Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
35 Cards in this Set
- Front
- Back
|
Which of the following patients has the highest risk of developing osteoporosis?
a. 50 year old male w/ a 3 year history of alcohol use b. 55 year old female who exercises regularly c. 65 year old female who had a history of hip fracture d. 35 year old male w/ a sedentary lifestyle |
C. 65 year old female who had a history of hip fracture
Postmenopausal women, women 65 years and older and have a history of low trauma fracture are at a higher risk of developing osteoporosis. Men usually develop osteoporosis in their 7th or 8th decade of life. (ch. 53, p 1153) |
|
|
A nursing student driving to school accidentally hit a pedestrian. After calling 911 and confirming that the person is alert, awake, and alive, the nursing student noticed the person’s leg looks fractured. Which of the following should be the nursing student’s next action?
a. Try to realign the person’s leg while waiting for the ambulance b. Assist the person to a sitting position w/ legs extended c. Assess for motor function by asking the patient to move the leg d. Immobilize the affected leg and encourage the person to stay still |
D. Immobilize the affected leg and encourage the person to stay still
For any patient who experiences trauma in the community, first call 911 then assess ABCs. Provide lifesaving care if needed before being concerned about the fracture. The affected area should be immobilized by splinting, including joints above and below the affected site. (ch. 54, p 1186) |
|
|
Application of a “Buck’s” traction is included in the care plan of a patient w/ a fracture. The primary purpose of applying that traction is to:
a. Reduce muscle spasms and promote immobilization b. Aid in bone realignment c. Prevent low back problems d. Allow free movement of the joint |
A. Reduce muscle spasms and promote immobilization
Skin traction / Buck’s traction decreases painful muscle spasms that accompany fractures. (ch. 54, p 1189) |
|
|
The nurse is assessing a patient who underwent external fixation for a tibia-fibula fracture 2 days ago. The nurse noted clear, serous drainage around the pin sites. What should be the nurse’s next action?
a. Inform physician about the finding and administer PRN antibiotic b. Inform surgeon about the finding and prepare patient for emergency surgery c. Document finding as normal d. Readjust the pins and keep the leg elevated |
C. Document finding as normal
In the first 48 – 72 hours after external fixation, clear fluid drainage or weeping is expected. (ch. 54, p 1191) |
|
|
Which of the following would indicate an early sign of compartment syndrome?
a. Pain b. Pallor c. Paresthesia d. Pulselessness |
C. Paresthesia
Numbness and tingling (paresthesia) are early signs of compartment syndrome. Losses of function and decreased pulselessness are late signs of compartment syndrome (ch. 54, p 1181) |
|
|
A nurse is assessing a patient who has a lower leg cast. The nurse noted minor skin irritations near the edges of the cast. Which of the following would be the most appropriate action by the nurse?
a. Apply adhesive tape over the edges of the cast b. Apply calamine lotion over the skin to prevent itching c. Contact physician for resizing of the cast d. Contact physician and order topical antibiotic |
A. Apply adhesive tape over the edges of the cast
Occasionally, plaster cast may have rough edges which can crumble and cause skin irritation. Small strips of tape are placed over the rough edges to protect the skin. (ch. 54, p 1186) |
|
|
A 35 year old patient is admitted for swelling of the right leg, fever, and chronic pain. Which of the following assessment findings by the nurse would support the diagnosis of osteomyelitis?
a. Short stature b. Sedentary lifestyle c. Recent open fracture of the leg d. Recent viral infection |
C . Recent open fracture of the leg
Osteomyelitis can be exogenous, in which infectious organisms enter from outside the body, like in an open fracture. (ch. 53, p 1165) |
|
|
A nurse is providing skin care instructions for a patient who just had an arm cast removed. Which of the following patient statements would indicate a need for further teaching?
a. “I have to soak my arm to remove scaly, dead skin” b. “weakness and discomfort is common after removing the cast” c. “I can scrub my arm using mild soap and water” d. “I have to use pillows to support my arm while resting” |
C. “I can scrub my arm using mild soap and water”
Scaly, dead skin should be removed by soaking and avoid scrubbing. Discomfort, weakness, and decreased ranged of motion is expected after cast removal. (ch. 54, p 1194) |
|
|
A patient diagnosed w/ osteoporosis is mostly at risk for developing which of the following complications?
