MUSCULOSKELETAL DISORDERS

POST TEST
Dra. Ameera Sarah Baylon, RM, RN, MAN

1. In healthcare, when lead apron is required in any procedure like orthopedic surgery, there is
danger of exposure to:
a. Radiation
b. Bone fragments
c. Water and blood splashes
d. Instrumentation

2. A nurse is caring for a child who has just received a cast. Which of the following
considerations is important in providing care for this child?
a. Assess the casted extremity every 15-30 minutes the first two hours after cast
application.
b. Handle the cast with all extremities
c. The child is placed on NPO after casting
d. All of the above

Situation 1 – A preschool child sustained fracture of the right femur when the bicycle he was
riding hit a sharp pavement. The physician ordered 90 – 90 degree skeletal traction.

3. The mother asks the nurse what the procedure is all about. The nurse addresses the question
correctly when she states that in a 90 – 90 degree traction a/the:
a. Proximal tibia is pulled is opposition direction at 90 degrees
b. Pin is inserted at 90-degree through the distal femur and proximal tibia and traction is
applied
c. Displaced fractured femur is pulled in the opposite direction
d. 90-degree flexion of both hip and knee; lower extremity in a boot cast. Weights are
suspended by a pin through the lower portion of the thighbone.

4. A major nursing consideration to be observed when caring for the above child is all of the
following except:
a. Avoid skin breakdown around the hips and sacrum
b. Maintain proper body alignment and positioning
c. Report immediately any signs of neurovascular problems
d. Avoid any movement of bed or leg or traction set up

5. These are things to consider in caring for this child, but one:
a. Make sure the weights do not hang freely and do not touch the floor.
b. Apply an antibiotic ointment around the pin, if ordered.
c. After traction equipment is removed, provide skin care every four hours.
d. Clean the pins with normal saline, when ordered.
6. Frank, 40 year old, sustained multiple fracture of both legs. Part of the management is bed
rest with skeletal traction. Which of the following nursing intervention would be MOST
effective in preventing footdrop:
a. Trochanter roll
b. Ben cradle
c. Foot board
d. Pillow placed at the foot part

7. Benny, 40 years old, is set in a long leg cast. The nurse must assess the leg for signs of
compromised circulation such as:
a. Swelling of the toes
b. Change of color of the toes
c. warm sensation of the toes
d. drainage from the cast

8. Which of the following finding would alert the nurse to notify the physician of a serios
complication of Benny’s cast on his leg?
a. Continuous irritation and itching under the cast
b. Pinking up of the nail beds more than 3 seconds after compression
c. Pain not relieved by cold application and pain medications
d. Movement of toes showing neurologic compromise

9. A 30 year old client had a cast applied in his left arm the day before. He is complaining of
numbness of his fingers. Which of the following must the nurse do first?
a. Notify the physician
b. Assess the circulation of the fingers
c. Cut the edges of the cast to loosen
d. Position the casted arm correctly

10. Which of the following is a skeletal traction?

a. Bryant traction
b. Buck traction
c. Balanced suspension traction
d. Russel’s traction

SITUATION 2 – Juanito, 6 years old, was brought to the OPD Pediatric clinic by his mother
because she observed him to be weak with swollen painful joints in his feet. After a series of
diagnostic tests, Juanito was diagnosed as having Juvenile Idiopathic Arthritis.

11. As Juanito’s nurse, you explained to his mother that the possible cause of the medical
problem of her son is .
a. not known
b. related to a previous injury
c. viral in nature
 d. genetic

12. History findings in children with JIA include:

a. History of school absences or limited ability to participate in PE
b. Evanescent rash on trunk and extremities
c. Joint pains for 6 weeks or more
d. All of the above

13. A nurse reviewing a plan of care for a child with juvenile idiopathic arthritis (JIA). The
nurse determines which of the following is a priority diagnosis?
a. Acute pain
b. Risk for injury
c. Disturbed body image
d. Bathing/hygiene self-care deficit

