Deck 26: Management of Clients with Musculoskeletal Disorders

Question 1

The client with osteomalacia is depressed and anxious about the outcome of the illness. The most beneficial nursing response would be

A) "Cortisone and active weight-bearing exercises will reduce the symptoms."
B) "Don't worry; some adjustments in lifestyle can offer a normal life expectancy."
C) "I can see you are upset. Did the doctor tell you this is easy to treat and control?"
D) "Treatment with high-dose calcium supplements will correct the disorder."

Answer 1

"I can see you are upset. Did the doctor tell you this is easy to treat and control?"

Question 2

The nurse is counseling a client at risk of osteoporosis that one of the most beneficial exercises is

A) cycling.
B) swimming.
C) walking.
D) water aerobics.

Answer 2

walking.

Question 3

In the initial visit to a recently discharged client with osteoporosis, the home health nurse will reinforce the priority topic of

A) diet low in phosphates.
B) exercise regimen.
C) hazards to home safety.
D) medication administration.

Answer 3

hazards to home safety.

Question 4

When counseling a client who is a strict vegan, the nurse would caution that this diet puts the client at risk for

A) gout.
B) osteoarthritis.
C) osteomalacia.
D) Paget's disease.

Question 5

A client with osteoporosis complains that avoiding coffee will be very difficult. To offset coffee consumption, the nurse might suggest that for every cup of coffee consumed, the client should

A) add 1 serving of leafy green vegetables.
B) combine 20 minutes of exercise to the daily program.
C) drink 1 glass of orange juice or grapefruit juice.
D) take 40 mg of over-the-counter calcium.

Question 6

The nurse discussing treatment options with a client with Paget's disease will focus on the most frequent treatment, which is with

A) bisphosphonates.
B) calcium supplements.
C) heat and cold application.
D) splinting.

Question 7

A client is being managed for prevention of gout and the nurse is reviewing the client's medication list and teaching about the medications. The nurse evaluates that the client understands the medication when the client says

A) "Allopurinol blocks production of uric acid."
B) "Colchicine can be used with probenecid."
C) "Long-term steroids are needed to prevent attacks."
D) "NSAIDs are not effective against the pain of gout."

Question 8

A client has been diagnosed with early osteoarthritis (OA) in the hips. The nurse explains that the first medical treatment that will be tried is administration of

A) acetaminophen (Tylenol).
B) celecoxib (Celebrex).
C) misoprostol (Citotec).
D) nonsteroidal anti-inflammatory drugs (NSAIDs).

Question 9

The nurse teaching a class on osteoarthritis (OA) stresses that this disorder is best described as

A) degeneration of articular cartilage in synovial joints.
B) enzymatic breakdown of tissue in non-weight-bearing joints.
C) joint destruction caused by an autoimmune process.
D) overproduction of synovial fluid, resulting in joint destruction.

Question 10

On admission assessment of a client with Paget's disease, the nurse would anticipate the client to complain of

A) continuous bone pain.
B) fever in the afternoon.
C) pain on ambulation.
D) swelling at site of deformity.

Question 11

The nurse counseling a client with osteoporosis identifies one of the medications that may have contributed to the condition as

A) aspirin.
B) colchicine.
C) ibuprofen.
D) prednisone.

Question 12

After surgical debridement of diseased bone, a client with acute osteomyelitis asks how long antibiotics will be administered. The nurse should respond that the antibiotic protocol will be

A) oral antibiotics for 2-4 weeks.
B) oral antibiotics for 4-8 weeks.
C) parenteral for 4-8 weeks, then oral for 4-8 weeks.
D) parenteral for 4-8 weeks, then oral for 1 year.

Question 13

The nurse instructing a client on considerations regarding the medication calcium carbonate would include in the teaching plan that the client

A) has to wait 1 hour after meals to take the medication.
B) may experience nausea or diarrhea.
C) needs to take the calcium with an 8-ounce glass of water.
D) should take the calcium carbonate with food.

Question 14

The nurse is assessing a client with osteoporosis. The finding that is consistent with the nurse's understanding of the disease is

A) a stiff posture.
B) kyphosis.
C) pain in long bones.
D) weight loss.

Question 15

On admitting a client with acute osteomyelitis, the nurse is not surprised at the client's complaint of

A) generalized bone pain.
B) localized pain and redness.
C) nausea and vomiting.
D) paresthesias in the affected extremity.

