WorksheetsExam 6 43-46
Total questions: 45
Worksheet time: 28mins
A patient who has gout calls the clinic to report having flank pain and blood in her urine. Which of the following actions should you take?
Report s/s of urinary stones to the physician immediately.
Tell her that these symptoms are normal with gout and that they will improve soon.
Make an appointment for her to see the physician in one week.
Document her complaints in her record and ask her to call the next day if symptoms continue.
Following a total knee replacement, a CPM machine is ordered. The nurse should explain to the patient that the purpose of the CPM machine is to: (SATA)
promote joint flexibility
prevent scar tissue formation
lubricate the prosthesis
restore muscle strength
test the prosthetic joint.
One week after total hip replacement surgery, a patient complains of sudden severe pain in the affected hip and inability to bear weight on that leg. Which of the following should be suspected.
wound dehiscence
prosthesis rejection
a new hip fx
test the prosthetic joint.
Which joint is the most common source of disability caused by osteoarthritis?
shoulder
knee
hip
spine
Which is the most serious complication for the postoperative patient with a hip or knee replacement?
DVT
infection
dislocation of replacement
hemorrhage
Which patient is most likely to have primary gout?
A 45-year-old man who weighs 280 lb and drinks one to two martinis per day.
A 25-year-old woman who weighs 130 lb and admits to social drinking.
A 30-year-old man who weighs 185 lb and drinks six beers per week.
A 40-year-old woman who weighs 150 lb and drinks three to four alcohol drinks per week.
Which of these conditions is most notable for effecting the synovial joints?
Rheumatic fever
Rheumatoid arthritis
Polymyalgia rheumatica
Osteoarthritis
Age-related changes in connective tissue include which the following?:
Hardening of bone tissue
decreased water content
loss of cartilage elasticity
development of bone spurs
Immobility reduces muscle contractions and can lead to which of these?
Epimysium
Atrophy
Hypertrophy
Dystrophy
The nurse is caring for an older adult patient with a musculoskeletal condition. The patient needs assistance with making adaptations at home to allow maximal possible function. Which of these specialists would be most appropriate to consult?
Physical therapy
Medical social worker
Occupational therapy
Speech therapy
What is the safest category of drugs used in the treatment of arthritis?
NSAIDs
DMARDs
Glucocorticoids
Gold salts
The erythrocyte sedimentation rate (ESR) is decreased with which condition?
Osteoarthritis
Rheumatoid arthritis
Rheumatic fever
Polymyalgia rheumatica
The nurse is caring for a patient with a ruptured Achilles tendon who is asking about the injury. The nurse should explain which features of tendons?
Tendons anchor muscles to bones.
Tendons provide flexible support for part of the adult skeleton.
Tendons are located where two or more bones are joined.
Tendons connect bones and cartilage.
The nurse is caring for an older adult patient with joint pain and limited mobility. The nurse knows that age-related joint changes are related to which factor?
A decrease in the growth of osteophytes
Cartilage becoming hardened
An increase in elasticity in cartilage
A decrease in water content in cartilage
The nurse is conducting a health history on a patient. Which finding from the functional assessment would alert the nurse that the patient may be suffering from a connective tissue disorder?
Recent weight gain
Had to decrease work time from full to part-time
Pain in the right leg
Family history of pancreatic cancer
The nurse is conducting a physical examination on an older adult patient. Which finding would alert the nurse that the patient may have an inflammatory joint disease?
Pale
Crepitus
Heart rate of 60 beats/min
Old bruise on the knee
A patient is prescribed celecoxib (Celebrex) for its anti-inflammatory action. What instruction should the nurse provide with this drug?
The drug may cause decreased blood pressure.
There is no risk of bleeding with this drug.
Take on an empty stomach.
Take with food.
What education is provided to a patient prescribed prednisone (Deltasone) for use in inflammatory conditions?
The patient may stop the drug when the condition improves.
The drug must be tapered off rather than stopped abruptly.
There is less potential for infection while taking prednisone (Deltasone).
Take the lowest dose early in the morning.
Which of these findings is characteristic of gout?
Kidney stones
Hyperglycemia
Hyperuricemia
Hypercalcemia
Patients with gout are instructed on which of these dietary modifications to prevent or reduce future attacks?
Limit plant-based protein.
Limit fluid intake.
Limit dairy intake.
Limit animal protein.
To reduce the risk of DVT, what is usually ordered in the postoperative patient with hip replacement? (Select all that apply.)
Anticoagulant drugs
Bedrest for 24 hours
Pneumatic compression devices
Antiembolic stockings
Pillows under the legs
The nurse provides teaching to the female patient about calcium intake for the prevention of osteoporosis. Which of these are included in the teaching? (Select all that apply.)
Limit intake of alcohol and caffeine.
After the age of 50, women need 1200 mg of calcium per day.
Taking excessive amounts of calcium can cause kidney stones.
Postmenopausal women should not initiate an exercise program.
Whole milk contains the most calcium.
A patient had a total hip replacement of the right hip. Which postoperative actions would be appropriate? (Select all that apply.)
Place an adductor support between the legs.
Maintain the hip in a flexed position.
Place a pillow between the lower extremities when lying on the unaffected side.
Limit flexion of the hip to less than 90 degrees.
Do not turn the patient onto the operative side.
Identify risk factors for osteoporosis. (Select all that apply.)
Playing sports
Taking corticosteroids
cushing syndrome
Menopause
Smoking
Which fracture is a most commonly seen in children?
