Question

Musculoskeletal Nursing

Which of the following nursing interventions is appropriate care for a client who is two days post op with a below the knee amputation of the left leg?

1. Wrap the stump only at night so the suture line is open to air during the day.
2. Encourage the patient to lie only on their back and unoperative side.
3. Elevate the foot of the bed slightly to decrease edema.
4. Elevate the stump on pillows to prevent contractures.

The nurse is caring for a patient who complains of severe pain due to rheumatoid arthritis. Which of the following nursing interventions would be appropriate when caring for the patient? (select all that apply)

1. Administer PRN medications as far apart as possible since this condition is chronic.
2. Maintain body alignment using trochanter rolls and sandbags if needed.
3. Encourage joint rest during the acute stage of the illness.
4. Encourage and assist with an exercise program for the patient's joints.

The nurse is caring for a 78 year old patient who has been diagnosed with osteoporosis. She drinks coffee throughout the day.   She does not like fruits or vegetables, but does like to eat meat and dairy products.   She enjoys walking in her apartment complex each day.   Which of the following would be appropriate teaching for this patient?

1. Decrease the amount of coffee you drink
2. Increase your intake of meat but decrease your intake of dairy products
3. Increase your intake of meat, fruits, and vegetables
4. Do not go on walks because you can cause more compression fractures

The nurse is caring for a patient that is scheduled for an arthrocentesis of the right knee. Which of the following statements by the patient indicates he/she needs further teaching?

1. "This procedure is used to remove fluid from the joint."
2. "This procedure is used to examine fluid under a microscope."
3. "This procedure is used to diagnose trauma, gout, osteoarthritis, or rheumatoid arthritis."
4. "This procedure is used to examine a joint with a lighted scope."

The nurse is caring for a 78 years old female patient who has recently been diagnosed with osteoporosis. When the nurse reviews her medications after her physician's visit, the nurse finds that she is on new medications for her osteoporosis. Which of the following would not be a new medication for osteoporosis?

1. Vitamin D
2. Calcium
3. Estrogen supplement
4. Potassium

A pedestrian is struck by a car and sustains a leg injury. Upon admission to the emergency department, it is observed that the injured leg is painful, swollen, ecchymotic, and is shorter than the other leg. What condition are these findings consistent with?

1. Congenital Hip Dysplagia
2. Fat Embolis
3. Osteomyelitis
4. Fracture of the femur

The nurse is caring for a four-year-old pediatric patient diagnosed with a fractured femur. The chart indicates the patient is in Bryant's traction. In what position will the nurse expect to find the child?

1. Lying in a supine position with both legs suspended at a 90 degree angle to his body
2. Lying in a prone position with both legs flat against the bed, with weights attached to both feet.
3. Lying in a prone position with one leg at a 90 degree angle to his body
4. Lying in a supine position with both legs flat on the bed, with weights attached to one foot

The nurse receives a patient from the emergency department in Buck's traction following a fractured right femur. The nurse documents which of the following as a priority in the client's medical record?

1. Type of pin, wire or tongs used
2. Status of skin underneath the traction and over boney prominences
3. Medications given in the emergency department
4. The effectiveness of pain medication given before the emergency room

The nurse is caring for a patient with severe osteoarthritis of the hip. Medical management has failed to resolve the patient's pain and immobility. To treat the patient's severe osteoarthritis surgically, which of the following procedures will be performed?

                A. total hip fusion surgery

                B. open reduction, internal fixation surgery

                C. total hip replacement surgery

                D. continuous passive motion surgery

The nurse is caring for a patient who has an infection in his right femur. The physician orders Keflex 250 mg po qid. You have on stock Keflex 500 mg tabs. How much will you give___________________

                A. 1 tab

                B. 3/4 tab

                C. 1/2 tab

                D. 2 tabs

The nurse is working on an orthopedic unit of the hospital. The nurse is assigned to care for a 25-year-old patient who was injured in a bungee-jumping accident. He suffered a comminuted fracture of the right tibia and an impacted fracture of the right femur. How would the nurse describe the injury to his right tibia?

A. The lower part of his tibia is forcible wedged into the upper part of his tibia

B. His tibia is broken and bent but still secure on one side

C. He has a break that runs at a 45 degree angle to the length of the tibia

D. His tibia has splintered into three or more fragments, with more than one fracture line

The nurse is caring for a patient taking a nonsteroidal anti-inflammatory (NSAID) medication for osteoarthritis. Which of the following should the nurse include when teaching the patient about his medications?

                A. Take this medication only for a short time.

                B. Do not use alcohol or OTC meds while taking this.

                C. Taper off the medication as ordered; do not stop abruptly.

                D. Watch for signs of GI Irritation and bleeding.

Two hours after a child has a cast applied for a fractured radius, the nurse assessment reveals swelling in the hand, which is elevated higher than the heart. Ice has been applied continuously. The child does not complain of pain but does complain of numbness and tingling. Which should the nurse do first?

                A. Call the physician

                B. Provide the child with diversional activities

                C. Medicate for pain

                D. Elevate the injured extremity even higher

How is oxygen debt repaid?

                A. By breathing rapidly and deeply to get more oxygen in the blood

                B. By giving extra oxygen from an oxygen tank

                C. By taking oxygen out of the muscle cells and putting it into the blood cells

                D. By taking more oxygen out of the lungs each time you breathe

The nurse is caring for a client with multiple myeloma. As the nurse looks through the patient's chart, which of the following lab tests would the nurse expect to be affected by her diagnosis of multiple myeloma?

                A. Uric acid level

                B. Rheumatoid factor (RF)

                C. Complete blood count (CBC)

                D. Sedimentation rate (ESR)

Answer 1

Ans) A) Wrap the stump only at night so the suture line is open to air during the day.

Explanation:

- Wrap the residual limb with an elastic bandage in a figure eight configuration.

- The wound may also open up along the surgical line (dehiscence). This happens when the wound is not strong enough to resist the forces placed on it and could result in muscle and bone is exposed. These forces include a direct fall (most common), trauma, or shearing. Other causes may include removing the sutures too soon or swelling of the residual limb. Surgical intervention is usually indicated with total dehiscence.

A) Administer PRN medications as far apart as possible since this condition is chronic.
B) Maintain body alignment using trochanter rolls and sandbags if needed.
C) Encourage joint rest during the acute stage of the illness.
D) Encourage and assist with an exercise program for the patient's joints

All of the above interventions are for rheumatoid arteritis

A)Decrease the amount of coffee you drink.

Explanation:

- Best Diet to Beat Osteoporosis
The safest strategy is eating a diet that's low in salt and rich in fresh and minimally processed whole grains, fruits, and vegetables. Include enough calcium and vitamin D from foods, and supplements if necessary, and be sure to limit caffeine and carbonated drinks.

B) This procedure is used to examine fluid under a microscope."

Explanation:

-  Joint aspiration is a procedure whereby a sterile needle and syringe are used to drain synovial fluid from a patient's joint. Joint aspiration is sometimes called joint drainage and is medically referred to as arthrocentesis.