Answer Key

Question 1:
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A client is scheduled for a laminectomy to repair a hernia the nurse should include which action? Turning the client from side to side, using the logroll tech

Explanation: To avoid twisting the spine or hips when tur Question 2:

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A nurse is caring for an elderly female client with osteop about which major complication? Bone fracture

Explanation: Bone fracture is a major complication of ost Question 3:

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The client with a fractured tibia has been taking methoca having the intended effect? Relief of muscle spasms.

Explanation: Methocarbamol is a muscle relaxant and ac Question 4:

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Which of the following nursing measures is most useful immobilized? Beginning weight-bearing activities as soon as possible.

Explanation: In order to prevent disuse osteoporosis, it is Question 5:

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A client comes to the emergency department complainin that the client has a history of obesity and hypertension. which musculoskeletal disorder? Degenerative joint disease

Explanation: Obesity predisposes the client to degenera Question 6:

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Two days after surgery to amputate his left lower leg, a c the nurse is most appropriate? Administer medication, as ordered, for the reported disco Explanation: The sensation of pain and discomfort in an

Question 7:
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A nurse is caring for a client who complains of lower bac back injury?

You selected: Correct

"Stand close to the object you're lifting."

Explanation: Standing close to an object when lifting mo Question 8:

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When developing a care plan for a client newly diagnose Impaired skin integrity

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Explanation: Impaired skin integrity is a concern for the c Question 9:

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A client is admitted with acute osteomyelitis that develop client's care, the nurse should anticipate which measure Administering large doses of I.V. antibiotics as ordered

Explanation: Treatment of acute osteomyelitis includes la Question 10:

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A client asks the nurse what the difference is between os correct? "OA is a noninflammatory joint disease. RA is characteri

Explanation: OA is a degenerative arthritis, characterized Question 11:

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A client reports having pain in the casted left arm that is notes that the fingers are swollen and difficult to separat Elevate the arm on two pillows and reassess in 30 minut

Call the physician to report swelling and pain. Explanation: The most appropriate action is to report the

Question 12:
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When the client who has had a hip replacement is lying o between the legs to prevent: Adduction of the hip joint.

Explanation: After hip replacement surgery, the client sh Question 13:

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A client has been diagnosed with degenerative joint dise clients history would most likely increase the joint sympt Obesity. Explanation: Osteoarthritis most commonly results from

Question 14:
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Which information should the nurse include when perform approach for a total hip replacement? Select all that app Do not extend the operative leg backwards. Avoid turning the toes or knee outward. Use an elevated toilet seat and shower chair.

Correct

Explanation: A client who has had a total hip replacemen Question 15:
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A client has sustained a right tibial fracture and has just cast care? "Keep your right leg elevated above heart level."

Explanation: The nurse should instruct the client to eleva Question 16:
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A client is recovering from an attack of gout. Client teach

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weight loss will reduce uric acid levels and reduce stress

Explanation: Weight loss will reduce uric acid levels and Question 17:
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A client takes prednisone for an acute exacerbation of rh client understands how to take the prednisone? "It is best if I take this medication with some food. Explanation: Prednisone is a gastrointestinal irritant that

Question 18:
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The nurse assigns a nursing assistant to the care of a cl wrist and application of an arm cast. The nurse should s following assessments immediately? The client is feeling heat from the plaster cast.

Client cannot move the fingers on the right hand. Explanation: The assistant should be told to report imme

Question 19:
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A client who had a total hip replacement 4 days ago is w by saying which of the following? "Activities that tend to cause adduction of the hip tend to

Explanation: Dislocation precautions include: avoid extre

Question 20:
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Which of the following is the priority for a client with a fr Prevent effects of immobility while in traction.

You selected: Question 1:

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A client with osteoarthritis tells the nurse she is concerne suggestion should the nurse offer? "Pace yourself and rest frequently, especially after activi

Explanation: A client with osteoarthritis must adapt to thi Question 2:

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Following a total hip replacement, the nurse should posit

You selected: Correct

Keep the extremity in slight abduction using an abductio

Explanation: After total hip replacement, proper positioni Question 3:

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To protect a clients skin under a back brace, the nurse s

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Have the client wear a thin cotton shirt under the back br

Explanation: Having the client wear a thin cotton shirt un Question 4:

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A nurse is managing the care of a client with osteoarthrit

You selected: Correct

administration of nonsteroidal anti-inflammatory drugs (N

Explanation: NSAIDs are routinely used for anti-inflamm Question 5:

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In preparation for total knee surgery, a 200-lb client with should the nurse recommend as best if the client has no Aquatic exercise.

Explanation: When combined with a weight loss program Question 6:

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Which of the following instructions regarding body mech injury? Avoid prolonged sitting and standing.

Explanation: Prolonged sitting and standing should be av

Question 7:
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A client is experiencing an acute exacerbation of rheuma

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Administering ordered analgesics and monitoring their e

Explanation: An acute exacerbation of rheumatoid arthrit Question 8:

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The nurse has instructed the client about the correct pos the following statements indicates that the client has und I should avoid bending over to tie my shoes.