Longitudinal
greenstick
displaced
avulsion
The nurse is at the bedside completing an assessment on a patient who has a hip fracture. Which signs and symptoms are indicative of fat embolism?
Local pain, redness, and fever
Increasing pain, instability, and decreased function in the affected area
Measles-like rash over the neck, upper arms, chest, or abdomen
Anxiety; pallor; and cool, clammy skin
A patient has a complete fracture of the right humerus in the middle part of the bone. Which treatment would the nurse expect the health care provider to use to correct the fracture?
Internal fixation
Closed reduction
Open reduction
External fixation
Which type of gait is appropriate for use with a walker?
Swing-through gait
Modified swing-to gait
Swing-to gait
Modified swing-through gait
Many factors can affect the healing of a fracture. Which of these is considered a long-term complication of a fracture?
Fat embolism
Infection
Avascular necrosis
DVT
A patient has sustained an open fracture and is admitted for a closed reduction. The nurse assigned to this patient is at the bedside assisting with data collection. Which statement by the patient alerts the nurse that the patient may be experiencing compartment syndrome?
"I have a terrible pain in my calf muscle.”
“I’m having trouble breathing.”
“I’d rate my soreness as 3 out of 10 since I took my pain medication.”
“I have extreme pain that the pain medication is not relieving.”
Which long-term complication of a fracture is treated by physical therapy, nerve blocks, or muscle relaxants?
Posttraumatic arthritis
Complex regional pain syndrome
Malunion
Nonunion
The health care provider has applied a long arm cast made of plaster of Paris to treat an ulnar fracture. The nurse is teaching the patient about cast care. Which statement made by the patient indicates a need for further teaching?
“My cast will be drying for 10 to 15 minutes.”
“I cannot get my cast wet.”
“My cast will be strong and dry in 24 to 72 hours.”
“My cast may feel hot as it dries.”
During which stage of bone healing does the permanent bone callus begin to form and allow the broken bone pieces to begin to knit?
Fibrocartilage formation
Ossification
Callus formation
Hematoma formation
A total hip replacement is performed after a patient sustains a hip fracture. Which nursing interventions are appropriate for the patient recovering from total hip surgery?
Limit weight bearing on the affected side initially.
Ask the patient to cross the leg over the center of the body to assess a range of motion.
A Caucasian patient recently had a below-the-knee amputation. Which assessment finding of the skin flap would require immediate intervention by the nurse?
The skin flap is pale and cool to touch.
Skin flap is pink and dry to touch.
Skin flap is pink and warm to touch.
Skin flap is pink and slightly moist to touch.
A patient is scheduled for a below-the-knee amputation because of gangrene. Which type of amputation should the nurse anticipate caring for postoperatively?
Partial amputation
Closed amputation
Open amputation
Prosthetic amputation
A patient required an above-the-knee amputation for a crush injury to the lower left leg. Twenty-four hours after surgery, the patient is complaining that his left foot is itching and asks why this is happening. What would be the best response by the nurse?
“You should talk with your doctor about this because this is abnormal.”
“The itching occurs because you are experiencing phantom limb pain.”
“You are having this sensation because the nerve endings are still intact in the left foot.”
“You are experiencing phantom limb sensation, which is a completely normal response after amputation.”
The nurse is assessing the compression dressing for a patient 4 hours after a below-the-knee amputation for bleeding. A small amount of drainage is noted on the dressing. The nurse correctly documents the drainage by which method?
Reinforcing the dressing with Kerlix
Changing the dressing, and then documenting it in the patient’s chart
Circling the drainage with a pen and then documenting it in the patient’s chart
Removing and discarding the dressing, and then leaving the wound to air
A 57-year-old male patient is undergoing a complete physical examination before undergoing an amputation of the right leg. What is the most likely reason for this type of amputation?
Tumor
congenital defect
vascular disease
trauma
Which conditions or situations may lead to an amputation? (Select all that apply.)
tumors
trauma
disease
Congenital anomalies
Thyroid disorder
The greatest danger in the immediate postoperative period is hemorrhage in the patient with an amputation. Which of these may be early signs of hemorrhage? (Select all that apply.)
increasing pulse rate
cyanosis
restlessness
hypotension
Increasing respiratory rate
The nurse is caring for a patient who has undergone successful replantation of an upper extremity. What postoperative teaching is important at discharge? (Select all that apply.)
Avoid tight clothing around the affected extremity
Avoid nicotine and caffeine for 3 days
Elevate the limb above the level of the heart
Report changes in color or warmth of replanted limb
A nurse is caring for multiple patients with above-the-knee amputations. Which patient would the nurse assess first
A patient with pain rated 4 on scale of 1 to 10.
A patient who complains of phantom limb pain.
A patient who refuses to move the leg at all.
A patient who complains of constipation and gas discomfort.
A patient with diabetes is hospitalized for a below-the-knee amputation. Because of the patient’s history of diabetes, what would the nurse specifically assess for?
Slight redness at the incision site
Separation of wound edges (dehiscence)
Edematous residual limb
Slight bleeding at several staple sites
AKA Fosamax
Use and action: Increase bone and mineral density by impairing bone resorption.
Side effects: abdominal pain, muscle pain, diarrhea, constipation, severe GI disturbances with overdose, hypocalcemia.
Nursing interventions: take 6-8oz of water upon arising, nothing else by mouth for thirty minutes. Patients should not lay down 30-minutes after taking.
Baclofen
DMARDs
Alendronate
Glucocorticoids
