A pt had a total hip arthroplasty. What manifestation would indicate to the nurse that the prosthesis is dislocated?

The left leg is internally rotated

A client asks the nurse why his residual limb cannot be elevated on a pillow.

Elevating the stump may increase your chances of compartment syndrome

Which aspect of postop will the nurse plan to discuss with a client about to undergo an arthroscopic repair of the knee?

Pharmacy for client medications

A nurse is caring for a pt following foot surgery. Which nursing intervention is most important for the nurse to include

Perform neuromuscular assessment every hour

How should a nurse position a pt who just came out of surgery for a hip fracture?

With the leg on the affected side abducted

Stevens-Johnson Syndrome:

A rare serious disorder of the skin and mucous membranes

The older client asks the nurse how best to maintain strong bones. What is the nurses best response?

Weight-bearing exercises can strengthen bones

When checking the traction apparatus for a pt in skin traction. Which finding would require the nurse to intervene?

Weights hanging and touching the floor

What is a priority education when administering Adalimumab (Humira) (for autoimmune diseases, RA, Chrons, UC, Psoriasis)

The med is associated with a serious infection risk

The nurse recognizes that RA is characterized by:

Ulnar deviation (hand tilts inward)

Which can be done to a sterile field without contaminating it?

Opening a packaged item so that it drops onto the field, Close the client's door to reduce traffic, Do not reach over the field

What should the nurse inform the client before the cast is removed?

The leg will look moist and will have small bumps that will go away soon

While applying a fiberglass cast a pt starts yelling "It burns, Take it off!" what should the nurse say in response?

Explain that the sensation is normal and it won't burn him

Which nursing intervention for the client with a closed reduction extremity fracture?

Encourage participation in ADLs

The nurse is providing care to a client following a knee arthroscopy. What should the nurse include in the care plan?

Administering the prescribed analgesic

Third intention wound healing:

Delayed closure, 1st leave open to heal then close with sutures

The nurse in the day surgery floor is making pt assignments for the staff should include: Which would be the best option

arthroscopic surgery of the shoulder under local anesthesia

Which of the following is the most important nursing diagnosis for an elderly patient diagnosed with osteoporosis?

Sufficient knowledge about osteoporosis and the treatment regimen

What is the expected HIV testing schedule for a nurse who has been stuck with a used needle?

Tested at 2 months, 4 months, and 6 months

Lifestyle risk factors for osteoporosis include:

Lack of aerobic exercise, Lack of sunshine exposure, An estrogen deficiency or menopause

Which pt would the nurse identify as having the greatest risk for osteoporosis?

A small framed thin 45 yo white woman

Which statement is accurate regarding the care of a plaster cast? Select all that apply

The cast can be dented while it is damp, A dry plaster cast is dull and gray

What is the benefit of a CPM device when applied after knee surgery?

It promotes healing by increasing circulation and movement of the knee

Which would be consistent as a component of self-care activities for the client with a cast?

Cushion rough edges of the cast with tape

Which medication is most commonly associated/causes Stevens-Johnson syndrome (extreme allergic reaction)?

Phenobarbital (seizures), Allopurinol (gout), Sulfasalazine (IBS and arthritis)

A nurse is teaching a pt who was recently diagnosed with carpal tunnel syndrome. Which statement should be included?

Ergonomic changes can be incorporated into your workday to reduce stress

What should a nurse teach a pt who has just been diagnosed with glaucoma?

Demonstrate eyedrops instillation

Alginate dressings are used:

Highly absorbent fabric derived from seaweed

A client is diagnosed with scabies. The nurse expects which medication to be prescribed for pruritus (itchy dry skin)?

Permethrin (parasite infection)

