64 Flashcards

1
Q

A patient is hospitalized for initiation of regional antibiotic irrigation for acute osteomyelitis of the right femur. Which intervention will be included in the plan of care?

a. Immobilization of the right leg
b. Frequent weight-bearing exercise
c. Avoiding administration of nonsteroidal anti-inflammatory drugs (NSAIDs)
d. Support of the right leg in a flexed position

A

a. Immobilization of the right leg

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2
Q

A patient is being discharged after 2 weeks of IV antibiotic therapy for acute osteomyelitis in the left leg. Which information will be included in the discharge teaching?

a. How to apply warm packs safely to the leg to reduce pain
b. How to monitor and care for the long-term IV catheter site
c. The need for daily aerobic exercise to help maintain muscle strength
d. The reason for taking oral antibiotics for 7 to 10 days after discharge

A

b. How to monitor and care for the long-term IV catheter site

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3
Q
  1. A patient has chronic osteomyelitis of the left femur, which is being managed at home with administration of IV antibiotics. The nurse chooses a nursing diagnosis of ineffective health maintenance when the nurse finds that the patient
    a. takes and records the oral temperature twice a day.
    b. is unable to plantar flex the foot on the affected side.
    c. uses crutches to avoid weight bearing on the affected leg.
    d. is irritable and frustrated with the length of treatment required.
A

b. is unable to plantar flex the foot on the affected side.

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4
Q

Which statement by a patient who is scheduled for an above-the-knee amputation for treatment of an osteosarcoma of the right tibia indicates that patient teaching is needed?

a. “I did not have this bone cancer until my leg broke a week ago.”
b. “I wish that I did not have to have chemotherapy after this surgery.”
c. “I know that I will need to participate in physical therapy after surgery.”
d. “I will use the patient-controlled analgesia (PCA) to control postoperative pain.”

A

a. “I did not have this bone cancer until my leg broke a week ago.”

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5
Q
  1. A 20-year-old patient with a history of muscular dystrophy is hospitalized with a respiratory tract infection. Which nursing action will be included in the plan of care?
    a. Assist the patient with ambulation.
    b. Logroll the patient every 1 to 2 hours.
    c. Discuss the need for genetic testing with the patient.
    d. Teach the patient about the muscle biopsy procedure.
A

a. Assist the patient with ambulation.

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6
Q

A patient has muscle spasms and acute low back pain. An appropriate nursing intervention for this problem is to teach the patient to

a. avoid the use of cold because it will exacerbate the muscle spasms.
b. keep both feet flat on the floor when prolonged standing is required.
c. keep the head elevated slightly and flex the knees when resting in bed.
d. twist gently from side to side to maintain range of motion in the spine.

A

c. keep the head elevated slightly and flex the knees when resting in bed.

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7
Q

A patient whose work involves lifting has a history of chronic back pain. After the nurse has taught the patient about correct body mechanics, which patient statement indicates that the teaching has been effective?

a. “I plan to start doing exercises to strengthen the muscles of my back.”
b. “I will try to sleep with my hips and knees extended to prevent back strain.”
c. “I can tell my boss that I need to change to a job where I can work at a desk.”
d. “I will keep my back straight when I need to lift anything higher than my waist.”

A

a. “I plan to start doing exercises to strengthen the muscles of my back.”

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8
Q

A patient with a herniated intravertebral disk undergoes a laminectomy and discectomy. Following the surgery, the nurse should position the patient on the side by

a. instructing the patient to move the legs before turning the rest of the body.
b. having the patient turn by grasping the side rails and pulling the shoulders over.
c. placing a pillow between the patient’s legs and turning the entire body as a unit.
d. turning the patient’s head and shoulders first, followed by the hips, legs, and feet.

A

c. placing a pillow between the patient’s legs and turning the entire body as a unit.

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9
Q

After teaching a patient with a bunion about how to prevent further problems, the nurse will determine that more teaching is needed if the patient says,

a. “I will throw away my high heel shoes.”
b. “I will use the bunion pad to relieve the pain.”
c. “I will need to wear open sandals at all times.”
d. “I will take ibuprofen (Motrin) when I need it.”

A

c. “I will need to wear open sandals at all times.”

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10
Q

An assessment finding that alerts the nurse to the presence of osteoporosis in a middle-aged patient is

a. measurable loss of height.
b. the presence of bowed legs.
c. an aversion to dairy products.
d. statements about frequent falls.

A

a. measurable loss of height.

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11
Q

A 58-year-old woman who has a family history of osteoporosis is diagnosed with osteopenia following densitometry testing. In teaching the woman about her osteoporosis, the nurse explains that

a. estrogen replacement therapy must be started to prevent rapid progression to osteoporosis.
b. continuous, low-dose corticosteroid treatment is effective in stopping the course of osteoporosis.
c. with a family history of osteoporosis, there is no way to prevent or slow gradual bone resorption.
d. calcium loss from bones can be slowed by increasing calcium intake and weight-bearing exercise.

A

d. calcium loss from bones can be slowed by increasing calcium intake and weight-bearing exercise.

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12
Q

Which menu choice by a patient with osteoporosis indicates that the nurse’s teaching about appropriate diet has been effective?

a. Pancakes with syrup and bacon
b. Whole wheat toast and fruit jelly
c. Two-egg omelet and a half grapefruit
d. Oatmeal with skim milk and fruit yogurt

A

d. Oatmeal with skim milk and fruit yogurt

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13
Q

Which assessment information will the nurse obtain to evaluate the effectiveness of the prescribed calcitonin (Cibacalcin) and ibandronate (Boniva) for a patient with Paget’s disease?

a. Pain level
b. Oral intake
c. Daily weight
d. Grip strength

A

a. Pain level

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14
Q

A patient is receiving gentamicin (Garamycin) 80 mg IV twice daily for acute osteomyelitis. Which action should the nurse take before administering the gentamicin?

a. Ask the patient about any nausea.
b. Obtain the patient’s oral temperature.
c. Change the prescribed wet-to-dry dressing.
d. Review the patient’s blood urea nitrogen (BUN) and creatinine levels.

A

d. Review the patient’s blood urea nitrogen (BUN) and creatinine levels.

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15
Q

The nurse is caring for a patient who has had a surgical reduction of an open fracture of the left tibia. Which assessment finding is most important to report to the health care provider?

a. Left leg muscle spasms
b. Serous wound drainage
c. Left leg pain with movement
d. Temperature 101.4° F (38.6° C)

A

d. Temperature 101.4° F (38.6° C)

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16
Q

Following a laminectomy with a spinal fusion, a patient reports numbness and tingling of the right lower leg. The first action indicated by the nurse is to

a. report the patient’s complaint to the surgeon.
b. check the vital signs for indications of hemorrhage.
c. turn the patient to the side to relieve pressure on the right leg.
d. check the chart for preoperative neuromuscular assessment data.

A

d. check the chart for preoperative neuromuscular assessment data.

17
Q

When administering alendronate (Fosamax) to a patient, the nurse will first

a. be sure the patient has recently eaten.
b. ask about any leg cramps or hot flashes.
c. assist the patient to sit up at the bedside.
d. administer the ordered calcium carbonate.

A

c. assist the patient to sit up at the bedside.

18
Q

Which of these nursing actions included in the care of a patient after laminectomy can the nurse delegate to experienced nursing assistive personnel (NAP)?

a. Ask about pain control with the patient-controlled analgesia (PCA).
b. Determine the patient’s readiness to ambulate.
c. Check ability to plantar and dorsiflex the foot.
d. Turn the patient from side to side every 2 hours.

A

d. Turn the patient from side to side every 2 hours.