MDC1 EXAM2 Test PDF

lOMoARcPSD|43964769 MDC1 EXAM2 Test MDC1 (Rasmussen University) Scan to open on Studocu Studocu is not sponsored or endorsed by any college or university Downloaded by Bruce Lee ([email protected]) ...

lOMoARcPSD|43964769 MDC1 EXAM2 Test MDC1 (Rasmussen University) Scan to open on Studocu Studocu is not sponsored or endorsed by any college or university Downloaded by Bruce Lee ([email protected])  lOMoARcPSD|43964769 MDC1 EXAM 2 Sample Test 1. 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. 2. 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 3. 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 4. 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 5. 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. Downloaded by Bruce Lee ([email protected])  lOMoARcPSD|43964769 D. Applying warm compresses. 6. 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 7. 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 8. 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. Thomas splint C. Buck's D. Balanced suspension 9. The nurse is providing instructions to the client who is being prepared for skeletal traction. Which statement by the client indicates teaching was effective? A. "Metal pins will go through my skin to the bone." B."I will wear a boot with weights attached." C."A belt will go around my pelvis and weights will be attached." D The traction can be removed once a day so I can shower." 10. A client is reporting pain following orthopedic surgery. Which intervention will help relieve pain? A. Elevate the affected extremity and use cold applications. B. Breathe deeply and cough every 2 hours until ambulation is possible. C. Do ROM exercises as indicated. D. Apply antiembolism stockings as indicated. Downloaded by Bruce Lee ([email protected])  lOMoARcPSD|43964769 11. A client has severe osteoarthritis in the left hip and is having surgery to replace both articular surfaces of the hip. What type of surgical procedure will the nurse prepare the client for? A. Arthrodesis B. Hemiarthroplasty C. Total arthroplasty D. Osteotomy 12. A client is brought to the emergency department by a softball team member who states the client and another player ran into each other, and the client is having severe pain in the right shoulder. What symptoms of a fractured clavicle does the nurse recognize? A. Client complains of tingling and numbness in the right shoulder. B. Right shoulder is elevated above the left. C. Client complains of pain in the unaffected shoulder. D. Right shoulder slopes downward and droops inward. 13. The nurse is preparing a client to have his cast cut off after having it for 6 weeks to treat a fractured tibia. What should the nurse inform the client prior to the cast being removed? A. The leg will look as it did prior to the cast being applied. B. The leg will look moist and will have small bumps that will go away in a few days. C. The skin may be covered with a yellowish crust that will shed in a few days. D. The leg strength is enforced by the wearing of the cast. 14. A client was playing softball and dislocated four of his fingers when diving for a ball. The physician manipulated the fingers into alignment and applied a splint to maintain alignment. What type of procedure does the nurse document this as? A. Open reduction B. Closed reduction C. Open reduction with internal fixation D. External fixation 15. Which would be consistent as a component of self-care activities for the client with a cast? A. Cover the cast with plastic to insulate it B. Cushion rough edges of the cast with tape Downloaded by Bruce Lee ([email protected])  lOMoARcPSD|43964769 C. Frequently place the casted extremity in a dependent position D. Use a plastic hanger wrapped in gauze to scratch under the cast. 16. A client with a long arm cast continues to complain of unrelieved throbbing pain even after receiving opioid pain medication. Which is the priority action by the nurse? A. Assess for complications. B. Assess for previous opioid drug use. C. Reposition the client for comfort. D. Teach relaxation techniques. 17. 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 18. 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. 19. 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 20. 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 Downloaded by Bruce Lee ([email protected])  lOMoARcPSD|43964769 D. crepitus of the knee joint 21. 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?" 22. 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 23. 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 24. 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 25. 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 Downloaded by Bruce Lee ([email protected])  lOMoARcPSD|43964769 26. 