Musckuloskeletal

Question 0

What are the nursing implications of an arthrocentesis?

Answer 0

*Inform consent is required.
*Assist the client to remain in one position.
*

Question 1

Explain an Arthrocentesis. What is it used to detect? What are the normal findings?

Answer 1

A sterile procedure where a needle is injected into the joints. It is used to the diagnosis of arthritis, gout, infection, infection, joint inflammation, and synovitis.

Normal findings include straw colored fluids, with few WBCs and crystals

Question 2

Explain an arthroscopy.

Answer 2

It is a highly accurate endoscopic procedure because it provides direct visualization of the joints. It does not leave large scarring, it leave small puncture holes.

Question 3

What are the contraindications of an athroscopy?

Answer 3

Skin infection

Question 4

NCLEX-PN Review - Chapter 58

802. A nursing instructor asks a nursing student about the risk factors associated with osteoporosis. The instructor tells the student that she needs to read and learn about this disorder if the student states that which of the following is an associated risk factor?

A. Postmenopausal age
B. Family history of osteoporosis
C. High-calcium diet consumption
D. Long-term use of corticosteroids

Answer 4

C. High-calcium diet consumption

Question 5

NCLEX-PN Review - Chapter 58

803. A nurse is providing instructions to a client with osteoporosis regarding appropriate food items to include in the diet. The nurse tells the client that which food item would provide the least amount of calcium?

A. Pork
B. Seafood
C. Sardines
D. Plain yogurt

Answer 5

A. Pork

Question 6

NCLEX-PN Review - Chapter 58

818. Alendronate (Fosamax) is prescribed for a client with osteoporosis. The nurse instructs the client to:

A. Take the medication at bedtime.
B. Take the medication in the morning with breakfast.
C. Lie down for 30 min after taking the medication.
D. Take the medication with a full glass of water after rising in the morning.

Answer 6

D. Take the medication with a full glass of water after rising in the morning.

Question 7

NCLEX-PN Review - Chapter 58

804. A nurse is caring for a client with osteoarthritis. The nurse collects data, knowing that which of the following is a clinical manifestation associated with the disorder?

A. Morning stiffness
B. Positive rheumatoid factor
C. An elevated sedimentation rate
D. Dull aching pain in the affected joints.

Answer 7

D. Dull aching pain in the affected joints.

Question 8

NCLEX-PN Review - Chapter 58

783. A nurse is one of several people who witness a vehicle hit a pedestrian at a fairly low speed on a small street. The individual is dazed and tries to get up, and the leg appears fractured. The nurse would plant to:

A. Try to manually reduce the fracture.
B. Assist the person to get up and walk to the sidewalk.
C. Leave the person for a few moments to call an ambulance.
D. Stay with the person and encourage the person to remain still.

Answer 8

D. Stay with the person and encourage the person to remain still.

Question 9

NCLEX-PN Review - Chapter 58

784. A nurse witnesses a client sustain a fall and suspects that the client’s leg may be fractured. Which action is the priority?

A. Take a set of vital signs.
B. Call the radiology department.
C. Immobilize the leg before moving the client.
D. Reassure the client that everything will be fine.

Answer 9

C. Immobilize the leg before moving the client.

Question 10

NCLEX-PN Review - Chapter 58

785. A client with a hip fracture asks the nurse why Buck’s extension traction is being applied before surgery. The nurse’s response is based on the understanding that Buck’s extension traction primarily:

A. Allows bony healing to begin before surgery
B. Provides rigid immobilization of the fracture site.
C. Lengthens the fractured leg to prevent severing of blood vessels.
D. Provides comfort by reducing muscle spasms and provides fractures immobilization.

Answer 10

D. Provides comfort by reducing muscle spasms and provides fractures immobilization.

Question 11

NCLEX-PN Review - Chapter 58

786. A nurse is evaluating the pin sites of a client in skeletal traction. The nurse would be LEAST concerned with which finding?