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MDC1 exam 2

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Answers

1
A pt sustains a fracture of the arm. When does the nurse anticipate the pendulum exercise should begin?
In 2-3 months
As soon as tolerated
In 4-5 weeks
In 2-3 weeks
2
A pt had a total hip arthroplasty. What manifestation would indicate to the nurse that the prosthesis is dislocated?
There are diminished peripheral pulses on the affected extremity
The leg length is the same as the right leg
The left leg is internally rotated
The pt has discomfort when moving in bed
3
A client asks the nurse why his residual limb cannot be elevated on a pillow.
You need to turn yourself side to side. If your leg is on a pillow you cant
Elevating the stump may increase your chances of compartment syndrome
I am sorry, we are all out of pillows. We can use blankets
Elevating the leg might lead to a fixation contracture
4
Which test should be ordered before starting Tazarotene (Tazorac) for Psoriasis in a 26yo female?
LFTs (liver function test)
Urine drug screening
CBC (complete blood count)
Urine HCG (pregnancy test)
5
Which aspect of postop will the nurse plan to discuss with a client about to undergo an arthroscopic repair of the knee?
Physical therapy for exercises
Dietitian for nutrition
Social worker for care coordination
Pharmacy for client medications
6
A nurse is caring for a pt following foot surgery. Which nursing intervention is most important for the nurse to include
Perform neuromuscular assessment every hour
Examine the surgical dressing every hour
Administer pain meds per pts request
Monitor vital signs every 4 hours
7
Which test would evaluate muscle weakness or deterioration?
A magnetic resonance imaging MRI
An arthroscopy
A serum calcium test
An electromyography EMG
8
The dr manipulated the fingers into alignment and applied a splint to maintain alignment. What type of procedure it this
Open reduction with internal fixation
Closed reduction
External fixation
Open reduction
9
How should a nurse position a pt who just came out of surgery for a hip fracture?
With the leg on the affected side adducted
With the leg on the affected side abducted
With the affected hip rotated externally
With the affected hip flexed acutely
10
Which type of fracture is one in which the skin or mucous membrane wound extend to the fractured bone?
Complete
Incomplete
Simple
Compound
11
Stevens-Johnson Syndrome:
Broad term used for a variety inflammatory skin diseases
Red and purple discoloration spots are visibly notable on the skin
A rare serious disorder of the skin and mucous membranes
Pregnancy-related, silver to pink jagged lines on the skin
12
The nurse is performing a neuromuscular assessment of a pts injured extremity. What would the nurse report?
Capillary refill of 3 seconds
Positive pedal pulses
Skin warm to touch
Dusky or mottled skin color
13
The older client asks the nurse how best to maintain strong bones. What is the nurses best response?
Cardio training is the best way to build bones
Weight resistance exercises
Range of motion exercises build bone mass
Weight-bearing exercises can strengthen bones
14
Assessment of a pt reveals signs and symptoms of Paget's disease. Which of the following would be most likely?
Lordosis
Upright gait
Long bone bowing
Skull narrowing
15
During cast removal, it is important for the nurse to assure:
That the cast cutter blade is new
That the leg will be as good as new
That pedal pulses are present
The client that they won't be cut
16
When checking the traction apparatus for a pt in skin traction. Which finding would require the nurse to intervene?
Weights hanging and touching the floor
Pulleys without evidence of the obstruction
Ropes freely moving over pulleys
Body aligned opposite to line of traction pull
17
Primary intention applies to:
Surgical wounds
Wounds stitched up within 6hours
When a dressing is applied in 6 hours
Wound left open
18
A pt is having surgery to replace both articular surfaces of the hip. What type of surgical process is this?
Total arthroplasty
Osteotomy
Hemiarthroplasty
Arthrodesis
19
What is a priority education when administering Adalimumab (Humira) (for autoimmune diseases, RA, Chrons, UC, Psoriasis)
The medication is given via pen injection
Maintenance doses are given every other week
The loading dose is given as 2 injections
The med is associated with a serious infection risk
20
A pt has undergone 6 weeks of antibiotic therapy and the wound is not healing. What should be done to promote healing?
Vitamin supplements
Wound packing
Wound irrigation
Surgical debridement
21
The nurse recognizes that RA is characterized by:
Ulnar deviation (hand tilts inward)
Fasciculations (under skin twitching)
Clonus (rhythmic muscle contractions)
