RN Musculoskeletal system EAQ 2022

RN Musculoskeletal system EAQ 2022 Why is Phalen’s test performed in a client? To diagnose atrophy To diagnose bone tumor To detect rotator cuff injuries To detect carpal tunnel syndrome A client injures an amphiarthrodial joint. Which joint did the client injure? Knee joint Pelvic joint Elbow joint Cranial joint A client admitted to the hospital with an acute episode of rheumatoid arthritis (RA) asks why physical therapy has not been prescribed. What is the most appropriate nursing response? "Your primary healthcare provider must have forgotten to prescribe it." "Your condition is not severe enough to have physical therapy approved." "Your joints are still inflamed, and physical therapy can be harmful." "Physical therapy is not helpful for persons who suffer from RA." A nurse is providing postoperative teaching to a client who is scheduled to have an above-theknee amputation. The client will use crutches during the postoperative period. Which activity will prepare the client for crutch walking? Lifting weights Changing bed positions Caring for the residual limb Performing phantom limb exercises A nurse is caring for a client with a below-the-knee amputation. What should the nurse encourage the client to do to prepare the residual limb for a prosthesis? Abduct the residual limb when ambulating. Dangle the residual limb off the bed frequently. Soak the residual limb in warm water twice a day. Press the end of the residual limb against a pillow periodically. Which diagnostic study is used to investigate the cause of an inflamed joint and determines a client’s response to antiinflammatory drug therapy? Duplex venous Doppler Plethysmography Thermography Somatosensory evoked potential Which joint in the human body is an example of a condyloid joint? Wrist jointElbow joint Shoulder joint Sacroiliac joint Non–weight bearing with crutches has been prescribed for a client with a leg injury. The nurse provides teaching before ambulation is begun. To facilitate walking with crutches, what is the most important activity the nurse should teach the client? Sit up in a chair to help strengthen back muscles. Keep the unaffected leg in extension and abduction. Exercise the triceps, finger flexors, and elbow extensors. Use a trapeze frequently to strengthen the biceps muscles. What is the nurse’s primary consideration when caring for a client with rheumatoid arthritis? Surgery Comfort Education Motivation Which ethnic group has a greater incidence of osteoporosis due to musculoskeletal differences? Irish Americans African Americans Chinese Americans Egyptian Americans The school nurse is attending to a student athlete who reports muscle pain after a practice session. Which should the nurse identify as a cause of this pain when providing instruction to the student? Lactic acid Acetoacetic acid Hydrochloric acid Beta-hydroxybutyric acid Which type of bone tumor is commonly seen in elderly clients? Endochroma Osteosarcoma Chondrosarcoma Osteochondroma Which is the first line treatment for Paget disease? Oral alendronate 1500 mg of calcium Intravenous pamidronateIntravenous zoledronic acid After an amputation of a limb, a client begins to experience extreme discomfort in the area where the limb once was. What is the nurse’s greatest concern at this time? Addressing the pain Reversing feelings of hopelessness Promoting mobility in the residual limb Acknowledging the grieving for the lost limb Which joint permits movement in any direction? Pivot joint Hinge joint Biaxial joint Ball-and-socket joint Which radiographic test is used to view the entire skeleton? Bone scan Gallium and thallium scan Computed tomography (CT) Magnetic resonance imaging (MRI) scan The primary healthcare provider prescribes one unit of packed red blood cells to be administered to the client who suffered a hip fracture. Several minutes after the start of the infusion, the client reports itching. Upon further assessment, the nurse observes hives on the client’s chest. Which action should the nurse take next? Call the primary healthcare provider to obtain a prescription for an antihistamine. Flush packed red blood cells with 5% dextrose and 0.45% normal saline. Slow down the rate of the infusion. Stop the transfusion immediately. Which term should the nurse use to describe bone loss greater than normal but less than that caused by osteoporosis? Osteopenia Osteomyelitis Osteomalacia Osteoarthritis Which diagnostic test is used for the direct visualization of ligaments, menisci, and articular surfaces of joints? Arthroscopy Muscle biopsy UltrasonographyElectromyography Which condition is characterized by infection of a client’s bone or bone marrow? Osteomalacia Osteomyelitis Herniated disc Spinal stenosis A home care nurse is visiting a client who had a below-the-knee amputation. Which client statement indicates to the nurse that further teaching is needed? "At night, I sleep with a pillow under my knees." "When I sit in a chair, I put my legs out straight on an ottoman." "I apply a firm, even bandage around the end of my affected leg every day." "I press the end of my affected leg against a soft surface several times during the day." Which diagnostic scan is used to detect diffuse or localized muscle weakness? Arthroscopy Radiography Myelography Electromyography When providing discharge teaching to a client who had a total hip replacement, what should the nurse instruct the client to avoid? Climbing stairs Stretching exercises Sitting in a low chair Lying prone for more than 15 minutes Which estrogen antagonist is specifically used to prevent and treat osteoporosis in postmenopausal women? Raloxifene Denosumab Alendronate Zoledronic acid The nurse is providing discharge teaching to a 30-year-old client who was hospitalized for exacerbation of rheumatoid arthritis. Which statement by the client indicates correct understanding of the treatment plan? "I will plan to rest in bed for the next 2 weeks." "I will only take my medications when I am having joint pain." "When I exercise, I will reduce the number of repetitions when I have pain.""When I get out of bed, I will push off with my fingers rather than the palms of my hands." Which musculoskeletal system change is associated in older adult clients? Decreased in height Decreased neck rigidity Increased fine-motor dexterity Increased range of motion (ROM) After surgery for a fractured hip, a client states, "I don’t remember when I have ever been so uncomfortable." What should the nurse’s initial response be? Notify the primary healthcare provider. Use distraction techniques. Medicate the client as prescribed. Perform a complete pain assessment. Which joint helps in the gliding movement of the wrist? Pivot joint Hinge joint Biaxial joint Ball and socket joint Which type of cast will the nurse be caring for in a child with a fractured femur? Cylinder Hip spica Prefabricated knee Robert Jones After becoming incontinent of urine, an older client is admitted to a nursing home. The client’s rheumatoid arthritis contributes to severely painful joints. Which need is the primaryconsideration in the care of this client? Control of pain Immobilization of joints Motivation and teaching Bladder training and control Which disorder of the foot is caused by continual pressure over bony