Ortho Certification Exam: Questions and Answers on Osteoarthritis and Rheumatoid Arthritis, Study notes of Nursing

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Ortho certification Exam 99 Questions with Verified

Answers

What is a major difference between osteo and rheumatoid arthritis - CORRECT ANSWER Osteoarthritis is local versus systemic Which test is used for diagnosing osteoarthritis - CORRECT ANSWER X-rays Which describes joint crepitation - CORRECT ANSWER Grating sound What is a presenting symptom of hip osteoarthritis - CORRECT ANSWER Groin pain What is a Herberdens node - CORRECT ANSWER Osteophyte formation Which of the following is often found in degenerative disc disease - CORRECT ANSWER A normal physical exam Mrs. Rockwood is having more and more problems with her osteoarthritis her right shoulder and back have been really bothering her she enjoys housekeeping and takes pride in her clean house and is having difficulty getting it accomplished what would you suggest - CORRECT ANSWER Space the cleaning out throughout the week cleaning one room Per day Mrs. Rockford is prescribed physical and occupational therapy is to help with her pain. What information should the nurse include in teaching? - CORRECT ANSWER Take oral pain medication 45 minutes before your therapy session What is a management goal of osteoarthritis - CORRECT ANSWER Maintain joint function and mobility What is an advantage of NSAIDS WITH COX2 selectivity - CORRECT ANSWER Les G.I. toxicity

Mrs. Myers a 57-year-old factory worker comes to the clinic complaining of right shoulder pain for two days. Denies trauma. Start of the day after she cleaned the kitchen cabinets. I sees her left hand to come her hair because of her pain. More bothersome at night and has had to sleep in a recliner for comfort. She's on Synthroid and has been on estrogen replacement for five years. She is prescribed NSAIDS what shows understanding - CORRECT ANSWER I should take it with food An MRI is ordered what should be included in pretest teaching - CORRECT ANSWER Remove all jewelry An MRI shows osteoarthritis and right shoulder what might be expected method of treatment - CORRECT ANSWER Heat or ice If surgery becomes an indication for a shoulder what would be a treatment goal - CORRECT ANSWER Improvement of function What is a surgical procedure for shoulder arthritis - CORRECT ANSWER Hemi arthroplasty What is a consideration of a complication of Osteoarthritis - CORRECT ANSWER Loss of joint function Mr. Baldwin has severe left shoulder arthritis related to repetitive heavy lifting at work. He wants conservative treatment not surgery. What is a likely treatment option for Mr. Baldwin - CORRECT ANSWER Corticosteroid injections Which of the following will Mr. Baldwin likely need since is left is his dominant arm - CORRECT ANSWER Therapy Mrs. Ray is a 62-year-old female admitted post shoulder arthroplasty the nurse is assisting her and placement of the sling how should the abduction sling be applied - CORRECT ANSWER Across the hips and slightly forward How long should someone wear a sling after post shoulder arthroplasty - CORRECT ANSWER 4 to 6 weeks

What is a safety issue for those with upper extremity surgery - CORRECT ANSWER Ambulation. Because of balance Following a shoulder arthroplasty what can one accomplish with occupational therapy - CORRECT ANSWER ADLs After shoulder arthroplasty what indicates a need for further teaching regarding signs and symptoms of shoulder dislocation - CORRECT ANSWER I should not worry about decreased ability to move A patient is scheduled to have a cemented total shoulder arthroplasty. History includes sleep apnea obesity hypertension. Patient arrives with PCA patient states that she is in severe pain and doesn't want to push some buttons and the nurses instructed the patient on PCA use what is the next step - CORRECT ANSWER Call the doctor and make the suggestion for an NSAID an oral opioid What non-pharmacological modalities can a nurse use to help relieve pain from a total shoulder arthroplasty - CORRECT ANSWER Supports affected arm on with pillows How would you describe what a trapeze bar on the bed is. For a total shoulder patient - CORRECT ANSWER Using the trapeze bar allows you to move yourself around in bed by using only the unaffected arm What position after a total shoulder arthroplasty Should the shoulder be placed in

• CORRECT ANSWER A sling Discharge teaching plan for a total left shoulder regarding future restriction - CORRECT ANSWER With nothing other than a glass with your affected hand If a patient feels they do not need to do exercises at home what is the best response - CORRECT ANSWER Exercises will help your arm become strong After a total left shoulder patient wants to know how she will perform her usual household duties what is the best intervention - CORRECT ANSWER Assist her and her family and the readjusting role expectations