Question 16

A nurse admitting a 22-year-old client with septic arthritis in the knees would inquire about recent infection with

A) a respiratory tract virus.
B) gonorrhea.
C) strep throat.
D) urinary tract manifestations.

Question 17

The nurse explains that the most common early manifestation of a primary bone tumor is

A) fever.
B) fracture.
C) mass.
D) redness.

Question 18

The nurse assesses that the individual most susceptible to osteoporosis is the

A) muscular 50-year-old man with diabetes.
B) obese 50-year-old woman who is allergic to milk.
C) thin 70-year-old man with gout.
D) very slender 75-year-old woman.

Question 19

The nurse instructing a client at risk for osteoporosis would encourage the client to include which item in the client's diet?

A) Beans
B) Citrus fruits
C) Dairy products
D) Red meat

Question 20

The nurse recognizes the significant laboratory finding helpful in confirming the diagnosis of a bone tumor as

A) decreased calcium level.
B) decreased potassium level.
C) elevated alkaline phosphatase level.
D) elevated creatinine level.

Question 21

A client had a total hip arthroplasty from the posterolateral approach. The nurse ensures correct positioning by placing the client with the operative leg

A) abducted with a triangular foam pillow.
B) externally rotated to 90 degrees.
C) in a flexed position with pillows between the knees.
D) internally rotated to no more than 60 degrees.

Question 22

The nursing care of a client with muscular dystrophy is focused on symptomatic treatment and supportive care, with a major emphasis on problems pertinent to

A) ambulation.
B) elimination.
C) nutrition.
D) respiration.

Question 23

A client has septic arthritis of the knee and the inflammation is beginning to subside. The best nursing action to prevent joint contractures at this point is to

A) encourage the client to get out of bed and ambulate.
B) have physical therapy plan an active ROM regimen.
C) immobilize the joint in a sling until the infection resolves.
D) provide passive ROM for the affected joint.

Question 24

The nurse is transferring a client with a noncemented total hip arthroplasty (THA) from bed to walker. In order to assist the client safely, which action will the nurse encourage before the client uses the walker? The nurse will tell the client to

A) place one foot on floor and hold the walker to stand.
B) push off of the bed with the arms and gain balance on one foot.
C) slowly bear weight on both legs.
D) stand at the bedside on both feet so the nurse can assess for syncope.

Question 25

The nurse is caring for a client with a continuous passive motion (CPM) machine after a total knee arthroplasty. An important safety measure the nurse should add to the plan of care is to

A) allow the client to use the machine 10-12 hours daily.
B) keep the head of the bed elevated at least 30 degrees.
C) position the client supine during CPM machine use.
D) remove the CPM machine during meals.

Question 26

Psychosocial implications of a diagnosis of osteoporosis the nurse should assess for can include (Select all that apply)

A) anxiety over disfigurement.
B) chronic pain.
C) fear of falling.
D) poor quality of life.
E) self-esteem problems.

Question 27

As a beneficial exercise program, the nurse teaching a group of clients with osteoarthritis would suggest

A) daily vigorous aerobic exercise followed by a warm shower or bath.
B) minimal exercise several times daily, followed by rest periods.
C) regular daily, low-impact exercise program.
D) strength-building exercises with weights or resistance.

Question 28

The client returns from surgery for a THA with a Hemovac in place. The nurse assesses the first 6 hours drainage as 350 ml. The most appropriate action by the nurse is to

A) change the client's position to supine.
B) drain the Hemovac and record the amount.
C) notify the physician of the amount of drainage.
D) report the excessive drainage to the oncoming nurse.

Question 29

A client has severe osteoarthritis in the hips. An important psychosocial assessment the nurse should make on this client is

A) ability to obtain medications.
B) hobbies and leisure time interests.
C) job-related physical restrictions.
D) sexual role functioning.

Question 30

A client wears joint-protecting splints and needs assistance with some ADLs and mobility. The nurse delegating this care to an unlicensed assistive personnel (UAP) should (Select all that apply)

A) allow the UAP to do as much for the client as possible.
B) assess the client's baseline status and make modifications to the care plan.
C) instruct the UAP to have the client stop activities that cause new pain.
D) tell the UAP to report any redness or skin irritation under the splint to the nurse.
E) verify the UAP's competency to do the assigned tasks.

Question 31

The nurse caring for a client who has undergone total hip replacement (THR) assesses for manifestations of the most common and serious complication after hip surgery, which is

A) contractures.
B) deep vein thrombosis.
C) infection.
D) prosthesis dislocation.