prominences? Corn Plantar wart Hammer toe Hallux rigidus According to the common scale for grading muscle strength, what rating will be given to a client who can complete range of motion with some resistance?1 2 3 4 Which hormone aids in regulating intestinal calcium and phosphorous absorption? Insulin Thyroxine Glucocorticoids Parathyroid hormone Which structure protects a client’s internal organs, supports blood cell production, and stores minerals? Joints Bones Muscles Cartilages A client who is receiving radiation therapy for bone cancer lives alone and works full time. What should the nurse encourage this client to do? Perform regularly scheduled aerobic activity daily. Take a leave of absence from work when receiving therapy. Include rest periods during the day while receiving radiation. Continue the activities usually performed before becoming ill. Which synovial joint movement is described as turning the sole outward away from the midline of the body? Pronation Eversion Adduction Supination Which nursing intervention prevents footdrop in a client with osteomyelitis? Elevating the foot with the use of pillows Consistently flexing the affected extremity Encouraging the client to change positions Neutral positioning of the foot with the use of a splint What is a goniometer used for?To assess range of motion To reduce phantom limb sensation To prevent hip flexion contractures To immobilize a joint during fracture Which hormone increases the rate of protein synthesis in a client? Estrogen Thyroxine Parathormone Vitamin D A client falls at home and is brought to the emergency department by family members. The client reports intercostal pain and is confused and disoriented. Which is the best way for the nurse to determine whether this behavior is new for the client? Interview the client to identify when the confusion started. Question the family members about the client’s usual behavior. Ask the primary healthcare provider when the confusion was noted first. Observe the client for a few hours before determining the onset of confusion. The nurse is preparing to initiate intravenous antibiotic therapy for a client who developed an infection along the incision after having a total knee replacement. Before starting the first dose of intravenous antibiotics, which task should the nurse ensure has been completed? Red blood cell count Wound culture Knee x-ray Urinalysis Which term should the nurse use to describe synovial joint movement that moves away from the midline of the body? Inversion Extension Pronation Abduction An older female client is seen in the primary healthcare provider’s office. Upon initial nursing assessment the nurse notes the client’s height has decreased by 1 inch (2.5 cm) since the last visit 1 year ago. The nurse knows that what is the mostlikely reason for this finding? The nurse was in error. Older adults are not active enough so they lose bone mass. Older adults have poor posture so they are shorter. Older adults may have osteoporosis-related height changes.Three days after a cast is applied to a client’s fractured tibia, the client reports that there is a burning pain over the ankle. The cast over the ankle feels warm to the touch, and the pain is not relieved when the client changes position. What is the nurse’s priority action? Obtain a prescription for an antibiotic. Report the client’s concern to the primary healthcare provider. Administer the prescribed medication for pain. Explain that this is typical after a cast is applied. A client with pain and paresthesia of the left leg is scheduled for an electromyogram. What should the nurse discuss with the client before the test is performed? Bed rest must be maintained after the procedure. The involved area will be shaved before the procedure. Needles will be inserted into the affected muscles during the test. Monitoring of the heart rate and rhythm will be done throughout the test. A client with a history of a herniated nucleus pulposus is scheduled for total hip replacement surgery. To prevent the most common complication associated with this type of surgery, the nurse should instruct the client to perform which activity? Straight-leg raises Buerger-Allen exercises Deep breathing and coughing Plantar flexion and dorsiflexion exercises A nurse is assessing a client with a cast to the extremity. Which assessment finding is the priority? Warmth Numbness Skin desquamation Generalized discomfort Which clinical manifestation can a client experience during a fat embolism syndrome (FES)? Nausea Dyspnea Orthopnea Paresthesia Which instrument is the nurse using in this image?Arthroscope Orthoses Goniometer External fixator Which treatment is beneficial for a client with muscle spasm? Thermotherapy Muscle massage Frequent position changes Muscle-strengthening exercise regimen The nurse is providing postoperative care to a client who had surgery in which a hip prosthesis was inserted. An abductor splint is in place. When should the nurse remove the splint? When the client gets up to sit in a chair If the client needs a change of position Once the client’s edema and pain have ceased During the client’s skin care and physical therapy A client has injured a short bone. Which is an example of a short bone? Tibia Femur Tarsals Humerus Which factor may cause a client neck pain? Headache Poor postureLow body weight Sedentary lifestyle A client sustains a fractured right femur after an automobile accident and is admitted to the hospital’s emergency department. Which assessment is the priority? Turn the client to the side-lying position. Take the client’s pedal pulse in the affected extremity. Instruct the client to wiggle the toes of the right foot. Ask the client if numbness or tingling is present in the right foot. A nurse performs full range-of-motion exercises on a client’s extremities. When putting an ankle through range-of-motion exercises, what must the nurse perform? Flexion, extension, and rotation Abduction, flexion, adduction, and extension Pronation, supination, rotation, and extension Dorsiflexion, plantar flexion, eversion, and inversion A client who had an above-the-knee amputation (AKA) has a pressure dressing on the end of the residual limb. The client asks, "Why do I have to have this tight dressing on my leg?" Which answer by the nurse is correct? "It decreases the swelling of the area." "It decreases the formation of scar tissue." "It prevents the formation of blood clots." "It reduces phantom limb pain." What are examples of a client’s flat bones? Select all that apply. Sacrum Scapula Sternum Humerus Mandible Which child is at the highest risk for blunt trauma associated with the indirect entry (hematogenous stage) of microorganisms? 