Chapter 36: Musculoskeletal Disorders
Continuous passive motion is used after which surgery?:
A. Hip
B. Wrist
C. Knee
D. Neck
Answer: C. Knee
True or False: Nursing care for a patient with an external fixator includes adjusting the clamps on the external fixator frame.
Answer: False
The nurse never adjusts the clamps on the external fixator frame. It is the primary provider’s responsibility to do so. A nursing intervention within scope of practice is cleaning the pin site.
Fill in the blank: _______ ________ is an intervention to promote deep breathing and provides visual feedback to encourage the patient to inhale slowly and deeply to maximize lung inflation and prevent or reduce atelectasis.
Answer: Incentive Spirometry
What are the three primary symptoms of COPD? Name all three.
Chronic cough, sputum production that increases in winter, and dyspnea
Fill in the blank: Calcium is controlled by these hormones, _____ and ______.
Answer: Calcitonin and Parathyroid hormone
Wound suction drains should be removed in:
A. One week
B. 24-48 hours
C. 72 hours
D. 5 days
Answer: B. 24-48 hours
Fill in the blank: _______ is a device that uses a pulling force to promote and maintain alignment to an injured part of the body. It is a short-term intervention used until other modalities, such as external or internal fixation, are possible.
Answer: Traction
Fill in the blank: This antibiotic is given as the first line of therapy when a patient presents with a lung abscess: ________.
Answer: Clindamycin
A patient has been instructed in pursed-lip breathing. The patient asks the nurse the purpose behind the breathing pattern. The nurse's best response to this question would be:
A. "Pursed-lip breathing prevents airway collapse and enhances effective breathing."
B. "You will be more comfortable if you use pursed-lip breathing techniques."
C. "Pursed-lip breathing exercises help to prevent the accumulation of secretions."
D. "Pursed-lip breathing increases the strength of the respiratory muscles."
Answer: A. "Pursed-lip breathing prevents airway collapse and enhances effective breathing."
Fill in the blank: What is the main purpose for the use of an abduction pillow on a patient who just recently went into a total hip replacement? Prevention of hip _________.
Answer: Dislocation
Post-op discharge criteria include all of the following except?
A. Ambulation
B. Hemodynamic stability
C. Pain control
D. Ride home
E. Prescription for narcotic pain medication
Answer: E. Prescription for narcotic pain medication
True or False: The nurse’s priority concern following the application of an immobilization device (a cast, splint, or braces) is assessment and prevention of neurovascular dysfunction or compromise of the affected extremity.
Answer: True
Assessments are performed at least every hour for the first 24 hours and every 1 to 4 hours thereafter to prevent neurovascular compromise related to edema and/or the device.
Fill in the blank: This drug is used as a bactericidal agent when treating TB and also causes an increase in uric acid: _________.
Answer: Pyrazinamide
The patient has an order for each of the following inhalers. Which one should the nurse offer to the patient at the onset of an asthma attack?
A. Albuterol (Proventil)
B. Salmeterol (Serevent)
C. Beclomethasone (Qvar)
D. Ipratropium bromide (Atrovent)
Answer: A. Albuterol (Proventil)
A nurse is conducting a neurovascular assessment on a recently admitted patient. What are the six P’s of a neurovascular assessment? Name all six.
Answer: pain, pallor, pulse, paresthesia, paralysis, poikilothermia
What nutrition item should you avoid when on bed rest?
A. Large amounts of milk
B. Protein
C. Fiber
D. Fruit
Answer: A. Large amounts of milk
Milk increases the risk of developing urinary calculi
Which of the following is not within a nurse’s scope of practice in emergency management of a patient with an open fracture?
A. Covering the fracture with a sterile dressing
B. Applying splints for immobilization
C. Reducing the fracture
D. Assessing neurovascular status before and after splinting
Answer: C. Reducing the fracture
Fill in the blank: This lung infection is more likely to occur when the respiratory defense mechanism is ‘incompetent’: __________.
Answer: Pneumonia
The nurse is assessing the client diagnosed with COPD. Which data require immediate intervention by the nurse?
A. Large amounts of thick white sputum.
B. Oxygen flowmeter set on 8 liters.
C. Use of accessory muscles during inspiration.
D. Presence of a barrel chest and dyspnea.
Answer: B. Oxygen flowmeter set on 8 liters.
What are some of the complications of fractures? Name at least three.
Answers: Shock, Fat Embolism, VTE, PE, Compartment Syndrome
The major goals for a patient with osteoporosis include which of the following? Select all that apply.
A. Improvement of bowel elimination
B. Relief of pain
C. Absence of additional fractures
D. Encourage bed rest
Answers. A, B, C
A. Improvement of bowel elimination, B. Relief of pain, C. Absence of additional fractures
What clinical signs and symptoms can you expect to see in a patient with a fracture? Select all that apply.
A. Loss of function
B. Acute pain
C. Deformity
D. Crepitus
E. Localized edema and ecchymosis
Answers: A, B, C, D, E
A. Loss of function, B. Acute pain, C. Deformity, D. Crepitus, E. Localized edema and ecchymosis
Which diagnostic test is most accurate in assessing acute airway obstruction?
A. Tonsillectomy
B. Thoracentesis
C. ABGs
D. Pulmonary function studies
Answer: D. Pulmonary function studies
Which statements indicate to the nurse the client diagnosed with asthma understands the teaching regarding inhaled corticosteroid medications? Select all that apply.
A. “I should call my doctor if I have a sore throat or mouth.”
B. “I must taper off the medications and not stop taking them abruptly.”
C. “These drugs will be most effective if taken at bedtime.”
D. “These drugs are not good at the time of an attack.”
E. “If I need both inhalers, I should take my bronchodilator first.”
Answer: D, E
D. “These drugs are not good at the time of an attack.”
E. “If I need both inhalers, I should take my bronchodilator first.”
A recently admitted patient reports that his left leg is shorter than his right leg after having left knee surgery. The nurse performs a head to toe assessment and confirms the assessment finding. What should be the first intervention implemented by the nurse?
A. Ensure the patient that dietary calcium will help the bone grow
B. Report finding to the physician
C. Comfort the patient
D. Put orthopedic boot on affected extremity
Answer: B. Report finding to the physician