1. A client comes to the emergency department reporting pain in the right leg. When obtaining the history, the nurse learns that the client has a history of obesity and hypertension. Based on this information the nurse anticipates the client having which musculoskeletal disorder?
a) Degenerative joint disease
b) Paget's disease
c) Muscular dystrophy
2. In preparation for total knee surgery, a 200-lb (90.7 kg) client with osteoarthritis must lose weight. Which exercise should the nurse recommend as best if the client has no contraindications?
a) weight lifting
b) aquatic exercise
d) tai chi exercise
3. During a routine physical examination on a 75-year-old female client, a nurse notes that the client is 5 feet, 3/8 inches (1.6 m) tall. The client states, "How is that possible? I was always 5 feet and 1/2 inches (1.7 m) tall." Which statement is the best response by the nurse?
a) "After age 40, height may show a gradual decrease as a result of spinal compression"
b) "After menopause, the body's bone density declines, resulting in a gradual loss of height."
c) "The posture begins to stoop after middle age."
d) "There may be some slight discrepancy between the measuring tools used."
4. To ensure safe postoperative care of a client after a total hip arthroplasty, which actions are most appropriate for the nurse to perform? Select all that apply.
a) Teach the client not to cross their legs.
b) Use a pillow under the knees to prevent hip flexion.
c) Limit movements resulting in internal rotation and adduction of the affected hip.
d) Reduce extension and hyperextension of the affected hip.
e) Elevate the client's legs above the level of the heart.
5. The nurse is caring for a client on a second course of antibiotics to eliminate osteomyelitis. It is most essential for the nurse to instruct on which aspect of daily care?
a) Limited exercise to only bathroom privileges
b) Use assistive devices when ambulation
c) Use of opioid therapy for pain management
d) A diet high in protein and nutrients
6. A client who has had a total hip replacement has a dislocated hip prosthesis. The nurse should first:
a) apply an ice pack to the affected hip.
b) notify the orthopedic surgeon.
c) position the client toward the opposite side of the hip.
d) stabilize the leg with Buck's traction.
7. Which of the following instructions regarding body mechanics would be most appropriate for helping a client to avoid back injury?
a) Sit in chairs with soft cushions.
b) Avoid prolonged sitting and standing.
c) Pull objects rather than push them.
d) Sleep on a soft mattress.
8. A client has been diagnosed with osteoporosis after a bone density test and is asking what has caused it. Discussion of risk factors would include which of the following?
a) Diet deficient in vegetables and fruits, high intake of red meats, and increased alcohol intake
b) Regular exercise, low fat intake, and recurrent trauma to the bones through increased weight-bearing activities
c) Excessive sunlight exposure, adequate calcium intake, and lactose intolerance
d) Heavy smoking, sedentary lifestyle, and high intake of carbonated drinks
9. 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."
d) "Ergonomic changes can be incorporated into your workday to reduce stress on your wrist."
10. A client has a leg immobilized in traction. Which observation by the nurse indicates that the client understands actions to take to prevent muscle atrophy?
a) The client asks the nurse to add a 5-lb (2.3-kg) weight to the traction for 30 minutes per day.
b) The client adducts the affected leg every 2 hours.
c) The client rolls the affected leg away from the body's midline twice per day.
d) The client performs isometric exercises to the affected extremity three times per day.
11. A client who had a total hip replacement 4 days ago is worried about dislocation of the prosthesis. The nurse should respond by saying:
a) "Decreasing use of the abductor pillow will strengthen the muscles to prevent dislocation."
b) "Do not worry. Your new hip is very strong."
c) "Use of a cushioned toilet seat helps to prevent dislocation."
d) "Activities that tend to cause adduction of the hip tend to cause dislocation, so try to avoid them."
12. A nurse is teaching a female client about preventing osteoporosis. Which teaching point is correct?
a) To prevent fractures, the client should avoid strenuous exercise.
b) Obtaining the recommended daily allowance of calcium requires taking a calcium supplement.
c) Obtaining an X-ray of the bones every 3 years is recommended to detect bone loss.
d) The recommended daily allowance of calcium may be found in a wide variety of foods.
13. After instructing a 40-year-old woman about osteoporosis after menopause, the nurse determines that the client needs further instruction when the makes which client statement?
a) "Estrogen therapy at menopause can reduce the risk of osteoporosis."
b) "Women who do not eat dairy products should consider calcium supplements."
c) "Women of African descent are at the greatest risk for osteoporosis."
d) "A standard serving of yogurt is the equivalent of one glass of milk."