8-year-old boy 10-year-old girl 13-year-old girl 14-year-old boy The nurse is caring for a client with rheumatoid arthritis. When should the nurse expect the client to experience the most pain and limited movement of the joints? After assistive exercise When the room is coolDuring the evening hours In the morning on awakening Which individual is at risk of developing carpal tunnel syndrome? Housekeeper Software engineer Healthcare worker Professional athlete Which diagnostic study is used to detect deep vein thrombosis in the client’s lower extremities? Thermography Plethysmography Duplex venous doppler Somatosensory evoked potential Which structure connects the client’s tibia to the femur at the knee joint? Fascia Bursae Tendons Ligaments A client who has paraplegia often loses calcium from the skeletal system. The nurse concludes that what factor contributes to calcium loss in this client? Decreased activity Inadequate fluid intake Decreased calcium intake Inadequate kidney function An x-ray film indicates that an older client has a fractured femur. The client asks the nurse, "Will I be able to walk again?" What is the best response by the nurse? "I have no idea because only time will tell." "You only broke a bone. It could have been worse." "You’ll walk again. This is a common issue in older people." "Tell me more about your concerns about being able to walk." While caring for a client with a second-degree left ankle sprain, a nurse raises the injured part above heart level. What is the reason behind this nursing intervention? To promote bone density To prevent further edema To reduce pain perception To increase muscle strengthIn the postanesthesia care unit after a below-the-knee amputation, a client begins crying after feeling for the affected lower leg. How should the nurse respond? Administer medication to induce sleep. Allow the client to ventilate feelings of loss. Provide time for privacy by leaving the room. Do not address the behavior until the client is more alert. A client with rheumatoid arthritis asks the nurse about ways to decrease morning stiffness. What should the nurse suggest? Wearing loose but warm clothing Planning a short rest break periodically Avoiding excessive physical stress and fatigue Taking a hot tub bath or shower in the morning Which joint in the client’s body is an example of a gliding joint? Wrist Elbow Shoulder Sacroiliac A client has had a below-the-knee amputation of the leg. What is important for the nurse to consider when providing postoperative care for a client who had an amputation of a lower extremity? Strict bed rest is maintained for at least several days. The residual limb should not be elevated for the first 24 hours. Hemorrhage rarely occurs during the early postoperative period. Primary healthcare providers usually change the dressing on the residual limb within 48 hours. A nurse is caring for a client who will have a below-the-knee amputation with an immediate postoperative prosthesis. The client asks the nurse the advantage of having an immediate prosthesis. What should the nurse explain is the advantage? Decreases phantom limb sensations Encourages a normal walking pattern Reduces the incidence of wound infection Allows for fitting of the prosthesis before discharge A client who is scheduled for a muscle biopsy tells the nurse, "They better give me a general anesthetic. I don’t want to feel anything." Which is the most therapeutic initial response by the nurse? "You seem to be worried about the test.""This test is done under local anesthesia." "Tell them when you have pain so they can take care of it." "You probably will not have pain so try not to think about it." A client with a distal femoral fracture has a long leg cast applied. Which important element of a discharge program should the nurse focus on when teaching crutch-walking? Establishing a schedule for pain medication Maintaining a fixed schedule of daily activities Modifying the home environment to prevent accidents Understanding that a more sedentary lifestyle is necessary While awaiting the biopsy report before removal of a bone tumor, the client reports being afraid of a diagnosis of cancer. How should the nurse respond? "Worrying is not going to help the situation." "Let’s wait until we hear what the biopsy report says." "It is very upsetting to have to wait for a biopsy report." "Operations are not performed unless there are no other options." A nurse is caring for a client who just had an above-the-knee amputation. Which is the key factor in assessing how the client will cope with the body image change? Extent of the change Suddenness of the change Obviousness of the change Personal perception of the change A registered nurse (RN) is giving home care instructions to a client who was treated for injuries due to a fall. Which statement made by the client indicates a need for correction? pA registered nurse (RN) is giving home care instructions to a client who was treated for injuries due to a fall. Which made by the client indicates a need for correction?/p "I should walk on scatter rugs at home." "I should drink 3000 mL of water every day." "I should eat fruits and vegetables six times a day." "I should exercise the joints above and below the cast daily." Which hormones are involved in building and maintaining healthy bone tissue? Select all that apply. Insulin Thyroxine Glucocorticoids Growth hormone Parathyroid hormone Which bursae are found between the client’s elbow and the skin?Olecranon Prepatellar Subacromial Trochanteric Which principle should the nurse consider when assisting a client with crutches to learn the fourpoint gait? Elbows should be kept in rigid extension. Most of the weight should be supported by axillae. The client must be able to bear weight on both legs. The affected extremity should be kept off the ground. The nurse is caring for a client who is 1 day postoperative for a left hip fracture repair. During the assessment, which finding should the nurse assess further? Pain at the surgical site Small amount of serosanguinous drainage Decreased range of motion to the left extremity Sudden shortness of breath A client returns from surgery after a right below-the-knee amputation with the residual limb elevated on a pillow to prevent edema. In which position should the nurse place the client after the first postoperative day? With the residual limb immobilized Turn client to prone position at least three times a day For short periods in the right side-lying position With the residual limb elevated for a total of three days X-ray films reveal that a client has closed fractures of the right femur and tibia. In addition, multiple soft-tissue contusions are present. Which action is most important for the nurse to take? Perform a neurovascular assessment of the extremity. Reassure the client that these injuries are not that serious. Gather equipment needed for the application of skeletal traction. Prepare the client for a surgical reduction of the injured extremity. A client with arthritis reports receiving several dietary suggestions over the years. Which recommendation for a daily diet should the nurse reinforce? Wheat germ and yeast Yogurt and blackstrap molasses Multiple vitamin supplements in large doses Adequate foods in a variety of different food groupsWhich factor does the nurse consider most likely contributes to the increased incidence of hip fractures in older adults? Carelessness Fragility of bone Sedentary existence Rheumatoid diseases A 90-year-old resident of a nursing home falls and fractures the proximal end of the right femur. The surgeon plans to reduce the fracture with an internal fixation device. What general fact about the older adult should the nurse consider when caring for this client? Aging causes a lower pain threshold. Physiologic coping defenses are reduced. Most confused states result from dementia. Older adults psychologically tolerate changes