Musculoskeletal
The nurse is caring for a client who had open reduction and internal fixation (ORIF) of the right femur. The client reports intense pain, swelling, tenderness, warmth at the site; chills; malaise; and has a temperature of 102.2 F and leukocytosis. The nurse concludes that this data is consistent with which complications?
1. fat embolism
2. Compartment syndrome
3. Osteomyelitis
4. Malunion of the bone
3. Osteomyelitis
10. A patient presents at a clinic complaining of back pain that goes all the way down the back of the leg to the foot. The nurse should document the presence of what type of pain?
A) Bursitis
B) Radiculopathy
C) Sciatica
D) Tendonitis
C) Sciatica
A nurse is collaborating with the physical therapist to plan the care of a patient with osteomyelitis. What principle should guide the management of activity and mobility in this patient?
A) Stress on the weakened bone must be avoided.
B) Increased heart rate enhances perfusion and bone healing.
C) Bed rest results in improved outcomes in patients with osteomyelitis.
D) Maintenance of baseline ADLs is the primary goal during osteomyelitis treatment.
A) Stress on the weakened bone must be avoided.
A nursing educator is reviewing the risk factors for osteoporosis with a group of recent graduates. What risk factor of the following should the educator describe?
A) Recurrent infections and prolonged use of NSAIDs
B) High alcohol intake and low body mass index
C) Small frame, female gender, and Caucasian ethnicity
D) Male gender, diabetes, and high protein intake
C) Small frame, female gender, and Caucasian ethnicity
35. A patient with diabetes has been diagnosed with osteomyelitis. The nurse notes that the patients right foot is pale and mottled, cool to touch, with a capillary refill of greater than 3 seconds. The nurse should suspect what type of osteomyelitis?
A) Hematogenous osteomyelitis
B) Osteomyelitis with vascular insufficiency
C) Contiguous-focus osteomyelitis
D) Osteomyelitis with muscular deterioration
B) Osteomyelitis with vascular insufficiency
The nurse is providing discharge instructions to a client who had a hip replacement. The nurse should teach the client to avoid what activity to prevent dislocation of the hip?
A. crossing the legs at the knee
B. Taking leisure walks
C. Sitting in a chair that has arms
D. Using a raised toilet seat
A. crossing the legs at the knee
The nurse is caring for a client with skeletal traction. Which priority intervention should the nurse carry out?
1. evaluate the pin site for unusual redness, swelling, purulent drainage, and foul odor
2. measure the distance between the client's hip and the traction
3. record the number of times the client exercises the affected limb.
4. Report how the client is coping with immobilization
1. evaluate the pin site for unusual redness, swelling, purulent drainage, and foul odor
6. A nurse is teaching a patient with osteomalacia about the role of diet. What would be the best choice for breakfast for a patient with osteomalacia?
A) Cereal with milk, a scrambled egg, and grapefruit
B) Poached eggs with sausage and toast
C) Waffles with fresh strawberries and powdered sugar
D) A bagel topped with butter and jam with a side dish of grapes
A) Cereal with milk, a scrambled egg, and grapefruit
8. Which of the following patients should the nurse recognize as being at the highest risk for the development of osteomyelitis?
A) A middle-age adult who takes ibuprofen daily for rheumatoid arthritis
B) An elderly patient with an infected pressure ulcer in the sacral area
C) A 17-year-old football player who had orthopedic surgery 6 weeks prior
D) An infant diagnosed with jaundice
B) An elderly patient with an infected pressure ulcer in the sacral area
30. A patient has been admitted to the hospital with a spontaneous vertebral fracture related to osteoporosis. Which of the following nursing diagnoses must be addressed in the plan of care?
A) Risk for Aspiration Related to Vertebral Fracture
B)Constipation Related to Vertebral Fracture
C) Impaired Swallowing Related to Vertebral Fracture
D) Decreased Cardiac Output Related to Vertebral Fracture
B)Constipation Related to Vertebral Fracture
The nurse is preparing to receive a client from the ER who has an acute fractured femur as a result of a fall. For which potential complication should the nurse monitor the client?
1. crush injury
2. chronic pain
3. fat embolism
4. disturbed body image
3. fat embolism
A client is admitted following a motor vehicle crash where the left thigh was crushed beneath the vehicle. The nurse should assess the client for which complications? select all that apply
1. acute renal failure
2. hyperkalemia
3. hypernatremia
4. hypertension
5. fat emboli syndrome
1. acute renal failure
2. hyperkalemia
The nurse is conducting a class on health promotion. Which risk factors identified by the nurse would pit a client at risk for developing osteoporosis? select all that apply
1. menopause
2. sedentary lifestyle
3. decreased intake of calcium
4. use of glucocorticoids
5. increased fluid intake
1. menopause
2. sedentary lifestyle
3. decreased intake of calcium
4. use of glucocorticoids
A nurse is providing an educational class to a group of older adults at a community senior center. In an effort to prevent osteoporosis, the nurse should encourage participants to ensure that they consume the recommended adequate intake of what nutrients? Select all that apply.
