Musculoskeletal Examination (Exam Mode) By Rnpedia.Com
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- 1.A client is 1 day postoperative after a total hip replacement. The client should be placed in which of the following position?
- A.
Supine
- B.
Semi Fowler's
- C.
Orthopneic
- D.
Trendelenburg
- 2.A client who has had a plaster of Paris cast applied to his forearm is receiving pain medication. To detect early manifestations of compartment syndrome, which of these assessments should the nurse make?
- A.
Observe the color of the fingers
- B.
Palpate the radial pulse under the cast
- C.
Check the cast for odor and drainage
- D.
Evaluate the response to analgesics
- 3.After a computer tomography scan with intravenous contrast medium, a client returns to the unit complaining of shortness of breath and itching. The nurse should be prepared to treat the client for:
- A.
An anaphylactic reaction to the dye
- B.
Inflammation from the extravasation of fluid during injection.
- C.
Fluid overload from the volume of the infusions
- D.
A normal reaction to the stress of the diagnostic procedure
- 4.While caring for a client with a newly applied plaster of Paris cast, the nurse makes note of all the following conditions. Which assessment finding requires immediate notification of the physician?
- A.
Moderate pain, as reported by the client
- B.
Report, by client, the heat is being felt under the cast
- C.
Presence of slight edema of the toes of the casted foot
- D.
Onset of paralysis in the toes of the casted foot
- 5.Which of these nursing actions will best promote independence for the client in skeletal traction?
- A.
Instruct the client to call for an analgesic before pain becomes severe.
- B.
Provide an overhead trapeze for client use
- C.
Encourage leg exercise within the limits of traction
- D.
Provide skin care to prevent skin breakdown.
- 6.A client presents in the emergency department after falling from a roof. A fracture of the femoral neck is suspected. Which of these assessments best support this diagnosis.
- A.
The client reports pain in the affected leg
- B.
A large hematoma is visible in the affected extremity
- C.
The affected extremity is shortnend, adducted, and extremely rotated
- D.
The affected extremity is edematous
- 7.The nurse is caring for a client with compound fracture of the tibia and fibula. Skeletal traction is applied. Which of these priorities should the nurse include in the care plan?
- A.
Order a trapeze to increase the client's ambulation
- B.
Maintain the client in a flat, supine position at all times.
- C.
Provide pin care at least every hour
- D.
Remove traction weights for 20 minutes every two hours.
- 8.To prevent foot drop in a client with Buck's traction, the nurse should:
- A.
Place pillows under the client's heels.
- B.
Tuck the sheets into the foot of the bed
- C.
Teach the client isometric exercises
- D.
Ensure proper body positioning.
- 9.Which nursing intervention is appropriate for a client with skeletal traction?
- A.
Pin care
- B.
Prone positionin
- C.
Intermittent weight
- D.
5lb weight limit
- 10.In order for Buck's traction applied to the right leg to be effective, the client should be placed in which position?
- A.
Supine
- B.
Prone
- C.
Sim's
- D.
Lithotomy
- 11.An elderly client has sustained intertrochanteric fracture of the hip and has just returned from surgery where a nail plate was inserted for internal fixation. The client has been instructed that she should not flex her hip. The best explanation of why this movement would be harmful is:
- A.
It will be very painful for the client
- B.
The soft tissue around the site will be damaged
- C.
Displacement can occur with flexion
- D.
It will pull the hip out of alignment
- 12.When the client is lying supine, the nurse will prevent external rotation of the lower extremity by using a:
- A.
Trochanter roll by the knee
- B.
Sandbag to the lateral calf
- C.
Trochanter roll to the thigh
- D.
Footboard
- 13.A client has just returned from surgery after having his left leg amputated below the knee. Physician's orders include elevation of the foot of the bed for 24 hours. The nurse observes that the nursing assistant has placed a pillow under the client's amputated limb. The nursing action is to:
- A.
Leave the pillow as his stump is elevated
- B.
Remove the pillow and elevate the foot of the bed
- C.
Leave the pillow and elevate the foot of the bed
- D.
Check with the physician and clarify the orders
- 14.A client has sustained a fracture of the femur and balanced skeletal traction with a Thomas splint has been applied. To prevent pressure points from occurring around the top of the splint, the most important intervention is to:
- A.
Protect the skin with lotion
- B.
Keep the client pulled up in bed
- C.
Pad the top of the splint with washcloths
- D.
Provide a footplate in the bed
- 15.The major rationale for the use of acetylsalicylic acid (aspirin) in the treatment of rheumatoid arthritis is to:
- A.
Reduce fever
- B.
Reduce the inflammation of the joints
- C.
Assist the client's range of motion activities without pain
- D.
Prevent extension of the disease process
- 16.Following an amputation, the advantage to the client for an immediate prosthesis fitting is:
- A.
Ability to ambulate sooner
- B.
Less change of phantom limb sensation
- C.
Dressing changes are not necessar
- D.
Better fit of the prosthesis
- 17.One method of assessing for sign of circulatory impairment in a client with a fractured femur is to ask the client to:
- A.
Cough and deep breathe
- B.
Turn himself in bed
- C.
Perform biceps exercise
- D.
Wiggle his toes
- 18.The morning of the second postoperative day following hip surgery for a fractured right hip, the nurse will ambulate the client. The first intervention is to:
- A.
Get the client up in a chair after dangling at the bedside.
- B.
Use a walker for balance when getting the client out of bed
- C.
Have the client put minimal weight on the affected side when getting up
- D.
Practice getting the client out of bed by having her slightly flex her hips
- 19.A young client is in the hospital with his left leg in Buck's traction. The team leader asks the nurse to place a footplate on the affected side at the bottom of the bed. The purpose of this action is to:
- A.
Anchor the traction
- B.
Prevent footdrop
- C.
Keep the client from sliding down in bed
- D.
Prevent pressure areas on the foot
- 20.When evaluating all forms of traction, the nurse knows the direction of pull is controlled by the:
- A.
Client's position
- B.
Rope/pulley system
- C.
Amount of weight
- D.
Point of friction
- 21.When a client has cervical halter traction to immobilize the cervical spine counteraction is provided by:
- A.
Elevating the foot of the bed
- B.
Elevating the head of the bed
- C.
Application of the pelvic girdle
- D.
Lowering the head of the bed
- 22.After falling down the basement steps in his house, a client is brought to the emergency room. His physician confirms that his leg is fractured. Following application of a leg cast, the nurse will first check the client's toes for:
- A.
Increase in the temperature
- B.
Change in co
- C.
Edema
- D.
Movemen
- 23.A 23 year old female client was in an automobile accident and is now a paraplegic. She is on an intermittent urinary catheterization program and diet as tolerated. The nurse's priority assessment should be to observe for:
- A.
Urinary retention
- B.
Bladder distention
- C.
Weight gain
- D.
Bower evacuation
- 24.A female client with rheumatoid arthritis has been on aspirin grain TID and prednisone 10mg BID for the last two years. The most important assessment question for the nurse to ask related to the client's drug therapy is whether she has
- A.
Headache
- B.
Tarry stool
- C.
Blurred vision
- D.
Decreased appetite
- 25.A 7 year old boy with a fractured leg tells the nurse that he is bored. An appropriate intervention would be to
- A.
Read a story and act out the part
- B.
Watch a puppet show
- C.
Watch television
- D.
Listen to the radio
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