should the nurse include in the discharge teaching? a) "You need to perform weight-bearing exercises twice a week." b) "You will receiv |
Answer B is correct. This is required to prevent esophageal problems. The medication should be taken in the morning before food or other medications with water, making answers A and C incorrect choices. It should also be taken as ordered, which makes answ
The nurse is caring for a client with osteoporosis who is being discharged on alendronate (Fosamax). Which statement would indicate effective teaching?
A.“I should take the medication immediately before bedtime.” B.“I should remain in an upright position |
C. Compartment syndrome is caused by bleeding and swelling within a compartment, which is lined by fascia that does not expand. The bleeding and swelling place pressure on the nerves, muscles, and blood vessels in the compartment, triggering the symptoms
The nurse is caring for a client who develops compartment syndrome from a severely fractured arm. The client asks the nurse how this can happen. The nurse's response is based on the understanding that:
a) A bone fragment has injured the nerve supply in t |
B. To achieve proper traction, weights need to be free-hanging, with knots kept away from the pulleys. Weights are not to be kept resting on a firm surface. The head of the bed is usually kept low to provide countertraction.
The nurse is assigned to care for a client who is in traction. The nurse ensures a safe environment for the client by:
a) making sure that the knots are at the pulleys b) checking the weights to be sure that they are off the floor c) making sure that the |
D. Buck's extension traction is a form of skin traction and involves the use of a belt or boot that is attached to the skin and soft tissues. The purpose of this type of traction is to decrease painful muscle spasms that accompany fractures. The weight th
Buck's extension traction is applied to an older client following a hip fracture. The nurse explains to the client that this type of traction is:
a) traction involving the use of a cast b) skeletal traction involving the use of surgically inserted pins c |
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A. "After menopause, the body's bone density declines, resulting in a gradual loss of height."
Explanation: The nurse should tell the client that after menopause, the loss of estrogen leads to a loss in bone density, resulting in a loss of height. This
During a routine physical examination on a 75-year-old female client, a nurse notes that the client is 5 feet, 3/8 inches (1.6 m) tall. The client states, "How is that possible? I was always 5 feet and 1/2? (1.7 m) tall." Which statement is the best respo
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Answer is A. Everything else are normally observed after a cast placement
A client with a compound (open) fracture of the radius has a plaster cast applied in the emergency department. The nurse provides home-care instructions and tells the client to seek medical attention if which of the following occurs?
a) numbness and tin |
B. The client needs to be instructed to not sit continuously for more than 1 hour. The client should be instructed to stand, stretch, and take a few steps periodically. The client cannot drive a car for 6 weeks after surgery unless allowed to do so by a p
The nurse is teaching a client who is preparing for discharge from the hospital after a total hip replacement. Which statement by the client would indicate the need for further instructions?
a) I cannot drive a car for probably 6 weeks b) I should not s |
B. So that the nurse may assess the ulnar nerve status, the client is asked to spread all of the fingers wide and resist pressure. Weakness against pressure may indicate compromise of the ulnar nerve. Option A assesses the flexion of the biceps and determ
The nurse monitors a client for brachial plexus compromise after shoulder arthroplasty and is checking the status of the ulnar nerve. Which technique should the nurse use to assess the status of this nerve?
a) ask the client to raise the forearm above th |
D. If the cast gets wet, it can be dried with a hair dryer set to a cool setting. The client is instructed to avoid walking on wet, slippery floors to prevent falls. If the skin under the cast itches, cool air from a hair dryer may be used to relieve it.
PHYSICAL CHALLENGE
The nurse has given the client with a nonplaster (fiberglass) leg cast instructions regarding cast care at home. The nurse determines that the client needs further instructions if the client makes which statement? a) I should avoid w |
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Answer C is correct. Fat emboli occur more frequently with long bone or pelvic fractures and usually in young adults age 20–30. Answers A, B, and D are not high-risk incidents and do not fall in the greater risk category, so they are incorrect.
4) Which client would be at greatest risk for a fat emboli following a fracture?
A.A 50-year-old with a fractured fibula B.A 20-year-old female with a wrist fracture C.A 21-year-old male with a fractured femur D.An 8-year-old with a fractured arm |
Answer D is correct. The symptoms of this fracture include shortened, adducted, and external rotation. Answer A is incorrect because the patient usually is unable to move the leg due to pain. Answer B is incorrect because the symptom is adduction, not abd
An elderly female is admitted with a fractured right femoral neck. Which assessment finding is expected?
* A.Free movement of the right leg B.Abduction of the right leg C.Internal rotation of the right hip D.Shortening of the right leg |
Answer is A. Normal uric acid levels are 3.5 and 7.2 mg/dL. Normal Calcium levels are 8.5 to 10.2 mg/dL. Normal phosphprus levels are 2.4 - 4.1 mg/dL. Normal potassium levels are 3.5-5.0 mg/dL
PHYSICAL CHALLENGE
The nurse is caring for a client with a gout. Which of the following laboratory values does the nurse expect to note in the client? a. Uric acid level of 8 mg/dl b. Calcium level of 9 mg/dl c. Phosphorus level of 3 mg/dl d. Potassium |
B. PaO2
A key feature of fat embolism is a significant degree of hypoxemia with a Pao2 often less than 60 mm Hg. Other features that distinguish fat embolism from pulmonary embolism are an elevated temperature and the presence of fat in the blood with
The client with a fractured femur experiences sudden dyspnea. A set of arterial blood gases reveal the following: pH is 7.32, PaCO2 is 43, PaO2 is 58, and HCO3 is 20. Which of the following components of the ABG results supports the nurse's suspicion of f
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3,5,6 Rationale: Supportive, nonpharmacologic measures for the client with rheumatoid arthritis include applying splints to treat inflamed joints, using Velcro fasteners on clothes to aid in dressing, and applying moist heat to joints to relax muscles and
Which nonpharmacologic interventions should a nurse include in the care plan for a client who has moderate rheumatoid arthritis? Select all that apply.
1. massaging inflamed joints 2. avoiding range-of-motion exercises 3. applying splints to inflamed join |
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