Question 1

The nurse observes a petechial rash and respiratory distress in a patient recovering from a fractured femur.What should these findings suggest to the nurse?

Accepted Answer

A)  Infection 
B)  Pneumonia 
C)  Fat embolism 
D)  Pleural effusion

Question 2

The nurse is evaluating teaching provided to a patient with gout.Which patient menu selection indicates that additional teaching is required?

Accepted Answer

A)  Pike 
B)  Bass 
C)  Perch 
D)  Sardines

Question 3

The nurse is caring for a patient who had a closed reduction of the ulna with a cast applied.Later the patient reports left arm pain.What should the nurse do first?

Accepted Answer

A)  Pad the edges of the cast. 
B)  Notify the physician immediately. 
C)  Administer an analgesic as ordered. 
D)  Perform neurovascular check on fingers.

Question 4

A patient with a casted,fractured left leg asks why the leg has to be elevated.What should the nurse respond to this patient?

Accepted Answer

A)  "Decreases swelling." 
B)  "Prevents cast cracking." 
C)  "Increases your comfort." 
D)  "Allows the cast to dry evenly."

Question 5

The nurse finds a 2-day postoperative patient who had a right total hip replacement lying supine with crossed legs.What data should the nurse collect on this patient?

Accepted Answer

A)  The right leg for shortening 
B)  The right knee for crepitation 
C)  The left leg for internal rotation 
D)  The left leg for loss of function

Question 6

The nurse reinforces medication teaching provided to a patient with rheumatoid arthritis.Which medication should the patient identify as helpful to control the symptoms of the health problem?

Accepted Answer

A)  "Digoxin." 
B)  "Ibuprofen." 
C)  "Morphine." 
D)  "Penicillin."

Question 7

A patient in the ambulatory clinic is diagnosed with a muscle strain.What actions should the nurse instruct the patient to do to treat this injury? (Select all that apply.)

Accepted Answer

A)  Rest the limb. 
B)  Elevate the limb. 
C)  Apply heat for 1 hour. 
D)  Apply ice to the area. 
E)  Wrap with an elastic bandage.

Question 8

The nurse sees a neighbor fall and fracture a leg.What should the nurse do first for the neighbor?

Accepted Answer

A)  Assess pain. 
B)  Transport to an emergency department. 
C)  Cover site of open fracture with clean dressing. 
D)  Immobilize the affected limb using minimal movement.

Question 9

The nurse is contributing to the plan of care for a patient who is scheduled for a below-the-knee amputation.What nursing diagnosis should be recommended for the preoperative plan of care?

Accepted Answer

A)  Anxiety 
B)  Self-Care Deficit 
C)  Fluid Volume Deficit 
D)  Ineffective Airway Clearance

Question 10

The nurse checks a patient's casted right leg resting upon a pillow and finds that the cast appears too tight.What should the nurse do?

Accepted Answer

A)  Notify the RN. 
B)  Administer pain medication. 
C)  Apply an extra blanket to the leg. 
D)  Remove the pillow under the cast.

Question 11

A patient asks the difference between osteoarthritis and rheumatoid arthritis.What manifestations should the nurse explain are characteristic of rheumatoid arthritis? (Select all that apply.)

Accepted Answer

A)  Low-grade fever 
B)  Heberden's nodes 
C)  Autoimmune disease 
D)  Activity increases pain 
E)  Early morning stiffness
F) Involvement of other major organs

Question 12

The nurse is collecting data from a patient suspected of developing a fat embolus from a fracture of the right femur.Which manifestations should the nurse expect? (Select all that apply.)

Accepted Answer

A)  Petechiae 
B)  A migraine 
C)  Tachycardia 
D)  Mental confusion 
E)  Numbness in the right leg
F) Muscle spasms in the right thigh

Question 13

The nurse is caring for a patient with gout.Which laboratory value should the nurse review which indicates that the treatment plan is effective?

Accepted Answer

A)  Uric acid: 7.9 mg/dL 
B)  Creatinine: 0.8 mg/dL 
C)  Blood urea nitrogen: 15 mg/dL 
D)  Low-density lipoprotein (LDL): 115 mg/dL

Question 14

The nurse is reinforcing teaching provided to a patient who is postmenopausal,has lost 2 inches of height,and has osteoporosis.Which patient statement indicates correct understanding of the purpose of calcium supplements?

Accepted Answer

A)  To decrease bone loss 
B)  To increase energy levels 
C)  To decrease serum calcium 
D)  To increase excretion of calcium

Question 15

The nurse is assisting in the development of an educational seminar on prevention of osteoporosis for a group of community members.Which actions should the nurse suggest be included in this presentation? (Select all that apply.)

Accepted Answer

A)  Drink one cup of caffeinated coffee each day 
B)  Ensure an adequate intake of calcium each day 
C)  Participate in weight-bearing exercise every day 
D)  Wear well-supporting nonskid shoes at all times 
E)  Consider participating in resistance exercise training

Question 16

A patient 48 hours after surgery for a fractured femoral shaft is experiencing mental confusion,tachycardia,tachypnea,and dyspnea.The patient's blood pressure is elevated and petechiae are present on the chest.After reporting the findings to the RN what should the nurse do while awaiting the physician's specific orders? (Select all that apply.)

Accepted Answer

A)  Administer oxygen. 
B)  Prepare patient for arterial blood gas tests. 
C)  Prepare patient for chest x-ray or lung scan. 
D)  Maintain bedrest and keep movement to a minimum. 
E)  Ask patient to move affected limb to see if pain is worse.
F) Place patient in high Fowler's position or raise the head of the bed.

Question 17

The nurse is reviewing data collected during the health history for a patient with osteoporosis.What should the nurse identify as a risk factor for osteoporosis development?

Accepted Answer

A)  Daily use of antacid 
B)  Walking 1 mile daily 
C)  Increased caffeine intake 
D)  Increased dairy food intake

Question 18

The nurse is contributing to the plan of care for a patient recovering from total hip replacement.Which exercises should the nurse recommend to help prevent deep vein thrombosis (DVT)formation? (Select all that apply.)

Accepted Answer

A)  Foot circles 
B)  Toe touches 
C)  Heel pumping 
D)  Deep knee bends 
E)  Quadriceps setting
F) Straight leg raises (SLRs)

Question 19

The nurse is contributing to the plan of care for a patient who has an upper extremity amputation.Why should the nurse keep in mind that this type of amputation can be more debilitating than a lower extremity amputation when planning care?

Accepted Answer

A)  The upper extremity is more visible. 
B)  Prosthetic fitting is easier for the leg. 
C)  The upper extremity is more specialized. 
D)  There is greater blood supply to the upper extremity.

Question 20

A patient has an open reduction of a radial fracture and is casted.Several hours after the operation,the patient reports a throbbing pain in the arm.What nursing action is essential for the nurse to take?

Accepted Answer

A)  Reposition arm. 
B)  Perform neurovascular checks. 
C)  Administer analgesics as ordered. 
D)  Notify the physician immediately.

Exam 46: Nursing Care of Patients With Musculoskeletal and Connective Tissue Disorders