Question 1

A patient, age 89, has had a right below-the-knee amputation. He is progressing well but continues to complain of pain in the toes on his right foot. The physician told him that he is suffering from "phantom pain" in his amputated extremity. He asks the nurse to explain phantom pain. The most appropriate response would be

Accepted Answer

A)   "Phantom pain does not exist except in your mind."
B)   "I can't answer that. You'll have to ask the physician."
C)   "Phantom pain occurs because the nerve tracts that register pain in the amputated limb continue to send a message to the brain."
D)   "Phantom pain occurs when you start thinking about your loss. It's best to keep your mind occupied with other things." C

Question 2

The main purpose of traction is to (Select all that are correct)

Accepted Answer

A)   Align and stabilize a fracture
B)   Prevent deformities
C)   Relieve muscle spasms
D)   Promote bed rest
E)   Increase circulation to the rest of the body A, B, C

Question 3

__________ traction is utilized to provide support for the patient with a hip fracture.

Accepted Answer

Buck's
This traction is frequently used to maintain the reduction of a hip fracture before surgery.

Question 4

Certain foods may increase the pain associated with gout. Which foods have the highest concentration of purines?

Accepted Answer

A)   Brain, liver, kidney
B)   Lettuce, corn, potatoes
C)   Beef, pork, chicken
D)   Fruits and fruit juices

Question 5

A patient, age 68, has suffered an intertrochanteric fracture of the right hip. Before surgery, to provide support and comfort, an immobilizing device is applied. This is called a

Accepted Answer

A)   Thomas splint.
B)   Bryant's traction.
C)   Russell's traction
D)   Buck's traction.

Question 6

A patient, age 64, has osteoarthritis of the left hip. He has had a left total hip replacement. The nurse should

Accepted Answer

A)   encourage use of the high Fowler's position.
B)   administer oxygen through a nasal cannula.
C)   encourage use of an incentive spirometer.
D)   turn the patient frequently from side to side.

Question 7

A patient's patellar-femoral cartilage has deteriorated due to arthritis. The medial and lateral cartilage is undamaged. This patient is likely to undergo _________ knee replacement surgery.

Accepted Answer

The answer of A patient's patellar-femoral cartilage has deteriorated due...

Question 8

A 71-year-old patient is manifesting signs and symptoms of gout. When assessing him for signs and symptoms of gout, the nurse should pay particular attention to

Accepted Answer

A)   dietary intake of foods high in cholesterol.
B)   mobility in the hip and knee joints.
C)   edema or discoloration of the great toe.
D)   a history of trauma or occupational injury.

Question 9

When caring for the patient who is in shock, the nurse should provide

Accepted Answer

A)   adequate oral fluids to replace blood loss.
B)   external heat to combat shivering.
C)   sedatives to decrease anxiety and apprehension.
D)   oxygen to support respiratory function.

Question 10

A patient, age 72, has a left intertrochanteric fracture as a result of a fall. In planning ways to increase her safety, the nurse realizes it is most important to determine

Accepted Answer

A)   preexisting health conditions.
B)   nutritional status.
C)   psychosocial history.
D)   pain level.

Question 11

In gangrene, there is an acute infection to the skeletal muscle. If untreated, _________ will destroy the tissue.

Accepted Answer

The answer of In gangrene, there is an acute infection...

Question 12

Which nursing intervention would be appropriate for a patient with rheumatoid arthritis?

Accepted Answer

A)   Sleeping at least 8 hours at night and a nap during the day
B)   Sleeping at 4-hour intervals at night
C)   No exercise regimen and apply ice to joints as needed
D)   Jogging at least 20 minutes three days a week

Question 13

Prolonged bed rest puts the older adult at risk for

Accepted Answer

A)   ankylosing spondylitis.
B)   pathological fractures.
C)   osteomyelitis.
D)   gout.

Question 14

A patient fell 2 days ago; he has a compound fracture of his left tibia. The physician performed an open reduction with internal fixation (ORIF) to treat the fracture. An important nursing assessment for him would include

Accepted Answer

A)   hyperactive bowel sounds.
B)   elevated temperature and presence of erythema at incision site.
C)   ecchymosis and edema at incision site.
D)   complaints of activity intolerance.

Question 15

A patient, age 45, has had a left intramedullary rod placed into his left femur. He is presenting with signs and symptoms of postoperative shock. The recommended position for a person going into shock is

Accepted Answer

A)   semi-Fowler's.
B)   supine.
C)   Fowler's
D)   Trendelenburg.

Question 16

The immediate medical management of any fracture is:

Accepted Answer

A)   Observe patient for signs of shock.
B)   Administer analgesics for pain.
C)   Splint and elevate the involved part.
D)   Apply heat to control pain.

Question 17

The movement of an extremity away from the midline of the body is called

Accepted Answer

A)   abduction.
B)   adduction.
C)   flexion.
D)   extension.

Question 18

A patient, age 45, has worked as a basket weaver for the past 10 years. She is being seen at the clinic for symptoms of carpal tunnel syndrome. Collection of subjective data might include

Accepted Answer

A)   complaints of burning pain or tingling in the hands.
B)   edema of the fingers.
C)   radicular pain.
D)   complaints of weight loss and fatigue.

Question 19

Rheumatoid arthritis is distinguished from osteoarthritis in that:

Accepted Answer

A)   Rheumatoid arthritis is an autoimmune, systemic disease; osteoarthritis is a degenerative disease of the joints.
B)   Rheumatoid arthritis is an autoimmune, degenerative disease; osteoarthritis is a systemic inflammatory disease.
C)   People with osteoarthritis are considered to be genetically predisposed; there is no known genetic component to rheumatoid arthritis.
D)   Osteoarthritis is often caused by a virus; viruses play no part in the pathogenesis of rheumatoid arthritis.

Question 20

A patient, age 24, has a compartment syndrome after a fracture of his radius and ulna. Nursing assessment will include careful observation for signs and symptoms of

Accepted Answer

A)   buccal petechiae.
B)   thromboembolism.
C)   Volkmann's contracture.
D)   fat embolism.

Exam 4: Care of the Patient With a Musculoskeletal Disorder