Professional Documents
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Exam Musko
Exam Musko
Which of the following interventions will assist the patient with a bone
tumor to reduce the risk for pathologic fractures?
Incorrect
Rationale: During nursing care, the affected extremities will be
supported and handled gently. External supports (splints) may be
used for additional protection. Prescribed weight-bearing restrictions
must be followed. Assistive devices are used to strengthen the
unaffected extremities.
2. A patient on long-term corticosteroid therapy is diagnosed with
osteoporosis. The corticosteroids are discontinued, but the patient
remains concerned about her osteoporosis and long-term prognosis.
Which of the following statements is the nurses best response to the
patients concerns regarding the corticosteroid therapys effect on her
osteoporosis?
Incorrect
Rationale: When the corticosteroid therapy is discontinued, the
progression of osteoporosis is halted, but restoration of lost bone
mass usually done not occur.
3. Which of the following may be an effective approach to managing
tendonitis conservatively?
Weight reduction
Stress reduction
Incorrect
Rationale: Conservative management of tendonitis includes rest of
the extremity, intermittent ice and heat to the joint, and the use of
nonsteroidal anti-inflammatory drugs to control the inflammation and
pain.
4. An orthopedic nurse instructs a patient with plantar fasciitis that the
pain associated with this condition is best relieved by:
Incorrect
Rationale: Plantar fasciitis leads to pain that is localized to the
anterior medial aspect of the heel and diminishes with gentle
stretching of the foot and Achilles tendon.
5. While providing an educational class to a group of older adults at a
community senior center, the nurse informs the group that the
recommended adequate intake (RAI) level of calcium daily is:
1100 mg
1000 mg
1300 mg
1200 mg
Incorrect
Rationale: The RAI level of calcium for adults 51 years of age and
older is 1200 mg per day. The RAI level of calcium for ages 9 to 19
years of age is 1300 mg per day. The RAI level for adults 19 to 50
years of age is 1000 mg per day.
6. Twelve hours after a patient has foot surgery, the nurse assesses the
presence of edema in the foot. Which nursing measure will the nurse
implement to control the edema?
Administer a diuretic
Incorrect
Rationale: To control the edema in the foot of a patient after foot
surgery, the nurse elevates the foot on several pillows when the
patient is sitting or lying down. Ice packs should be applied to the
surgical area intermittently during the first 24 to 48 hours after
surgery to control edema and provide some pain relief. Diuretic
therapy is not an appropriate intervention for edema related to
Incorrect
Rationale: When corticosteroid therapy is discontinued, the
progression of osteoporosis is halted, but restoration of lost bone
mass does not occur. Osteoporosis is not a disease of the elderly
because its onset occurs earlier in life, when bone mass peaks and
then begins to decline. A persons level of physical activity is a
modifiable factor that influences peak bone mass. Lack of activity
Incorrect
Rationale: Patients who are at high risk of developing osteomyelitis
include those who are poorly nourished, elderly, and obese. The
elderly patient with an infected sacral pressure ulcer is at the
greatest risk for the development of osteomyelitis, as this patient has
two risk factors: age and the presence of a soft tissue infection that
has the potential to extend into the bone. The patient with
rheumatoid arthritis has one risk factor: the arthritis. The football
player 6 weeks post-surgery is beyond the window of time for the
development of a postoperative surgical wound infection. The infant
with jaundice has no identifiable risk factors.
9. While discussing pain management with a patient experiencing low
back pain, the nurse discusses modifiable risk factors. Which of the
following is a modifiable risk factor that may contribute to the
presence of low back pain?
Age
Obesity
Depression
Correct
Rationale: Obesity is a modifiable risk factor that may contribute to
back pain. Through proper nutritional intake, the patient will be able
to modify his weight and reduce his back pain.
10.
Lift objects while holding the object away from the body
Incorrect
Rationale: The nurse instructs the group on the safe and correct way
to lift objects using the strong quadriceps muscles of the thighs, with
minimal use of the weak back muscles. To prevent recurrence of
acute low-back pain, the nurse may instruct the group to avoid lifting
more than one-third of body weight without help. The group will be
informed to place the feet a hip width apart to provide a wide base of
support. The manual laborer should bend the knees, tighten the
abdominal muscles, and lift the object close to the body with a
smooth motion, avoiding twisting and jerking.
12.
the day. Based upon this information, the nurse anticipates that the
patient will be diagnosed with:
Impingement syndrome
Dupuytren's contracture
Ganglion
Incorrect
Rationale: The patient will most likely be diagnosed with carpel
tunnel syndrome. Patients who perform repetitive movements along
with hand exposure to cold, vibration, or extreme direct pressure are
at a greater risk of developing carpal tunnel syndrome. The patient
experiences pain, numbness, paresthesia, and possibly weakness
along the median nerve.
13.
Incorrect
Rationale: The nurse will assist the patient in selecting the meal
option that contains the highest dietary sources of calcium and
vitamin D. The best selection is eggs and cereal with milk, as these
foods contain calcium and vitamin D in a higher quantity than the
other menu options.
14.
Osteoporosis
Sepsis
Anemia
Paget's disease
Incorrect
Rationale: When the infection is bloodborne, the onset is usually
sudden, often occurring with the clinical and laboratory manifestation
of sepsis. Such clinical manifestations include chills, high fever, rapid
pulse, and general malaise.
15.
Incorrect
Rationale: The nurse teaches the patient strategies to promote
healing through aseptic dressing changes and proper wound care.
The patient is encouraged to perform range-of-motion exercises after
the infection subsides. The inflamed joint is supported and
immobilized in a functional position by a splint to increase the
patients comfort. Antibiotic therapy will be required until the
symptoms disappear.