A diagnosis of herniated nucleus pulposus The etiology of this condition is likely from what - CORRECT ANSWER Degeneration of the disc What is now rarely used as a diagnostic for HNP since the availability of MRI - CORRECT ANSWER A myelogram After lumbar percutaneous discectomy and what must you do immediately postop - CORRECT ANSWER Logroll when turning An important nursing intervention in the postop. For a lumbar percutaneous discectomy - CORRECT ANSWER Perform frequent neurovascular checks Patient had two pain pills one hour ago and his IV pain medication ordered for breakthrough pain. The patient rates his pain seven out of 10 what else can be done - CORRECT ANSWER Give the IV pain medication The patient rings the call late for his pain medication exactly when it's due but does this most likely indicate - CORRECT ANSWER But his pain medicine is inadequate What should be included in discharge teaching for lumbar percutaneous discectomy - CORRECT ANSWER Proper body mechanics are essential in all activities Patient complains of numbness of the right lateral phi and top of the lower leg. He is unable to walk on his heels upon request which nerve root is likely affected - CORRECT ANSWER L L5 nerve root irritation is evidenced by - CORRECT ANSWER Sensory deficit in the lateral aspect of the thigh, anterior aspect of the lower leg, and the space between the great and second toes. Never deficit is noticed by week hip extensors difficulty with your walking we ankle inversion Sensory deficit in the medial forearm and diminished or absent and finger flexion would be what cervical level - CORRECT ANSWER C

What is removed in a total knee replacement - CORRECT ANSWER The distal femur and proximal tibial bone A typical therapy of gold prior to discharge after a right total knee would be - CORRECT ANSWER Muscle strengthening To establish a diagnosis of osteoporosis a DEXA a scan may be completed how will this show osteoporosis - CORRECT ANSWER The bone density of the person will be compared to that of a healthy young adult and age matched adults Patient education regarding Actonel should include - CORRECT ANSWER After taking this medication you should remain in an upright position for at least 30 minutes Bio phosphonate should be taken - CORRECT ANSWER On an empty stomach 30 minutes before breakfast and then remain upright for at least 30 minutes If a patient has lactose intolerant they should be taught about non-dairy food sources of calcium what is a food source that has high calcium - CORRECT ANSWER One cup of spinach If a mother has osteoporosis a 50-year-old daughter is at risk for this condition what factors place her at an increased risk - CORRECT ANSWER Smoking cigarettes A 35-year-old patient that has intermittent swelling and pain in the joints of her hands feet and knees has been treating herself with non-steroid all anti- inflammatory drugs a friend who is a nurse suspects she might have rheumatoid arthritis based upon this early symptom - CORRECT ANSWER Fatigue. Rheumatoid arthritis usually begins gradually accompanied by systemic manifestations such as anorexia weight loss fatigue muscle aching and stiffness joints most commonly affected our fingers and wrist knees and feet Bloodwork or labs that would likely be elevated during a rheumatoid arthritis flare up would include - CORRECT ANSWER An elevation in ESR

A newly diagnosed rheumatoid arthritis is typically given a non-steroid old anti- inflammatory drug and methotrexate because - CORRECT ANSWER It will help maximize the control of inflammation One of the most common side effects of methotrexate occur in which body system - CORRECT ANSWER Gastrointestinal Name the deformity th - CORRECT ANSWER Boutonniere deformity's PIP joint - CORRECT ANSWER Proximal interphalngeal D IP joint - CORRECT ANSWER Distal interphalangeal joint Hyper extension of the PIP joint with flexion of the metacarpal phalangeal in D IP joints - CORRECT ANSWER Swans neck deformity A patient who is on Coumadin after total knee what should the nurse instruct the patient about urine - CORRECT ANSWER Report tea colored urine immediately A 12-year-old patient experiences and Epicondyler fracture and a long arm cast as applied if the cast needs to be splint after application to allow for tissue swelling the nurse will buy them of the cast by splitting it in which direction - CORRECT ANSWER Medially and laterally The use of bucks traction is used to - CORRECT ANSWER Minimize muscle spasms A patient is placed in the CPM machine following a total knee arthroplasty he nurse recognizes one benefit of the CPM is decreased - CORRECT ANSWER Joint hemarthrosis Following application of a short arm cast the nurse will assess sensation and motion in the patient's digits numbness and tingling in between the thumb and index finger may indicate compromise of which nerve - CORRECT ANSWER Radial A patient receiving Mitroxantrone for treatment of an exacerbation of MS the nurse should be aware - CORRECT ANSWER The patient's urine may turn a blue green color and Initially