a. Osteomyelitis b. Fractures c. Hypocalcemia d. Muscle atrophy |
B. Fractures
Osteoporosis is characterized by porous bone, low bone mass and structural deterioration of bone tissue. Increased bone fragility increases the risk of developing fractures. (ch. 53, p 1153-1156; see also notes: Osteoporosis) |
|
|
Which of the following nursing interventions would be the top priority for a patient w/ a skin traction on his right leg?
a. Check the skin for signs of irritation b. Check for signs of inflammation around the pin sites c. Assess motor movement of the right leg d. Assess patient’s mental status |
A. Check the skin for signs of breakdown
Skin tractions use Velcro boots, slings, and wraps that are applied to the patient’s leg. Pins aren’t used in skin tractions. Skin breakdown is the priority for a patient on a skin traction. (ch. 54, p 1189-1190) |
|
|
A patient diagnosed w/ osteoporosis tells the nurse that she is going to start taking swim programs in the local community center every day. Which of the following would be the most appropriate response by the nurse?
a. Praise and encourage the patient to do what she’s planning b. Encourage to swim for at least 1 hour every day c. Encourage to swim for at least 30 minutes every other day instead of every day d. Recommend walking for 30 minutes every other day rather than swimming |
D. Recommend walking for 30 minutes every other day rather than swimming
Weight-bearing exercise such as walking for 30 minutes 3 – 5 times a week is the single most effective exercise for osteoporosis management. (ch. 53, p 1157) |
|
|
Which intervention should be implemented in a long term care facility to help prevent complications secondary to osteoporosis?
a. Perform passive range-of-motion exercises b. Repositioning every 2 hours c. Avoid using scatter rugs in rooms d. Encourage increased fluid intake |
C. Avoid using scatter rugs in rooms
Persons w/ osteoporosis are at an increased risk for fracture if a fall occurs. Hospitals and long term care facilities should promote a hazard free environment. (ch. 53, p 1155-1157) |
|
|
A nurse is teaching a patient about taking Alendronate (Fosamax). Which of the following should the nurse include in the teaching?
a. Take medication w/ food or milk to prevent GI irritation b. Take medication w/ a full glass of water c. Monitor blood pressure before taking medication d. Medication may cause urinary stone formation |
B. Take medication w/ a full glass of water
Alendronate (Fosamax), a bisphosphonate, prevents bone loss and increases bone density. It should be taken on an empty stomach, 30 minutes before food, drink, or other drugs. (ch. 53, p 1158-1159) |
|
|
Which of the following interventions is a top priority for a patient w/ a right lower leg fracture who is on a Buck’s traction?
a. Encourage passive range-of-motion exercises on the right leg b. Keep weights on a flat, firm surface c. Assess pin insertion sites for signs / symptoms of infection d. Assess skin condition every 8 hours |
D. Assess skin condition every 8 hours
Weights should be freely hanging and not resting on the floor. Buck’s traction doesn’t have pin insertion sites. The right leg should be assessed at least every 8 hours for skin irritation. (ch. 54, p 1189-1190) |
|
|
Which of the following assessment findings would be noted in patients diagnosed w/ rheumatoid arthritis (RA)? [select all that apply]
a. Anxiety b. Anorexia c. Inflammation d. Weight gain e. Morning stiffness |
B. Anorexia
C. Inflammation E. Morning stiffness A patient w/ RA typically reports generalized weakness and morning stiffness. Anorexia and weight loss of about 2 – 3 lbs usually occur early in the disease process. (ch. 20, p 337-228) |
|
|
A nurse is performing discharge teaching to a patient diagnosed w/ gout. Which of the following should not be included in the teaching?
a. Decreased fluid intake b. Take medications w/ food c. Take NSAIDs for pain d. Avoid taking aspirin |
A. Decreased fluid intake
Patient w/ gout should be encouraged to increase fluid intake. Increased fluid intake helps dilute urine and prevent sediment formation. A combination of colchicine and NSAID are typically prescribed for acute gout. (ch. 20, p 354) |
|
|
When assessing for late manifestations of rheumatoid arthritis, the nurse would note for:
a. Moderate pain and morning stiffness b. Paresthesia c. Fatigue d. Low-grade fever |
A. Moderate pain and morning stiffness
Late disease manifestations include moderate to severe pain and morning stiffness which lasts for 45 minutes to several hours. (ch. 20, p 338) |
|
|
A patient asked the nurse how his medication, Allopurinol, will help treat his gout. What should be the nurse’s response?
