Question 1

The nurse sees a neighbor fall and fracture a leg.What should the nurse do first for the neighbor?

Accepted Answer

For emergency care of a suspected fracture,do not try to reposition the limb.Splint it as it lies and ensure that the limb is secured above and below the break to minimize movement and bone grating.A.B.C.Then cover site,transport,and assess pain level.

Question 2

The nurse is reinforcing teaching provided to a patient with rheumatoid arthritis (RA).Which patient statement indicates understanding of the symptoms of RA?

Accepted Answer

Because of the systemic nature of RA,in addition to pain and joint involvement,the patient may have a low-grade fever,malaise,depression,lymphadenopathy,weakness,fatigue,anorexia,and weight loss.B.C.D.Paralysis,crepitation,and shortness of breath are not manifestations of RA.

Question 3

The nurse is contributing to the plan of care for a patient who has an upper extremity amputation.Why should the nurse keep in mind that this type of amputation can be more debilitating than a lower extremity amputation when planning care?

Accepted Answer

Upper extremity amputations are usually more significant than lower extremity amputations as the arms and hands are necessary for performing activities of daily living.A.B.D.Upper extremity amputations are not more debilitating because the upper extremity is more visible,the prosthetic fitting is easier for the leg,or because of a greater blood supply to the upper extremities.

Question 4

The nurse is caring for a patient who had a closed reduction of the ulna with a cast applied.Later the patient reports left arm pain.What should the nurse do first?

Accepted Answer

The nurse should begin with data collection to determine what the next action is to take.The nurse should perform a neurovascular check.A.The edges of the cast may need to be padded if this is the cause of the patient's pain.B.The physician should not be notified until neurovascular checks are performed.C.The nurse needs to assess the patient's pain level before providing an analgesic.

Question 5

The nurse is reinforcing teaching provided to a patient recovering from right total hip replacement.Which patient statement indicates a correct understanding of the teaching?

Accepted Answer

Prevention of dislocation is a major nursing responsibility.Correct positioning of the surgical leg is critical.The primary goals are to prevent hip adduction which is done by keeping the legs apart.B.C.D.These actions will not prevent hip adduction.

Question 6

The nurse is monitoring a patient with a casted left tibial fracture and a contusion of the thigh.The patient reports increasing pain in the left foot that has not been relieved by morphine injections.What should the nurse do?

Accepted Answer

The early symptom of acute compartment syndrome is the patient's report of severe,increasing pain that is not relieved with narcotics,so the physician should be notified.A.B.C.These actions might be done if prescribed by the physician.

Question 7

The nurse is evaluating teaching provided to a patient with gout.Which patient menu selection indicates that additional teaching is required?

Accepted Answer

The patient should avoid high-purine (protein)foods,such as organ meats,shellfish,and oily fish (e.g.,sardines).A.B.C.These food items would be appropriate for the patient being treated for gout.

Question 8

The nurse is caring for a patient who has had a right hip replacement.For which position is the nurse attempting to achieve when a pillow is placed between the legs during turning?

Accepted Answer

A trapezoid-shaped abduction pillow (sometimes called a triangular pillow),splint,wedge,or regular bed pillows may be used between the legs to maintain abduction and prevent adduction.Some research,however,indicates that these precautions may not be necessary and may slow recovery.A.D.The pillow is not used to support knee flexion or hyperextension.C.Adduction of the hip joint is to be prevented.

Question 9

A patient with a 36-hour-old fractured femur is in traction and is prescribed morphine 10 mg every 3 hours as needed.The patient received a dose 3 hours ago and is now reporting a pain level of 8.The patient is stable.Which action should the nurse take?

Accepted Answer

The data collection findings are normal.Since it is time for the pain medication and the patient is in pain,the medication can be given.A.B.D.There is no need to hold the medication,notify the RN,or wait to give the medication in 30 minutes.

Question 10

The nurse observes a petechial rash and respiratory distress in a patient recovering from a fractured femur.What should these findings suggest to the nurse?

