Fractures
A patient with a fracture of a long bone suddenly develops shortness of breath and tachypnea. What should the nurse do first.
a. Stay with the patient and offer reassurance.
b. Administer prescribed PRN O2 at 4 L/min.
c. Check the patient’s legs for swelling or tenderness
d. Notify the health care provider.
Administer prescribed PRN O2 at 4 L/min.
How can a patient with RA relieve joint stiffness and pain in the morning?
a. a brief routine of isometric exercises.
b. a warm bath followed by a short rest.
c. active range-of-motion (ROM) exercises.
d.stretching exercises to relieve joint stiffness.
b. a warm bath followed by a short rest.
A new clinic patient with joint swelling and pain is being tested for systemic lupus erythematosus. Which test will provide the most specific findings for the nurse to review?
a. Rheumatoid factor (RF)
b. Antinuclear antibody (ANA)
c. Anti-Smith antibody (Anti-Sm)
d. Lupus erythematosus (LE) cell prep
c. Anti-Smith antibody (Anti-Sm)
The nurse is planning care for a patient with hypertension and gout who has a red and painful right great toe. Which nursing action will be included in the plan of care?
a. Gently palpate the toe to assess swelling.
b. Use pillows to keep the right foot elevated.
c. Use a footboard to hold bedding away from the toe.
d. Teach patient to avoid use of acetaminophen (Tylenol).
c. Use a footboard to hold bedding away from the toe.
Which finding will the nurse expect when assessing a 58-year-old patient who has osteoarthritis (OA) of the knee?
a. Discomfort with joint movement
b. Heberden’s and Bouchard’s nodes
c. Redness and swelling of the knee joint
d. Stiffness that increases with movement
a. Discomfort with joint movement
A patient comes in with possible right lower leg fractures. The first action by the nurse should be to?
a.elevate the right leg.
b.splint the lower leg.
c.assess the pedal pulses.
d.verify tetanus immunization.
assess the pedal pulses.
Which laboratory result will the nurse monitor to determine if prednisone has been effective, in a patient with an acute exacerbation of rheumatoid arthritis?
a.Blood glucose
b.C-reactive protein
c.Serum electrolytes
d. Liver function tests
b. C-reactive protein
A 25-year-old female patient with systemic lupus erythematosus (SLE) who has a facial rash and alopecia tells the nurse, “I never leave my house because I hate the way I look.” An appropriate nursing diagnosis for the patient is
a. activity intolerance related to fatigue and inactivity.
b. impaired social interaction related to lack of social skills.
c. impaired skin integrity related to itching and skin sloughing.
d. social isolation related to embarrassment about the effects of SLE.
d. social isolation related to embarrassment about the effects of SLE.
Patient comes into the ED with a dislocated knee, the nurse receives orders to prepare the patient for resolution of the dislocation, what should the nurse educate the patient about?
a. How and when to wear the knee immobilizer.
b. The anticipated routine for gentle knee flexion.
c.Use of and monitoring for conscious sedation.
d. Severity and length of physical activity restrictio
c. Use of and monitoring for conscious sedation.
A patient has been diagnosed with osteoarthritis (OA). The nurse will anticipate the need to teach about which medication?
a.Prednisone
b. Adalimumab (Humira)
c.Capsaicin cream (Zostrix
d.Sulfasalazine (Azulfidine)
c. Capsaicin cream (Zostrix
A nurse is educating a patient about his new short-arm synthetic cast, which statement by the patient's indicates a good understanding of the cast?
a. “I can get the cast wet as long as I dry it right away with a hair dryer.”
b. “I should avoid moving my fingers and elbow until the cast is removed.”
c. “I will apply an ice pack to the cast over the fracture site off and on for 24 hours.”
d. “I can use a cotton-tipped applicator to rub lotion on any dry areas under the cast.”
“I will apply an ice pack to the cast over the fracture site off and on for 24 hours.”
Ice application for the first 24 hours after a fracture will help reduce swelling and can be placed over the cast.
As a nurse what can you say to a patient recently diagnosed with rheumatoid arthritis (RA) that tells you life is very stressful.
a. “You need to see a family therapist for some help with stress.”
b. “Tell me more about the situations that are causing you stress.”
c. “Your family should understand the impact of your rheumatoid arthritis.”
d. “Perhaps it would be helpful for your family to be involved in a support group.”
b. “Tell me more about the situations that are causing you stress.”
The nurse is teaching a female patient with rheumatoid arthritis (RA) about the use of methotrexate in disease control, what statement made by the patient indicates further teaching is needed?
a.“Acetaminophen-containing medications are to be avoided.”
b.“Effectiveness may not be achieved for up to several weeks.
c. “Methotrexate has no restrictions in pregnancy or breast-feeding.”
d. “Crowded locations and ill persons should be avoided.”
c. “Methotrexate has no restrictions in pregnancy or breast-feeding.”