14. The pediatric nurse educator provides a teaching session to the nursing staff regarding
juvenile idiopathic arthritis (JIA). Which action by a nursing staff member in the care of a
child with JIA indicates a need for further education?
a. Assesses for joint stiffness in the child
b. Encourages performance of isometric exercises
c. Administers nonsteroidal anti-inflammatory medication
d. Emphasizes the importance of rising quickly in the mornings

15. The ultimate goals in managing rheumatoid arthritis are the following, except:
a. To prevent or control joint damage
b. To prevent loss of function
c. To decrease pain
d. None of the above

16. Mr. M was diagnosed with gouty arthritis. As his nurse, you know that this type of
arthritis affects what kind of joint?
a. Monoarticular
b. Polyarticular
c. Mononuclear
d. Polynuclear

17. You read colchicine as the doctor’s prescription for Mr. M. You know that colchicine acts
to:
a. Relieve joint inflammation
b. Aids in excretion of uric acid in the urine
c. Inhibits the enzyme responsible for producing uric acid
d. All of the above
18. Mr. M asked you if he would be given a uricosuric drug. Which of the following
would it be?
a. Colchicine
b. Probenecid
c. Allopurinol
d. NSAID

19. Which of the following must be tested prior to giving and monitored when a
uricosuric drug is prescribed?
a. Liver Enzymes
b. Renal Function
c. Cardiac Function
d. Fluids and Electrolytes

20. Knowing Mr. M’s condition, which of the following foods must he avoid?
a. Fruits and Vegetables
b. Chicken meat
c. Chicken Liver
d. Swiss Cheese

Situation 3: The use of assistive devices is important for clients with musculoskeletal disorders.
The nurse must therefore be knowledgeable about the principles involved herewith.

21. Nurse Philip was asked to teach the client who has a right sided weakness the use of a cane.
Which observation will indicate that the client is using the cane correctly?
a. Client keeps the cane on the right side along the weak leg
b. He advances the cane followed by the left leg
c. Clients lean to the left side, which is the stronger
d. The cane on one foot or both feet are on the floor at all times

22. When caring for a patient in restraints, on what area of the bed should the restraints be
anchored?
a. The side rails
b. The mattress hook
c. The footboard
d. The bed frame

23. Which of the following ways of ambulation using walker is correct?

a. Move the walker and the weaker leg forward at the same time
b. Move the walker forward, then the weaker leg, then last, the stronger leg
c. Move the walker forward, followed by a stronger leg and then the bad leg
d. Either B or C may do depending upon the scenario
24. The patient is ambulating with crutches utilizing a three-point gait. The nurse will not
correct patient’s method of ambulation it:
a. He advances both crutches and the weaker leg first together
b. He moves the left crutch and the right leg forward 4 to 6 inches
c. He advances the left crutch forward followed by the right leg
d. He walks downstairs moving down his weaker leg before the crutches.

25. A client is to be discharged from the hospital after amputation of his right leg. In teaching
the client with the use of the crutches, the patient would most likely use whish of the following
gait?
a. Four-point gait
b. Swinging-gait
c. Three-point gait
d. Two-point gait

26. A client is in skeletal traction. The nurse understands that this procedure involves pulling
force:
a. Using more than one force to support the injures extremity
b. Directly through pins inserted into the bone
c. Directly through the client’s skin
d. Physically on the extremity affected

27. While doing your assessment, Geo asks you “Do I have a fracture? I don’t want to have a
cast.” The most appropriate nursing response would be:
a. “You have to have an x-ray first to know if you have a fracture.”
b. “You seem to be concerned about being in a cast.”
c. “Why do you sound so scared? It is just a cast and it’s not painful.”
d. “Based on my assessment, it doesn’t seem that there is.”

Situation 4: Ms. Wah., 44 years old, has been complaining of severe back pain that has been
treated conservatively for the past year. She is admitted to the hospital for treatment of a
herniated disk.

