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60 Item Medical Surgical Nursing

60 Item Medical Surgical Nursing

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Published by mervilyn
Godbless. 10% work and 90% prayer. :)
Godbless. 10% work and 90% prayer. :)

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Published by: mervilyn on Aug 17, 2010
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01/28/2013

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60 Item Medical Surgical Nursing : Musculoskeletal Examination1. A client is 1 day postoperative after a total hip replacement. The client should be placedin which of the following position?
a. Supineb. Semi Fowler'sc. Orthopneicd. Trendelenburg
2. A client who has had a plaster of Paris cast applied to his forearm is receiving painmedication. To detect early manifestations of compartment syndrome, which of theseassessments should the nurse make?
a. Observe the color of the fingersb. Palpate the radial pulse under the castc. Check the cast for odor and drainaged. Evaluate the response to analgesics
3. After a computer tomography scan with intravenous contrast medium, a client returnsto the unit complaining of shortness of breath and itching. The nurse should be prepared totreat the client for:
a. An anaphylactic reaction to the dyeb. Inflammation from the extravasation of fluid during injection.c. Fluid overload from the volume of the infusionsd. A normal reaction to the stress of the diagnostic procedure.
4. While caring for a client with a newly applied plaster of Paris cast, the nurse makes noteof all the following conditions. Which assessment finding requires immedite notification of the physician?
a. Moderate pain, as reported by the clientb. Report, by client, the heat is being felt under the castc. Presence of slight edema of the toes of the casted footd. Onset of paralysis in the toes of the casted foot
5. Which of these nursing actions will best promote independence for the client in skeletaltraction?
a. Instruct the client to call for an analgesic before pain becomes severe.b. Provide an overhead trapeze for client usec. Encourage leg exercise within the limits of tractiond. Provide skin care to prevent skin breakdown.
6. A client presents in the emergency department after falling from a roof. A fracture of thefemoral neck is suspected. Which of these assessments best support this diagnosis.
a. The client reports pain in the affected legb. A large hematoma is visible in the affected extremity
 
c. The affected extremity is shortenend, adducted, and extremely rotatedd. The affected extremity is edematous.
7. The nurse is caring for a client with compound fracture of the tibia and fibula. Skeletaltraction is applied. Which of these priorities should the nurse include in the care plan?
a. Order a trapeze to increase the client's ambulationb. Maintain the client in a flat, supine position at all times.c. Provide pin care at least every hourd. Remove traction weights for 20 minutes every two hours.
8. To prevent foot drop in a client with Buck's traction, the nurse should
:a. Place pillows under the client's heels.b. Tuck the sheets into the foot of the bedc. Teach the client isometric exercisesd. Ensure proper body positioning.
9. Which nursing intervention is appropriate for a client with skeletal traction?
a. Pin careb. Prone positioningc. Intermittent weightsd. 5lb weight limit
10. In order for Buck's traction applied to the right leg to be effective, the client should beplaced in which position?
a. Supineb. Pronec. Sim'sd. Lithotomy
11. An elderly client has sustained intertrochanteric fracture of the hip and has justreturned from surgery where a nail plate was inserted for internal fixation. The client hasbeen instructed that she should not flex her hip. The best explanation of why thismovement would be harmful is:
a. It will be very painful for the clientb. The soft tissue around the site will be damagedc. Displacement can occur with flexiond. It will pull the hip out of alignment
12. When the client is lying supine, the nurse will prevent external rotation of the lowerextremity by using a:
a. Trochanter roll by the kneeb. Sandbag to the lateral calf c. Trochanter roll to the thighd. Footboard
 
13. A client has just returned from surgery after having his left leg amputated below the knee.Physician's orders include elevation of the foot of the bed for 24 hours. The nurse observes thatthe nursing assistant has placed a pillow under the client's amputated limb. The nursing action isto:a. Leave the pillow as his stump is elevatedb. Remove the pillow and elevate the foot of the bedc. Leave the pillow and elevate the foot of the bedd. Check with the physician and clarify the orders
14. A client has sustained a fracture of the femur and balanced skeletal traction with aThomas splint has been applied. To prevent pressure points from occurring around the topof the splint, the most important intervention is to:
a. Protect the skin with lotionb. Keep the client pulled up in bedc. Pad the top of the splint with washclothsd. Provide a footplate in the bed
15. The major rationale for the use of acetylsalicylic acid (aspirin) in the treatment of rheumatoid arthritis is to:
a. Reduce feverb. Reduce the inflammation of the jointsc. Assist the client's range of motion activities without paind. Prevent extension of the disease process
16. Following an amputation, the advantage to the client for an immediate prosthesis fittingis:
a. Ability to ambulate soonerb. Less change of phantom limb sensationc. Dressing changes are not necessaryd. Better fit of the prosthesis
17. One method of assessing for sign of circulatory impairment in a client with a fracturedfemur is to ask the client to:
a. Cough and deep breatheb. Turn himself in bedc. Perform biceps exercised. Wiggle his toes
18. The morning of the second postoperative day following hip surgery for a fracturedright hip, the nurse will ambulate the client. The first intervention is to:
a. Get the client up in a chair after dangling at the bedside.b. Use a walker for balance when getting the client out of bedc. Have the client put minimal weight on the affected side when getting upd. Practice getting the client out of bed by having her slightly flex her hips

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