Download NUR2356 Final Exam-Multidimensional Care I -with 100% verified solutions-2023-2024 and more Exams Health sciences in PDF only on Docsity! NUR2356 Final Exam-Multidimensional Care I - with 100% verified solutions-2023-2024 A client's left leg is in skeletal traction with a Thomas leg splint and Pearson attachment. Which intervention should the nurse include in this client's care plan? A. Apply the traction straps snugly. B. Assess the client's level of consciousness. C. Remove the traction at least every 8 hours. D. Teach the client how to prevent problems caused by immobility. D. Teach the client how to prevent problems caused by immobility. A nurse is caring for a client placed in traction to treat a fractured femur. Which nursing intervention has the highest priority? A. Assessing the extremity for neurovascular integrity B. Keeping the client from sliding to the foot of the bed C. Keeping the ropes over the center of the pulley D. Ensuring that the weights hang free at all times A. Assessing the extremity for neurovascular integrity Which orthopedic surgery is done to correct and align a fracture after surgical dissection and exposure of the fracture? A.Arthrodesis B.Joint arthroplasty C.Total joint arthroplasty D.Open reduction D.Open reduction The client displays manifestations of compartment syndrome. What treatment will the nurse expect the client to be scheduled for? A. An open reduction B. A fasciotomy C. A total hip replacement D. A total knee replacement B. A fasciotomy A client who is undergoing skeletal traction reports pressure on bony areas. Which action would be most appropriate to provide comfort for the client? A. Assisting with range-of-motion and isometric exercises. B. Changing the client's position within prescribed limits. C. Administering prescribed analgesics. D. Applying warm compresses. B. Changing the client's position within prescribed limits. A client's fracture was reduced by surgically exposing the bone and realigning it. What type of treatment does the nurse identity this as? A. Buck's traction B. Skeletal traction C. Internal fixation D. Open reduction D.Open reduction The nurse is checking the traction apparatus for a client in skin traction. Which finding would require the nurse to intervene? A. Body aligned opposite to line of traction pull B. Weights hanging and touching the floor C. Pulleys without evidence of the obstruction D. Ropes freely moving over pulleys B.Weights hanging and touching the floor A group of students is studying for a test on traction. The students demonstrate understanding of the types of traction when they identify which of the following as an example of skin traction? A. Crutchfield tongs B. Assess for previous opioid drug use. C.Reposition the client for comfort. D.Teach relaxation techniques. A.Assess for complications. A client arrives in the emergency department with a suspected bone fracture of the right arm. How does the nurse expect the client to describe the pain? A.A dull, deep, boring ache B.Sharp and piercing C.Similar to "muscle cramps" D.Sore and aching B.Sharp and piercing Which is a benefit of a continuous passive motion (CPM) device when applied after knee surgery A.It provides active range of motion. B. It promotes healing by increasing circulation and movement of the knee joint. C. It promotes healing by immobilizing the knee joint. D. It prevents infection and controls edema and bleeding. B.It promotes healing by increasing circulation and movement of the knee joint. A client with a musculoskeletal injury is instructed to alter the diet. The objective of altering the diet is to facilitate the absorption of calcium from food and supplements. Considering the food intake objective, which food item should the nurse encourage the client to include in the diet? A.Red meat B.Bananas C.Vitamin D-fortified milk D.Green vegetables C.Vitamin D-fortified milk The nurse is screening children for scoliosis. What nursing assessment finding is indicative of scoliosis? A. lateral curvature of the spine B. loss of 1 inch (2.5 cm) in height C.contracture of the wrists D.crepitus of the knee joint A.lateral curvature of the spine The nurse is conducting the admission assessment for a client who is to undergo an arthrogram. What is the priority question the nurse should ask A. "Do you have any allergies?" B. "When did you last eat?" C. "When did you last urinate?" D. "Are you claustrophobic?" A."Do you have any allergies?" Which client would the nurse identify as having the greatest risk for osteoporosis? A.A 40-year-old overweight African American woman B.A 16-year-old male with a history of asthma C.A small-framed, thin 45-year-old white woman D.A 20-year-old