1. The nurse instructs a patient with a clavicle fracture who is wearing a
sling for support of the arm to:
Incorrect
Compartment syndrome
Correct
Activity intolerance
Incorrect
Rationale: Frequent assessment of neurovascular function after a
fracture is essential and should focus on pain, paralysis,
paresthesias, pallor, and pulselessness. The priority nursing
diagnosis for compartment syndrome is risk for peripheral
neurovascular dysfunction.
Incorrect
Rationale: Keeping the patient active helps decrease the occurrence
of phantom pain. Early intensive rehabilitation and stump
desensitization with kneading massage brings relief. Hot compresses
should be avoided as the extreme heat can compromise the tissue
integrity of the area of healing. It is not necessary for the patient
experiencing phantom pain to assess a pulse in the affected
extremity, as the cause of the pain is unknown.
5. The orthopedic nurse is aware that a patient with a fracture of which
of the following bones is at risk for Volkmanns contracture?
Clavicle
Radial head
Femur
Humerus
Incorrect
Rationale: The most serious complication of a supracondylar fracture
of the humerus is Volkmanns ischemic contracture, which results
from antecubital swelling or damage to the brachial artery.
6. An athletic patient presents to the ambulatory care facility
complaining of pain in the right knee with weight bearing. He states
that two days ago he ran 10 miles and woke up the next morning
with knee pain. Upon examination, the nurse notes edema,
tenderness, muscle spasms and, ecchymosis. Based upon these
symptoms, the nurse anticipates the patient has experienced a:
Second-degree strain
First-degree strain
Second-degree sprain
First-degree sprain
Incorrect
Rationale: A second-degree strain involves tearing of muscle fibers
and is manifested by notable loss of load-bearing strength with
accompanying edema, tenderness, muscle spasm, and ecchymosis.
A first-degree strain involves tearing of few muscle fibers and is
accompanied by minor edema, tenderness, and mild muscle spasm,
without noticeable loss of function. A first-degree sprain is caused by
tearing of few ligamentous fibers and is manifested by mild edema,
local tenderness, and pain that is elicited when the joint is moved,
but there is no joint instability. A second-degree sprain involves
tearing of nerve fibers and results in increased edema, tenderness,
pain with motion, joint instability, and partial loss of normal joint
function.
7. A patient with a tibial fracture is placed in a short leg cast 4 weeks
after the removal of the leg walking cast. The nurse explains to the
patient that the short leg cast will allow for:
Knee motion
Ankle motion
Toe motion
Hip motion
Incorrect
Rationale: A short leg cast or brace is placed 3 to 4 weeks after the
fracture and allows for knee motion that is prevented by the long leg
walking cast.
8. A patient scheduled for a Symes amputation asks the nurse about
his ability to stand on the amputated extremity. The nurses best
response is:
Correct
Rationale: A Symes amputation (modified ankle disarticulation
amputation) is performed most frequently for extensive foot trauma
and produces a painless, durable extremity end that can withstand
full weight bearing.
9. While providing teaching, the nurse instructs the patient with a
simple fracture to:
Incorrect
The nurse caring for a patient with an open fracture of the radius
is developing a care plan for the patient. The nurse will assign
priority to which of the following nursing diagnoses?
Incorrect
Rationale: All of these nursing diagnoses may be pertinent to the
care of a patient with an open fracture of the radius, but the highest
priority diagnosis is risk for infection of osteomyelitis and tetanus.
arriving on the orthopedic floor and states that the patient has a
fracture of the nose that has resulted in a skin tear and involvement
of the mucous membranes of the nasal passages. The orthopedic
nurse is aware that this description likely indicates which type of
fracture?
Compression
Compound
Impacted
Transverse
Correct
Rationale: A compound fracture involves damage to the skin or
mucous membranes and is also called an open fracture. A
compression fracture involves compression of bone and is seen in
vertebral fractures. An impacted fracture occurs when a bone
The nurse caring for a patient who had a right extremity below the
Incorrect
Rationale: The nurse encourages the patient to turn from side to side
and to assume a prone position, if possible, to stretch the flexor
muscles and to prevent flexion contracture of the hip. Postoperative
ROM exercises include hip and knee exercises that are started early
The nurse preparing the patient who has sustained a sprain of the
left ankle for discharge from the emergency room to home correctly
instructs the patient to:
Incorrect
Rationale: Treatment of a sprain consists of resting and elevating the
affected part, applying cold, and using a compression bandage. After
the acute inflammatory stage (usually 24 to 48 hours after injury),
heat may be applied intermittently.
14.
The nurse is preparing a care plan for a patient who has sustained
a long bone fracture. Which intervention will the nurse include in the
care plan to enhance fracture healing?
Incorrect
Rationale: The nurse should monitor for sufficient blood supply by
assessing the color, temperature, and pulses of the affected
extremity, as adequate blood supply enhances the healing of a
fracture. Factors that inhibit fracture healing include inadequate or
lack of immobilization of the fracture fragments and administration of
corticosteroids. Weight-bearing exercises are encouraged for
patients with long bone fractures.
15.
Correct
Rationale: Deep vein thrombosis (DVT) is the most common
complication related to a hip fracture. To prevent DVT, the nurse
encourages intake of fluids and ankle and foot exercises. While
respiratory complications commonly include atelectasis and
pneumonia, the use of deep-breathing exercises, changes in position
at least every 2 hours, and the use of incentive spirometry helps
prevent them. Constipation may also occur after a hip fracture but is
not the most common complication.