Explanation: Acute flexion and adduction of the hip shou Question 9:

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During a scoliosis screening in a college health center, a untreated scoliosis. The nurse indentifies one of the dire impingement on pulmonary function.

Explanation: As untreated scoliosis progresses, the thora Question 10:

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A client with arterial insufficiency undergoes below-knee the postoperative care plan? Elevating the stump for the first 24 hours

Explanation: Stump elevation for the first 24 hours after s Question 11:
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The nurse is planning an educational program about the community center. Which of the following preventive me plan? Encouraging weight-bearing exercise on a regular basis.

Explanation: Exercise, especially weight-bearing exercis Question 12:

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A diet plan is developed for a client with gouty arthritis. T organ meats.

You selected: Correct

Explanation: Gouty arthritis is a disorder of purine metab Question 13:

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A nurse suspects that a client with a recent fracture has

You selected: Incorrect

inability to perform passive movement and pain with acti

Correct response:

inability to perform active movement and pain with passi Explanation: With compartment syndrome, the client can

Question 14:
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A client is hospitalized for open reduction of a fractured f client is restless and she observes petechiae on the clien Contact the physician.

Administer oxygen. Explanation: The client is demonstrating clinical manifes

Question 15:
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A client has a tibial fracture that required casting. Approx tibial fracture despite the morphine injection administere next assessment? Presence of a distal pulse. Explanation: The nurse should assess the client's ability

Question 16:
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The client returns from surgery for a below-the-knee amp elastic bandage. At first, the bandage was dry. Now, 30 The nurse should first? Mark the area of drainage.

Explanation: The nurse should mark the bloody drainage Question 17:
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What would be the most important nursing intervention in amputation of the left leg? Elevating the residual limb on a pillow.

Explanation: Elevating the residual limb on a pillow for th Question 18:

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Which nursing intervention is essential in caring for a clie

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Removing all external sources of pressure, such as cloth

Explanation: Nursing measures should include removing Question 19:

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When admitting a client with a fractured extremity, the nu The area distal to the fracture.

You selected: Correct

Explanation: The nursing assessment is first focused on

Question 20:
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After a laminectomy, the client states, "The physician sa activities indicates the need for further teaching? Sweeping the front porch. Explanation: Sweeping causes a twisting motion, which o...(more)

Question 1:
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When using crutches, the nurse should instruct the clien Hands.

You selected: Correct

Explanation: The proper use of crutches requires suppor Question 2:

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A nurse suspects that a client with a recent fracture has

You selected: Correct

inability to perform active movement and pain with passi

Explanation: With compartment syndrome, the client can mo...(more) Question 3:

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Which statement by a staff nurse on the orthopedic floor

You selected: Incorrect Correct response:

"Bleeding is a complication associated with the continuo

"The client is receiving physical therapy twice per day, so Explanation: Further staff education is needed when the

Question 4:
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A client diagnosed with arthritis doesn't want to take med consulted for nonpharmacologic measures to control pai plan to help control this client's pain? Acupuncture

An exercise routine that includes range-of-motion (ROM Explanation: Physical and occupational therapy will mos

Question 5:
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During a routine physical examination on a 75-year-old f m) tall. The client states, "How is that possible? I was alw response by the nurse? "After menopause, the body's bone density declines, res

Explanation: The nurse should tell the client that after me Question 6:
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The nurse is teaching a client with osteoporosis about ta the client is to take the medication: With a full glass of water and remain upright for 30 minu

Explanation: Clients are instructed to take Fosamax on a Question 7:

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The client who had an open femoral fracture was discha restlessness, and restrictive movement of the fractured l findings? Osteomyelitis.

Explanation: Fever, night sweats, chills, restlessness, an Question 8:

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A nurse is teaching a female client about preventing oste

You selected: Correct

The recommended daily allowance of calcium may be fo

Explanation: Premenopausal women require 1,000 mg o d...(more) Question 9:

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A nurse is caring for a client placed in traction to treat a f Assessing the extremity for neurovascular integrity

You selected: Correct

Explanation: Although all measures are correct, assessin Question 10:

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A client undergoes a total hip replacement. Which statem further teaching? "I don't know if I'll be able to get off that low toilet seat at Explanation: The client requires additonal teaching if he

Question 11:
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You selected: Correct

A client with rheumatoid arthritis has increasing fatigue a following nursing interventions is most appropriate? Encourage the client to alternate periods of rest and acti

Explanation: The client with rheumatoid arthritis should b Question 12:

A 14-year-old has just had a plaster cast placed on his lo

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Use only the palms of the hand when handling the cast.

Explanation: The wet plaster cast should be handled usi Question 13:
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You selected: Correct

A client who has had an above-the-knee amputation dev in the postanesthesia recovery unit. The nurse should: Draw a mark around the site.

Explanation: The priority action is to draw a mark around Question 14:

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A nurse is caring for a client who underwent a total hip re prevent dislocation of the new prosthesis? Prevent internal rotation of the affected leg.