male athlete with repeated injuries C.A small-framed, thin 45-year-old white woman Which diagnostic test would the nurse expect to be ordered for a client with lower extremity muscle weakness? A.Electromyograph (EMG) B.Arthrocentesis C.Bone scan D.Biopsy A.Electromyograph (EMG) A client has had surgical repair of a hip injury after joint manipulation was unsuccessful. After surgery, the nurse implements measures to prevent complications. Which complications is the nurse seeking to prevent? Select all that apply A. skin breakdown B. wound infection C.pneumonia D.diarrhea A. skin breakdown B. wound infection C.pneumonia Radiographic evaluation of a client's fracture reveals that a bone fragment has been driven into another bone fragment. The nurse identifies this as which type of fracture? A.Comminuted B.Compression C.Impacted D.Greenstick C.Impacted A client is experiencing muscle weakness in the upper extremities. The client raises an arm above the head but then loses the ability to maintain the position. Muscular dystrophy is suspected. Which diagnostic test would evaluate muscle weakness or deterioration? A.A serum calcium test B.An electromyography C.An arthroscopy D.A magnetic resonance imaging (MRI) B.An electromyography A client asks the nurse why his residual limb cannot be elevated on a pillow. What is the best response by the nurse? A. "Elevating the leg might lead to a flexion contracture." Which statement describes paresthesia? A.Absence of muscle movement suggesting nerve damage B.Involuntary twitch of muscle fibers C.Abnormal sensations D.Absence of muscle tone C.Abnormal sensations What is the term for a rhythmic contraction of a muscle? A.Atrophy B.Clonus C.Hypertrophy D.Crepitus B.Clonus The client presents with an exaggeration of the lumbar spine curve. How does the nurse interpret this finding? A.Lordosis B.Scoliosis C.Kyphosis D.Dowager's hump A.Lordosis The older client asks the nurse how best to maintain strong bones. What is the nurse's best response? A."Weight-bearing exercises can strengthen bones." B."Range-of-motion exercises build bone mass." C."Cardio training is the best way to build bones." D."Weight-resistance exercises can strengthen bones." A."Weight-bearing exercises can strengthen bones." Which assessment finding would cause the nurse to suspect compartment syndrome in the client following a bone biopsy? A.Increased diameter of the calf B.Capillary refill < 3 seconds C.Toes move freely without pain D.Bounding dorsalis pedis pulses A.Increased diameter of the calf A client has just undergone arthrography. What is the most important instruction for the nurse to include in the teaching plan? A.Avoid sunlight or harsh, dry climate. B.Avoid intake of dairy products. C.Report joint crackling or clicking noises occurring after the second day. D.Gently massage joints with any crackling or clicking joint noises. C.Report joint crackling or clicking noises occurring after the second day. The nurse is providing care to a client following a knee arthroscopy. What would the nurse expect to include in the client's plan of care? A. Keeping the affected knee flexed. B. Applying warm packs to the insertion site. C. Maintaining the client's NPO status. D.Administering the prescribed analgesic. D.Administering the prescribed analgesic. The nurse is performing a neurovascular assessment of a client's injured extremity. Which would the nurse report? A.Positive distal pulses B.Capillary refill of 3 seconds C.Dusky or mottled skin color D.Skin warm to touch C.Dusky or mottled skin color A patient has had a stroke and is unable to move the right upper and lower extremity. During assessment the nurse picks up the arm and it is limp and without tone. How would the nurse document this finding? A.Rigidity B.Flaccidity C.Atonic D.Tetanic B.Flaccidity A nurse is teaching a client who was recently diagnosed with carpal tunnel syndrome. Which statement should the nurse include? A. "This condition is associated with various sports." B. "Surgery is the only sure way to manage this condition." C. "Using arm splints will prevent hyperflexion of the wrist." A nurse is planning discharge instructions for the client with osteomyelitis. What instructions should the nurse include in the discharge teaching? A. "Use your continuous passive motion machine for 2 hours each day." B. "You need to perform weight-bearing exercises twice a week." C. "You need to limit the amount of protein and calcium in your diet." D. "You will receive IV antibiotics for 3 to 6 weeks." D."You will receive IV antibiotics for 3 to 6 weeks." Which of the following presents with an onset of heel pain with the first steps of the morning? A. Plantar fasciitis