A patient is diagnosed with osteoio osteoma The nurses able to confirm this is a benign tumor that - CORRECT ANSWER Causes night paying that can be relieved by aspirin The most common primary malignant bone tumor and children is the - CORRECT ANSWER Osteosarcoma greater occurrence in boys than girls A patient is diagnosed with slipped capital femoral epiphysis. The nurse recognizes this patient is at high-risk the normal of developing - CORRECT ANSWER Degenerative arthritis Patient teaching for Osgood Schlatter disease - CORRECT ANSWER Symptoms will stop by the end of skeletal growth this disease is self-limiting condition of preadolescence the symptoms stop when the epiphyses is fully ossified A type of implant that would be considered a biological implant - CORRECT ANSWER An allograft bone Which of the following nerves may sustain injury when the patient is placed in a lateral position and there is an adequate padding under the fibular head - CORRECT ANSWER Peroneal nerve The best way to evaluate balance is two says strength of the opposing muscle groups while using and performing what kind of measurement devices - CORRECT ANSWER Isometric measuring devices Extreme involves - CORRECT ANSWER Muscle or tendon trauma A sprain involves - CORRECT ANSWER Ligament trauma Most important therapeutic modality used in treating muscle strains is - CORRECT ANSWER Rest Antioxidants that protect the body from oxidation stress and provide nutritional support during times of increased activity - CORRECT ANSWER Vitamins BC and E

Carb loading is important one to four hours prior to athletic performance which food is a good source of carbohydrates with low glycemic index - CORRECT ANSWER Apples Which substance has been been banned from used by participants and athletic events by the national sports regulating agencies - CORRECT ANSWER Cardiovascular and antihypertensives The best way to evaluate pounds is to sell strength of the opposing muscle groups are using performing which of the following - CORRECT ANSWER Isometric measuring device What is the difference between a strain and sprain - CORRECT ANSWER Strain involves muscle or tendon drama. Sprain is a ligament drama On exam patient complains of point tenderness and muscle spasms x-ray reveals no fracture patient unable to move ankle palpation reveals bolts at ankle what is the likely injury - CORRECT ANSWER 3rd° angle strain What is the most important treatment modality and treating muscle strains - CORRECT ANSWER Rest Cryotherapy decreases blood flow to the vessels by causing them to contract what should be known about cryotherapy - CORRECT ANSWER Cold compress should be maintained for 30 minutes on and 15 minutes off for 72 hours What should be taught regarding ace bandage wrapping - CORRECT ANSWER Should be applied tight enough to promote venous return When I'm tanning a history during evaluation of a sports injury why is the mechanism of injury important - CORRECT ANSWER Helps determine diagnostic imaging that would be helpful All strains are these type of injuries - CORRECT ANSWER Ligament injuries

There are three grades of muscle injury what would a grade to muscle injury involved - CORRECT ANSWER 10 to 50% of muscle fibers are toward palpation reveals a defect of the muscle There are three grades of injury describing a ligament what would describe a grade one ligament injury - CORRECT ANSWER 0 to 20% of ligament fibers are torn What is a common characteristic of a stress fracture - CORRECT ANSWER Full and painless range of motion at the adjacent joints The apprehension test is used to test instability of what body part - CORRECT ANSWER The shoulder Lesions may be detected on x-ray of the shoulder following dislocation what is the name of the lesion on the glenoid rim - CORRECT ANSWER Bankhart Where is a hill Sachs lesion - CORRECT ANSWER Humeral head Where is a Bennett's lesion found - CORRECT ANSWER In an avulsion fracture of the hand Neurovascular assessment is important phone shoulder dislocation which artery may become impinged as a result of shoulder dislocation - CORRECT ANSWER Radial Dequervein tenosynovitis is caused by repetitive and forceful exertions of the wrist and hand which of the following test is positive in dequerveins tenosynovitis

• CORRECT ANSWER Finkelstein's test. Owner deviation of hand and thumb flexed against Palm Gate used to comedy pain on weight-bearing - CORRECT ANSWER Antalgic PRICEMM - CORRECT ANSWER Rotator cuff repair will exhibit pain and which position - CORRECT ANSWER Abduction and external rotation

Diagnosis of right full fitness rotator cuff pair what symptoms would be associated with this injury - CORRECT ANSWER Dropping on to waste upon passive abduction After rotator cuff repair for rehabilitation after the surgery is - CORRECT ANSWER 6 to 12 months Sensitive to touch stiffness at The elbow function is normal what is likely the problem with elbow - CORRECT ANSWER Medial epicondylitis Stiffness on the inside of the elbow is likely - CORRECT ANSWER Medial epicondylitis occurs with repeated stress on the muscle tendon units during pitching golfing results in pain and stiffness Tennis players are at risk for elbow problems a high risk for lateral epicondylitis - CORRECT ANSWER 40-year-old tennis player who plays daily