A. Inflammation.
B. Serous drainage.
C. Pain at pin site.
D. Purulent drainage.

Answer 11

B. Serous drainage.

Question 12

NCLEX-PN Review - Chapter 58

787. A nurse is caring for the client who has had skeletal traction applied to the left leg. The client is complaining of severe left leg pain. Which action should the nurse take first?

A. Provide pin care.
B. Call the physician immediately.
C. Check the patient’s alignment in bed.
D. Medicate the client with an analgesic.

Answer 12

C. Check the patient’s alignment in bed.

Question 13

NCLEX-PN Review - Chapter 58

789. A nurse is checking the casted extremity of a client. The nurse would check for which of the following signs and symptoms indicative of infection?

A. Dependent edema
B. Diminished distal pulse
C. Presence of a “hot spot” on the cast
D. Coolness and pallor of the extremity

Answer 13

C. Presence of a “hot spot” on the cast.

Question 14

NCLEX-PN Review - Chapter 58

790. A client has sustained a closed fracture and has just had a cast applied to the affected arm. The client is complaining of intense pain. The nurse has elevated the limb, applied an ice bag, and administered an analgesic, which was ineffective in relieving the pain. The nurse interprets that his pain may be caused by:

A. Infection under the cast
B. The anxiety of the client
C. Impaired tissue perfusion
D. The newness of the fracture

Answer 14

C. Impaired tissue perfusion

Question 15

NCLEX-PN Review - Chapter 58

791. A nurse is assigned to care for a client with multiple trauma who is admitted to the hospital. The client has a leg fracture, and a plaster cast has been applied. In positioning the casted leg, the nurse should:

A. Keep the leg in a level position.
B. Elevate the leg for 3 hours, and put it flat for 1 hour.
C. Keep the leg level for 3 hours, and elevate it for 2 hour.
D. Elevate the leg on the pillow continuously for 24 to 48 hours.

Answer 15

D. Elevate the leg on the pillow continuously for 24 to 48 hours.

Question 16

NCLEX-PN Review - Chapter 58

792. A client is complaining of skin irritation from the edges of a cast applied the previous day. The nurse should plan for which of the following actions?

A. Massaging the skin at the rim of the cast.
B. Petaling the cast edges with adhesive tape.
C. Using a rough file to smooth the cast edges.
D. Applying lotion to the skin at the rim of the cast.

Answer 16

B. Petaling the cast edges with adhesive tape.

Question 17

NCLEX-PN Review - Chapter 58

793. A client is being discharged home after application of a plaster leg cast. The nurse determines that the client understands proper care of the cast if the client states that he or she will:

A. Avoid getting the cast wet.
B. Cover the casted leg with warm blankets.
C. Use the fingertips to lift and move the leg.
D. Use a padded coat hanger end to scratch under the cast.

Answer 17

A. Avoid getting the cast wet.

Question 18

NCLEX-PN Review - Chapter 58

794. A nurse is planning to provide instructions to the client about how to stand on crutches. In the written instructions, the nurse plans to tell the client to place the crutches:

A. 3 inches to the front and side of the client’s toes
B. 8 inches to the front and side of the client’s toes
C. 20 inches to the front and side of the client’s toes
D. 15 inches to the front and side of the client’s toes

Answer 18

B. 8 inches to the front and side of the client’s toes

Question 19

NCLEX-PN Review - Chapter 58

795. A nurse is evaluating the client’s use of a cane for left-sided weakness. The nurse would intervene and correct the client if the nurse observed that the client:

A. Holds the cane on the right side.
B. Moves the cane when the right leg is moved.
C. Leans on the can when the right leg swings through.
D. Keeps the cane 6 inches out to the side of the fight foot.

Answer 19

B. Moves the cane when the right leg is moved.

Rationale:
The can is held on the stronger side to minimize stress on the affected extremity and provide a wide base of support. THe can is held 6 inches lateral to the fifth great toe. The can is moved forward with the affected leg. The client leans on the cane for added support while the stronger side swings through.