!4. A nurse is caring for a client with a spinal cord injury. The client is experiencing blurred vision and has a blood pressure of 204/102 mm Hg. What should the nurse do first?
a) Position the client on the left side.
b) Check the client's bladder for distention.
c) Control the environment by turning the lights off and decreasing stimulation for the client.
d) Administer pain medications.
15. After total hip replacement, a client is receiving epidural analgesia to relieve pain. Which action is a nursing priority for this client?
a) Assessing capillary refill time
b) Keeping the client flat in bed
c) Changing the catheter site dressing every shift
d) Assessing for sensation in the legs
16. After the nurse teaches a client about wearing a back brace after a spinal fusion, which statement indicates effective teaching?
a) "I will be sure to pad the area around my iliac crest."
b) "I should wear a thin cotton undershirt under the brace."
c) "I can use baby powder under the brace to absorb perspiration."
d) "I will apply lotion before putting on the brace."
17. After a person experiences a closure of the epiphyses, which statement is true?
a) No further increase in bone length occurs.
b) The bone increases in thickness and is remodeled.
c) The bone grows in length but not thickness.
d) Both bone length and thickness continue to increase.
18. A nurse suspects that a client with a recent fracture has compartment syndrome. Assessment findings may include:
a) body-wide decrease in bone mass.
b) inability to perform passive movement and pain with active movement.
c) inability to perform active movement and pain with passive movement.
d) a growth in and around the bone tissue.
19. A client is scheduled to undergo an open reduction internal fixation of the right femur. The night before surgery, the nurse administers zolpidem as ordered. Which statement about zolpidem is correct?
a) The nurse shouldn't use the liquid if it becomes slightly darkened.
b) The nurse should administer the drug immediately before bedtime.
c) The nurse should dilute it in fruit juice to improve absorption.
d) Avoid administration with grapefruit juice; it interferes with absorption.
20. When admitting a client with a fractured extremity, the nurse should first assess:
a) the area distal to the fracture.
b) the opposite extremity for baseline comparison.
c) the area proximal to the fracture.
d) the actual fracture site.
21. A client undergoes a total hip replacement. Which statement made by the client indicates to the nurse that the client requires further teaching?
a) "I don't know if I'll be able to get off that low toilet seat at home by myself."
b) "I need to remember not to cross my legs. It's such a habit."
c) "I'll need to keep several pillows between my legs at night."
d) "The occupational therapist is showing me how to use a sock puller to help me get dressed.
22. Which of the following pieces of equipment should the nurse plan to use to help prevent external rotation of the client's right leg postoperatively?
a) A high footboard.
b) A metal bed cradle.
d) A rubber air ring.
23. Which nursing diagnosis takes highest priority for a client with a compound fracture?
a) Risk for infection related to effects of trauma
b) Imbalanced nutrition: Less than body requirements related to immobility
c) Impaired physical mobility related to trauma
d) Activity intolerance related to weight-bearing limitations
24. Which discharge instruction should a nurse give a client who's had surgery to repair a hip fracture?
a) "Don't flex your hip more than 30 degrees, don't cross your legs, and have someone help you put your shoes on."
b) "Don't flex your hip more than 90 degrees, don't cross your legs, and have someone help you put your shoes on."
c) "Don't flex your hip more than 120 degrees, don't cross your legs, and have someone help you put your shoes on."
d) "Don't flex your hip more than 60 degrees, don't cross your legs, and have someone help you put your shoes on."
25. The nurse is evaluating a client in skin traction. Which of the following indicate the traction is applied for maximum effectiveness?
a) The client is positioned low in the bed.
b) The weights rest securely on the bed frame.
c) The weights are increased by one-half pound (0.23 kg) each shift
d) The ropes are in the wheel grooves of the pulleys
26. What is the most important assessment for the nurse to make when assessing peripheral pulses on a client who is post limb fracture?
a) Local temperature and visible pulsations
b) Color of the skin and rhythm above the affected fracture site
c) Amplitude and symmetry of both extremities
d) Strong contractility and rate of only the unaffected limb
27. The nurse should plan to use an abduction pillow (or splint) after a total hip replacement to:
a) Prevent hip flexion.
b) Decrease formation of sacral pressure ulcers.
c) Increase peripheral circulation.
d) Prevent dislocation of the prosthesis.