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) 27. 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." B. "You need to turn yourself side to side. If your leg is on a pillow, you would not be able to do that." C. "Elevating the extremity may increase your chances of compartment syndrome." D. "I am sorry. We ran out of pillows. I can elevate it on a few blankets." 28. A client with a fractured ankle is having a fiberglass cast applied. The client starts yelling, "My leg is burning, take it off." What action by the nurse is most appropriate? A. Explain that the sensation being felt is normal and will not burn the client. B. Remove the cast immediately, notifying the physician. C. Administer antianxiety and pain medication. D. Call for assistance to hold the client in the required position until the cast has dried. 29. The nurse is caring for a patient who had a total hip replacement. What lethal postoperative complication should the nurse closely monitor for? A. Atelectasis B. Hypovolemia C. Pulmonary embolism D. Urinary tract infection 30. A patient sustains a fracture of the arm. When does the nurse anticipate pendulum exercise should begin? A.As soon as tolerated, after a reasonable period of immobilization B. In 2 to 3 weeks, when callus ossification prevents easy movements of bony fragments C. In about 4 to 5 weeks, after new bone is well established D. In 2 to 3 months, after normal activities are resumed Downloaded by Bruce Lee ([email protected])  lOMoARcPSD|43964769 31. Which of the following is the most important nursing diagnosis for an elderly patient diagnosed with osteoporosis? A. Deficient knowledge about osteoporosis and the treatment regimen B. Acute pain related to fracture and muscle spasm C. Risk for constipation related to immobility D. Risk for injury related to fractures due to osteoporosis 32. A client with a right leg fracture is returning to the orthopedist to have the cast removed. During cast removal, it is important for the nurse to assure: A. the client that he or she won't be cut. B. that the cast cutter blade is new. C. that pedal pulses are present. D. that the leg will be as good as new. 33. After a person experiences a closure of the epiphyses, which statement is true? A. The bone grows in length but not thickness. B. The bone increases in thickness and is remodeled. C. Both bone length and thickness continue to increase. D. No further increase in bone length occurs. 34. 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 35. What is the term for a rhythmic contraction of a muscle? A. Atrophy B. Clonus C. Hypertrophy D. Crepitus 36. The client presents with an exaggeration of the lumbar spine curve. How does the nurse interpret this finding? A. Lordosis B. Scoliosis Downloaded by Bruce Lee ([email protected])  lOMoARcPSD|43964769 C. Kyphosis D. Dowager's hump 37. 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." 38. 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 39. 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. 40. 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. 41. 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 Downloaded by Bruce Lee ([email protected])  lOMoARcPSD|43964769 42. 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 43. 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." 44. A client is admitted with acute osteomyelitis that developed after an open fracture of the right femur. When planning this client's care, the nurse should anticipate which measure? A. Administering large doses of oral antibiotics as ordered B. Instructing the client to ambulate twice daily C. Withholding all oral intake D. Administering large doses of I.V. antibiotics as ordered 45. A nurse is teaching a client about preventing osteoporosis. Which teaching point is correct? A. Obtaining an X-ray of the bones every 3 years is recommended to detect bone loss. B. To prevent fractures, the client should avoid strenuous exercise. C. The recommended daily allowance of calcium may be found in a wide variety of foods. D. Obtaining the recommended daily allowance of calcium requires taking a calcium supplement. 46. A nurse notices a client lying on the floor at the bottom of the stairs. The client is alert and oriented and denies pain other than in the arm, which is swollen and appears deformed. After calling for help, what should the nurse do? A. Place the client in a sitting position. B. Immobilize the client's arm. C. Help the client walk to the nearest nurses' station. D. Raise the client's arm above the heart. Downloaded by Bruce Lee ([email protected])  lOMoARcPSD|43964769 47. The nurse teaches the client with a high risk for osteoporosis about risk-lowering strategies, including which action? A. Increase fiber in the diet B. Walk or perform weight-bearing exercises outdoors C. Reduce stress D. Decrease the intake of vitamin A and D 48. A nurse is caring for a client following foot surgery. Which nursing intervention is most important for the nurse to include in the nursing care plan? A. Examine the surgical dressing every hour. B. Administer pain medication per client request. C. Monitor vital signs every 4 hours. D. Perform neuromuscular assessment every hour. 49. What food can the nurse suggest to the client at risk for osteoporosis? A. Carrots B. Broccoli C. Chicken D. Bananas 50. 