well. Which physiologic changes of the musculoskeletal system are related to aging? Select all that apply. Slowed movement Cartilage degeneration Increased bone density Increased range of motion Increased bone prominence What does grade 3 indicate according to the muscle-strength scale? Active movement against gravity and some resistance Active movement of body part with elimination of gravity Active movement against full resistance without evident fatigue Active movement against gravity only and not against resistance The x-ray report of a client shows the presence of a greenstick fracture. What is a greenstick fracture? A fracture with more than two fragments An incomplete fracture with one side bent A spontaneous fracture at the site of bone disease A fracture that extends across the longitudinal axis of the bone shaft Which type of joint is present in the client’s shoulders? Pivotal Saddle Condyloid SpheroidalA client reports burning sensation and sharp pain on the sole of a foot. Which condition does the nurse suspect in the client? Torticollis Pes planus Crepitation Plantar fasciitis Which term should the nurse use to describe a flat, poorly defined mass on the sole over a bony prominence caused by pressure? Plantar wart Callus Ingrown nail Hypertrophic ungual labium One week after an above-the-knee amputation, a client refuses to go to physical therapy and tells the nurse, "I’ll never be a whole person again!" What is the nurse’s best response? "You’re still the same person you’ve always been. Just relax." "You’ve lost a part of yourself. That must be very difficult for you." "You may feel that way, but I’m sure your family considers you a whole person." "You must go to physical therapy every day or you will develop muscle contractures." A client with terminal bone cancer is to receive 2 mg of hydromorphone intravenously (IV) every 4 hours as needed for severe breakthrough pain. The vial contains 10 mg/mL. When the client reports severe pain, how much solution of hydromorphone should the nurse administer? Record your answer using one decimal place. Include a leading zero if applicable. 0.2 During a follow-up visit, a nurse finds that flexion contractures have developed in a client with osteoarthritis (OA). Which factor may have led to this condition? Wearing shoes without insoles Elevating the legs 8 to 12 inches Using large pillows under the knees or head Placing a small pillow under the head in the supine position A client with an above-the-knee amputation asks why the residual limb needs to be wrapped with an elastic bandage. The nurse explains the purpose is to do what? Limit the formation of blood clots.Decrease the phantom limb sensation. Prevent hemorrhage and cover the incision. Support the soft tissue and minimize swelling. An older client experiences urinary frequency and nocturia. While ambulating, the client develops severe back pain and is found to have a vertebral compression fracture. When planning care, the nurse will focus interventions on which type of fracture? Collapse of vertebral bodies Demineralization of the spinal cord Wear and tear of the spinous processes Bulging of the spinal cord from the vertebra After an amputation, the client’s residual limb is bandaged snugly throughout the postoperative period. Which goal should the nurse identify as the primary reason for this intervention? Promoting shrinkage Preventing injury to the area Preventing suture line infection Promoting drainage of secretions A client had an above-the-knee amputation of the left leg because of trauma from a motor vehicle collision. The primary healthcare provider prescribes ambulation with crutches until the residual limb is healed and the client can be fitted with a prosthesis. What should be the nurse’s initial action? Demonstrate the swing-through crutch walking gait. Determine whether the client has ever used crutches before. Introduce the client to another client who is using crutches. Provide a pamphlet that has information about using crutches. A client sustains a back injury after falling 20 feet (6 m). In which position should the nurse place the client? Lateral position with a pillow between the knees Any position that reduces pain and is comfortable Supine position while not allowing the spine to flex Sitting position with a pillow placed in the small of the back The nurse is reviewing the blood test reports of a child whose blood sample was tested after receiving a general anesthetic. The nurse finds that the client has increased intracellular calcium levels. What medication would be beneficial to the client? Aspirin (Anacin) Naproxen (Aleve) Ibuprofen (Advil) Dantrolene (Dantrium)client with dementia is admitted with a fractured hip after a fall at home. The client’s family member witnessed the fall. Four hours after admission, the client’s blood pressure increases to a moderately severe hypertensive level. The client pulls on the bedclothes continuously. The client’s family member asks for pain medication for the client. What does the nurse concludes? The client has the need to go to the bathroom. The client may be in pain and unable to respond appropriately. The family member may be trying to keep the client overmedicated. The family member feels guilty about the fall and wants to keep the client pain free. A client with a fractured head of the right femur and osteoporosis is placed in Buck extension before surgical repair. What should the nurse do when caring for this client until surgery is performed? Remove the weights from the traction every 2 hours to promote comfort. Turn the client from side to side every 2 hours to prevent pressure on the coccyx. Raise the knee gatch on the bed every 2 hours to limit the shearing force of traction. Assess the circulation of the affected leg every 2 hours to ensure adequate tissue perfusion. To reduce a fracture of the hip, a client is placed in Buck traction before surgery. Because the client keeps slipping down in bed, increased countertraction is prescribed. What should the nurse do to increase countertraction? Add more weight to the traction. Elevate the head of the client’s bed. Use a slight Trendelenburg position. Apply a chest restraint around the client. A client with osteoporosis is prescribed raloxifene. What should the nurse monitor in the client? pA client with osteoporosis is raloxifene. What should the nurse monitor in the client?