Ballottement sign (fluid rebound test)
22
Which can be done to a sterile field without contaminating it?
Opening a packaged item so that it drops onto the field
Close the client's door to reduce traffic
Do not reach over the field
Turn away from a sterile field to grab supplies
23
What of the following is an example of skin traction?
Balanced suspension
Thomas splint
Buck's
Crutchfield tongs
24
A nurse is instructing a pt who has been prescribed calcium citrate (Citracal). Which instruction does the nurse include
One-third of the daily dose is best taken during the day.
For best absorption, take Citracal with a carbonated beverage
Take Citracal with food.
Milk of Magnesia (MOM) should be taken with Citracal.”
25
What should the nurse inform the client before the cast is removed?
The leg strength is enforced by the wearing of the cast
The leg will look as it did prior to the cast being applied
The leg will look moist and will have small bumps that will go away soon
The skin may be covered with yellowish crust that will shed soon
26
The pt presents with an exaggeration of the lumbar spine curve. How does the nurse interpret this finding?
Lordosis
Dowager's hump
Kyphosis
Scoliosis
27
What action is the highest priority for a nurse's pt with a femur fracture that was just admitted to the ER?
Administer pain meds per orders
Assess pedal pulses
Assess the diameter of the thigh
Assess vital signs and LOC
28
While applying a fiberglass cast a pt starts yelling "It burns, Take it off!" what should the nurse say in response?
Administer pain meds
Explain that the sensation is normal and it won't burn him
Remove the cast immediately
Call the doctor
29
Which nursing intervention for the client with a closed reduction extremity fracture?
Promote intake of omega 3 fatty acids
Administer prescribed enema to prevent constipation
Encourage participation in ADLs
Use frequent dependent positioning to prevent edema
30
What priority question should the nurse ask someone about to undergo an arthrogram (injected dye into joints)?
When did you last urinate
When did you last eat
Are you claustrphobic
Do you have any allergies
31
The nurse is providing care to a client following a knee arthroscopy. What should the nurse include in the care plan?
Administering the prescribed analgesic
Applying warm packs to the insertion site
Keeping the affected knee flexed
Maintaining the pts NPO status
32
Third intention wound healing:
Clean minor wounds, no infection close via sutures
Larger complicated wounds leave open and never do surgery
Delayed closure, 1st leave open to heal then close with sutures
33
The nurse in the day surgery floor is making pt assignments for the staff should include: Which would be the best option
admitted for surgery after sustaining an ankle fracture
requires a pneumatic tourniquet applied before knee surgery
arthroscopic surgery of the shoulder under local anesthesia
teaching about quadriceps-setting exercises after knee arthroscopy
34
Which of the following is the most important nursing diagnosis for an elderly patient diagnosed with osteoporosis?
Sufficient knowledge about osteoporosis and the treatment regimen
Risk for constipation related to immobility
Acute pain related to fracture and muscle spasm
Risk for injury related to fractures due to osteoporosis
35
What is the expected HIV testing schedule for a nurse who has been stuck with a used needle?
Immediately and then again at 3 months
Tested 6 months and 12 months
Tested at 2 months, 4 months, and 6 months
Immediately and then again in 12 months
36
Lifestyle risk factors for osteoporosis include:
A low protein, high fat diet
Lack of aerobic exercise
Lack of sunshine exposure
An estrogen deficiency or menopause
37
Which pt would the nurse identify as having the greatest risk for osteoporosis?
A small framed thin 45 yo white woman
A 20 yo athlete with repeated injuries
A 40 yo overweight African American woman
A 16 yo male with a history of Asthma
38
Which statement is accurate regarding the care of a plaster cast? Select all that apply
The cast must be covered with a wet blanket for the first 24hrs
The cast can be dented while it is damp
The cast will dry in 12 hours
A dry plaster cast is dull and gray
39
What is the benefit of a CPM device when applied after knee surgery?
It provides active range of motion
It promotes healing by increasing circulation and movement of the knee
It promotes healing by immobilizing the knee joint
It prevents infection and controls edema and bleeding
40
Which would be consistent as a component of self-care activities for the client with a cast?
Cover the cast with plastic to insulate it
Use a plastic hanger wrapped in gauze to scratch under the cast
Cushion rough edges of the cast with tape
Frequently place the casted extremity in a dependent position
