MDC1 Exam 2 Questions & Stuff

A nurse is caring for a client that has a right femur fracture. What laboratory test would be the nurse’s priority to review?

Hemoglobin and hematocrit

A client does not understand why vision loss due to glaucoma is irreversible. What is the best explanation?

Too many nerve fibers have become ischemic and died so vision loss is permanent

The client states “I was told that I’m nearsighted; I do not understand what that means.” What would be the best response from the nurse?

Nearsighted, or myopia means that you have difficulty seeing things at a distance.

A client relates that the vision in the left eye has greatly decreased from the day before. Which nursing intervention is the most appropriate?

Perform an in-depth assessment

The nurse is caring for an adolescent who recently had an injury to the face with a softball. Which action should the nurse take first?

Assess vital signs of the client.

A nurse is transcribing a client’s medication prescription and is having difficulty reading the provider’s handwriting. Which of the following actions should the nurse take?

Contact the provider to clarify the prescription

The nurse is discussing with a client the effects of immobility on the urinary system. Which statement by the client indicates teaching was effective?

“If I do not stay mobile, I may have increased kidney stones.:

Which laboratory value for calcium is indicative of possible history of multiple fractures?

13\.0 mg/dL

What test is used in the diagnosis of osteoporosis?

Bone scan

The nurse is caring for a client with musculoskeletal trauma. Which abnormal laboratory finding is associated with soft tissue damage?

Increased erythrocyte sedimentation rate (ESR)

The nurse is caring for a client diagnosed with late stage Alzheimer’s disease, and the client requires full assistance with transfers to and from bed. What would you do to promote the safe handling of this client?

Provide the client with brief and clear instructions that are phrased positively.

A nurse is caring for a client who has a right leg cast. Which of the following should the nurse include in the home care instructions?

Weight bearing restrictions on the injured leg

The nurse is creating a plan of care to prevent cardiovascular complications for a client with immobility. Which of the following should be included in the plan of care?

Encourage range of motion exercises every 4 hours

A nurse educates an older adult with impaired mobility about physical activity and exercise benefits. Which of the following should the nurse include in the education?

Exercise improves and maintains strength and independence

The nurse is providing care to a client with a nursing diagnosis of hygiene self care deficit. Which of these should the nurse include in the plan of care for this client?

Assist with activities of daily living

A nurse is caring for a client with a post surgical total knee repair on bedrest and is experiencing constipation. Which nursing intervention is appropriate for this client?

Administer a fiber supplement as ordered

The nurse is creating a plan of care to prevent gastrointestinal complications for a client with immobility. Which of the following should be included in the plan of care?

Encourage increased fluids and high fiber diet

A nurse is caring for a client with limited hand movement. Which of the following actions should the nurse take to support nutrition?

Offer protein-rich diet to maintain muscle mass

The nurse should instruct the postoperative client that anti-embolic stockings are used for which purpose?

To promote venous return

The nurse is caring for a client with a leg fractur. The nurse is assisting the client with range of motion by straightening the hinge joint to 180 degrees. Which of these describes this type of motion?

Joint extension

The nurse is assigned to care for a client with a detached retina. Which of the following symptoms should the nurse expect?

Small flashes of light seen as “shooting stars”

The nurse is completing an eye assessment and finds a difference in pupil size. The client states that the different sizes of pupils have been present since childhood. Which best describes this condition?

Anisocoria

A nurse is caring for an elderly client in a long term care facility with an unsteady gait and lower extremity weakness. The client can stand and walk with assistance. Which if the most appropriate piece of equipment to use when ambulating the client?

A walker

What device would be the best to use to move a client from a sitting to a standing position?

A standing assist device

A client with a metastatic bone tumor reports severe pain at the tumor site. Which of the following would the nurse expect to be included in pharmacological pain management?

Administer barbiturates and apply ice

A client is at risk for osteoporosis is taking Calcium and Vitamin D suppelements. What findings would indicate that the client is hypercalcemic?

Cardiac dysthymias and changes in skeletal muscle tone

What medication class is used to decrease inflammation, and is also a known cause of secondary osteoporosis?

Corticosteroids

The HCP ordered calcium and vitamin D3 supplementation for a postmenopausal client. This treatment will promote bone health and help prevent which of the following musculoskeletal conditions?

Osteoporosis

The nurse is caring for a client admitted with actue osteomyelitis. What medication would the nurse expect the HCP to order for treatment of this condition?

Antibiotics

A client with glaucoma is prescribed a beta-adrenergic antagonist (beta blocker) to reduce interocular pressure. What should the nurse include in the discharge instructions?