A patient tells the nurse he does not know if he could live with having his leg amputated. Which response by the nurse is best?
a. “You are upset, but you may lose the foot anyway.”
b. “Many people are able to function with a foot prosthesis.”
c. “Tell me what you know about your options for treatment.”
d. “If you do not want an amputation, you do not have to have it.”
c. “Tell me what you know about your options for treatment.”
Which assessment finding about a patient who has been using naproxen (Naprosyn) for 6 weeks to treat osteoarthritis is most important for the nurse to report to the health care provider?
a. The patient has gained 3 pounds.
b. The patient has dark-colored stools.
c. The patient’s pain has become more severe.
d. The patient is using capsaicin cream (Zostrix).
b. The patient has dark-colored stools.
A patient is non-weight bearing on the right leg. Which observation by the nurse would indicate the patient can safely ambulate independently on crutches?
a. The patient moves the right crutch with the right leg and then the left crutch with the left leg.
b. The patient advances the right leg and both crutches together and then advances the left leg.
c. The patient uses the bedside chair to assist in balance as needed when ambulating in the room.
d. The patient keeps the padded area of the crutch firmly in the axillary area when ambulating.
The patient advances the right leg and both crutches together and then advances the left leg.
A 31-year-old woman is taking methotrexate (Rheumatrex) to treat rheumatoid arthritis. Which information from the patient’s health history is important for the nurse to report to the health care provider about the methotrexate?
a. The patient had a history of infectious mononucleosis as a teenager.
b. The patient is trying to get pregnant before her disease becomes more severe.
c. The patient has a family history of age-related macular degeneration of the retina.
d. The patient has been using large doses of vitamins and health foods to treat the RA.
b. The patient is trying to get pregnant before her disease becomes more severe.
A nurse has been teaching a patient about their new diagnosis of systemic lupus erythematosus (SLE). What statement from the patient indicates teaching effective? Select all that apply.
a. “ I will avoid fatigue by balancing exercise with rest periods as needed.”
b. “Whenever I go outside, I will use sunscreen, even on cloudy days.”
c. “When I have discomfort, I will use nonsteroidal anti-inflammatory drugs.”
d. “I will use oral contraceptives to avoid getting pregnant.”
a. “ I will avoid fatigue by balancing exercise with rest periods as needed.”
b. “Whenever I go outside, I will use sunscreen, even on cloudy days.”
c. “When I have discomfort, I will use nonsteroidal anti-inflammatory drugs.”
Which information will the nurse include when teaching a patient with newly diagnosed chronic fatigue syndrome about self-management?
a. Avoid use of over-the-counter antihistamines or decongestants.
b. A low-residue, low-fiber diet will reduce any abdominal distention.
c. A gradual increase in your daily exercise may help decrease fatigue.
d. Chronic fatigue syndrome usually progresses as patients become older.
c. A gradual increase in your daily exercise may help decrease fatigue.
What is the primary medication that a nurse will educate a patient with OA about?
a.Acetaminophen (Tylenol)
b.Cyclobenzaprine hydrochloride (Flexeril)
c.Hyaluronate (Hyalgan)
d.Ibuprofen (Motrin)
a.Acetaminophen (Tylenol)
A patient is on bed rest after a car accident that resulted in a pelvic fracture. What are possible signs a complication from this type of fracture is occurring?
a. The patient states the pelvis feels unstable.
b.Abdomen is distended and bowel sounds are absent.
c. The patient complains of pelvic pain with palpation.
d.Ecchymosis is visible across the abdomen and hips.
Abdomen is distended and bowel sounds are absent.
The nurse teaching a support group of women with rheumatoid arthritis (RA) about how to manage activities of daily living suggests that they
a. stand rather than sit when performing household and yard chores.
b. strengthen small hand muscles by wringing sponges or washcloths.
c. protect the knee joints by sleeping with a small pillow under the knees.
d. avoid activities that require repetitive use of the same muscles and joints.
d. avoid activities that require repetitive use of the same muscles and joints.
There is a critical lab on a patient with systemic lupus erythematosus (SLE). Which finding is most important for the nurse to communicate to the health care provider
a. Decreased C-reactive protein (CRP)
b. Elevated blood urea nitrogen (BUN)
c.Positive antinuclear antibodies (ANA)
d.Positive lupus erythematosus cell prep
b. Elevated blood urea nitrogen (BUN)
Elevated BUN and serum creatinine indicate possible lupus nephritis and a need for a change in therapy to avoid further renal damage.
During assessment of the patient with fibromyalgia, the nurse would expect the patient to report which of the following (select all that apply)? a. Sleep disturbances
b. Multiple tender points
c. Cardiac palpitations and dizziness
d. Multijoint pain with inflammation and swelling
e. Widespread bilateral, burning musculoskeletal pain
a. Sleep disturbances
b. Multiple tender points
e. Widespread bilateral, burning musculoskeletal
A patient needs a total knee replacement, but is told by the doctor it is not possible to do the procedure because of an absolute contraindication. Which of the following complications does the nurse suspect?
a.Needs multiple dental filling
b.Over age 85
c.Severe osteoporosis
d.Urinary tract infection
c. Severe osteoporosis