28. The most common manifestation of herniation of a lumbar disc is:

a. loss of control in elimination
b. pain radiating to the hip and leg
c. paralysis of both lower extremities
d. overgrowth of tissue in the lower back

29. A nurse is caring for a client with a herniated lumbar intervertebral disc. The nurse plans to
place the client in which position to minimize the pain?
a. High-Fowler’s position with the foot of the bed flat
b. Semi-Fowler’s position with the knee gatch slightly raised
c. Semi-Fowler’s position with the foot of the bed flat
 d. Flat with the knees raised

30. A laminectomy with spinal fusion is scheduled. When Ms. Wah. returns to the unit after
surgery, she is afraid to turn. Of the following maneuvers she plans to use to avoid pain, which is
unsafe?
a. Asking for pain medication.
b. Log rolling.
c. Sitting up in bed.
d. Placing pillows between her legs.

31. A client with a 4-day old lumbar vertebral fracture experiencing muscle spasms. The nurse
avoids using which of the following in an effort to relieve the spasm.
a. analgesics
b. cold
c. heat
d. prescribed intermittent traction

Situation 7: Lolo Arturo complains of joint pains due to osteoarthritis.

32. Which of the following conditions or actions can cause primary osteoarthritis?
a. Overuse of joints, aging, obesity
b. Obesity, diabetes mellitus, aging
c. Congenital abnormality, aging, overuse of joints
d. Diabetes mellitus, congenital abnormality, aging

33. Bouchard’s nodes are a common sign of osteoarthritis. Which of the following
statements is correct about this deformity?
a. It appears only in men
b. It appears on the distal interphalangeal joint
c. It appears on the proximal interphalangeal joint
d. It appears on the dorsolateral aspect of the interphalangeal joint

34. For a client with severe painful osteoarthritis, a regimen of heat, massage and
exercise will:
a. Help relax muscles, pain and stiffness
b. Restore range of motion probably lost
c. Prevent the inflammatory process
d. Help keep the client’s mind of the pain

35. Clients in the late stages of osteoarthritis often use which of the following terms to
describe joint pain?
a. Grating
b. Dull ache
c. Deep aching pain
d. Deep aching, relieved with rest
36. The risk of osteoporosis is increased when a client:
a. Receives long-term steroid therapy
b. Has a history of hypoparathyroidism
c. Engages in strenuous physical activity
d. Consumes excessive amounts of estrogen

37. Primary prevention of osteoporosis includes which of the following measures?

a. Place items within reach of the client
b. Install bars in the bathroom to prevent falls
c. Maintain the optimal calcium intake
d. Use a professional alert system in the home in case a fall occurs when the client is alone

38. When counseling women about exercise to prevent osteoporosis, the nurse knows the best
exercise is:
a. Isometric exercises of all major muscle groups
b. Leg raises with the knees bent
c. Swimming
d. Walking

39. A client with osteoporosis is vulnerable to:

a. Fatigue fractures
b. Pathologic fractures
c. Greenstick fractures
d. Compound fractures

40. When helping an 82-year-old woman with advanced osteoporosis to complete morning care,
the nurse should:
a. Avoid bright lights and loud noises
b. Be gentle when moving her
c. Keep the head of her bed elevated 30 degrees
d. Restrict fluids to 1500 ml per day

41. An assessment finding for a 55-year-old client that alerts the nurse to the presence of
osteoporosis is
a. the presence of bowed legs.
b. a measurable loss of height.
c. the aversion to dairy products.
d. a statement about frequent falls.

42. Which of the following instructions would be included when teaching a client how to
protect his back?
a. “Carry objects at arm’s length.”
 b. “Carry objects at forearm’s length.”
c. “Carry objects close to your body.”
d. “Carry objects away from your body.”

43. The chief concern of the nurse during the first few hours of applying a hip spica cast is:
a. Prevention of neurovascular complications
b. Prevention of loss of muscle tone
c. Immobilization of the affected limb
d. Using heated fans to dry the cast

44. A client with hip spica cast should avoid gas-forming foods. Which of the following
rationales best explains why?
a. To prevent flatus
b. To prevent diarrhea
c. To prevent constipation
d. To prevent abdominal distention

45. Synthetic casts take approximately how long to dry completely?

a. Immediately
b. 20 minutes
c. 45 minutes
d. 2 hours

46. As the cast is drying, a client complains of heat from the cast. Which of the following
interventions is the most appropriate?
a. Remove the cast immediately.
b. Explain this is a normal sensation.
c. Notify the physician.
d. Assess the client for other signs of infection.