B. Hallux valgus C. Morton's neuroma D.Ganglion A.Plantar fasciitis A client has experienced increasing pain and progressing inflammation of the hands and feet. The rheumatologist has prescribed NSAID use to treat the condition. What client education is most important for the nurse to address with the use of these medications? A. common adverse effects B. dietary restrictions C. activity restrictions D.loading-dose schedule A.common adverse effects A client with chronic osteomyelitis has undergone 6 weeks of antibiotic therapy. The wound appearance has not improved. What action would the nurse anticipate to promote healing? A. Wound packing B. Wound irrigation C. Vitamin supplements D. Surgical debridement D.Surgical debridement Assessment of a client reveals signs and symptoms of Paget's disease. Which of the following would be most likely? A.Skull narrowing B.Lordosis C.Long bone bowing D.Upright gait C.Long bone bowing When providing discharge teaching to a client with a fractured toe, the nurse should include which instruction? a.Apply heat to the fracture site. b.Apply ice to the fracture site. c.Perform ankle dorsiflexion three times per day. d.Use crutches for 1 week. b.Apply ice to the fracture site. After surgery to treat a hip fracture, a client returns from the postanesthesia care unit to the medical-surgical unit. Postoperatively, how should the nurse position the client? a. With the affected hip flexed acutely b. With the leg on the affected side abducted c. With the leg on the affected side adducted d. With the affected hip rotated externally b.With the leg on the affected side abducted A client with arterial insufficiency undergoes below-knee amputation of the right leg. Which action should the nurse include in the postoperative care plan? A.Elevating the stump for the first 24 hours B.Maintaining the client on complete bed rest C.Applying heat to the stump as the client desires D.Removing the pressure dressing after the first 8 hours A.Elevating the stump for the first 24 hours Which type of fracture is one in which the skin or mucous membrane wound extends to the fractured bone? a.Compound b.Complete c.Incomplete d.Simple a.Compound Which is a hallmark sign of compartment syndrome? a.Motor weakness b.Edema c.Pain d.Weeping skin surfaces A client undergoes an arthroscopy at the outpatient clinic. After the procedure, the nurse provides discharge teaching. Which response by the client indicates the need for further teaching? a."Elevating my leg will reduce swelling after the procedure." b."My physician may prescribe pain pills after the procedure." c."I should use my heating pad this evening to reduce some of the pain in my knee." d."I may notice some bruising or swelling in my knee." c."I should use my heating pad this evening to reduce some of the pain in my knee." he nurse is preparing the client for computed tomography. Which information should be given by the nurse? a. "You must remain very still during the procedure." b. "A small bit of tissue will be removed and sent to the lab." c. "Fluid will be removed from you affected joint." d. "A radioisotope will be given through an IV." a."You must remain very still during the procedure." The nurse recognizes that rheumatoid arthritis is characterized by: a.Ulnar deviation b.Ballottement sign c.Clonus d.Fasciculations a.Ulnar deviation A client is scheduled to undergo an electromyography. When performed, what will this test evaluate? a.Muscle weakness b.Muscle composition c.Bone density d.Metastatic bone lesions a.Muscle weakness Which device is designed specifically to initially support and immobilize a body part in a desired position until swelling subsides? a.Brace b.Continuous passive motion (CPM) device c.Splint d.Trapeze c.Splint Which statement is accurate regarding care of a plaster cast? a.The cast must be covered with a blanket to keep it moist during the first 24 hours. b.The cast will dry in about 12 hours. c.The cast can be dented while it is damp. d.A dry plaster cast is dull and gray. c.The cast can be dented while it is damp. Which action would be most important postoperatively for a client who has had a knee or hip replacement? a.Providing crutches to the client. b.Assisting in early ambulation. c.Using a continuous passive motion (CPM) machine. d.Encouraging expressions of anxiety. b.Assisting in early ambulation. Which is not a guideline for avoiding hip dislocation after replacement surgery. a.The hip may be flexed to put on clothing such as pants, stockings, socks, or shoes. b.Keep the knees apart at all times. c.Put a pillow between the legs when sleeping. d.Never cross the legs when seated. a.The hip may be flexed to put on clothing such as