Accepted Answer

The earliest manifestation of fat embolism syndrome is altered mental status from a low arterial oxygen level.The patient then experiences tachycardia,tachypnea,fever,high blood pressure,severe respiratory distress,and petechiae.A.B.D.These findings are not manifestations of infection,pneumonia,or pleural effusion.

Question 11

The nurse is contributing to the plan of care for a patient who has a fractured hip and is placed in Buck's (boot)traction while awaiting surgery.What is the desired outcome for placing the patient in Buck's traction?

Accepted Answer

Buck's traction does not promote bone alignment or healing but is used instead for relief of painful muscle spasms that often accompany fractures.A.Traction is not used to restrain a patient.

Question 12

The nurse is reinforcing teaching for a patient who has had a total hip replacement on correct sitting positions.Which position should the nurse teach the patient to avoid?

Accepted Answer

Legs should be kept abducted (away from center of body),so legs should not be crossed.B.C.D.These positions do not need to be avoided for the patient with a total hip replacement.

Question 13

A patient with a casted,fractured left leg asks why the leg has to be elevated.What should the nurse respond to this patient?

Accepted Answer

A casted limb is elevated for 24 to 48 hours,and ice can be applied above and below the cast to reduce swelling.B.C.D.The limb is not elevated to prevent cast cracking,promote comfort,or to allow the cast to dry evenly.

Question 14

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 decreases uric acid production.A.C.D.Allopurinol (Zyloprim)does not excrete proteins or increase the formation or metabolism of purines.

Question 15

The nurse is contributing to the plan of care for a patient who has a right fractured femur.What intervention should the nurse include in the plan of care to prevent fat emboli?

Accepted Answer

Prevention of fat emboli includes keeping the fracture immobilized and hydrating the patient to help dilute and excrete any fat that may escape from the fractured bone.A.Decreasing the consumption of fat will not help prevent fat emboli.C.D.Deep breathing and coughing and performing passive range of motion will not prevent the development of fat emboli.

Question 16

The nurse is reinforcing teaching provided to a patient with gout.Which food should the patient state will be avoided that indicates teaching has been effective?

Accepted Answer

The patient should be instructed to avoid high-purine (protein)foods such as organ meats,shellfish,and oily fish.A.B.D.Rice,beets,and bananas do not need to be avoided.

Question 17

A patient has an open reduction of a radial fracture and is casted.Several hours after the operation,the patient reports a throbbing pain in the arm.What nursing action is essential for the nurse to take?

Accepted Answer

The nurse should begin with data collection to determine what the next action to take.For this patient the nurse should perform neurovascular checks.A.The arm might need to be positioned however this should not be done until a neurovascular check is completed.C.Administering pain medication might be indicted however should not be done until a pain assessment is completed.D.The nurse needs to determine the patient's neurovascular status before notifying the physician.

Question 18

The nurse is contributing to the plan of care for a patient with Paget's disease.Which outcome should the nurse identify as being appropriate for this patient?

Accepted Answer

Pain control is a major issue with many patients with Paget's disease.The outcome stating that pain is relieved at a satisfactory level is the most appropriate for this patient.A.B.C.Outcomes that address weight gain,intake and output,and coping skills are not necessarily appropriate for this patient.

Question 19

The nurse is caring for a patient who has a newly casted,fractured wrist.Data collection reveals slightly puffy fingers with good capillary refill.What should the nurse do now to prevent complications?

Accepted Answer

A casted limb is elevated for 24 to 48 hours,and ice can be applied above and below the cast to reduce swelling.A.The RN does not need to be notified.B.Heat should not be applied at this time.D.The pillow should not be removed from under the cast.

Question 20

The nurse finds a 2-day postoperative patient who had a right total hip replacement lying supine with crossed legs.What data should the nurse collect on this patient?

Accepted Answer

Crossing the legs puts the hip at risk for dislocation.Symptoms are pain in the affected hip,shortening of the leg,and possibly rotation of the surgical leg.B.The patient did not have surgery on the right knee.C.D.The patient did not have surgery to the left limb.

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