47. A nurse is assessing the casted extremity of a client for signs of infection. Which of the
following findings is indicative of infection?
a. Coolness and pallor of the skin
b. Presence of a “hot spot” on the cast
c. Diminished distal pulse
d. Dependent edema

48. Which of the following client statements identifies a knowledge deficit about cast care?
a. “I’ll elevate the cast above my heart initially.”
b. “I’ll exercise my joints above and below the cast.”
c. “I can pull out cast padding to scratch inside the cast.”
d. “I’ll apply ice for 10 minutes to control edema for the first 24 hours.”
49. A client has long leg cast applied. Which nursing actions should be taken while the cast is
still wet?
a. Use only fingertips when moving the cast
b. Keep the client and cast covered with blankets
c. Support the cast on plastic covered pillows
d. Place a heat lamp directly over the cast

50. Ms. Rhea states, “I can’t do my household chores without becoming tired. My knees hurt
whenever I walk. Which nursing diagnosis would be most appropriate?
a. Activity intolerance related to fatigue and pain
b. Self-care deficit related to increasing joint pain
c. Ineffective coping related to chronic pain
d. Disturbed body image related to fatigue and joint pain

51. The nurse expects a person with rheumatoid arthritis to have the most difficulty with pain
and stiffness after:
a. ADL
b. Heat applications
c. Meals
d. Waking up

52. The nurse is admitting the client with rheumatoid arthritis. Which of the following
laboratory results would the nurse evaluate as being elevated and used to monitor the disease
activity?
a. Serum uric acid
b. Erythrocyte sedimentation rate
c. Bence jones protein
d. WBC count

53. Which of the following statements explains the main difference between rheumatoid
arthritis and osteoarthritis?
a. Osteoarthritis is gender-specific, rheumatoid arthritis isn’t
b. Osteoarthritis is a localized disease, rheumatoid arthritis is systemic
c. Osteoarthritis is a systemic disease, rheumatoid arthritis is localized
d. Osteoarthritis has dislocation and subluxations, rheumatoid arthritis doesn’t

54. Which of the following goals of medication prescribed for rheumatoid arthritis is
correct?
a. to cure the disease
b. to prevent osteoporosis
c. to control inflammation
d. to encourage bone regeneration
55. The nursing care plan for a client post operative right leg amputation should include which
measures to decrease edema?
a. Apply ice packs to the stump for 72 hours
b. Elevate the stump by raising the foot of the bed for the first 24 hours
c. Wrap the stump with Ace bandages from proximal to distal
d. Administer anti-inflammatory medications as ordered

56. The client has diabetic retinopathy that requires amputation of his right leg below the knee.
In the immediate postoperative period, a priority nursing action would be to:
a. Check for bleeding from the incision
b. Keep the stump adducted from the hip
c. Notify the prosthetist to prepare the artificial limb
d. Have the physical therapist begin partial weight-bearing

57. To prevent a hip flexion contracture following an amputation of a lower limb the nurse
should teach the client to:
a. Sit in a chair for 30 minutes tid
b. Lie on the abdomen 30 minutes qid
c. Turn from side to side every 2 hours
d. Perform quadriceps muscle setting exercises bid

58. To control edema of the residual limb a week after a client has had an above-the- knee
amputation, the nurse should:
a. Administer the prescribed diuretic
b. Restrict the client’s oral fluid intake
c. Rewrap the elastic bandage as necessary
d. Keep the residual limb elevated on a pillow

59. After an above the knee amputation of the right leg a client reports pain in the right
foot. A nurse should inform the client that phantom limb pain is the result of
A. tactile illusions associated with severed blood vessels.
B. an unconscious phenomenon to aid with grieving over the lost body part.
C. hallucinations secondary to emotional symptoms associated with the distress of
amputation.
D. nerve endings in the limb are still intact and react to stimuli.

