Reference no: EM133848565

Musculoskeletal System Disorders

1. A cylinder cast needs to be applied to a client with a fracture. What is the role of the nurse during the procedure?

1. Gently massage the arm or the leg.

2. Hold the arm or the leg in place.

3. Provide intense heat or a cast dryer to speed the evaporation.

4. Compress the cast on a hard surface for better support.

2. Which of the following factors should the nurse emphasize while instructing a client with a cast about the lower extremities?

1. The importance of following a regular diet

2. The use of prescribed analgesics to manage the pain

3. Instructions about ambulating with the crutches

4. The importance of regular exercise

3. A client with a cast reports a throbbing pain. Which of the following actions should the nurse take to relieve the pain?

1. Administer antibiotics.

2. Elevate the extremity.

3. Petal cast edges with waterproof tape.

4. Massage the area of pain.

4. It is important for the nurse to maintain proper pin care for which of the following methods of treating a fracture?

1. Closed reduction

2. Open reduction

3. External fixation

4. Internal fixation

5. A client who has a musculoskeletal problem is being discharged after a few days of hospital care. Why should the nurse consider factors related to the home environment while de- termining a plan for the continued rehabilita- tion of the client?

1. To include additional care for clients who lack the basic amenities at home.

2. To determine the client's access to the nearest drugstore.

3. To modify the client's living arrangements or make other accommodation changes.

4. To determine whether the client can con- tinue with self-care.

6. A patient is being discharged following a leg amputation. Which of the following instructions should the nurse give the client regarding home care?

1. Elevate the stump when sitting, as in- structed by the physician.

2. Apply a non-prescription ointment to the stump to relieve pain.

3. Do not wash the bandages.

4. Stretch the bandages when reapplying them.

7. Which of the following may reduce the risk of excessive bleeding in a client who is sched- uled to undergo an orthopedic surgery?

1. Withholding aspirin before the surgery.

2. Limiting antacids before the surgery.

3. Encouraging the intake of red meat before the surgery.

4. Avoiding excess fluid intake before the surgery.

8. A client who underwent an amputation a week ago still feels an itching sensation or a dull pain in the missing limb. Which of the following nursing actions would help the client in getting relief?

1. Seek an additional prescription for an an- algesic from the physician.

2. Advise the client to meet a psychiatrist.

3. Discuss with the physician the possibility of a surgical removal of the nerve endings at the end of the stump.

4. Discuss with the client the phenomenon of phantom pain.

9. A nurse is assisting a client who is scheduled for a leg amputation surgery. What are the pre surgery nursing management strategies used to assist the client?

1. Evaluate pain level and discomfort.

2. Evaluate the client's mental acceptance.

3. Evaluate bleeding and hemorrhage.

4. Evaluate client for risk of infection.

10. A nurse evaluates a client for postoperative complications following joint replacement surgery. Upon discharge, the nurse teaches the client that the risk of infection is present for how long after surgery?

1. Two weeks

2. One month

3. Three months

4. Six months

11. The client tells the nurse that there was over- stretching of the arm muscles when lifting a heavy suitcase. When examining the client, the nurse expects which of the following signs and/or symptoms if the injury is a strain?

1. Ecchymosis and hematoma from ruptured blood vessels without loss of function.

2. Partial tearing of muscle and tendon with- out loss of function.

3. Loss of function following an over twisting of the joint.

4. Torn ligament with detachment of a bone fragment.

12. Which of the following measures should the nurse strongly recommend to a client recov- ering from a ruptured Achilles tendon to help regain mobility, strength, and the full range of motion?

1. Regular use of NSAIDs

2. Vigorous exercise

3. Physical therapy

4. Nonmedical interventions, such as yoga

13. A client, who spends hours working on the computer, complains of slight pain in the right hand, which is more prominent at night and early in the morning. Which of the following measures should the nurse suggest to help alleviate the pain?

1. Flexing the affected wrist

2. Shaking the affected hand

3. Using surgical intervention

4. Applying physical therapy

14. Which of the following symptoms should the nurse specifically monitor while assessing a client with a femoral neck fracture?