41
A client arrives in the ER with a suspected bone fracture of the right arm. What kind of pain does the nurse expect?
Sore and aching
Dull, deep, boring ache
Similar to muscle cramps
Sharp and piercing
42
Which medication is most commonly associated/causes Stevens-Johnson syndrome (extreme allergic reaction)?
Phenobarbital (seizures)
Allopurinol (gout)
Valacyclovir (herpes)
Sulfasalazine (IBS and arthritis)
43
A pts fracture reveals that a bone fragment has been driven into another bone fragment. How does the nurse identify this
Greenstick (incomplete fracture)
Comminuted (fragment)
Compression (compression bone)
Impacted (whole bone)
44
A nurse is teaching a pt who was recently diagnosed with carpal tunnel syndrome. Which statement should be included?
Using arm splints will prevent hyperflexion of the wrist
Surgery is the only sure way to manage this condition
This condition is associated with various sports
Ergonomic changes can be incorporated into your workday to reduce stress
45
What should a nurse teach a pt who has just been diagnosed with glaucoma?
Demonstrate eyedrops instillation
Teach about intraocular lens cleaning
Assess the clients visual acuity
Provide instruction on eye patching
46
Define innate:
Forgotten
Born with
Learned
Unnatural
47
When an EMG is performed, what will this test evaluate?
Metastatic bone lesions
Muscle weakness
Bone density
Muscle composition
48
Alginate dressings are used:
Highly absorbent fabric derived from seaweed
To control infection
To retain fluid within a wound
To keep the dressing in place
49
A client is diagnosed with scabies. The nurse expects which medication to be prescribed for pruritus (itchy dry skin)?
Famciclovir (herpes)
Permethrin (parasite infection)
Acyclovir (herpes)
Etanercept (Autoimmune disorders)
50
The nurse is monitoring a pt who sustained an open fracture of the left hip. What type of shock is the pt at risk for
Septicemic
Cardiogenic
Neurogenic
Hypovolemic
51
The doctor is concerned that a client will develop an infection, because which of the following lab values are low?
Neutrophils
Eosinophils
Hematocrit
Hemoglobin
52
A pt is exhibiting diminished ROM, loss of flexibility, stiffness, and loss of height. What area is affected?
Muscles
Ligaments
Joints
Bones
53
What should a nurse include in the discharge for someone with osteomyelitis?
You need to limit the amount of protein and calcium in your diet
You will receive IV antibiotics for 3-6 weeks
Use your continuous passive motion machine for 2 hrs each day
You need to perform weight bearing exercises twice a week
54
Which is the best way to decrease the risk for osteoporosis in a pt who has just been deemed to be at high risk?
Walk for 30 minutes three times a week.
Engage in high-impact exercise, such as running.
Increase nutritional intake of calcium.
Increase nutritional intake of phosphorus.
55
A pt is unable to move the right upper and lower extremity. They are limp and without tone. What is the finding?
Flaccidity (lack of muscle tone/muscle state)
Rigidity (stiffness)
Atonic (lacking muscle tone)
Tetanic (muscle contraction)
56
Which orthopedic surgery is done to correct and align a fracture after surgical dissection and exposure of the fracture?
Arthrodesis
Open reduction
Joint arthroplasty
Total joint arthroplasty
57
The chain of infection includes:
Bacteria, susceptible hose, mode of transmission, entry/ exit portal
Pathogen, host, mode of transmission, and portal of entry/exit
58
A pt with arterial insufficiency undergoes below-knee amputation. What should the nurse include in post-care?
Applying heat to the stump as the pt desires
Maintaining the client on complete bed rest
Elevating the stump for the first 24hrs
Removing the pressure dressing after the first 8hrs
59
A pt is diagnosed with carpel tunnel syndrome. What assessment findings should the nurse expect to find?
A decrease in grasp strength
Pain radiating down the dorsal surface of the forearm
Tenderness in the affected wrist
Inability to flex index and middle fingers
60
Which is a hallmark sign of compartment syndrome?
Motor weakness
Pain
Edema
Weeping skin surfaces
61
The pt displays manifestations of compartment syndrome. What treatment will the nurse expect the pt to be scheduled for?
An open reduction
Fasciotomy
A total knee replacement
A total hip replacement
62
What does HIV attack?
Pancreas
Brain
Immune system
Nothing
63
What is maceration?
I don't need to know this
Wounds from pressure
Skin breakdown related to moisture
Tearing of skin
64
In chronic osteomyelitis, antibiotics are adjunctive therapy in which situation?
Surgical debridement
Wound packing
Vitamin supplements
Wound irrigation
65
Which statement indicates the pt teaching about skeletal traction is correct?
A belt will go around my pelvis and weights will be attached
