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6. The nurse is teaching the client with right leg fracture regarding the
physicians order for partial weight bearing status. The client understands
the health teaching if he verbalizes:
a. Let the client raise his forearm and monitor for flexion of the biceps
b. Ask the client move his thumb toward the palm and back to the
neutral position
c. have the client grasp the nurses hand while noting the clients
strength of the first and second fingers.
d. Have the client spread all the fingers wide and resist pressure.
8. A client has suffered from fall and sustained a leg injury. Which
appropriate question would the nurse ask the client to help determine if
the injury caused fracture?
a. Edema
b. Weak distal pulse
c. Coolness of the skin
d. Presence of hot spot on the cast
11. The nurse would include which nursing intervention in the care plan
for a client with an L5-S1 intervertebral disc herniation?
effects."
d. "Take the medication on an empty stomach to increase absorption."
a. 25 gtt/min
b. 30 gtt/min
c. 35 gtt/min
d. 45 gtt/min
17. The physician orders non-weight bearing with crutches for Joy, who
had surgery for a fractured hip. The most important activity to facilitate
walking with crutches before ambulation begun is:
19. The nurse includes the important measures for stump care in the
teaching plan for a client with an amputation. Which measure would be
excluded from the teaching plan?
20. A 70-year-old female comes to the clinic for a routine checkup. She
is 5 feet 4 inches tall and weighs 180 pounds. Her major complaint is
pain in her joints. She is retired and has had to give up her volunteer
work because of her discomfort. She was told her diagnosis was
osteoarthritis about 5 years ago. Which would be excluded from the
clinical pathway for this client?
21. The nurse is caring for a post-surgical client at risk for developing
deep vein thrombosis. Which intervention is an effective preventive
measure?
22. The nurse is caring for a 13 year-old following spinal fusion for
scoliosis. Which of the following interventions is appropriate in the
immediate post-operative period?
23. The nurse is caring for a client with a long leg cast. During
discharge teaching about appropriate exercises for the affected extremity,
the nurse should recommend
a. Isometric
b. Range of motion
c. Aerobic
d. Isotonic
a. Before log rolling, place a pillow under the clients head and a pillow
between the clients legs.
b. Before log rolling, remove the pillow from under the clients head and
use no pillows between the clients legs.
c. Keep the knees slightly flexed while the client is lying in a semi-
Fowlers position in bed.
d. Keep a pillow under the clients head as needed for comfort.
a. 19.0 to 26' C
b. 26.6 to 33.3' C
c. 34.5 to 36' C
d. 36.6 to 40.5' C
28. A patient with complaints of pelvic and long bones pain was ordered
to undergo an x-ray. Findings showed " punche-out" appearance of bone
with increase bone thickness. These manifestations are indicative of which
bone disease?
a. Rhuematoid arthritis
b. Paget's disease
c. Gouty arthritis
d. Osteoarthritis
a. Alendronate (Fosamax)
b. Pamidronate (Aredia)
c. Calcium supplements
d. Human calcitonin ( Cibacalcin
a. Osteomalacia
b. Osteitis deformans
c. Hyperurecemia
d. Degenerative joint disease
a. Alendronate (Fosamax)
b. Pamidronate (Aredia)
c. Calcium supplements
d. Human calcitonin ( Cibacalcin)
33. While doing your assessment, Lucky asks you "Do I have fracture? I
don't want to have cast". The most appropriate nursing response would
be:
a. "Why do you sound so scared? It is just a cast and it's not painful".
b. "You have to have an x-ray first to know if you have a fracture".
c. "Based on my assessment, there doesn't seem to be a fracture".
d. "You seem to be concerned about being in a cast".
34. Troy is a day one post open reduction and internal fixation(ORIF) of
the left hip and is in pain. Which of the following observation would
prompt you to call the doctor?
36. A drug that has been used for the prevention and treatment of acute
gout attacks is:
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a. Hydrocotisone
b. Aspirin
c. Colchicine
d. Probenecid
37. Luzida, 43 years old, has recently been diagnosed with rheumatoid
arthritis. The diet that the nurse should provide the client will have to
be:
38. After total hip replacement surgery, the nurse should avoid placing
the client in the:
a. Orthopneic position
b. Supine position
c. Lateral position
d. Standing position
a. Inherited condition
b. Advance age
c. Trauma
d. Obesity
40. Lerry tells the nurse that her mother has osteoporosis. She aks what
is th difference of her diagnosis to her mother's diagnosis. The nurse
explains to the patient that rheumatoid arthritis is a disease of the:
a. Bones
b. Joints
c. Connective tissues
d. Muscles
41. Which client goal would be most appropriate for a client diagnosed
with Osteoarthritis?