Explanation: The nurse and other caregivers should prev Question 15:
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A client has a leg immobilized in traction. Which of the fo understands actions to take to prevent muscle atrophy? The client performs isometric exercises to the affected e

Explanation: Isometric contractions increase the tension is...(more) Question 16:

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You selected: Correct

A 30-year-old client, hospitalized with a fractured femur b for 2 days. Which of the following interventions is most a Increase the client's fluid intake to 3,000 ml/day.

Explanation: Increasing the client's fluid intake to 3,000 m Question 17:

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A female client is at risk for developing osteoporosis. Wh Initiating weight-bearing exercise routines

You selected: Correct

Explanation: Performing weight-bearing exercise increas Question 18:

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To reduce the incidence of complications in a client in tra Remove the weights during linen changes. Increase fiber intake.

You selected: Incorrect Correct response:

Explanation: Immobility increases the incidence of const Question 19:

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Two days after being placed in a cast for a fractured fem confused and has an elevated temperature. The nurse s Fat embolism syndrome.

Explanation: Clients with fractures of the long bones suc Question 20:
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A client reports having pain in the casted left arm that is notes that the fingers are swollen and difficult to separat time? Call the physician to report swelling and pain.

Explanation: The most appropriate action is to report the Question 1:

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Which nursing diagnosis takes highest priority for a clien Risk for infection related to effects of trauma

You selected: Correct

Explanation: A compound fracture involves an opening in Question 2:

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A client is scheduled to undergo an open reduction intern administers zolpidem (Ambien) as ordered. Which statem The nurse should administer the drug immediately befor

Explanation: The nurse should administer zolpidem imm Question 3:

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You selected: Correct

A client has the leg immobilized in a long leg cast. Which circulatory impairment? Tingling of toes.

Explanation: Tingling and numbness of the toes would b Question 4:

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You selected: Correct

A client is scheduled for a laminectomy to repair a hernia plan, the nurse should include which action? Turning the client from side to side, using the logroll tech

Explanation: To avoid twisting the spine or hips when tur Question 5:

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A client undergoes hip-pinning surgery to treat an intertro intervention in the postoperative care plan?

You selected: Correct

Keeping a pillow between the client's legs at all times

Explanation: After hip pinning, the client must keep the a Question 6:
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Which findings best correlate with a diagnosis of osteoar Joint stiffness that decreases with activity

You selected: Correct

Explanation: A characteristic feature of osteoarthritis (de Question 7:

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You selected: Correct

After a right total knee replacement, the clients right leg responsibilities when caring for a client with this apparatu Maintaining proper positioning of the leg on the CPM ma

Explanation: The nurse must frequently evaluate the pos Question 8:

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Which statement by the client with rheumatoid arthritis w maximum benefit of aspirin therapy? I try to take aspirin only on days when the pain seems p

Explanation: Aspirin therapy in rheumatoid arthritis involv Question 9:

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After a car accident, a client is admitted to an acute care For 24 to 48 hours after the accident, the nurse must mo pelvis? Fat embolism

Explanation: Fat embolism is a relatively rare but life-thre Question 10:

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A physician orders chlorzoxazone (Paraflex), 500 mg P.O acting skeletal muscle relaxant, is commonly used to tre severe muscle spasm.

Explanation: Chlorzoxazone is used to treat acute, painf Question 1:

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To protect a clients skin under a back brace, the nurse s

You selected: Correct

Have the client wear a thin cotton shirt under the back br

Explanation: Having the client wear a thin cotton shirt un

Question 2:
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Which statement by a staff nurse on the orthopedic floor

You selected: Correct

"The client is receiving physical therapy twice per day, so

Explanation: Further staff education is needed when the Question 3:

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You selected: Correct

A client is admitted to the hospital with a diagnosis of a r right leg. The nurse should further assess the right leg to Shorter than the leg on the unaffected side. Explanation: After a hip fracture, the leg on the affected

Question 4:
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Which of the following indicates that a client with a fractu Acute respiratory distress syndrome.

You selected: Correct

Explanation: Fat emboli usually result in symptoms of ac Question 5:

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A nurse is assessing a client with possible osteoarthritis. age.

You selected: Correct

Explanation: Age is the most significant risk factor for de Question 6:

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You selected: Correct

A nurse is assessing a client for neurologic impairment a impairment in the affected extremity? Inability to move

Explanation: Being unable to move the affected leg sugg Question 7:

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The client with a fractured tibia has been taking methoca having the intended effect? Relief of muscle spasms.

Explanation: Methocarbamol is a muscle relaxant and ac Question 8:

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You selected: Correct

A client diagnosed with arthritis doesn't want to take med consulted for nonpharmacologic measures to control pai plan to help control this client's pain? An exercise routine that includes range-of-motion (ROM

Explanation: Physical and occupational therapy will mos Question 9:

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You selected: Correct

A client comes to the emergency department complainin learns that the client has a history of obesity and hyperte having which musculoskeletal disorder? Degenerative joint disease

Explanation: Obesity predisposes the client to degenera Question 10:

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The nurse should plan to use an abduction pillow (or spl Prevent dislocation of the prosthesis.

You selected: Correct

Explanation: After a total hip replacement, it is important