chapter 66 Flashcards
The nurse is caring for a client who is hospitalized for initiation of regional antibiotic irrigation for acute osteomyelitis of the right femur. Which of the following interventions should 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. Immobilization of the right leg
The nurse is preparing a client for discharge after 2 weeks of IV antibiotic therapy for acute osteomyelitis in the left leg. Which of the following information should 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 7–10 days after discharge
b. How to monitor and care for the long-term IV catheter site?
The home care nurse is caring for a client who has chronic osteomyelitis of the left femur who is being managed at home with administration of IV antibiotics. Which of the following findings would indicate to the nurse that a nursing diagnosis of ineffective health maintenance is appropriate for this client?
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
b. Is unable to plantar flex the foot on the affected side
Which of the following statements by a client who is scheduled for an above-the-knee amputation for treatment of an osteosarcoma of the right tibia indicates that client 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. “I did not have this bone cancer until my leg broke a week ago.”
The nurse is caring for a client with pes planus. Which of the following actions should the nurse expect to provide symptom relief for this client?
a. The administration of a corticosteroid
b. The use of longitudinal arch supports
c. Passive manual stretching of the PIP joint
d. Casting of the affected foot
b. The use of longitudinal arch supports
The nurse is caring for a client who has muscle spasms and acute low back pain. Which of the following actions is most appropriate to teach the client to promote comfort?
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 hips and knees flexed when resting in bed.
d. Twist gently from side to side to maintain range of motion in the spine.
c. Keep the hips and knees flexed when resting in bed.
The nurse is teaching a client whose work involves lifting and has a history of chronic back pain about proper body mechanics. Which of the following client statements 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. “I plan to start doing exercises to strengthen the muscles of my back.”
The nurse is caring for a client who has a herniated intravertebral disk who has had a laminectomy and discectomy. Following the surgery, which of the following actions should the nurse implement to position the client on his or her side?
a. Instruct the client to move the legs before turning the rest of the body.
b. Have the client turn by grasping the side rails and pulling the shoulders over.
c. Place a pillow between the client’s legs and turn the entire body as a unit.
d. Turn the client’s head and shoulders first, followed by the hips, legs, and feet.
c. Place a pillow between the client’s legs and turn the entire body as a unit.
The nurse is teaching a client with a bunion about how to prevent further problems. Which of the following client statements indicates that more teaching is required?
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 when I need it.”
c. “I will need to wear open sandals at all times.”
Which of the following assessment findings should alert the nurse to the presence of osteoporosis in an adult client?
a. Measurable loss of height
b. Presence of bowed legs
c. Aversion to dairy products
d. Statements about frequent falls
a. Measurable loss of height
The nurse is caring for an older female adult client who has a family history of osteoporosis and is diagnosed with osteopenia following densitometry testing. Which of the following explanations should the nurse provide when teaching the client about osteoporosis?
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.
d. Calcium loss from bones can be slowed by increasing calcium intake and weight-bearing exercise.
Which of the following menu choices by a client 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 omelette and a half grapefruit
d. Oatmeal with skim milk and fruit yogourt
d. Oatmeal with skim milk and fruit yogourt
The nurse is caring for a client who has Paget’s disease and is prescribed salmon calcitonin and acetaminophen. Which of the following assessment information will the nurse obtain to evaluate the effectiveness of these medications?
a. Pain level
b. Oral intake
c. Daily weight
d. Grip strength
a. Pain level
The nurse is caring for a client who has acute osteomyelitis and is receiving tobramycin 80 mg IV twice daily. Which of the following actions should the nurse take before administering the gentamicin?
a. Ask the client about any nausea.
b. Obtain the client’s oral temperature.
c. Change the prescribed wet-to-dry dressing.
d. Review the client’s blood urea nitrogen (BUN) and creatinine levels.
d. Review the client’s blood urea nitrogen (BUN) and creatinine levels.
The nurse is caring for a client who has had a surgical reduction of an open fracture of the left tibia. Which of the following assessment findings 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 38.6°C (101.5°F)
d. Temperature 38.6°C (101.5°F)