60. Which of the following statements explain an open reduction of a fractured femur?
a. Traction will be used
b. A cast will be applied
c. Crutches will be used after surgery
d. Some form of screw, plate, nail, or wire is usually used to maintain alignment.
61. A nurse is caring for the client who develops compartment syndrome from a severely
fractured arm. The client asks the nurse how this can happen. The nurse’s response is based on
the understanding that:
a. An injured artery causes impaired arterial perfusion through the compartment
b. The fascia expands with injury, causing pressure on underlying nerves and muscles
c. A bone fragment has injured the nerve supply in the area
d. Bleeding and swelling cause increased pressure in an area that cannot expand

62. Treatment of compartment syndrome includes which of the following measures?

a. Amputation
b. Casting
c. Fasciotomy
d. Observation, no treatment is necessary

63. After treatment of compartment syndrome, a client reports experiencing paresthesia. Which
of the following symptoms would be seen with paresthesia?
a. Fever and chills
b. Change in range of motion
c. Pain and blanching
d. Numbness and tingling

64. Following total hip replacement, immediately postoperatively you will formulate a goal to
include:
a. Head of bed elevated to 45-degrees
b. Operative leg maintained in abducted position
c. Buck’s traction until hip can be put through range of motion
d. Turn on operatively side only immediately postoperatively

65. After surgery and insertion of a total joint prosthesis, a client develops severe sudden pain
and an inability to move the extremity. The nurse correctly interprets these findings as indicating
which of the following?
a. A developing infection
b. Bleeding in the operative site
c. Joint dislocation
d. Glue seepage into soft tissue

66. The nurse advises the client who has had a femoral head prosthesis placement on the type of
chair to sit in during the first 6 to 8 weeks after surgery. Which would be the correct type to
recommend?
a. A desk-type swivel chair
b. A padded upholstered chair
c. A high-backed chair with armrests
d. A recliner with an attached footrest
67. Which of the following discharge instructions should be given to a client after surgery of a
hip fracture?
a. “Don’t flex the hip more than 30 degrees. Don’t cross your legs, get help when putting
on shoes.”
b. “Don’t flex the hip more than 60 degrees. Don’t cross your legs, get help putting on
your shoes.”
c. “Don’t flex the hip more than 90 degrees. Don’t cross your legs, get help putting on
your shoes.”
d. “Don’t flex the hip more than 120 degrees. Don’t cross your legs, get help putting on
your shoes.”

68. Inability to dorsiflex the foot means a dysfunction of what nerve?

a. Sciatic nerve
b. Superficial Peroneal nerve
c. Tibial nerve
d. Deep Peroneal nerve

69. A young woman consulted in the OPD due to pain radiating from her wrist to the thumb till
her middle finger. This happens intermittently over 3 months before her consultation. A
diagnosis of Carpal Tunnel Syndrome was made. Which of the following is a risk factor for her
condition?
a. She works as a teacher in an elementary school
b. She is an architect who accepted drafting the blueprints of many different projects
c. She is a slim ballerina
d. She is a policewoman who works during the day but often extends for an over time

70. Carpal Tunnel Syndrome can be associated with:

a. Arthritis
b. Diabetes mellitus
c. Tumors
d. All of these

71. What structure is cut during the curative surgery for CTS?
a. Transverse Carpal Ligament
b. Transverse Carpal Tendon
c. Flexor Tendon Sheath
d. Palmar band

72. Full recovery of motor and sensory function after open nerve release may take:
a. Several days to weeks
b. Several weeks to months
c. Several months to years
d. Immediately after the surgery
73. MR consulted due to a flexion deformity of his ring finger. He describes this as having a
sensation of locking or catching the finger when it is bent, and then there is pain. It is also
difficult to place it back to the extended position. This is most likely:
a. Rheumatoid Arthritis
b. Stenosing Tenosynovitis
c. Gouty Arthritis
d. Dupuyten’s contracture

74. In such case as above, MR was managed conservatively with rest, splinting, and oral pain
medications, however the condition seems to have no improvement. You would expect that the
next management for his condition is:
a. Finger exercises
b. Steroid Injection
c. Surgery
d. All of these

75. A 26-year-old woman has been diagnosed with early systemic lupus erythematosus (SLE)
involving her joints. In teaching the patient about the disease, the nurse includes the information
that SLE is a(n):
A. Hereditary disorder of women but usually does not show clinical symptoms
unless a woman becomes pregnant.
B. Autoimmune disease of women in which antibodies are formed that destroy all
nucleated cells in the body.
C. Disorder of immune function, but it is extremely variable in its course, and there is no
way to predict its progression.
D. Disease that causes production of antibodies that bind with cellular estrogen
receptors, causing an inflammatory response.