You must check your pulse twice per day and contact your provider if it is consistently below 60 beats/minute

The nurse is educating a client that has just been prescribed several medications to treat their glaucoma. Which nursing statement is appropriate to include in the education?

Wait 5-10 minutes between drug instillations to prevent one drug from diluting another.

How many mg is 10,000 mcg?

10

A nurse is caring for clients with reduced vision. What nursing action would be the best approach when communicating?

Introduce yourself before entering the room

What nursing intervention is best to improve communication with a hearing impaired client?

Speak slowly and clearly while facing the client

A nurse is educating a Spanish speaking client that states “I can speak a little English” for cataract surgery. What nursing action would be the best approach to therapeutically communicate?

Obtain the assistance of an interpreter if needed

To provide for the psychosocial needs of an immobilized client, an appropriate statement by the nurse is which of the following?

“Let’s discuss the routine to see if there are any changes we can make”

A client is experiencing a pain level of 5 (0-10 scale) after spraining an ankle. What type of pain is the client is experiencing?

Somatic pain

A bone is separated into two sections and is broken across the entire width of the bone. Which best describes the musculoskeletal trauma?

A complete fracture

What complication of fractures is caused by increased pressure which results in decreased circulation to the area?

Acute compartment syndrome

What activities should the nurse include in client education that may lead to increased interocular pressure (Select all that apply)

Lifting items greater than 10 lbs, Bending from the waist, Straining with a bowel movement

Which of these interventions should a nurse include in the care plan to prevent complications of immobility? (Select all that apply)

Breathing exercises, Offer fluids

A client complains of low back pain radiating down the left posterior thigh. The nurse should ask the client if the pain is worsened or aggravated by which factor?

Bending or lifting

A nurse is educating a client on the causes of conductive hearing loss. What topic should the nurse include in the education?

Otitis media

The nurse is caring for a client with otitis media. The client reports that the pain was severe during the night but was gone when he woke up in the morning. Which finding will the nurse expect find during the client’s physical assessment?

Purulent fluid is present in the ear canal

An older adult client is wearing thick glasses and a hearing aid. Which intervention is priority to facilitate communication?

Allow time for the client to respond

The nurse notes that the primary HCP has documented a diagnosis of presbycusis. Which of the following explanations should the nurse give to the client to reinforce an explanation of the disorder?

A sensorineural hearing loss that occurs with aging

The client arrives in the emergency department with a foreign body in the left ear has been determined to be an insect. Which initial intervention should the nurse anticipate being prescribed?

Instillation of mineral oil or diluted alcohol

Which is a complication of syndactylism?

Fusion of two or more fingers or toes

Which of the following are physiological outcomes of immobility?

Decreased lung expansion

Which of the following are physiological outcomes of immobility?

Decreased lung expansion

The nurse is caring for a client who is bedridden due to surgery on the spine. Which respiratory complications may occur if the client is bedridden for a long duration?

Atelectasis

An immobilized client is suspected of having atelectasis. Which clinical manifestation is associated with this condition?

Diminished breath sounds

A client arrives at the emergency department with metal shavings in both eyes. What is the correct procedure for occular irrigation for this client?

Irrigate both eyes simultaneously with 0.9% normal saline, using separate personnel and equipment

The nurse knows that muscle strengthening exercises for a client with osteoporosis is to achieve which goal?

Prevent bone los

Osteoporosis often occurs in women due to what factor?

A decrease in estrogen levels as they age

Which statement best describes the procedure used to assess capillary refill in a client with a musculoskeletal disorder?

Briefly press the tip of the nail with firm, steady pressure, then release and observe for changes in color

What best describes the reason a client with osteoporosis is prone to fracture?

Decreased bone density

The nurse is teaching a client who obtained a fracture of the femur about the imporatnce of nutrition for proper bone healing. Which statement by the client indicates they understood?

I will increase calcium and protein rich foods in my diet

A patient with bone cancer states that he is in too much pain to walk today. What should the nurse do first?

Inquire about the frequency, quality, and location of the pain

A goal for a client who has difficulty with self-feeding due to rheumatoid arthritis is to use adaptive devices. The nurse caring for the client should initiate a referall to which of the following members of the interprofessional team?

Occupational therapist

The nurse is admitting a Native American client to the surgical unit for an ankle fracture. The client informs the nurse they need a medicine man present prior to the procedure. Which nursing intevention should the nurse include in the plan of care?