/p Check serum creatinine Monitor urinary calcium Monitor liver function tests Observe for anxiety and drowsiness While assessing the health of a 69-year-old client, the nurse finds an age-related change. Which finding in the client supports the nurse's conclusion? Big eyes, wide open Presence of facial hair A bruise on the elbow Walking with neck bent forward The medical history of a client with osteoporosis indicates renal calculi. Which medication would be contraindicated?Os-cal Raloxifene Ibandronate Zoledronic acid A nurse is caring for a client with rheumatoid arthritis. Based on the client’s diagnosis, the nurse should review the result of which laboratory test? Pancreatic lipase Bence Jones protein Antinuclear antibody Alkaline phosphatase A client had a cerebrovascular accident (also known as a "brain attack"), and bed rest is prescribed. What can the nurse use to best prevent footdrop in this client? Splints Blocks Cradles Sandbags A client with osteomyelitis has a slow rate of healing. Which factors can contribute to reduced healing in the client? Select all that apply. Diabetes Cataract Smoking Dermatitis Alcoholism A client returns to work as a carpenter after surgery for carpal tunnel syndrome of the right hand. What instructions should the nurse give to help prevent further problems with the hands when the client returns to work? "Avoid carrying tools with the arms." "Learn to hammer with the left hand." "Do stretching exercises during breaks." "Avoid power tools such as cordless screwdrivers." The nurse is caring for a client with a long leg cast. Which clinical findings indicate compromised circulation? Select all that apply. Foul odor Swelling of the toes Drainage on the cast Increased temperatureProlonged capillary refill A client with rheumatoid arthritis calls the outpatient clinic to report that pain with exercising has increased. What should the nurse suggest to the client to decrease pain? "For morning stiffness, take a tub bath rather than a hot shower." "Apply an ice pack directly to the involved joint for no more than 20 minutes at a time." "Decrease the number of repetitions of the exercises." "Cease exercising for a day." The laboratory reports reveal that a client has a serum calcium level of 7.9 mg/dL (.43 mmol/L). Which hormone would be elevated in the client? Estrogen Thyroxine Growth hormone Parathyroid hormone (PTH) A 52-year-old client reports fatigue and decreased strength in the limbs. Which suggestion given to the client will be mostbeneficial? "Include protein-rich food in your diet." "Drink two cups of milk daily." "Perform push-ups in the morning." "Give warm compresses to the limbs." The nurse is teaching a client undergoing intravenous gentamicin therapy for the treatment of acute osteomyelitis. Which statement by the client indicates effective learning? "I should drink lots of water if I retain urine." "I should use eyeglasses if I have vision problems." "I should stop the medication when the symptoms have subsided." "I should report any hearing loss to the primary healthcare provider." Which drug is used in the treatment of a client with intervertebral disc disease? Etidronate Zoledronic acid Cyclobenzaprine Salmon calcitonin After a painful exacerbation of rheumatoid arthritis, a client is scheduled to begin a walking and exercise program. Which is an expected outcome for this client? Only when pain free, begin exercising as part of a formal activity program. Avoid exercising when there is a moderate amount of discomfort. Exercise and be active unless the discomfort becomes too great.Walk and exercise even when the pain is severe. While assessing a client with a musculoskeletal disorder, the nurse gives the client a muscle strength rating of 3. What observation would correspond to this rating? No evidence of muscle contractility Can complete range of motion (ROM) against gravity No joint motion and slight evidence of muscle contractility Can complete ROM against gravity with some resistance Which joint surgery is used as a prophylactic measure and as a palliative treatment for clients with rheumatoid arthritis (RA)? Osteotomy Arthrodesis Synovectomy Debridement A nurse is caring for a client with pain due to muscle spasm. Which nursing action is beneficial for the client? Providing heat compresses at the site Providing a massage to the affected area Encouraging the client to perform isometric exercises Encouraging the client to do active-passive range-of-motion (ROM) exercises The nurse is providing postoperative care for a college student who has undergone a knee arthroscopy for a tendon repair. The client is scheduled to be discharged in a few hours and plans to return to the college dormitory and spend the weekend there before returning to class in 2 days. What is most important for the nurse to include in the client’s discharge plans? Arrange for a taxi to return the client to the dormitory. Instruct the client to restrict activities for at least several days. Suggest the client spend the weekend in a motel near the hospital. Ask the client who is available in the dormitory to provide assistance. A client with painful swelling of a distal joint of the ring finger is found to be in the early stages of rheumatoid arthritis (RA). A test for the rheumatoid factor is negative. The client asks about the reliability of the test, stating, "I don’t think the result is accurate. I have been diagnosed with RA, and I am in so much pain." How should the nurse respond? "It might help if you try not to think about your discomfort." "Don’t let that upset you; eventually the tests will be positive." "These tests will have to be repeated; they are complicated tests." "Laboratory tests often are negative in the early stages of the disease." The nurse enters a client’s room and finds the client on the floor crying for help. It is obvious to the nurse that the client has sustained a hip fracture. Which action should the nurse take first? Administer pain medication.Place the affected extremity in traction. Immobilize the affected extremity. Notify the primary healthcare provider on call. A client returns from the postanesthesia care unit after a right rotator cuff repair. What should the nurse do when performing a neurovascular assessment? Monitor for a pulse deficit. Obtain hourly blood pressure readings. Assess for capillary refill in the nail beds. Place the shoulder through range-of-motion exercises. A client has an above-the-knee amputation of the left leg because of arterial insufficiency. To prevent a hip flexion contracture, in what position should the nurse periodically place this client? Prone position Sitting position Supine position with a pillow under the residual limb Right side-lying position with a pillow between the thighs Which musculoskeletal abnormality does the nurse suspect in a client who exhibits short steps and drags a foot? Torticollis Pes planus Spastic gait Steppage gait Shoulder immobilization is prescribed after surgical repair of a client’s rotator cuff. Which criterion should the nurse use to determine that appropriate alignment is achieved by the immobilizer device? Forearm moves freely. Upper arm is in abduction. Hand is lower than the elbow. Upper arm lies close to the chest. The nurse is making rounds and stops to check a client who has had a total hip arthroplasty. Which action by the unlicensed assistive personnel (UAP) ([continuing care assistant (CCA]) will cause the nurse to intervene? The client’s heels are kept off the bed. The UAP (CCA) elevates the client’s affected leg on a pillow. The UAP (CCA) uses a pillow to keep the client’s legs abducted. The client uses a walker when ambulating with the UAP (CCA). A client sustains a complex comminuted fracture of the tibia with soft tissue injuries after being hit by a car while riding a bicycle. Surgical placement of an external fixator is performed to maintain the bone in alignment. Postoperatively it is most essential for the nurse to do what?Cleanse the pin sites with alcohol several times a day. Perform a neurovascular assessment of both lower extremities. Ambulate the client with partial weight bearing on the affected leg. Maintain placement of an abduction pillow between the client’s