76. A patient with an acute exacerbation of systemic lupus erythematosus (SLE) is hospitalized
with incapacitating fatigue, acute hand and wrist pain, and proteinuria. The health care provider
prescribes prednisone (Deltasone) 40 mg twice daily. Which nursing action should be included
in the plan of care?
A. Institute seizure precautions.
B. Reorient to time and place PRN.
C. Monitor intake and output.
D. Place on cardiac monitor.

77. A patient with systemic lupus erythematosus (SLE) who has a facial rash and alopecia
tells the nurse, "I hate the way I look! I never go anyplace except here to the health clinic."
An appropriate nursing diagnosis for the patient is:
A. Activity intolerance related to fatigue and inactivity.
B. Impaired skin integrity related to itching and skin sloughing.
C. Social isolation related to embarrassment about the effects of SLE.
D. Impaired social interaction related to lack of social skills.
78. Following instruction for a patient with newly diagnosed systemic lupus erythematosus
(SLE), the nurse determines that teaching about the disease has been effective when the
patient says:
A. "I should expect to have a low fever all the time with this disease."
B. "I need to restrict my exposure to sunlight to prevent an acute onset of
symptoms."
C. "I should try to ignore my symptoms as much as possible and have a positive
outlook."
D. "I can expect a temporary improvement in my symptoms if I become
pregnant."

79. The nurse is assigned to care for a client with systemic lupus erythematosus (SLE). The
nurse plans care knowing that this disorder is:
A. A local rash that occurs as a result of allergy
B. A disease caused by overexposure to sunlight
C. An inflammatory disease of collagen contained in connective tissue
D. A disease caused by the continuous release of histamine in the body

80. Which client is at the highest risk for systemic lupus erythematous (SLE)?
A. An Asian male
B. A white female
C. An African-American male
D. An African-American female

81. The relationship of the femoral head to the pelvis is under:

a. Ball and socket joint
b. Hinge joint
c. Saddle joint
d. Pivot joint

82. When teaching seniors at the RHU, which information will the nurse include about ways
to prevent fractures?
a. Tack down scatter rugs in the home.
b. Most falls happen outside the home.
c. Buy shoes that provide good support and are comfortable to wear.
d. Range-of-motion exercises should be taught by a physical therapist.

83. A construction worker has repetitive strain syndrome in the right elbow. The nurse will
plan to teach the patient about:
a. surgical options.
b. elbow injections.
c. wearing a left wrist splint.
d. modifying arm movements.
84. The occupational health nurse will teach the patient whose job involves many hours of
typing about the need to
a. obtain a keyboard pad to support the wrist.
b. do stretching exercises before starting work.
c. wrap the wrists with compression bandages every morning.
d. avoid using nonsteroidal antiinflammatory drugs (NSAIDs) for pain.

85. Which discharge instruction will the emergency department nurse include for a patient
with a sprained ankle?
a. Keep the ankle loosely wrapped with gauze.
b. Apply a heating pad to reduce muscle spasms.
c. Use pillows to elevate the ankle above the heart.
d. Gently move the ankle through the range of motion.

86. Manny Pacquiao had an arthroscopic repair of a rotator cuff injury performed in same-day
surgery. When the nurse plans postoperative teaching for the patient, which information will
be included?
a. "You will not be able to box again."
b. "You will work with a physical therapist tomorrow."
c. "The doctor will use the drop-arm test to determine the success of surgery."
d. "Leave the shoulder immobilizer on for the first 4 days to minimize pain."