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." 51. 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 Downloaded by Bruce Lee ([email protected])  lOMoARcPSD|43964769 52. 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 53. 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 54. 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 55. 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. 56. After surgery to treat a hip fracture, a client returns from the post-anesthesia 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 Downloaded by Bruce Lee ([email protected])  lOMoARcPSD|43964769 57. 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 58. 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 59. Which is a hallmark sign of compartment syndrome? a. Motor weakness b. Edema c. Pain d. Weeping skin surfaces 60. 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 61. Which nursing intervention is appropriate for a client with a closed-reduction extremity fracture? a. Encourage participation in ADLs b. Promote intake of omega-3 fatty acids c. Use frequent dependent positioning to prevent edema d. Administer prescribed enema to prevent constipation 62. A client is transported to the emergency department for a femur fracture following a motor vehicle crash. What action by the nurse is the highest priority? a. Assess vital signs and level of consciousness. Downloaded by Bruce Lee ([email protected])  lOMoARcPSD|43964769 b. Administer pain medication per orders. c. Assess pedal pulses. d. Assess the diameter of the thigh every 15 minutes. 63. A patient sustains an open fracture of the left arm after an accident at the roller skating rink. What does emergency management of this fracture involve? (Select all that apply.) a. Covering the area with a clean dressing if the fracture is open b. Immobilizing the affected site c. Splinting the injured limb d. Asking the patient if he or she is able to move the arm e. Wrapping the arm in an ace bandage 64. The nurse is monitoring a patient who sustained an open fracture of the left hip. What type of shock should the nurse be aware can occur with this type of injury? a. Cardiogenic b. Hypovolemic c. Neurogenic d. Septicemic 65. A nurse is assigned to support a patient while a cast is being applied to treat a greenstick fracture. The nurse documents that this fracture is classified as what type of fracture? A. Closed b. Incomplete c. Stress d. Compression 66. 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." 67. The 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." Downloaded by Bruce Lee ([email protected])  lOMoARcPSD|43964769 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." 68. The nurse recognizes that rheumatoid arthritis is characterized by: a. Ulnar deviation b. Ballottement sign c. Clonus d. Fasciculations 69. 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 70. 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 71. 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. 72. 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. Downloaded by Bruce Lee ([email protected])  lOMoARcPSD|43964769 d. Encouraging expressions of anxiety. 73. 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. 74. 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." 75. 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 76. A client had a total left hip arthroplasty. What clinical manifestation would indicate to the nurse that the prosthesis is dislocated? a. The left leg is internally rotated. b. The leg length is the same as the right leg. c. The client has discomfort when moving in bed. d. There are diminished peripheral pulses on the affected extremity. 77. On a visit to the family health care provider, a client is diagnosed with a bunion on the lateral side of the great toe at the metatarsophalangeal joint. Which statement should the nurse include in the teaching session? a. "Bunions are congenital and can't be prevented." b. "Bunions may result from wearing shoes that are too big, causing friction when the shoes slip back and forth." Downloaded by Bruce Lee ([email protected])  lOMoARcPSD|43964769 c. "Some bunions are congenital; others are caused by wearing shoes that are too short or narrow." D. "Bunions are caused by a metabolic condition called gout." 78. During a routine physical examination on an older 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? (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. "There may be some slight discrepancy between the measuring tools used." d. "The posture begins to stoop after middle age." 79. Lifestyle risk factors for osteoporosis include a. lack of aerobic exercise. b. a low-protein, high-fat diet. c. an estrogen deficiency or menopause. d. lack of exposure to sunshine. 