Medal pins will go through my skin to the bone
I will wear a boot with weights attached
The traction can be removed once a day to shower
66
The inflammatory response involves:
Redness and heat at the site
Improved function of the injured area
Reduced blood flow to the area
Increased pain and swelling
67
Which of the following increases the risk of glaucoma?
Age younger than 40 years old
History of respiratory disease
Hyperopia since age 20 years
Prolonged use of corticosteroids
68
What type of fracture is a greenstick fracture classified as?
Compression
Incomplete
Closed
Stress
69
The inflammatory phase lasts:
1-8 hours
72-148 hours
Begins at the time of injury or cell death and lasts 3 to 5 days
1-2 hours
70
Post-op patient has an eviscerated wound. Which nursing intervention should you implement?
Place patient in reverse trendelenburg position
Use sterile gloves to replace protruding parts
Apply sterile normal saline dressing
Administer IV antibiotic STAT
71
Which statement describes paresthesia?
Involuntary twitch of muscle fibers
Abnormal sensations
Absence of muscle tone
Absence of muscle movement suggests nerve damage
72
What is the portal of entry?
The site through which microorganisms enter the susceptible host
A black hole into the universe
How infectious agents enter the body through various portals
None of the above
73
Which diagnostic test would the nurse expect to be ordered for a pt with lower extremity muscle weakness?
Electromyograph EMG
Arthrocentesis
Bone scan
biopsy
74
A pt accidentally splashes chemicals in their eye and the nurse washes it with tap water. What was the point of this?
To hasten formation of scar tissue
To prevent vision loss
To serve as a stopgap measure until help arrives
To eliminate the need for medical care
75
Imiquimod (topical cream for abnormal skin/cell growth) is indicated for?
Hyponatremia (low sodium)
Acne Vulgaris (pimples)
Anemia (low blood iron)
Actinic keratosis (precancerous skin lesion)
76
A pt is undergoing skeletal traction and reports pressure on bony areas. What should the nurse do?
Change the pt's position within prescribed limits
Assisting with ROM and isometric exercises
Administering prescribed analgesics
Applying warm compresses
77
What education is important for the nurse to give a pt that is taking NSAIDs?
Loading-dose schedule
Dietary restrictions
Activity restrictions
Common adverse effects
78
The nurse is caring for a pt who had a total hip replacement. What lethal postoperative complication should be monitored
UTI
Pulmonary embolism
Atelectasis
Hypovolemia
79
Which are complications of wound healing:
Fistula
Hemorrhage
Dehiscence and evisceration
Infection
80
A pt's left leg is in skeletal traction with a Thomas leg splint and Pearson attachment. What should the nurse include?
Remove the traction at least every 8 hours
Apply the traction straps snugly
Teach the client how to prevent problems causing immobility
Assess the pt's LOC
81
After a person experiences a closure of the epiphyses, which statement is true?
The bone increases in thickness and is remodeled
The bone grows in length but not thickness
Both bone length and thickness continue to increase
An increase in bone length occurs
82
What symptoms of a fractured clavicle does the nurse recognize?
Client complains of tingling and numbess in the right shoulder
Right shoulder is elevated about the left
Right shoulder slopes downward and droops inward
Client complains of pain in the unaffected shoulder
83
A pt is reporting pain following orthopedic surgery. What intervention will help relieve pain?
Apply anti-embolism stockings as indicated
Elevate the affected extremity and use cold applications
Breathe deeply and cough every 2 hrs until ambulation is possible
Do ROM exercises as indicated
84
The nurse teaches the pt with a high risk for osteoporosis about risk-lowering strategies, including which action?
Increase fiber in the diet
Reduce stress
Walk or perform weight bearing exercises outdoors
Decrease the intake of Vitamin A and D
85
A nurse is caring for a pt in traction to treat a fractured femur. Which nursing intervention has the highest priority?
Keeping the ropes over the center of the pulley
Keeping the client from sliding to the foot of the bed
Ensuring that the weights hang free at all times
Assessing the extremity for neurovascular integrity
86
Which diagnostic test will be appropriate to help determine this client’s risk for spine and hip fractures?
CT-based absorptiometry
Dual x-ray absorptiometry (DXA)
Vertebral imaging studies
Magnetic resonance spectroscopy (MRS)
87
Which of the following presents with an onset of heel pain with the 1st steps of the morning?
Morton's neuroma
Plantar fasciitis
Hallux valgus
Ganglion

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