pants, stockings, socks, or shoes. A client in the emergency department is being treated for a wrist fracture. The client asks why a splint is being applied instead of a cast. What is the best response by the nurse? a. "You would have to stay here much longer because it takes a cast longer to dry." b. "A splint is applied when more swelling is expected at the site of injury." c. "It is best if an orthopedic doctor applies the cast." d. "Not all fractures require a cast." b."A splint is applied when more swelling is expected at the site of injury." An older adult patient had a hip replacement. When should the patient begin with assisted ambulation with a walker? a.24 hours b.72 hours c.1 week d.2 to 3 weeks a.24 hours a.Promote pain relief and quality of life b.Reconstruct the bone with a prosthesis c.Diagnose the extent of bone damage d.Cure the diseased bone and cartilage a.Promote pain relief and quality of life Which is not a risk factor for osteoporosis? a.being male b.small-framed, thin White or Asian women c.being postmenopausal d.family history a.being male The nurse is asked to explain to the client the age-related processes that contribute to bone loss and osteoporosis. What is the nurse's best response? a.Decrease in estrogen b.Increase in calcitonin c.Decrease in parathyroid hormone d.Increase of vitamin D a.Decrease in estrogen Which factor inhibits fracture healing? a.Vitamin D b.Exercise c.Local malignancy d.Maximum bone fragment contact c.Local malignancy A client who has sustained a fracture reports an increase in pain and decreased function of the affected extremity. What will the nurse suspect? a.Infection b.Pulmonary embolism c.Avascular necrosis d.Hypovolemic shock c.Avascular necrosis Which of the following are associated with compartment syndrome? Select all that apply. a.Trauma from accidents b.Surgery c.Casts d.Tight bandages e.Crushing injuries a.Trauma from accidents b.Surgery c.Casts d.Tight bandages e.Crushing injuries A bone graft may be used for which of the following reasons? Select all that apply. a.Joint stabilization b.Defect filling c.Stimulation of bone healing d.Improvement of motion e.Reduction of a fracture a.Joint stabilization b.Defect filling c.Stimulation of bone healing A client with metastatic bone cancer sustained a left hip fracture without injury. What type of fracture does the nurse understand occurs without trauma or fall? a.Impacted fracture b.Transverse fracture c.Compound fracture d.Pathologic fracture d.Pathologic fracture In a client with a dislocation, the nurse should initially perform neurovascular assessments a minimum of every 15 minutes until stable. Which complication does the assessments help the nurse to monitor in the client? a.Disseminated intravascular coagulation b.Compartment syndrome c.Carpal tunnel syndrome d.Fat embolism syndrome b.Compartment syndrome A nurse is caring for a client who's experiencing septic arthritis. This client has a history of immunosuppressive therapy and the immune system is currently depressed. Which assignment is the most appropriate for the nurse caring for this client? a.The nurse caring for this client is also caring for four other immunosuppressed clients on the medical floor. b.The nurse caring for this client is also caring for four clients receiving chemotherapy for cancer treatment on the oncology floor. c.The nurse caring for this client is also caring for two other immunosuppressed clients on the medical intensive care unit. d.The nurse is caring for this client on the intensive care unit. d.The nurse is caring for this client on the intensive care unit. A client is diagnosed with carpal tunnel syndrome. Which assessment findings would the nurse expect? a.Pain radiating down the dorsal surface of the forearm b.Tenderness in the affected wrist c.Inability to flex index and middle fingers d.A decrease in grasp strength c.Inability to flex index and middle fingers The nurse is educating a client with low back pain on proper lifting techniques. The nurse recognizes that the education was effective when the client a.reaches over the head with the arms fully extended. b.places the load close to the body. c.uses a narrow base of support. d.bends at the hips and tightens the abdominal muscles. b.places the load close to the body. A patient is having low back pain. What position can the nurse suggest to relieve this discomfort? a.High-Fowler's to allow for maximum hip flexion b.Supine, with the knees slightly flexed and the head of the bed elevated 30 degrees c.Prone, with a pillow under the shoulders d.Supine, with the bed flat and a firm mattress in place b.Supine, with the knees slightly flexed and the head of the bed elevated