80. In chronic osteomyelitis, antibiotics are adjunctive therapy in which situation? a. Wound packing b. Wound irrigation c. Vitamin supplements d. Surgical debridement 81. A nurse is caring for a client following foot surgery. Which nursing intervention is most important for the nurse to include in the nursing care plan? a. Examine the surgical dressing every hour. b. Administer pain medication per client request. c. Monitor vital signs every 4 hours. d. Perform neuromuscular assessment every hour. - d. Perform neuromuscular assessment every hour. 82. The nurse recognizes that goal of treatment for metastatic bone cancer is to: a. Promote pain relief and quality of life b. Reconstruct the bone with a prosthesis c. Diagnose the extent of bone damage Downloaded by Bruce Lee ([email protected])  lOMoARcPSD|43964769 d. Cure the diseased bone and cartilage - a. Promote pain relief and quality of life 83. 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 84. 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 85. Which factor inhibits fracture healing? a. Vitamin D b. Exercise c. Local malignancy d. Maximum bone fragment contact - c. Local malignancy 86. 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 87. Which of the following are associated with compartment syndrome? Select all that apply. Downloaded by Bruce Lee ([email protected])  lOMoARcPSD|43964769 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 88. 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 89. 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 90. 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 91. A client with a recent left above-the-knee amputation states, "I can feel pain in my left toes." Which is the best response by the nurse? a. "Your left toes have been amputated." b. "The pain is really from the nerves in the upper leg." Downloaded by Bruce Lee ([email protected])  lOMoARcPSD|43964769 c. "Pain medication usually does not help this type of pain." d. "Describe the pain and rate it on the pain scale." - d. "Describe the pain and rate it on the pain scale." 92. Which statement by a staff nurse on the orthopedic floor indicates the need for further staff education? a. "The client is receiving physical therapy twice per day, so the client doesn't need a continuous passive motion device." b. "The continuous passive motion device can decrease the development of adhesions." c. "Bleeding is a complication associated with the continuous passive motion device." d. "Monitoring skin integrity is important while the continuous passive motion device is in place." - a. "The client is receiving physical therapy twice per day, so the client doesn't need a continuous passive motion device." 93. Which would be contraindicated as a component of self-care activities for the client with a cast? a. Cover the cast with plastic to insulate it b. Cushioning rough edges of the cast with tape c. Elevate the casted extremity to heart level frequently d. Do not attempt to scratch the skin under a cast - a. Cover the cast with plastic to insulate it 94. Which instruction should the nurse include when teaching the client following hip replacement surgery? (Select all that apply.) a. "You may cross your legs at the ankles only." b. "Place pillows between your legs when you lay on your side." c. "Avoid bending forward when sitting in a chair." d. "Use a raised toilet seat and high-seated chair." e. "It is okay to briefly flex the hip to put on your clothes." - b. "Place pillows between your legs when you lay on your side." c. "Avoid bending forward when sitting in a chair." d." Use a raised toilet seat and high-seated chair." 95. A variety of complications can occur after a leg amputation. Which is not a possibility in the immediate postoperative period? a. osteomyelitis b. hematoma c. hemorrhage d. infection Downloaded by Bruce Lee ([email protected])  lOMoARcPSD|43964769 - a. osteomyelitis 96. An unresponsive client had a plaster cast applied to the right lower leg 8 hours ago. When moving the client, the nurse notices an indentation on the posterior lower portion of the cast. What is the best action by the nurse? a. Document the findings. b. Notify the physician. c. Remove the cast immediately. d. Assess for pedal pulse and mobility of toes. - b. Notify the physician. 97. 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. 