87. The nurse will instruct the patient with a fractured left radius that the cast will need to
remain in place
a. for several months.
b. for at least 3 weeks.
c. until swelling of the wrist has resolved.
d. until x-rays show complete bony union

88. Which nursing intervention will be included in the plan of care after a patient with a right
femur fracture has a hip spica cast applied?
 a. Avoid placing the patient in prone position.
b. Ask the patient about abdominal discomfort.
c. Discuss remaining on bed rest for several weeks.
d. Use the cast support bar to reposition the patient.

89. A patient with a right lower leg fracture will be discharged home with an external
fixation device in place. Which information will the nurse teach?
a. "You will need to check and clean the pin insertion sites daily."
b. "The external fixator can be removed for your bath or shower."
c. "You will need to remain on bed rest until bone healing is complete."
d. "Prophylactic antibiotics are used until the external fixator is removed."

90. A patient who has had an open reduction and internal fixation (ORIF) of a hip fracture
tells the nurse that he is ready to get out of bed for the first time. Which action should the
nurse take?
a. Use a mechanical lift to transfer the patient from the bed to the chair.
b. Check the postoperative orders for the patient's weight-bearing status.
c. Avoid administration of pain medications before getting the patient up.
d. Delegate the transfer of the patient to nursing attendant

91. After the health care provider has recommended amputation for a patient who has
nonhealing ischemic foot ulcers, the patient tells the nurse that he would rather die than have an
amputation. 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."

92. The day after a having a right below-the-knee amputation, a patient complains of pain in
the right foot. Which action is best for the nurse to take?
a. Explain the reasons for the phantom limb pain.
b. Administer prescribed analgesics to relieve the pain.
c. Loosen the compression bandage to decrease incisional pressure.
d. Inform the patient that this phantom pain will diminish over time.

93. Which statement by a 62-year-old patient who has had an above-the-knee

amputation indicates that the nurse's discharge teaching has been effective?
a. "I should elevate my residual limb on a pillow 2 or 3 times a day."
b. "I should lay flat on my abdomen for 30 minutes 3 or 4 times a day."
c. "I should change the limb sock when it becomes soiled or each week."
d. "I should use lotion on the stump to prevent skin drying and cracking."
94. Which action will the nurse include in the plan of care for a patient who has had a total
right knee arthroplasty?
a. Avoid extension of the right knee beyond 120 degrees.
b. Use a compression bandage to keep the right knee flexed.
c. Teach about the need to avoid weight bearing for 4 weeks.
d. Start progressive knee exercises to obtain 90-degree flexion.

95. A high school teacher with ulnar drift caused by rheumatoid arthritis (RA) is scheduled for
a left hand arthroplasty. Which patient statement to the nurse indicates a realistic expectation
for the surgery?
a. "This procedure will correct the deformities in my fingers."
b. "I will not have to do as many hand exercises after the surgery."
c. "I will be able to use my fingers with more flexibility to grasp things."
d. "My fingers will appear more normal in size and shape after this surgery."

96. The parents of a preschooler diagnosed with muscular dystrophy are asking questions
about the course of their child's disease. Which should the nurse tell them?
a. "Muscular dystrophies usually result in progressive weakness."
b. "The weakness that your child is having will probably not increase."
c. "Your child will be able to function normally and not need any special
accommodations."
d. "The extent of weakness depends on doing daily physical therapy."

97. The mother of a child with Duchenne muscular dystrophy asks the nurse who in the family
should have genetic screening. Who should the nurse say must be tested?
a. Mother of the child
b. Father of the child
c. Sister of the child
d. Brother of the child

98. The nurse knows that teaching was successful when a parent states which of the
following are early signs of muscular dystrophy?
a. Increased muscle strength.
b. Difficulty climbing stairs.
c. High fevers and tiredness.
d. Respiratory infections and obesity

99. Which foods would be best for a child with Duchenne muscular dystrophy?
a. High-carbohydrate, high-protein foods.
b. No special food combinations.
c. Extra protein to help strengthen muscles.
d. Thickened liquids and smaller portions that are cut up.
100. Which will NOT help a school-age child with muscular dystrophy stay active
longer?
a. Normal activities, such as swimming.
b. Using a treadmill every day.
c. Several periods of rest every day.
d. Using a wheelchair upon getting tired

-END OF EXAM-