1. Severe pain at the site of the fracture

2. Bleeding from joint capsules

3. Muscle spasms

4. Crepitus at the site of the fracture

15. A nurse is working with an elderly client who is recovering from surgery for a fractured hip. For how long following surgery should the nurse leave the wound drain in place for this client?

1. 12 to 24 hours

2. 1 to 2 days

3. 3 to 4 days

4. 5 to 6 days ROT

16. A client's leg was crushed when a steel girder fell on it at a construction site. The nurse recognizes that such an injury puts the client at risk for fat embolism. Which of the following interventions is needed to prevent this complication?

1. Provide early respiratory support.

2. Administer blood and fluid volume replacements as prescribed.

3. Elevate the extremity.

4. Apply ice to the extremity.

17. For which of the following symptoms should the nurse closely monitor a client with a compartment syndrome in the upper arm?

1. Epicondylitis

2. Carpal tunnel syndrome

3. Volkmann's contracture

4. Ganglion cyst

18. A client has undergone surgery for a compound fracture that involved external fixation. Which of the following should the nurse do to prevent infection in this case?

1. Position the client in line with the pull exerted by the traction.

2. Administer an antibiotic.

3. Clean the pin sites.

4. Elevate the limb.

19. A fractured femur is found in a client with Paget's disease, but the client has been con- fined to the hospital bed for many days and has not suffered any kind of trauma of which the nurse is aware. Which type of fracture has this client experienced?

1. Pathologic

2. Compression

3. Depressed

4. Compound

20. A nurse receives word that a client is arriving with a compound fracture of the right tibia. What does the nurse expect to see in this client?

1. No evidence of trauma to the right lower extremity.

2. Client complains of pain when bearing weight.

3. Signs of skin and mucous membrane trauma as well as bone protrusion.

4. Areas of ecchymosis and swelling at site of injury.

21. Which of the following should the nurse em- phasize during the education of a client with degenerative joint disease?

1. Sleep on a firm mattress.

2. Maintain moderate activity.

3. Take aspirin on an empty stomach.

4. Avoid purine-rich foods.

22. When teaching a client about gout, the nurse is correct when stating which of the following increases the excretion of uric acid?

1. A high-fluid intake

2. Use of salicylates

3. A high intake of purine-rich foods

4. A low intake of carbohydrates

23. When examining a client with ankylosing spondylitis, which symptom does the nurse expect to see?

1. Painful movement of a joint

2. Swelling and tenderness at a joint

3. Low back pain and stiffness

4. Partial paralysis of lower extremities

24. Which of the following should a nurse in- struct a client with lupus erythematosus to use before performing ROM exercises?

1. Prescribed analgesics

2. Cold packs

3. Moist heat

4. Braces or splints

25. Which of the following symptoms would the nurse observe in a client who is in the mid- stage of Lyme disease?

1. Joint erosion

2. Fever, chills, and malaise

3. Arthritis bas

4. Facial palsy and meningitis

26. In providing care for clients with osteoporo- sis, the nurse emphasizes the need for a nutri- tious, well-balanced diet that is high in which of the following?

1. Calcium

2. Iron

3. Zinc

4. Carbohydrates

27. When reviewing lab results for a client with Paget's disease, a nurse is correct to expect which of the following results?

1. Elevated serum alkaline phosphatase level

2. Decreased urinary hydroxyproline excretion

3. Elevated leukocyte count

4. Elevated creatinine level

28. To reduce the risk of renal calculi, a complication of prolonged immobility and gout, the nurse should advise clients to drink at least _____quarts of fluid daily.

1. 1

2. 2

3. 3

4. 4

29. A client with a disease of the bones is begin- ning to feel better. Which of the following critical instructions should a nurse provide this client at this stage?

1. Advise the client to reduce the dosage of the prescribed drugs.

2. Caution the client against discontinuing the prescribed drugs.

3. Urge the client to resume heavy activity.

4. Encourage the client to gain weight.

30. Which of the following teaching points does the nurse stress to the client with systemic lu- pus erythematosus (SLE)?

1. Apply ice as instructed.

2. Avoid sunlight and ultraviolet radiation.

3. Use assistive devices appropriately.

4. Change dressing as prescribed.