98. 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 99. 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. Downloaded by Bruce Lee ([email protected])  lOMoARcPSD|43964769 100. 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 30 degrees 101. The nurse has educated a patient with low back pain about techniques to relieve the back pain and prevent further complications. What statement by the patient shows understanding of the education the nurse provided? a. "I will lie prone with my legs slightly elevated." b. "I will bend at the waist when I am lifting objects from the floor." c. "I will avoid prolonged sitting or walking." d. "Instead of turning around to grasp an object, I will twist at the waist." - c. "I will avoid prolonged sitting or walking." 102. A client is exhibiting diminished range of motion, loss of flexibility, stiffness, and loss of height. The history and physical findings are associated with age-related changes of which area? a. Joints b. Bones c. Muscles d. Ligaments - a. Joints 103. A client has undergone arthroscopy. After the procedure, the site where the arthroscope was inserted is covered with a bulky dressing. The client's entire leg is also elevated without flexing the knee. What is the appropriate nursing intervention required in caring for a client who has undergone arthroscopy? a. Apply a cold pack at the insertion site. b. Apply warm compresses to the insertion site. c. Provide a gentle massage. d. Assist with performing ROM exercises. - a. Apply a cold pack at the insertion site. 104. A client has just been diagnosed with early glaucoma. During a teaching session, the nurse should: a. provide instructions on eye patching. b. assess the client's visual acuity. Downloaded by Bruce Lee ([email protected])  lOMoARcPSD|43964769 c. demonstrate eyedrop instillation. d. teach about intraocular lens cleaning. - c. demonstrate eyedrop instillation. 105. A client accidentally splashes chemicals into one eye. The nurse knows that eye irrigation with plain tap water should begin immediately and continue for 15 to 20 minutes. What is the primary purpose of this first aid treatment? a. To hasten formation of scar tissue b. To prevent vision loss c. To eliminate the need for medical care d. To serve as a stopgap measure until help arrives - b. To prevent vision loss 106. The nurse is reviewing the medical record of a client with glaucoma. Which of the following would alert the nurse to suspect that the client was at increased risk for this disorder? a. Age younger than 40 years b. Hyperopia since age 20 years c. History of respiratory disease d. Prolonged use of corticosteroids - d. Prolonged use of corticosteroids 107. The nurse is giving a visual field examination to a 55-year-old male client. The client asks what this test is for. What would be the nurse's best answer? a. "This test measures visual acuity." b. "This test measures how well your eyes move." c. "This test is to see how well your eyes are aging." d. "This test measures peripheral vision and detects gaps in the visual field." - d. "This test measures peripheral vision and detects gaps in the visual field." 108. The nurse admits a client to the emergency department who has been referred by the eye clinic. Which condition is an emergency where the nurse should refer the client for medical treatment immediately? a. Chalazion b. Acute angle-closure glaucoma c. Hordeolum d. Blepharitis - b. Acute angle-closure glaucoma Downloaded by Bruce Lee ([email protected])  lOMoARcPSD|43964769 109. The nurse realizes that a client understands how to correctly instill ophthalmic medications when the client: a. pulls the tissue near the cheek downward to instill medication. b. wipes the lids and lashes prior to instillation in a direction toward the nose with moistened, soft gauze. c. allows the tip of the container to touch the eyelid while administering the medication. d. rubs the eye after administering medication. - a. pulls the tissue near the cheek downward to instill medication. 110. The client with chronic open-angle glaucoma is receiving timolol (Timoptic) eye drops. Which evaluation finding would indicate to the nurse the treatment is working? a. Intraocular pressure 15 mm Hg b. Reduced peripheral vision c. Halos around lights d. Decrease in nausea and vomiting - a. Intraocular pressure 15 mm Hg 111. A nurse conducted a history and physical for a newly admitted patient who states, "My arms are too short. I have to hold my book at a distance to read." The nurse knows that the patient is most likely experiencing: a. Opacity in the lens. b. Loss of accommodative power in the lens. c. Shrinkage of the vitreous body. d. Decreased eye muscle tone. - b. Loss of accommodative power in the lens. 112. The ophthalmologist tells a patient that he has increased intraocular pressure (IOP). The nurse understands that increased pressure resulting from optic nerve damage is indicated by a reading of: a. 0 to 5 mm Hg. b. 6 to 10 mm Hg. c. 11 to 20 mm Hg. d. >21 mm Hg. - d. >21 mm Hg. 113. On ocular examination, the health care provider notes severely elevated IOP, corneal edema, and a pupil that is fixed in a semi-dilated position. The nurse knows that these clinical signs are diagnostic of the type of glaucoma known as: Downloaded by Bruce Lee ([email protected])  lOMoARcPSD|43964769 a. Chronic open-angle. b. Normal tension. c. Acute angle-closure. d. Chronic angle-closure. - c. Acute angle-closure. 