a. The medication helps increase bone density b. The medication helps excrete uric acid from the body c. The medication relieves swelling of the joints d. The medication decreases uric acid production |
D. The medication decreases uric acid production
As a xanthine oxidase inhibitor, Allopurinol (zyloprim) prevents the conversion of xanthine to uric acid. (ch. 20, p 354) |
|
|
What intervention would help relieve morning stiffness for patients w/ rheumatic stiffness?
a. Hot bath b. Cold bath c. Passive range of motion exercises d. Morning stretches |
A. Hot bath
To relieve morning stiffness or pain, recommend a hot bath rather than a sponge bath or a tub bath. (ch. 20, p 345) |
|
|
All of the following statements are true regarding fibromyalgia syndrome (FMS) except:
a. Physical therapy is prescribed to help decrease pain b. Most patients diagnosed are women 30 – 50 years of age c. A low ANA titer is the main indicator of the condition d. Antidepressants may be used to promote sleep and reduce pain |
C. A low ANA titer is the main indicator of the condition
A low ANA titer is a marker for an autoimmune condition and isn’t considered diagnostic for fibromyalgia syndrome (FMS). physical therapy, along w/ NSAIDs and muscle relaxants may be prescribed to help decrease pain. (ch. 20, p 357-358; see also notes: Fibromyalgia syndrome (FMS)) |
|
|
Which of the following assessment findings are present in a patient w/ osteoarthritis (OA)? [select all that apply]
a. Warm, swelling around the joint b. Chronic pain and stiffness c. Low grade fever d. Morning stiffness e. Bony nodules in the hands |
B. Chronic pain and stiffness
E. Bony nodules in the hands OA is a degenerative and progressive disease most common in women. Inflammation isn’t characteristic of OA. (ch. 20, p 324-325) |
|
|
A nurse is ordered to administer Dilaudid for an older adult patient w/ osteoarthritis. Which of the following medications should also be taken by the patient regarding the condition?
a. Tylenol b. Colace c. Vitamin D d. Ibuprofen |
B. Colace
Patients taking opioids for pain control are at great risk for constipation. A mild stimulant laxative or stool softener may be taken. (ch. 20, p 326) |
|
|
The nurse is ordered to administer Cytotec for the patient w/ rheumatoid arthritis who regularly takes ibuprofen for chronic pain. The patient asked the nurse why the doctor ordered a new medication for him. Which of the following should be the nurse’s response?
a. It aids in the absorption of ibuprofen b. It helps prevent constipation c. It helps prevent heartburn d. It is a new and experimental pain medication |
C. It helps prevent heartburn
Cytotec (Misoprostol is given to patients taking NSAIDs to prevent gastric ulcers. (ch. 20, p 343) |
|
|
Which nursing diagnosis for a patient w/ osteoarthritis (OA) has the highest priority?
a. Impaired physical mobility b. Self care deficit c. Imbalanced nutrition d. Ineffective coping |
A. Impaired physical mobility
The main goals of treatment for OA are pain management and optimizing functional ability of the joints to ensure movement. (ch. 20, p 325-326) |
|
|
Which of the following pain manifestations is experienced by patients w/ osteomyelitis?
a. Bone pain w/ or w/out manifestation b. Morning pain c. Pain relieved by rest d. Pain not relieved by previous interventions |
A. Bone pain w/ or w/out manifestation
The patient w/ osteomyelitis may experience pain w/ or w.out manifestation. The pain is described as constant, localized, pulsating sensation that worsens w/ movement (ch. 53, p 1165) |
|
|
Which assessment findings are present in a patient w/ chronic osteomyelitis? [select all that apply]
a. Temperature = 102F b. Localized pain c. +2 pitting edema d. Redness of skin e. Skin ulcers |
B. Localized pain
E. Skin ulcers Fever, swelling, and erythema are less common in patients w/ chronic osteomyelitis. (ch. 53, p 1165-1166) |
|
|
A patient was brought to the emergency department presenting w/ signs and symptoms of fat embolism syndrome (FES). Which of the following assessment findings would be present for the patient?
