Question 1

The nurse is assisting with the preparation of materials for a health fair aimed at promoting health in women. Which reason does the nurse recognize as a probable cause of an increase in the incidence of osteoporosis?

Accepted Answer

The ages of adults have increased. Osteoporosis is a condition that is more common in older adults. As the population ages, the incidence of osteoporosis is likely to increase.

Question 2

An older adult patient is postoperative for a total hip joint replacement. Which nursing care is inappropriate for this patient on the day of surgery?

Accepted Answer

C

Question 3

The nurse is assisting with the care of patients who have had joint replacement surgery. Which action is unnecessary for the patient after a total knee replacement (TKR)?

Accepted Answer

Maintaining proper joint alignment is more critical for hip replacements to prevent dislocation, whereas knee replacements focus more on mobility and preventing complications like DVT and bleeding.

Question 4

The nurse is providing care for a patient being treated after a complicated femur fracture. The nurse has noticed drowsiness, tachycardia, and a low-grade fever. Which additional manifestation alerts the nurse to the possibility of a fat emboli?

Accepted Answer

The presence of a petechial rash on the chest and neck is a classic sign of fat embolism syndrome, which can occur after a long bone fracture like the femur. This syndrome can also present with respiratory distress, cerebral symptoms, and a petechial rash.

Question 5

The nurse is assisting with the care of a patient with rheumatoid arthritis (RA). The nurse must remember in which way RA care is different from osteoarthritis care. Which nursing care does the nurse specifically provide for the patient with RA?

Accepted Answer

Rheumatoid arthritis (RA) is a systemic autoimmune disease that can affect multiple body systems beyond the joints, including the skin, eyes, lungs, heart, and blood vessels. Therefore, it is essential to monitor all body systems for effects of the disease, distinguishing it from osteoarthritis, which is primarily a degenerative joint disease without systemic manifestations.

Question 6

A patient who has a displaced midshaft fracture of the left femur is in balanced suspension skeletal traction with 35 pounds of weight. The patient reports calf pain with right foot dorsiflexion. Which action does the nurse take?

Accepted Answer

The patient's symptoms suggest a possible deep vein thrombosis (DVT), which is a serious condition requiring immediate medical attention. Notifying the RN is the appropriate action to ensure prompt evaluation and treatment.

Question 7

The nurse is contributing to the plan of care for a patient who has an upper extremity amputation. Which factor does the nurse keep in mind about this type of amputation being more debilitating than a lower extremity amputation?

Accepted Answer

The upper extremity is more specialized, meaning it is involved in more complex functions such as grasping, holding, and manipulating objects, which are essential for many daily activities. This specialization makes an upper extremity amputation more debilitating compared to a lower extremity amputation, as it significantly impacts a person's ability to perform tasks and engage in self-care.

Question 8

The nurse is assisting with patients on an orthopedic unit. Which is an important factor to remember when caring for patients after a total hip replacement?

Accepted Answer

A triangular pillow, often called an abduction pillow, is used between the legs to prevent adduction and maintain proper hip alignment after a total hip replacement.

Question 9

The nurse is providing care for a patient who is scheduled for joint replacement the next day. Which patient care goals are appropriate at this time?

Accepted Answer

Managing preoperative pain is an appropriate patient care goal at this time because it can help to improve the patient's comfort and well-being before surgery.

Question 10

A patient is being prepared for a prosthesis following surgery for an amputation. Which information will the nurse provide to the client regarding the use of a prosthesis?

Accepted Answer

Skin inspection is performed each time the sock is removed to assess for any skin breakdown or irritation.

Question 11

The nurse is providing care for a patient after an above-the-knee amputation because of ischemia related to diabetes mellitus complications. Which nursing care is essential for promoting ambulation?

Accepted Answer

The answer of The nurse is providing care for a...

Question 12

The nurse is providing care for a patient who experienced a closed reduction to a fracture of the ulna. Which manifestation does the nurse recognize as an early symptom of acute compartment syndrome?

Accepted Answer

Pallor with extremity warmth is an early symptom of acute compartment syndrome, indicating compromised circulation and increased pressure within the compartment.

Question 13

The nurse is providing care for a patient with external fixation for a fracture involving severe bone damage. Which is the most important focus for the nurse during care of this patient?

Accepted Answer

Monitoring pin and wound sites for signs of infection is crucial in patients with external fixation devices to prevent complications such as osteomyelitis.

Question 14

The nurse is preparing for a home visit to a patient after surgery for a compound fracture. Which specific care does the nurse anticipate for this patient?

Accepted Answer

Changing wound dressings is a specific care that the nurse anticipates for a patient after surgery for a compound fracture.

Question 15

A patient asks the difference between osteoarthritis and RA. Which manifestations does the nurse explain are characteristic of RA? (Select all that apply.)

Accepted Answer

Rheumatoid arthritis (RA) is characterized by autoimmune disease processes, leading to inflammation and joint damage. Patients often experience low-grade fever, early morning stiffness, and systemic symptoms, unlike osteoarthritis, which is primarily due to wear and tear of the joints and does not typically involve systemic symptoms like fever. Heberden's nodes are associated with osteoarthritis, and pain in osteoarthritis often increases with activity, contrasting with the stiffness and pain of RA that may improve with activity after a period of rest.

Question 16

The nurse is providing care for a patient following an open reduction of a compound fracture. Which neurologic finding does the nurse report immediately to the HCP or registered nurse (RN)?

Accepted Answer

Numbness and tingling sensations can indicate nerve damage or compromised circulation, which requires immediate attention.

Question 17

A patient experiences a fracture of the lower leg and undergoes a closed reduction and placement of a fiberglass cast. The patient is 65 years old and has a medical 30-year history of diabetes mellitus. Which condition does the nurse recognize as a possible complication for this patient?

Accepted Answer

The patient's long history of diabetes mellitus can lead to poor circulation and neuropathy, which may result in delayed or absent healing of the fracture.

Question 18

A patient with gout has been instructed on the prescribed medication allopurinol (Zyloprim). Which patient statement indicates understanding of the action of this medication?

Accepted Answer

Allopurinol works by inhibiting xanthine oxidase, an enzyme involved in the conversion of purines to uric acid, thereby blocking the formation of uric acid, which is the cause of gout.

Question 19

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

Accepted Answer

Petechiae, tachycardia, and mental confusion are common manifestations of a fat embolus. Petechiae can appear on the skin due to small blood vessels being blocked by the fat emboli. Tachycardia and mental confusion can result from the emboli affecting the cardiovascular and central nervous systems, respectively.

Question 20

The home-care nurse is attending to a patient with osteomyelitis in a lower extremity from a traumatic bone fracture. The patient has an open wound that is infected. Which observation prompts the nurse to provide additional information to the patient and family?

Accepted Answer

Clean technique is not sufficient for managing an open wound that is infected, especially in a case of osteomyelitis. Aseptic technique should be used to prevent further infection.

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