114. There are four major types of ophthalmic procedures to complete a glaucoma examination. If the health care provider wants to inspect the optic nerve, the nurse would prepare the patient for: a. Tonometry. b. Ophthalmoscopy. c. Gonioscopy. d. Perimetry. - b. Ophthalmoscopy. 115. Assessment of visual acuity reveals that the client has blurred vision when looking at distant objects but no difficulty seeing near objects. The nurse documents this as which of the following? a. Myopia b. Astigmatism c. Hyperopia d. Emmetropia - a. Myopia 116. An aging client is brought to the eye clinic by the son. The son states he has seen his parent holding reading materials at an increasing distance to focus properly. What age-related changes does this indicate? a. Cataract b. Presbyopia c. Myopia d. Macular degeneration - b. Presbyopia 117. Which of the following is the role of the nurse toward a patient who is to undergo eye examinations and tests? a. Ensuring that the patient receives eye care to preserve his or her eye function and prevent further visual loss b. Conducting various tests to determine the function and the structure of the eyes c. Determining if further action is warranted d. Advising the patient on the diet and exercise regimen to be followed Downloaded by Bruce Lee ([email protected])  lOMoARcPSD|43964769 -a. Ensuring that the patient receives eye care to preserve his or her eye function and prevent further visual loss 118. A client has noticed recently having clearer vision at a distance than up close. What is the term used to describe this client's visual condition? a. hyperopia b. emmetropia c. myopia d. astigmatism - a. hyperopia 119. A client is examined due to recent vision changes and is diagnosed with myopia. What is the cause of this client's vision change? a. elongated eyeballs b. shortened eyeballs c. irregularly shaped corneas d. unequal curvatures in the cornea - a. elongated eyeballs 120. A nurse is performing an eye examination. Which question would not be included in the examination? a. "Are you able to raise both eyebrows?" b. Have you experienced blurred, double, or distorted vision?" c. "Do any family members have any eye conditions?" d. "What medications are you taking?" -a. "Are you able to raise both eyebrows?" 121. A client with chronic open-angle glaucoma is now presenting with eye pain and intraocular pressure of 50 mm Hg. An immediate iridotomy is scheduled. Which of the following describes the desired effects of this procedure? a. Reverse optic nerve damage b. Restore vision c. Improve outflow drainage d. To relieve pain - c. Improve outflow drainage 122. A patient visits a clinic for an eye examination. He describes his visual changes and mentions a specific diagnostic clinical sign of glaucoma. What is that clinical sign? Downloaded by Bruce Lee ([email protected])  lOMoARcPSD|43964769 a. A significant loss of central vision b. Diminished acuity c. Pain associated with a purulent discharge d. The presence of halos around lights - d. The presence of halos around lights 123. To straighten the ear canal in an adult for examination, the nurse practitioner would grasp the auricle and pull it: a. Up and backward. b. Upward and outward. c. Slightly outward. d. Downward. - a. Up and backward. 124. Which type of glaucoma presents an ocular emergency? a. Normal tension glaucoma b. Ocular hypertension c. Acute angle-closure glaucoma d. Chronic open-angle glaucoma - c. Acute angle-closure glaucoma 125. A 52-year-old comes to the clinic for a follow-up examination after being diagnosed with glaucoma. The client states, "I'm hoping that I don't have to use these drops for very long." Which response by the nurse would be most appropriate? a. "Most clients need to use the drops for only about a few months." b. "If the drops don't work, surgery may be needed to cure your condition." c. "You'll need to use the drops for the rest of your life to control the glaucoma." d. "These drops are just the first step to make sure that your vision doesn't get worse." - c. "You'll need to use the drops for the rest of your life to control the glaucoma." 