A) Vitamin B12
B) Potassium
C) Calcitonin
D) Calcium
E) Vitamin D
D) Calcium
E) Vitamin D
29. A nurse is caring for a patient who is being treated in the hospital for a spontaneous vertebral fracture related to osteoporosis. The nurse should address the nursing diagnosis of Acute Pain Related to Fracture by implementing what intervention?
A) Maintenance of high Fowlers positioning whenever possible
B) Intermittent application of heat to the patients back
C) Use of a pressure-reducing mattress
D) Passive range of motion exercises
B) Intermittent application of heat to the patients back
1. low bone mass leading to increased bone fragility
2. degeneration of the articular cartilage
3. recurrent attacks of acute arthritis
4. personality changes caused by chronic nature of illness
1. low bone mass leading to increased bone fragility
The nurse is caring for a client with Buck's traction following a hip fracture. Which nursing interventions are appropriate for this client? select all that apply
1. Remove weights prior to lifting the client up in bed
2. Maintain counter traction by hanging weights freely
3. administer analgesics as ordered
4. monitor neurovascular integrity of the affect leg
5. increase fluid intake
2. Maintain counter traction by hanging weights freely
3. administer analgesics as ordered
4. monitor neurovascular integrity of the affect leg
5. increase fluid intake
The nurse is caring for a client with a herniated lumbar disk. Following laminectomy surgery, how should the nurse turn and reposition the client?
1. Having the client use the side rails of the bed while twisting the upper body
2. Elevating the head of the bed 45 degrees, then turning the legs toward the floor, bending at the waist.
3. Logrolling the client as a unit, keeping the body in proper alignment.
4. Turning the client's head and shoulders, then hips
3. Logrolling the client as a unit, keeping the body in proper alignment.
the nurse is caring for a client who has a hip spica cast applied 4 hours earlier. While handling the cast to turn the client, the nurse uses the palms of the hands. When asked by family why this method is being used, which reply by the nurse is accurate?
1. to speed-dry the cast
2. To decrease pain from moving
3. To prevent damage to the cast
4. To prevent swelling
3. To prevent damage to the cast
A nurse is planning the care of an older adult patient with osteomalacia. What action should the nurse recommend in order to promote vitamin D synthesis?
A) Ensuring adequate exposure to sunlight
B) Eating a low-purine diet
C) Performing cardiovascular exercise while avoiding weight-bearing exercises
D) Taking thyroid supplements as ordered
A) Ensuring adequate exposure to sunlight
A client with a total hip replacement is concerned about dislocation of the prosthesis. The nurse should include which information in a response.
A. Activities that involve hip adduction may cause hip dislocation
B. Using elevated toilet seats may cause dislocation.
C. Exercises that involve bending are useful in preventing dislocation
D. Removing the foam abduction pillow will prevent hip dislocation
A. Activities that involve hip adduction may cause hip dislocation
A client in skeletal traction slides down in the bed so that the feet touch the foot of the bed. What should the nurse do to ensure that the pull of traction remains uninterrupted?
A. release weights, pull client up in bed, and then reapply weights
B. Ask provider for a change in the amount of weight ordered
C. Move client up in bed without releasing pull of traction on the extremity
D. Elevate the client's feet on a pillow
C. Move client up in bed without releasing pull of traction on the extremity
The nurse is preparing a teaching plan for a client who is being discharged following a total hip replacement. The nurse would include which of the following content as part of the teaching plan? select all that apply
1. avoid low, cushioned chairs
2. use a device that raises the toilet seat
3. avoid bending greater than 90 degrees
4. Turn at the waist to reach objects
5. Do not cross the legs
1. avoid low, cushioned chairs
2. use a device that raises the toilet seat
3. avoid bending greater than 90 degrees
5. Do not cross the legs
A client with a recently applied plaster leg cast reports unrelieved pain and paresthesia in the affected extremity. The assessment by the nurse reveals diminished pulse, pallor, and increased pain on passive motion. What should the nurse do first?
1. Monitor client for the next hour
2. Administer an analgesic for pain
3. administer an anxiolytic
4. Notify the primary care provider
4. Notify the primary care provider
17. A nurse is caring for a patient who is 12 hours postoperative following foot surgery. The nurse assesses the presence of edema in the foot. What nursing measure will the nurse implement to control the edema?
A) Elevate the foot on several pillows.
B) Apply warm compresses intermittently to the surgical area.
C) Administer a loop diuretic as ordered.
D) Increase circulation through frequent ambulation.
A) Elevate the foot on several pillows.