legs. A client reports pain in the posterior leg while walking and running. Which condition does the nurse suspect? Crepitation Paresthesia Plantar fasciitis Achilles tendinitis A client reports pain, weakness, and numbness in the neck, back, and shoulders after working long hours at a computer. Which condition will the nurse most likely observe in the client’s electronic medical record? Bursitis Meniscus injury Repetitive strain injury (RSI) Carpal tunnel syndrome (CTS) A client is scheduled for arthroscopic knee surgery and asks the nurse about the procedure. Which is the best response by the nurse? "It is surgical repair of a joint under direct visualization using a device with a tiny video camera attached to it." "It is a radiologic procedure in which dye is injected to help diagnose the extent of the knee injury." "The procedure will determine the type of treatments the primary healthcare provider will prescribe." "You will be anesthetized so that you do not remember anything about the procedure." A client is scheduled for a below-the-knee amputation. When should the nurse begin rehabilitation planning for the client? Before the surgery During the convalescent phase On discharge from the hospital When it is time for a prosthesis The nurse is caring for an elderly client who has a right hip fracture. Which priority intervention should be included in the plan of care? Oxygen therapy Cardiac monitoring Nutrition supplementsVenous thromboembolism (VTE) prevention A client who has intermittently been having painful, swollen knee and wrist joints during the past 3 months is diagnosed with rheumatoid arthritis. What type of diet should the nurse expect the primary healthcare provider to prescribe? Salt-free, low-fiber diet High-calorie, low-cholesterol diet High-protein diet with minimal calcium Regular diet with vitamins and minerals Which information indicates a nurse has a correct understanding about skeletal muscles? Skeletal muscle accounts for about half of a human being’s body weight. Skeletal muscle contraction propels blood through the circulatory system. Skeletal muscle contraction is modulated by neuronal and hormonal influences. Skeletal muscle occurs in the walls of hollow structures such as airways and arteries. What does the nurse instruct a client to do while performing McMurray’s test? To raise the leg to 60 degrees To abduct the arm to 90 degrees To flex, rotate, and extend the knees To flex the knee to 30 degrees and pull the tibia forward A client who had a total hip replacement is receiving continuous regional analgesia. The nurse recognizes what as the benefit of this treatment over conventional methods? It is easy to adjust the dose. Neuropathic pain can be relieved. Systemic side effects are minimal. The need for parenteral medication is prevented. The nurse provides moist heat to a client with cartilage degeneration. What is the rationale for this nursing intervention? To slow bone loss To prevent skin breakdown To increase muscle strength To increase blood flow to the area A client with an acute exacerbation of rheumatoid arthritis is in severe pain and tells the nurse, "The only time I am pain free is when I lie perfectly still." What complication should the nurse explain can be prevented by exercising every day? Paresthesias of the feet Shortening of the musclesDevelopment of osteoblasts Loss of muscular coordination The nurse is caring for a client with a distal femoral shaft fracture. For which clinical indicator unique to a fat embolus should the nurse assess the client? Oliguria Dyspnea Petechiae Confusion A college basketball player complains of a "click" in the knee when walking. The client states that the knee occasionally gives way when running and sometimes locks. The client does not recall any specific injury. What does the nurse suspect that the diagnostic tests will reveal? Cracked patella Ruptured Achilles tendon Injured cartilage in the knee Stress fracture of the tibial plateau As an acute episode of rheumatoid arthritis subsides, active and passive range-of-motion exercises are taught to the client’s spouse. The nurse should teach that direct pressure should not be applied to the client’s joints, because this may precipitate what? Pain Swelling Nodule formation Tophaceous deposits A nurse is teaching a client with a non–weight-bearing long leg cast. Which statement indicates the need for the nurse to reinforce discharge teaching? "The cast can be wrapped in plastic when I take a shower." "I called my office to let them know I will be back at work next week." "The physical therapist is going to teach me how to walk with crutches." "I am going to give myself a pedicure with red nail polish when I get home." A 70-year-old client is diagnosed with cartilaginous degeneration. Which action should the nurse take? Advise the client to use moist heat Teach the client isometric exercises Provide the client with supportive armchairs Demonstrate weight-bearing exercises to the client A client has a total hip arthroplasty. What should the nurse do when caring for this client after surgery? Use a pillow to keep the legs abducted.Elevate the client’s affected limb on a pillow. Turn the client using the log-rolling technique. Place a trochanter roll along the entire extremity. A registered nurse is teaching isometric exercises to an 80-year-old client. Which age change in the client necessitates the teaching of this exercise? Kyphotic posture Muscular atrophy Decreased bone density Cartilaginous degeneration Which alternative therapy may be beneficial for the nurse to discuss with a client who has terminal bone cancer? Biofeedback Radiotherapy Bariatric therapy Radioactive implants A client who had an open reduction and insertion of a prosthesis for a fracture of the femoral neck is stable after surgery and is returned to the orthopedic unit. What is most important for the nurse to do when positioning this client? Maintain both legs in abduction. Keep both legs in functional body alignment. Avoid placing the client in the supine or prone position. Prevent adduction and external rotation of the affected extremity. A client who had a right total hip replacement is progressing from the use of a walker to the use of a cane. In which hand should the nurse teach the client to hold the cane? Left hand Right hand Stronger hand Dominant hand Which diagnostic study is used to determine a client’s bone density? Diskogram Standard X-ray Computed tomography scan Magnetic resonance imaging The nurse provides self-care instructions to a client who is receiving external radiation therapy for metastasis to the bone. Which intended activity identified by the client demonstrates a need for further teaching? Avoiding exposing the area to the sunWearing loose-fitting cotton clothing over the area Drying the area with a patting motion using a soft towel Rubbing on talcum powder after washing the area with water The nurse is providing home care to an older adult client with decreased bone density. Which nursing intervention will be mostbeneficial for the client? Teaching isometric exercises Encouraging the client to do weight-bearing exercises Instructing the client to sit in supportive chairs with arms Providing moist heat such as shower or moist compresses A client reports pain in the posterior part