126. The nurse is caring for a client ordered for multiple eye screening. Following which procedure will the nurse instruct the client on a yellow coloring to the skin and urine as being normal? a. Ultrasonography b. Retinal Imaging c. Retinal Angiography d. Retinoscopy Downloaded by Bruce Lee ([email protected])  lOMoARcPSD|43964769 - c. Retinal Angiography 127. The nurse is demonstrating how to perform punctal occlusion. Which activities does the nurse perform? a. Applies gentle pressure bilaterally on the bridge of the nose to the inner canthus of each eye b. Holds down the lower lid of the eye by applying pressure on the eyeball and the cheekbone c. Applies gentle pressure to the upper eyelid to keep the lid open while telling the client to gaze upward d. Applies firm pressure to the upper and lower eyelids at the outer edges to keep eyelids in approximation - a. Applies gentle pressure bilaterally on the bridge of the nose to the inner canthus of each eye 128. The nurse is providing care to a client who has been admitted to the hospital for treatment of an infection. The client is visually impaired. Which of the following would be most appropriate for the nurse to do when interacting with the client? a. Talk to the client in a loud tone of voice. b. Avoid using the terms "see" or "look." c. Face the client when speaking directly to him. d. Touch the client before identifying himself or herself. - c. Face the client when speaking directly to him. 129. After surgery for removal of cataract, a client is being discharged, and the nurse has completed discharge instruction. Which client statement indicates that the outcome of the teaching plan has been met? a. "I need to wear sunglasses for the first 3 to 4 days even when I'm inside." b. "Dots or flashing lights in my vision are to be expected for the first few days." c. "I should avoid pulling or pushing any object that weighs more than 15 lbs." d. "I need to keep the eye patch on for about a week after surgery." - c. "I should avoid pulling or pushing any object that weighs more than 15 lbs." 130. A client diagnosed with a cataract comes into the clinic. What assessments should the nurse observe in this client? a. A burning sensation and the sensation of an object in the eye b. Blurred or cloudy visual image c. Inability to produce sufficient tears d. A swollen lacrimal caruncle - b. Blurred or cloudy visual image 131. The nurse is obtaining a visual history from a client who has noted an increase in glare and changes in color perception. Which assessment would the nurse anticipate to confirm a definitive diagnosis? Downloaded by Bruce Lee ([email protected])  lOMoARcPSD|43964769 a. Identification of opacities on the lens b. Identification of white circle around the cornea c. Identification of yellowish aging spot on the retina d. Identification of redness of the sclera - a. Identification of opacities on the lens 132. After a car accident, a client is admitted to an acute care facility with multiple traumatic injuries, including a fractured pelvis. For 24 to 48 hours after the accident, the nurse must monitor the client closely for which potential complication of a fractured pelvis? a. Compartment syndrome b. Fat embolism c. Infection d. Volkmann's ischemic contracture - b. Fat embolism 133. A health care provider diagnoses primary osteoporosis in a client who has lost bone mass. For which client is primary osteoporosis most common? a. elderly man b. young child c. young menstruating woman d. elderly postmenopausal woman - d. elderly postmenopausal woman 134. A nurse is planning discharge teaching regarding exercise for a client at risk for osteoporosis. Which exercise would the nurse be most likely to suggest? a. Yoga b. Walking c. Bicycling d. Swimming - b. Walking 135. A client presents to the emergency department with fever, chills, restlessness, and limited movement of a fractured jaw. What complication should the nurse interpret as the findings? a. Avascular necrosis b. Fat embolism Downloaded by Bruce Lee ([email protected])  lOMoARcPSD|43964769 c. Osteomyelitis d. Compartment syndrome - c. Osteomyelitis 136. The nurse is assigned to care for a client who has had an open reduction and internal fixation of a fractured right femur 2 days ago. The nurse is listening to the client's lungs and, when moving the gown, observes petechial hemorrhages on the skin of the chest. What is the first action by the nurse? a. Call the physician to inform them of the findings. b. Administer pain medication. c. Request an antihistamine for the allergic reaction. d. Increase the intravenous fluids for hemorrhage. - a. Call the physician to inform them of the findings. 