Conduct a culutural spiritual asssessment

The nurse is educating a client about nonmodifiable risk factors for osteoporosis. The nurse will include which of the following in the teaching?

prior removal of ovaries

What is the priority nursing diagnosis for a client with metastatic bone disease?

Chronic pain

The nurse is caring for a client who had a knee replacement 2 days ago. The client suddenly states, “I have tingling in my toes on the left foot.” What is the first thing the nurse should assess?

Bilateral pedal pulses

A nurse is assisting with discharge planning for a client who has no family and requires assistance with mobility after surgery. The client is concerned about moving to an assisted living facility. Which member of the interprofessional team should the nurse suggest a referral to?

Social worker

A nurse is caring for a client with impaired mobility. Which of the following support devices should the nurse plan to use to prevent the client from developing plantar flexion contractures?

Footboard

The nurse is assigned to care for four clients at the beginning of the shift. Which of these clients will the nurse assess first?

A client with sudden and increasing pain in his fractured arm not relieved by medication

A nurse is giving instructions to a client who had a surgical correction of a bunion. Which of the following information should the nurse include?

Place pillows under the knee to elevate the foot

While assessing the dorsalis pedis pulse of a client with an ankle injury, the nurse determines that the pulse is absent. However, the extermity is warm and pink with nail beds blanching at 2 to 3 seconds capillary refilling time. What nursing action is the most appropriate?

Reassess with lighter pressure applied over the pulse site

Before the nurse brings the client to the operating room (OR) for knee surgery, the client reports to the nurse that the surgeon did not mark the operative knee, Which is the best nursing action?

Call the surgeon to mark the site with the client before transfer to the OR

The nurse is completing preoperative teaching for a client, and it becomes apparent that the client does not understand the surgery that will be performed. Which is the best nursing action?

Notify surgeon and document findings

A client has a new arm cast. Which signs and symptoms would indicate that the client is experiencing negative side effects?

Report “hot spots” felt under the cast

The nurse is caring for a client with a suspected fracture of the upper arm. During the assessemtn which finding would be considered a late symptom of a fracture?

??? Pain at site, subcutaenous emphysema

The nurse is caring for a client who had kyphoplasty. The nurse would be most concerned with which assessment finding?

Temperature 101.8 F orally

What is the most common method of reducting and immobilizing a fracture?

Open reducation with internal fixation

Your client is experiencing immobility. What is your priority assessment for your client?

\
Respiratory Assessment

Your patient is not completing ROM exercises as instructed by PT. The nurse should state “You will never get stronger”. T/F

False

Which is the most appropriate nursing intervention to promote mobility?

ROM exercises q2h

Which statement by your patient indicates successful progress of your goal set to increase daily physical mobility?

“I don’t get as tired anymore when I go walking with my wife”

The nurse should perform PROM for a patient who can’t move independently following a car accident T/F

True

What should the nurse do to help promote independence for their patient?

Encourage the patient to perform the ADLs that are within their ability

Which statement by the new nurse indicates a need for further teaching for a patient with plantar fasciitis?

I will encourage my patient to apply heat packs at the end of the day.

Your patient has bone cancer. Which is your priority nursing diagnosis?

Chronic Pain

Your patient comes into the ER with pain. The nurse should assess the frequency, quality, and location of the pain. T/F

True

What is the nurse’s priority when caring for a patient with osteomyelitis?

Assess the patient’s pain and temperature

Which intervention should the nurse ensure the CNA is avoiding when ambulating the patient?

Walking on the side of and in front of the patient

Removal of ovaries is not a risk factor for osteoporosis T/F

False

What is a modifiable risk factor for developing osteoporosis?

Low intake of Vitamin D

What is a preventable measure of developing osteoporosis?

Limiting carbonated beverages and caffeine

What activity is best to reduce bone loss and prevent fractures?

Walking

Your patient 3 days post op newly complains of numbness in the affected extremity in the foot. What should the nurse do first?

Assess biltaterl doraslis pedis pulses

A nurse is caring for a patient who will have large surgical scars. The nurse should assess the client’s coping skills. T/F

True

Select the most common cause of osteoporosis

Calcium and Vitamin D

Weight bearing exercises should be encouraged for patients with early osteoporosis T/F

True

Hallux valgus enlargement is a corn T/F

False

Why are patients with osteoporosis high risk for fractures?

decreased bone density

Computer based occupations are high risk for developing carpal tunnel T/F

True

The first metatarsal head is circled in the picture T/F

False

Which is considered an age related musculoskeletal change?

decreased muscle mass

Pain in the arch of the foot is associated with a bunion T/F

False