Question 1

The nurse is caring for a patient in traction. What nursing action would be appropriate in caring for the traction weights? (Select all that apply.?

Accepted Answer

The answer of The nurse is caring for a patient...

Question 2

The nurse is reinforcing teaching on positioning for a patient after a right total knee replacement. Which of the following statements by the patient would indicate a correct understanding of the teaching?

Accepted Answer

After a right total knee replacement, the patient should be positioned supine with a pillow under the right knee to keep it in extension. This helps prevent flexion contractures and reduces the risk of dislocation. Prone and side-lying positions are not recommended, and using three pillows between the legs may not provide the right amount of support and alignment.

Question 3

The nurse is caring for a patient who has a displaced midshaft fracture of the left femur and is in balanced suspension skeletal traction with 35 pounds of weights. The patient reports calf pain with right foot dorsiflexion. Which of the following actions would be most appropriate for the nurse to take?

Accepted Answer

Calf pain with right foot dorsiflexion could be a sign of DVT (deep vein thrombosis) which is a serious complication associated with skeletal traction. The nurse should notify the registered nurse immediately for further assessment and intervention. Encouraging dorsiflexion more frequently or reducing 5 pounds of weight may not address the underlying issue and could potentially worsen the patient's condition. Checking the traction setup may be appropriate in other situations, but in this case, the patient's symptom requires prompt attention.

Question 4

The nurse is caring for a patient who has a fractured pelvis with a left acetabular fracture and is in a Thomas splint with a Pearson attachment with orders of bedrest. When the patient asks to toilet, which of these measures would be appropriate?

Accepted Answer

Using a trapeze allows the patient to maintain alignment and minimizes movement of the fractured pelvis, which is crucial for healing.

Question 5

The nurse is caring for a patient with gout. Which of the following laboratory values would indicate that the treatment plan was effective?

Accepted Answer

Uric acid is the laboratory value associated with gout. A decrease in uric acid levels would indicate that the treatment plan for gout is effective. The other laboratory values listed (BUN, Creatinine, and LDL) are not directly related to gout and are unlikely to change as a result of treatment for gout.

Question 6

The nurse is reinforcing teaching for carpal tunnel syndrome treatment. Which of the following statements by the patient would indicate a correct understanding of the teaching?

Accepted Answer

A wrist splint is used to immobilize the wrist and reduce pressure on the median nerve.

Question 7

The nurse is reinforcing teaching for a patient who is using a continuous passive motion (CPM) machine. Which of these, if stated by the patient, indicates to the nurse correct understanding of its purpose?

Accepted Answer

The purpose of a continuous passive motion (CPM) machine is to restore joint function by maintaining and improving the range of motion after surgery or injury. It does not directly control pain or relieve swelling, and although it may help prevent muscle atrophy, its primary goal is not to strengthen leg muscles.

Question 8

The nurse checks a casted right leg resting upon a pillow and finds that the cast appears too tight. What should the nurse do?

Accepted Answer

If the cast appears too tight, the nurse should notify the registered nurse or provider immediately. Adjustments may need to be made to avoid circulation problems or pressure ulcers. Removing the pillow or applying an extra blanket would not address the issue of the cast being too tight, and administering pain medication may not be appropriate if the cause of discomfort is due to the tight cast.

Question 9

The nurse is reinforcing teaching for a patient with osteoporosis. Which of the following should the nurse recommend be included in the patient's plan of care as a risk factor for osteoporosis development?

Accepted Answer

Increased caffeine intake can interfere with calcium absorption, which may contribute to the development of osteoporosis.

Question 10

The nurse has reinforced medication teaching with a patient who has rheumatoid arthritis. Which of these medications, if stated by the patient, indicates to the nurse correct understanding of symptom control with a medication?

Accepted Answer

Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) commonly used to control symptoms of rheumatoid arthritis, such as pain and inflammation. Digoxin is used to treat heart failure, morphine is a strong narcotic pain medication, and penicillin is an antibiotic used to treat bacterial infections, none of which are commonly used to treat rheumatoid arthritis symptoms.

Question 11

The nurse is providing care to an 87-year-old female with a history of osteoarthritis. The patient reports an average generalized pain score of 4 on a 0-to-10 scale wile using acetaminophen prn. Which of the following statements by the nurse is best?

Accepted Answer

CB) Asking the patient if they are satisfied with their level of pain control is important for assessing the effectiveness of the current pain management strategy and considering if adjustments are needed.C) Inquiring about a daily calcium supplement is relevant for a patient with osteoarthritis, as calcium is important for bone health, and osteoarthritis patients may have an increased risk of osteoporosis.