42. The occupational health nurse is teaching a class on the risk factors
for developing osteoarthritis. Which is a modifiable risk factor for
developing OA?
a. Being overweight.
b. Increasing age.
c. Previous joint damage.
d. Genetic susceptibility.
43. The HCP prescribes glucosamine and chondroitin for a client diagnosed
with OA. What is the scientific rationale for prescribing this medication?
a. The daily cardiac glycoside to a client diagnosed with back pain and
heart failure.
b. The routine insulin to a client diagnosed with neck strain and Type 1
diabetes.
c. The oral proton pump inhibitor to a client scheduled for a laminectomy
this A.M.
d. The fourth dose of IV antibiotic for a client diagnosed with a surgical
infection.
48. The nurse is caring for clients on an orthopedic floor. Which client
should be assessed first?
d. The client diagnosed with back pain who is being discharged and
whose ride is here.
a. Continue working until the shift is over and then try to sleep on a
heating pad.
b. Go immediately to the emergency department for treatment and muscle
relaxants.
c. Inform the charge nurse and nurse manager on duty and document the
occurrence.
d. See a private health-care provider on the nurses off time but charge
the hospital.
50. The nurse is admitting the client with OA to the medical floor. Which
statement by the client indicates an alternative form of treatment for
OA?
a. Assess ability to void and log roll every two (2) hours.
b. Medicate with IV steroids and keep the bed in a Trendelenburg
position.
c. Place sand bags on each side of the head and give cathartic
medications.
d. Administer IV anticoagulants and place on O2 at eight (8) L/min.
a. Allow the client to stay in bed until the pain becomes bearable.
b. Tell the assistant to give the client a bed bath this morning.
c. Try to encourage the client to get up and go to the shower.
d. Notify the family that the client is refusing to be bathed.
56. Which member of the health-care team should the nurse refer the
client diagnosed with OA who is complaining of not being able to get in
and out of the bathtub?
a. Physiatrist.
b. Social worker.
c. Physical therapist.
d. Counselor.
58. The client has been diagnosed with OA for the last 7 years and has
tried multiple medical treatments and alternative treatments but still has
significant joint pain. Which psychosocial client problem would the nurse
identify?
a. Severe pain.
b. Body-image disturbance.
c. Knowledge deficit
d. Depression
60. The client diagnosed with osteoporosis asks the nurse, Why does
smoking cigarettes cause my bones to be brittle? Which response by the
nurse would be most appropriate?
62. The nurse is caring for the following clients. After receiving the shift
report, which client should the nurse assess first?
63. The nurse is caring for an elderly client diagnosed with a herniated
nucleus pulposus of L4-L5. Which scientific rationale explains the incidence
of a ruptured disc in the elderly?
a. The client did not use good body mechanics when lifting an object.
b. There is an increased blood supply to the back as the body ages.
c. Older clients develop atherosclerotic joint disease as a result of fat
deposits.
d. Clients develop intervertebral disc degeneration as they age.
64. Which signs/symptoms would make the nurse suspect that the client
has developed osteoporosis?
66. The client diagnosed with cervical neck disc degeneration has
undergone a laminectomy.
Which interventions should the nurse implement?
67. The female client diagnosed with osteoporosis tells the nurse that she
is going to perform swim aerobics for 30 minutes every day. Which
response would be most appropriate by the nurse?
68. The nurse instructs the client with a right BKA to lie on the stomach
for at least 30 minutes a day. The client asks the nurse, Why do I need
to lie on my stomach? Which statement would be the most appropriate
statement by the nurse?
69. The client is being evaluated for osteoporosis. Which diagnostic test
is the most accurate when diagnosing osteoporosis?
a. Calcium deficiency.
b. Tobacco use.
c. Female gender.
d. High alcohol intake.
71. When assessing a client with a fractured left tibia and fibula, which
data should the nurse report to the health-care provider immediately?
74. The nurse is caring for a client with a right below the knee
amputation. There is a large amount of bright red blood on the clients
residual limb dressing. Which intervention should the nurse implement
first?
