MDC1 Exam 2

What is the priority assessment for a client experiencing immobility?

-Vascular Assessment -Respiratory Assessment -Integumentary Assessment -GI Assessment

What is the priority assessment for a client experiencing immobility?

-Vascular Assessment -Respiratory Assessment -Integumentary Assessment -GI Assessment

Respiratory Assessment

True or False: The nurse should state 'You will never get stronger' to a patient who is not completing ROM exercises as instructed by PT.

False

What is the most appropriate nursing intervention to promote mobility?

-Assess risk for edema -Decrease intake of fiber and fluids -ROM excercises q2h -Instruct the patient to do 30 jumping jacks every hour while awake

ROM exercises q2h

Which statement by a patient indicates successful progress in increasing daily physical mobility?

-"I am taking the stairs instead of the elevator" -"I don't get as tired anymore when I go walking with my wife" -"I only fell once yesterday" -"I have been sorer when I wake up in the morning than normal"

"I don't get as tired anymore when I go walking with my wife"

True or False: The nurse should perform PROM for a patient who cannot move independently following a car accident.

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 -Assist the patient with their ADLs -Do the patient ADLs for them -Tell the pt if they cannot perform their own ADLs, they will never go home

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

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

• "I will educate my patient to wear supportive arch shoes."

• "I will educate my patient to ice their feet."

• "I will educate my patient to allow proper rest and stretching their feet."

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

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

What is the priority nursing diagnosis for a patient with bone cancer?

-Risk for infection -Risk for immobility -Risk of knowledge deficit -Chronic Pain

Chronic Pain

True or False: When a patient comes into the ER with pain, the nurse should assess the frequency, quality, and location of the pain.

True

What is the nurse's priority when caring for a patient with Osteomyelitis?

-Assess the patient's pain and temperature -Evaluate the success of yesterday's plan of care -Assess patient knowledge of Osteomyelitis -Plan to ice the affected extremity

Assess the patient 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 -Use a transfer belt -Remove unnecessary items from the patient's pathway -Use appropriate ambulation devices such as a walker or cane if necessary

Walking on the side of and in front of the patient

True or False: Removal of ovaries is not a risk factor for osteoporosis.

False

Select a modifiable risk factor for developing osteoporosis.

-Low Intake of Vitamin D -Age -Genetic predisposition -Ethnicity

Low intake of Vitamin D

Select a preventable measure of developing osteoporosis.

-Decrease comsumption of vitamin D -Limiting carbonated beverages and caffeine -Refuse to get a hysterectomy -Eating a low protein and fat diet

Limiting carbonated beverages and caffeine

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

Running Cycling Weight Lifting Walking

Walking

What should the nurse do first if a patient complains of numbness in the affected extremity foot 3 days post-op?

Call the provider to notify of the change Ask the patient if they have history of neuropathy Assess the femoral pulse Assess bilateral dorsalis pedis pulses

Assess bilateral dorsalis pedis pulses

True or False: A nurse should assess a patient's coping skills for large surgical scars

True

What is the most common cause of osteoporosis?

Phosphorous Vitamin D and zinc Calcium and Vitamin D Vitamin D and C

Calcium & Vitamin D

True or False: Weight-bearing exercises should be encouraged for patients with early osteoporosis

True

True or False: Hallux valgus enlargement a corn

False

Why are patients with osteoporosis at high risk for fractures?

Bone spurs and deformities Decreased bone density Joint inflammation Weak muscles

Decreased Bone Density

True or False: Computer-based occupations are high risk for developing carpal tunnel

True

What is considered an age-related musculoskeletal change?

Decreased bone density Decreased muscle mass Decreased activity tolerance Increased muscle mass

Decreased muscle mass

True or False: Pain in the arch of the foot is associated with a bunion

False

True or False: Fowler's position would be 45 degrees HOB elevated

True

What medication class is used to decrease inflammation?

Opioids Anticoagulants Ice Corticosteroids

Corticosteroids

True or False: Patients should take bisphosphonates with food to avoid a potential complication of the treatment.

False

What are the potential complications of a patient medicating to prevent osteoporosis (hypercalcemia)?

Numbness and tingling in hands and feet Stomach ulceration Cardiac dysrhythmias and change in skeletal tone Diaphoresis and muscular cramping

Cardiac dysrhythmias and change in skeletal tone

Which musculoskeletal condition is treated with chemotherapy?

Osteoporosis Osteomyelitis Osteosarcoma Osteonecrosis

Osteosarcoma

How is osteomyelitis treated?

Physical therapy Biphosphonates Chemo Antibiotics

Antibiotics

True or False: NSAIDS can be incorporated with the treatment of plantar fascitis.

True

What is a pharmacological intervention for numbness in the hand distal to a ganglion cyst aspiration?

Heat application Chemo Cortisone injection NSAIDs

Cortisone injection

True or False: Chronic immunosuppressant use commonly causes secondary osteoporosis

True

Which type of medication is most likely to be effective in patients experiencing phantom limb pain?

Antiepileptics Antispasmodics Therapeutic mirroring Opioids

Antiepileptics

True or False: Opioids can NOT cause respiratory depression.

False

True or False: Vitamin D supplements are needed for calcium absorption

True

Does decreasing fluids, fiber, and movement help to have a bowel movement?