a. Low arterial oxygen level b. Paresthesia c. Bradycardia d. Metabolic alkalosis |
A. Low arterial oxygen level
The earliest manifestation of FES is altered mental status which is caused by low arterial oxygen level. (ch. 54, p 1182) |
|
|
A nurse in the orthopedic unit is caring for two patients who had ORIF surgery 2 days ago. Which of the following signs and symptoms would the nurse assess for as a classical sign of fat embolism syndrome (FES)?
a. Decreased temperature b. Rash on the upper extremities c. Wheezing d. Peripheral edema |
B. Rash on the upper extremities
Petechiae over the neck, upper arms, or chest are classic manifestations but can be a late sign of FES. (ch. 54, p 1182) |
|
|
During assessment of a patient w/ a cast on the lower left leg, the nurse noted presence of edema below the cast. Which of the following is indicated by the nurse’s finding?
a. Infection of the lower left leg b. Potential for compartment syndrome c. Impaired venous return d. Impaired arterial circulation |
C. Impaired venous return
Edema in the extremity indicates impaired venous return. Coolness, pallor are signs of impaired arterial circulation. Unusual odor and purulent discharge from the cast are signs of infection. (ch. 54, p 1186, 1189) |
|
|
A patient who was admitted for a leg fracture is having difficulty breathing, has an elevated HR, and delirious. Which of the following interventions should the nurse do first?
a. Perform neurological assessment b. Obtain vital signs c. Immobilize the patient d. Place patient in fowler’s position |
D. Place patient in fowler’s position
The patient w/ a fracture is experiencing signs and symptoms of fat embolism. Placing the patient in fowler’s position will help relieve dyspnea. Administering oxygen may be indicated. (ch. 54, p 1182) |
|
|
An ICU nurse is caring for an unconscious patient admitted w/ multiple rib fractures. Which of the following assessment findings from the patient would indicate of a possible fat embolism?
a. Increased respirations and increased SaO2 b. Decreased respirations and decreased SaO2 c. Increased respirations and decreased SaO2 d. Cyanosis, pallor, and edema |
C. Increased respirations and decreased SaO2
Assessment findings for fat embolism syndrome (FES) include increased respirations, dyspnea, crackles, and decreased SaO2. (ch. 54, p 1182) |
|
|
The nurse is reviewing the care plan for a patient w/ a fractured femur. Which of the following should be included in the care plan to prevent fat embolism syndrome (FES)?
a. Immobilization of affected leg b. Passive ROM of the affected leg c. Anticoagulant therapy d. Placing patient on a fat-free diet |
A. Immobilization of the affected leg
Prevention of motion at the fracture site and early immobilization can reduce the risk for fat embolism. (ch. 54, p 1182-1183) |
|
|
The nurse is teaching a patient about compartment syndrome. Which of the following statements should the nurse include in the teaching?
a. It is the most common complication of lower extremity surgery or trauma b. It is caused by bleeding and swelling resulting in increased pressure in an area that can’t expand c. it is caused by an obstruction of arterial blood flow to the affected area d. it is a potential life-threatening, systemic complication that results from hemorrhage or trauma |
B. It is caused by bleeding and swelling resulting in increased pressure in an area that can’t expand
Compartment syndrome is a condition in which increased pressure within one or more compartments reduces circulation to the area. It is caused by bleeding and swelling w/in a tissue compartment which doesn’t expand. (ch. 54, p 1180-1181) |
|
|
A nurse is caring for a patient who had a recent above-the-knee- amputation (AKA). To help relieve the phantom limb pain, the nurse should administer:
a. lidocaine patch over the affected area b. PO opioid analgesics c. IV morphine d. Beta blockers |
D. Beta blockers
Opioid analgesics aren’t as effective for phantom limb pain as they are for residual limb pain. Beta-blockers are used for constant, dull, burning pain. (ch. 54, p 1201) |
|
|
The nurse in the orthopedic unit is reviewing the post-op plan of care for a patient who recently had a below-the-knee amputation (BKA), which of the following interventions should the nurse question?
a. Assist patient to prone position b. Change soft dressing every day until sutures or staples are removed c. Limit mobility / movement of affected side d. Use of firm mattress for the bed |
C. Limit mobility / movement of the affected side
Patients should begin exercises as soon as possible after surgery. ROM exercises prevent flexion contractures, particularly of the hip and knee. Prone position Q3-4H for 20-30 minutes will help prevent hip flexion contractures. (ch. 54, p 1202) |