of the leg while walking that worsens upon rest. Which musculoskeletal abnormality is present in the client? Crepitus Ankylosis Contracture Achilles tendonitis A nurse cares for a client suspected of having atrial fibrillation. After reviewing the client’s medical history, the nurse suspects that the medication may have been administered at a fast rate. Which medication might have caused this condition? Citracal Raloxifene Alendronate Zoledronic acid What is the main reason a nurse raises three of the four side rails on the bed of an 83-year-old client who had surgery for a fractured hip? As a safety measure because of the client’s age Because clients older than 60 years of age should use side rails To be used as handholds to facilitate the client’s ability to move in bed Because all older adults are disoriented for several days after anesthesia A nurse records a 3 for a client during an assessment of muscle strength. According to the muscle strength scale, what does a score of 3 indicate in the client? Absence of muscular contraction Active movement against full resistance Barely detectable contraction with palpation Active movement against gravity only, and not against resistance A nurse is caring for a client with severe rheumatoid arthritis. What is most important in the nurse’s approach to help this client achieve self-reliance and independence? A series of limited objectivesA positive attitude toward the eventual outcome The understanding that little can be accomplished The recognition that a nursing home type of facility is needed A nurse develops a teaching plan for a client with rheumatoid arthritis. What should the nurse include in the plan about ways to reduce joint stress? "If experiencing pain after 1 to 2 hours of activity, actively take measures to address the pain." "When performing day-to-day tasks, use smaller muscles more frequently than large muscles." " Schedule all of the heavy tasks at one time, and then schedule a long rest period." "When the joints are swollen, an increase in exercise will help reduce swelling." A client has recently developed osteomyelitis. The client’s laboratory reports show strains of Escherichia coli. What might be a possible reason for this condition? Sickle cell disease Intravenous drug use Urinary tract infections Joint replacements A nurse plans care to prevent deformities in a client with rheumatoid arthritis. Which intervention should be alternated with periods of rest? Active exercises Passive massage Bracing of joints Isometric exercises The nurse is caring for a client who has sustained blunt trauma to the forearm. The nurse assesses the client for which early sign of compartment syndrome? Warm skin at the site of injury Escalating pain in the fingers Rapid capillary refill in affected hand Bounding radial pulse in the injured arm What should a nurse explains to a client is the best way to achieve stimulation of calcium deposition in the bone after a distal femoral fracture? Resting the extremity Weight-bearing activity Normal aging processes Ingesting foods high in calciumWhich point in the figure is the site of a subtrochanteric fracture? A B C D While assessing a client’s joint for mobility, the primary healthcare provider moved the client’s first and fifth metacarpals anteriorly from the flattened palm. Which type of synovial joint movement is this termed? Flexion Extension Abduction Opposition A spouse spends most of the day with a client who is receiving chemotherapy for inoperable bone cancer. The spouse asks the nurse, "What can I do to help?" How can the nurse best support the client’s spouse? Assist the couple to maintain open communication. Offer the couple a description of the disease process. Instruct the spouse about the action of the medications. Meet privately with the spouse to explore personal feelings. The nurse is teaching an elderly client isometric exercises. Which physiologic condition does the client have? KyphosisMuscle atrophy Decreased bone density Decreased range of motion (ROM) After a cervical neck injury, a client is placed in a halo fixation device with a body cast. Which statement indicates the client’s concern about body image has been resolved successfully? "I hate having everyone else do things for me." "I’ve gotten used to the brace. I may even miss it when it’s gone." "I’ve been keeping my daily calories low in an attempt to lose weight." "I can’t get to sleep. However, I make up for it in the morning by sleeping later." A nurse teaches an elderly client safety tip to prevent falls. Which physiologic change may have occurred in the client? Slowed movement Cartilage degeneration Decreased bone density Decreased range of motion (ROM) While grading a client’s muscle strength, the nurse records a score of 4. What does this indicate? No detection of muscular contraction A barely detectable flicker or trace of contraction Active movement against gravity and some resistance Active movement against gravity only, not against resistance The nurse is assessing a client with severe nodule-forming rheumatoid arthritis for possible Felty syndrome. Which assessment findings are consistent with Felty syndrome? Select all that apply. Itchy eyes Dry mouth Leukopenia Splenomegaly Photosensitivity While assessing a client’s musculoskeletal system, the nurse identifies genu valgum. Which joint might have been palpated by the nurse? Hip joint Knee joint Temporomandibular joint Metacarpophalangeal joint While assessing a client with a musculoskeletal disorder, the nurse gives the client a muscle strength rating of 2. What observation would correspond to this rating? Can complete range of motion (ROM) against gravityNo joint motion and slight evidence of muscle contractility Can complete ROM with gravity eliminated Can complete ROM against gravity with some resistance A client with severe chronic rheumatoid arthritis reports that pain lasts for 2 to 3 hours after exercising. What should the nurse should teach the client to do? Substitute isometric exercises for isotonic exercises. Stop the exercises for one day and then resume the exercises. Delay doing aerobic exercises until the pain subsides. Decrease the total time and number of repetitions of the exercise, A nurse is evaluating the actions of a caregiver for a client with a lower extremity cast. Which action of the caregiver indicates the nurse needs to follow up? Using a towel to dry the cast Moving joints above and below the cast regularly Elevating the injured part above heart level for 48 hours Wrapping the client’s cast with a plastic cover for 36 hours A client refuses to go to the twice-a-day prescribed sessions in physical therapy. How might the nurse best approach this problem? Having the client observe the progress of a more cooperative client with the same problem Being the client’s advocate and asking the primary healthcare provider whether therapy can be decreased to once daily Ensuring that pain medication is administered to the client before the scheduled physical therapy sessions Planning a conference with the client, the physical therapist, and the nurse present to discuss the client’s feelings Which type of joint is present in between the client’s tarsal bones? Pivot joint Hinge joint Saddle joint Gliding joint What is the role of unlicensed assistive personnel (UAP) in caring for a client with a cast or in traction? Select all that apply. Applying ice to the cast Positioning the casted extremity above heart level Marking the circumference of any drainage on the cast Looking for clinical manifestations of compartment syndromeTeaching range-of-motion exercises to the client and caregiver A client’s laboratory report shows altered serum calcium concentration. Which hormones are responsible for this condition? Select all that apply. Calcitonin Thyroxine Glucocorticoids Growth hormone Parathyroid hormone Which medications are useful to relieve pain associated with muscle spasms? Select all that apply. Cefazolin Carisoprodol Fondaparinux Methocarbamol Cyclobenzaprine After an above-the-knee amputation of a right leg, a client reports pain in the right foot. The nurse should inform the client that phantom limb pain is the result of what? Tactile illusions associated with severed blood vessels Nerve endings in the limb that are still intact and react to stimuli An unconscious phenomenon to aid with grieving over the lost body part Hallucinations secondary to emotional symptoms associated with the distress of amputation A nurse is caring for a client with a fracture of the femoral neck. Which clinical indicator should the nurse expect to identify when assessing this client? Adduction with internal rotation Abduction with external rotation Shortening of the affected extremity with external rotation Lengthening of the affected extremity with internal rotation A primary healthcare provider schedules a bone scan for a client with osteoporosis. Which nursing actions are beneficial for the client? Select all that apply. Placing the client in the supine position Verifying if the client has a shellfish allergy Ensuring that the client has no metal on the clothing Instructing the client to empty the bladder before the scan Informing the client that the postprocedure headache resolves in 2 days The nurse is preparing a care plan for a client who is to undergo an electromyography. Which nursing intervention should the nurse add to the care plan?Encourage the client to sleep quietly during the procedure Prepare the client to stay in a sitting position during the procedure Inform the client that the procedure is both painless and noninvasive Instruct the client to avoid drinking coffee or tea 24 hours before the procedure Upon palpation, the nurse identifies spongy swelling caused by synovial fluid. Which joint was most likely palpated? Biaxial joint Pivotal joint Synovial joint Temporomandibular joint A client reports mild tenderness and swelling near the ankle while running. Which nursing instruction would best benefit the client? "Do vigorous endurance exercises." "Complete your activity with a balancing exercise." "Perform strengthening exercises in between your activity." "Do warm-up muscle exercises before performing an activity." A client that has a diagnosis of bone cancer is being prepared for the first radiation treatment. As the nurse begins the treatment, the client starts crying, stating, "I’m so discouraged." What is the nurse’s best response? Tell the client, "It’s difficult to deal with your diagnosis and treatment." Complete the preparation and tell the client, "We can talk about this later." Explain the therapy and reinforce that it will only cause a little discomfort. Allow the client to be alone for a few minutes so the client can regain composure. A nurse provides discharge instructions to a client who had surgery for a left total hip replacement. Which should the nurse include when teaching the client about how to protect the affected hip when in the sitting position? "When sitting in a soft chair, the left leg should be elevated in a straight-out position." "When sitting in a firm armchair, the left foot should be flat on the floor’s surface." "Sit in a firm armchair with the left leg elevated on a high stool." "Sit in a soft chair with pillows tucked under the left hip." Which concentration of a client’s serum calcium level will stimulate the release of parathyroid hormone? 8.5 mg/dL (0.47 mmol/L) 9.0 mg/dL (0.5 mmol/L) 9.5 mg/dL (0.53 mmol/L) 10.0 mg/dL (0.56 mmol/L)The nursing student is teaching a client who has undergone hip replacement surgery. Which instructions from the nursing student indicate a need for correction? Select all that apply. Sit on chairs without arms. Use an elevated toilet seat. Cross legs at the knees or ankles. Use a pillow between legs for the first 6 weeks. Keep hips in a neutral, straight position when sitting. The nurse is caring for a client who may have Paget’s disease and osteomalacia. Which laboratory tests can be conducted to confirm the nurse’s suspicion? Select all that apply. Aldolase Serum calcium Alkaline phosphatase Lactic dehydrogenase Aspartate aminotransferase On the second day after surgery, a client reports pain in the right calf. What should the nurse do first? Apply a warm soak. Document the symptom. Elevate the leg above the heart. Notify the primary healthcare provider. The nurse is reviewing a plan of care for a client who has experienced a traumatic amputation of a leg. The nurse recognizes that which intervention listed on the plan is of lowest priority? Teaching residual limb care Monitoring hemoglobin levels Maintaining the compression dressing Using therapeutic interviewing techniques Which assessment finding supports the nurse’s conclusion that a prosthesis for a client with an above-the-knee amputation fits correctly? Skin that is cool to the touch Shrinking of the residual limb Absence of phantom limb pain Evenly darkened skin of the residual limb A nurse teaches a client about osteoporosis. Which client statement supports the nurse’s conclusion that the teaching is effective? "I know that certain illnesses can affect my body’s calcium level.""I think I can eat all the calcium I need rather than taking medication." "I will begin to actively monitor my risk for this disease after menopause." "I’m glad that drinking a little wine every day is advised to maintain calcium levels." A client experiences an acute episode of rheumatoid arthritis. The nurse observes that the client’s finger joints are swollen. The nurse concludes that this swelling most likely is related to which factor? Urate crystals in the synovial tissue Inflammation in the joint’s synovial lining Formation of bony spurs on the joint surfaces Deterioration and loss of articular cartilage joints A client has a long leg cast. What instructions should the nurse give the client in preparation for crutch walking? Use the trapeze to strengthen the biceps. Keep the affected limb in extension and abduction. Sit up straight in a chair to develop the back muscles. Perform exercises in bed to strengthen the upper extremities. A client with multiple injuries from a motor vehicle accident now is permitted out of bed to a chair but is not permitted to bear weight on the lower extremities. When using a mechanical lift to transfer the client, it is essential that the nurse do what? Fold the client’s arms across the chest. Place the sling so that the top is below the client’s scapulae. Call the primary healthcare provider to secure a prescription to use a mechanical lift. Raise the lift so that the sling is at least 12 inches (30.5 cm) above the mattress.