Question 12

The nurse is reinforcing teaching for a patient who has osteoporosis and is being taught complications that can occur from osteoporosis. Which of these, if stated by the patient, indicates to the nurse correct understanding of a complication of osteoporosis?

Accepted Answer

Hip fracture is a common complication of osteoporosis due to weakened bones. Increased bone density is not a complication but rather a desired outcome of treatment for osteoporosis. Overgrowth of bone and bone spur formation are not typically associated with osteoporosis.

Question 13

The nurse understands when collecting data on a patient that the appearance of a petechial rash and respiratory distress 3 days after a fracture of the femur are indications of which of these complications?

Accepted Answer

The appearance of a petechial rash and respiratory distress 3 days after a fracture of the femur is indicative of a fat embolism, which is a serious complication that can occur when fat droplets from bone marrow enter the bloodstream and become lodged in the lungs or other organs. Infection, pleural effusion, and pneumonia may also occur as complications following a fracture, but they are not typically associated with the specific symptoms described in the question.

Question 14

The nurse is reinforcing teaching for a patient who is postmenopausal, has lost 2 inches of height, and has osteoporosis. Which of these, if stated by a patient, indicates to the nurse correct understanding of the purpose of calcium supplements?

Accepted Answer

Calcium supplements are taken to decrease bone loss and help prevent osteoporosis. Calcium assists in building and maintaining strong bones. It is important for postmenopausal women who are at higher risk for bone loss and fractures. Calcium does not increase energy levels or excretion of calcium, nor does it decrease serum calcium.

Question 15

The nurse is collecting data for a patient suspected of developing a fat embolus from a fracture of the right femur. Which of these manifestations would the nurse expect? (Select all that apply.?

Accepted Answer

Mental confusion, petechiae, and tachycardia are all manifestations of a fat embolus. A migraine, numbness in the right leg, and muscle spasms in the right thigh are not typically associated with a fat embolus.

Question 16

The nurse is contributing to the plan of care for a patient who has a bone fracture that is splintered or shattered into numerous fragments. Which of the following describes this type of fracture?

Accepted Answer

A comminuted fracture is characterized by the bone being splintered or shattered into numerous fragments, which can make it more difficult to treat and require more extensive interventions such as surgery.

Question 17

The nurse has reinforced teaching with a patient who has an open fracture of the right leg about prevention of osteomyelitis. Which of the following statements by the patient would indicate a correct understanding of the teaching?

Accepted Answer

Washing hands prior to touching the fracture area can help prevent infection and the development of osteomyelitis. Increasing calcium intake and keeping the leg immobilized may be important for promoting healing of the fracture, but they do not directly prevent osteomyelitis. Applying ice to the right leg may help with pain and swelling, but it also does not directly prevent osteomyelitis.

Question 18

Which of the following are manifestations that are characteristic of rheumatoid arthritis and help distinguish it from osteoarthritis? (Select all that apply.?

Accepted Answer

Rheumatoid arthritis is characterized by early morning stiffness, systemic symptoms like low-grade fever, involvement of other organs, and is an autoimmune disease. These features help distinguish it from osteoarthritis, which typically involves Heberden's nodes and pain that worsens with activity.

Question 19

The nurse, when collecting data on a patient 48 hours after surgery for a fractured femoral shaft, notes mental confusion, tachycardia and tachypnea, dyspnea, high blood pressure, and petechiae on the chest and reports the findings to the RN. What nursing interventions are appropriate while awaiting the physician's specific orders? (Select all that apply.?

Accepted Answer

The symptoms described are indicative of a potential fat embolism syndrome (FES), a serious complication that can occur after fractures, particularly of long bones like the femur. The appropriate nursing interventions while awaiting physician's orders include: - Placing the patient in a high Fowler's position or raising the head of the bed (A) to improve ventilation and ease breathing.- Preparing the patient for diagnostic tests such as a chest x-ray or lung scan (C) to assess for pulmonary emboli.- Maintaining bedrest and keeping movement to a minimum (D) to reduce the risk of further embolization.- Administering oxygen (E) to support oxygenation due to respiratory distress caused by emboli.- Preparing the patient for arterial blood gas tests (F) to evaluate the extent of respiratory compromise and gas exchange efficiency.

Question 20

The nurse is contributing to the plan of care for a patient who is scheduled for a below-the-knee amputation. What nursing diagnosis should be recommended for the preoperative plan of care?

Accepted Answer

Anxiety is a common nursing diagnosis for patients who are scheduled for amputations or other major surgeries. The nurse should assess the patient's anxiety level and implement interventions to promote relaxation and reduce stress. While the other options may be applicable to some patients undergoing amputations, anxiety is the most relevant and specific nursing diagnosis for this particular patient.

Quiz 46: Nursing Care of Patients With Musculoskeletal and Connective Tissue Disorders