137. Which of the following factors would the nurse need to keep in mind about the focus of the initial history when assessing a new client with a musculoskeletal problem? a. Client's age b. Client's lifestyle c. Any chronic disorder or recent injury d. Duration and location of discomfort or pain - c. Any chronic disorder or recent injury 138. A nurse is caring for a client who has had an amputation. What interventions can the nurse provide to foster a positive self-image? (Select all that apply.) a. Encouraging the client to care for the residual limb b. Allowing the client to express grief c. Encouraging the client to have family and friends view the residual limb to decrease self-consciousness d. Encouraging family and friends to refrain from visiting temporarily because this may increase the client's embarrassment e. Introducing the client to local amputee support groups - a. Encouraging the client to care for the residual limb b. Allowing the client to express grief e. Introducing the client to local amputee support groups 139. A nurse is caring for a client who recently underwent a total hip replacement. What is the best action by the nurse for client care? a. Ease the client onto a low toilet seat. b. Allow the client's legs to be crossed at the knees when out of bed. Downloaded by Bruce Lee ([email protected])  lOMoARcPSD|43964769 c. Use soft chairs when the client is sitting out of bed. d. Limit hip flexion of the client's hip when the client sits up. - d. Limit hip flexion of the client's hip when the client sits up. 140. The nurse assesses subtle personality changes, restlessness, irritability, and confusion in a client who has sustained a fracture. The nurse suspects which complication? a. Compartment syndrome b. Hypovolemic shock c. Fat embolism syndrome d. Reflex sympathetic dystrophy syndrome - c. Fat embolism syndrome 141. The nurse is evaluating a client's peripheral neurovascular status. Which would the nurse report to the health care provider as a circulatory indicator of peripheral neurovascular dysfunction? a. Weakness b. Paresthesia c. Cool skin d. Paralysis - c. Cool skin 142. The nurse assesses soft subcutaneous nodules along the line of the tendons in a patient's hand and wrist. What does this finding indicate to the nurse? a. The patient has osteoarthritis. b. The patient has lupus erythematosus. c. The patient has rheumatoid arthritis. d. The patient has neurofibromatosis. - c. The patient has rheumatoid arthritis. 143. A healthcare provider asks a nurse to test a client for Tinel's sign to diagnose carpal tunnel syndrome. What should the nurse do to perform this assessment? a. Have the client make a fist and open the hand against resistance. b. Have the client stretch the fingers around a ball and squeeze with force. c. Have the client hold the palm of the hand up while the nurse percusses over the median nerve. d. Have the client pronate the hand while the nurse palpates the radial nerve. - c. Have the client hold the palm of the hand up while the nurse percusses over the median nerve. Downloaded by Bruce Lee ([email protected])  lOMoARcPSD|43964769 144. A client complains of vertigo. The nurse anticipates that the client may have a problem with which portion of the ear? a. External ear b. Middle ear c. Inner ear d. Tympanic membrane - c. Inner ear 145. Which terms refers to the progressive hearing loss associated with aging? a. Presbycusis b. Exostoses c. Otalgia d. Sensorineural hearing loss - a. Presbycusis 146. Which symptom is related to vertigo? a. Loss of consciousness b. Spinning sensation c. Fainting d. Syncope - b. Spinning sensation 147. You are doing discharge teaching with a client after a stapedectomy. Why would it be important for you to advise the client to refrain from blowing the nose? a. It may cause sudden headaches. b. It may cause vertigo. c. It may dislodge the prosthesis. d. It may cause excessive drainage. - c. It may dislodge the prosthesis. 148. A nurse is obtaining a history from a new client with glaucoma. The client indicates having read about the diagnosis and understanding that this type of glaucoma is due to the degeneration and obstruction of the trabecular meshwork, whose original function is to absorb the aqueous humor. The loss of absorption will lead to an increased resistance, and thus a chronic, painless buildup of pressure in the eye. Which type of glaucoma has the client described? Downloaded by Bruce Lee ([email protected])  lOMoARcPSD|43964769 a. open angle b. angle closure c. congenital d. secondary - a. open angle 149. Which precautions should the nurse take when a client is at risk of injury secondary to vertigo and probable imbalance? a. Grasp the siderails when rising to a standing position. b. Keep his or her eyes closed. c. Refrain from looking at one place. d. Immobilize the head to reduce the risk of falling - a. Grasp the siderails when rising to a standing position. Downloaded by Bruce Lee ([email protected])