75. The client is taking calcium carbonate (Tums) to help prevent further
development of osteoporosis. Which teaching should the nurse implement?
a. Encourage the client to take Tums with at least eight (8) ounces of
water.
b. Teach the client to take Tums with the breakfast meal only.
c. Instruct the client to take Tums 30 to 60 minutes before a meal.
d. Discuss the need to get a monthly serum calcium level.
76. Which foods should the nurse recommend to a client when discussing
sources of dietary calcium?
78. The nurse is caring for clients on a surgical unit. Which nursing task
would be most appropriate for the nurse to delegate to an unlicensed
nursing assistant?
a. Help the client with a 2-day postop amputation put on the prosthesis.
b. Request the assistant double-checks a unit of blood that is being
hung.
c. Change the surgical dressing on the client with a Syme amputation.
d. Ask the assistant to take the client to the physical therapy
department.
79. The 62-year-old client diagnosed with Type 2 diabetes who has a
gangrenous right toe is being admitted for a BKA amputation. Which
nursing intervention should the nurse implement?
80. The Jewish client with peripheral vascular disease is scheduled for a
left AKA. Which question would be most important for the operating room
nurse to ask the client?
a. Have you made any special arrangements for your amputated limb?
b. What types of food would you like to eat while youre in the
hospital?
c. Would like the rabbi to visit you while you are in the recovery
room?
d. Will you start checking your other foot at least once a day for
cuts?
81. The recovery room nurse is caring for a client that has just had a
left BKA. Which intervention should the nurse implement?
82. The client is 3 hours postoperative left AKA. The client tells the
nurse, My left foot is killing me. Please do something. Which
intervention should the nurse implement?
a. Explain to the client that his left leg has been amputated.
b. Medicate the client with a narcotic analgesic immediately.
c. Instruct the client on how to perform biofeedback exercises.
d. Place the clients residual limb in the dependent position.
83. The client with a right AKA is being taught how to toughen the
residual limb. Which intervention should the nurse implement?
84. During the morning assessment, the nurse determines that the 80-
year-old client admitted with a fractured right femoral neck is confused.
Which action should the nurse implement first?
86. The nurse is preparing the plan of care for the client with an open
fracture of the right arm. Which problem has the highest priority?
87. When preparing the nursing care plan for a client with a fractured
lower extremity, which would be the most appropriate treatment outcome
for the nurse to include?
88. When assessing the client 6 hours after having a right total knee
replacement, which data should the nurse report to the surgeon?
89. The male nurse is helping his friend cut wood with an electric saw.
His friend cut two fingers of his left hand off with the saw. Which
action should the nurse implement first?
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90. The unlicensed nursing assistant (NA) notifies the nurse of the vital
signs of a 28-yearold male client admitted the previous day with a
fractured femur. The NA reports a temperature of 101_F; pulse 115;
respiratory rate 28; copious amounts of thick, white sputum; and globs
floating in the urinal. What intervention should the nurse implement first?
a. Assess the client for dyspnea, breath sounds, and altered mental
status.
b. Draw blood for arterial blood gases and order a portable chest x-ray.
c. Call the health-care provider for an order to administer an antibiotic.
d. Instruct the assistant to encourage the client to deep breathe.
91. Which statement by the client diagnosed with a fractured ulna would
indicate that the nurse needs to do further teaching?
92. The nurse is preparing a plan of care for the client who has had a
total hip replacement. Which outcome would be most appropriate for this
client?
94. When preparing the discharge teaching for the 12-year-old with a
fractured humerus, which information should the nurse include regarding
cast care?
95. When preparing the client for the transition to home rehabilitation
after having a total knee replacement, which information regarding
discharge teaching would the nurse include?
96. The client that is 1 day postoperative total hip replacement complains
of hearing a popping sound when turning. What assessment data should
the nurse report immediately to the surgeon?
97. The nurse is caring for the client who had a total knee replacement
(TKR). Which data would the nurse observe to determine if the nursing
interventions are effective?
98. The nurse is preparing the preoperative client for a total hip
replacement. Which information should the nurse include concerning
postoperative care?
100. When assessing the wound of a client who had a total hip
replacement, the nurse finds small, fluid-filled lesions on the right side of
the dressing. What explanation is the most probable rationale for this
occurrence?