True

Should a client take Alendronate for osteoporosis while sitting upright and with a full glass of water?

True

Respirations are important to include in physical assessment for patients who are on opioid pain control.

True

A postmenopausal client is taking raloxifene for osteoporosis. Which statement by the patient indicated understanding?

I will call my doctor if i have pain, warmth, and swelling in my leg

Which of the following should the nurse asses with pt taking opoid medications such as ocycodone with acetaminophen?

bowel sounds and bowel movements

Select a complication of fractures caused by pressure which results in decreased circulation.

Compartment Syndrome

Edema is an early sign of fat embolism syndrome.

False

Somatic pain is muscle, joint, or bone pain

True

Avascular necrosis is when the blood supply to the bone is cut off or disrupted and death of the bone tissue occurs.

True

Which symptom occurs with neurovascular compromise?

Tingling

Complete Fracture: A bone separated into 2 sections and is broken across the entire width of the bone

True

Your patient that just came into the ER has their femur sticking out of their thigh. Which type of fracture is this?

Compound fracture

Compartment syndrome clinical manifestations typically subside after pain medication is administered.

False

Dyspnea and headache are clinical manifestations of fat embolism syndrome

True

Burning, sharp, shooting pain is classified as which type of pain?

Neuropathic

Your patient is experiencing a 9/10 pain in their sprained wrist. Which type of pain is this?

Somatic

Osteoporotic patients do not experience compression fractures very commonly

False

You are caring for a post op hip patient. What should you include in your dietary education?

Protein and calcium will help speed up my bone healing

Splinting and deep breathing with rib fracture healing helps to prevent pneumothorax.

True

Blood pressure will not increase if a patient is experiencing pain.

False

What is the most common treatment for reducing and immobilizing a fracture?

ORIF (open reduction and internal fixation)

True or False: 'Hot spots' under a cast can sometimes be normal.

False

True or False: Leg fractures in a plaster cast should be elevated on pillows continuously for 24 hours.

True

What injury is concerning if a client complains of not being able to ABDUCT the arm at the shoulder?

Rotator cuff injury

Which type of medication places patients at most risk for pneumonia?

Opioids

True or False: Pain in an extremity that is not there due to amputation is a psychogenic pain.

False

What should the nurse assess if a patient complains of numbness in the hand after trauma?

Radial pulse

True or False: RICE is Rest, Ice, Contain, Elevate.

False

What nursing intervention should the nurse complete first when a patient with a fractured arm arrives at the ER?

Remove jewelry

True or False: Handwashing is the best defense to avoid spread of infection.

True

What is the best way to prevent DVT after a hip fracture?

Apply antiembolism stockings

What should the nurse do first if a patient with skeletal traction is complaining of severe leg pain?

Assess body alignment in the bed

After applying pressure to the proximal artery to a compound fracture to stabilize a bleed, what should the nurse do next?

Perform a neurovascular assessment of BLE

True or False: Drying the prosthesis socket completely before applying to the limb is not priority.

False

True or False: The nurse should prevent hip flexion of the affected extremity after a total hip arthroplasty.

True

How often should the nurse assess skin when the patient is in skeletal traction?

8 hours

What can the nurse do to help an older patient who has fallen out of bed in the past, prevent another fall?

Ensure adequate lighting

What action should the nurse always take first?

Assess

What can be delegated to an Unlicensed Assistive Personnel (UAP)?

Providing a back massage

Hypothermia is an increase in body temperature

False

Select a nursing intervention for hypothermia

Apply blankets

What is the most important nursing action when caring for a post-operative patient?

Compare left and right dorsalis pedis pulses

Cold therapy is the best action after a musculoskeletal injury.

True

Ambulation assists with gas exchange

True

Explaining the procedure including risks and benefits initially, is the role of the preoperative nurse.

False

When a patient falls and reports knee pain, the nurse should ask "does the pain radiate to another area from your knee?"

True

You cannot compress the blood vessels when assessing a pulse

False

Calcium and Vitamin D supplementation is not necessary after a hip fracture or surgery.

False

What does the nurse do if her preoperative patient does not understand the surgery that will be performed?

Inform the surgeon and document their findings

A patient's surgical dressing is draining and the surgeon hasn't seen the patient yet. The nurse should change the dressing.

False

Naloxone is the reversal agent for opioids.

True

How is osteoporosis diagnosed?

Bone scan

Elevated WBC is indicative of an infection, such as osteomyelitis.

True

Which test is used to determine if a patient has soft tissue damage?

MRI

A goniometer is used by rehab therapists or nurses to provide an exact measurement of flexion and extension or ROM

True

Which lab result is typically associated with soft tissue damage?

Increased erythrocyte sedimentation rate (ESR)

Which of the following tests can be used to diagnose osteoporosis?

DEXA scan

Ultrasonography uses sounds waves to view surgical hardware placement

True

Soft tissue damage can be seen on an XRAY

False

What is an abnormal lab value of calcium that may indicate the patient has multiple fractures?

15.0

What is the purpose of osteoclasts?

Break down old and damaged tissue

What is the purpose of osteoblasts?

Repairs and builds damaged bone

What is synarthroses?

Immovable joints (structures between cranial bones)

What is amphiarthroses?

Limited movement (pubic, vertebrae)