Question 20

NCLEX-PN Review - Chapter 58

796. A nurse is caring for a client with fresh application of a plaster leg cast. The nurse plans to prevent the development of compartment syndrome by:

A. Elevating the limb and applying ice to the affected leg.
B. Elevating the limb and covering the limb with bath blankets.
C. Keeping the leg horizontal and applying ice to the affected leg.
D. Placing the leg in a slightly dependent position and applying ice.

Answer 20

A. Elevating the limb and applying ice to the affected leg.

Question 21

NCLEX-PN Review - Chapter 58

800. A client with a left arm fracture exhibits loss of sensation in the left fingers, pallor, slow refill, and diminished left radial pulse. The nurse should take which of the following actions?

A. Administer an analgesic
B. Notify the registered nurse.
C. Check the circulation
D. Provide range-of-motion exercises to the fingers of the left hand.

Answer 21

B. Notify the registered nurse.

Question 22

NCLEX-PN Review - Chapter 58

801. A client is complaining of pain underneath a cast in the area of a bony prominence. The nurse interprets that this client may need to have:

A. The cast bivalved.
B. A window cut in the cast.
C. The cast replaced with an air splint
D. Extra padding put over this area of the cast.

Answer 22

B. A window cut in the cast.

Rationale:
A window may be cut in a dried cast to relieve pressure, monitor pulses, relieve discomfort, or remove drains. Bivavling the cast involves splitting the cast along both sides to allow space for swelling, facilitate taking x-rays, or make a half-cast for use as an intermittent splint. Padding is not placed on top of a cast. The use of an air splint is not indicated.

Question 23

NCLEX-PN Review - Chapter 58

805. A client is treated in the physician’s office after a fall, which sprained the ankle. Radiography has ruled out fracture. Before sending the client home, the nurse would plan to teach the client about which item that is to be avoided in the next 24 hours?

A. Resting the foot.
B. Application of an Ace wrap.
C. Application of a heating pad.
D. Elevating the ankle on a pillow while sitting or lying down.

Answer 23

C. Application of a heating pad.

Rationale:
Soft tissue injuries such as sprains are treated by RICE (rest, ice, compression, elevation) for the first 24h after the injury. Heat is not applied because it can cause venous congestion, which would increase edema and pain.

Question 24

NCLEX-PN Review - Chapter 58

807. A nurse is preparing a list of cast care instructions for a client who just had a plaster cast applied to his right forearm. Select all instructions that the nurse includes on the list.

A. Keep the cast and extremity elevated.
B. The cast needs to be kept clean and dry.
C. Allow the wet cast 24 to 72 hours to dry.
D. Expect tingling and numbness in the extremity.
E. Use a hair dryer set on a warm to hot setting to dry the cast.
F. Use a soft padded object that will fit under the cast to scratch the skin under the cast.

Answer 24

A. Keep the cast and extremity elevated.
B. The cast needs to be kept clean and dry.
C. Allow the wet cast 24 to 72 hours to dry.

Question 25

Burke Book - Chapter 43

The nurse is teaching a client with rheumatoid arthritis about the prescribed drug, celecoxib (Celebrex). Which of the following does the nurse include? Select all that apply.

A. Always take this drug with food or milk to avoid gastric upset.
B. Take the drug as needed to manage pain and stiffness.
C. Contact your doctor if you develop stomach or abdominal pain.
D. You may use acetaminophen as needed for pain.
E. Like aspirin, this drug reduces your risk for heart attack.

Answer 25

C. Contact your doctor if you develop stomach or abdominal pain.
D. You may use acetaminophen as needed for pain.

Question 26

Burke Book - Chapter 43

The nurse is teaching a client who is recovering from an acute gout attack about his prescription for sulfinpyrazone (Anturane). Which statement by the client would indicate an understanding of the instructions?

A. “I’m going to drink less water so I won’t swell up.”
B. “I’ll take the colchicine every day.”
C. “I’ll let my doctor know if my stomach begins to hurt.”
D. “I will take my medicine on an empty stomach.”

Answer 26

C. “I’ll let my doctor know if my stomach begins to hurt.”