Practice Questions - Musculoskeletal Problems

Musculoskeletal Problems 1.) The nurse is caring for a patient who had a dual-energy x-ray absorptiometry (DEXA) scan and is now pre- scribed calcium with vitamin D twice a day. The patient asks the nurse the purpose of this drug. What is the nurse’s best response? Select all that apply. 1. “When your calcium and vitamin D levels are low, your risk for osteoporosis and osteomalacia increases.” 2. “When your vitamin D level is high, your bones release calcium to keep your blood calcium level in the normal range.” 3. “When your blood calcium is low, calcium is released from your bones increasing your risk for fractures.” 4. “When blood calcium is normal, long bones are formed increasing a person’s height.” 5. “The extra calcium and vitamin D will help protect your bones from damage such as fractures.” 6. “You can also get extra vitamin D by increasing your intake of beef and pork sources.” 2.) The nurse is caring for a patient with osteoporosis who is at increased risk for falls. Which intervention should the nurse delegate to the unlicensed assistive personnel (UAP)? 1. Identifying environmental factors that increase risk for falls 2. Monitoring gait, balance, and fatigue level with ambulation 3. Collaborating with the physical therapist to provide the patient with a walker 4. Assisting the patient with ambulation to the bath- room and in the halls 3.) The nurse is preparing to teach a patient with a new diagnosis of osteoporosis about strategies to prevent falls. Which teaching points should the nurse be sure to include? Select all that apply. 1. Wear a hip protector when ambulating. 2. Remove throw rugs and other obstacles at home. 3. Exercise to help build your strength. 4. Expect a few bumps and bruises when you go home. 5. Rest when you are tired. 6. Avoid consuming three or more alcoholic drinks per day. 4.) The charge nurse observes an LPN/LVN assigned to provide all of these interventions for a patient with Paget disease. Which action requires that the charge nurse intervene? 1. Administering 600 mg of ibuprofen to the patient 2. Encouraging the patient to perform exercises recommended by a physical therapist 3. Applying ice and gentle massage to the patient’s lower extremities want to apply heat!! 4. Reminding the patient to drink milk and eat cottage cheese 5.) The charge nurse is making assignments for the day shift. Which patient should be assigned to the nurse who was floated from the postanesthesia care unit (PACU) for the day? 1. A 35-year-old patient with osteomyelitis who needs teaching before hyperbaric oxygen therapy 2. A 62-year-old patient with osteomalacia who is being discharged to a long-term care facility 3. A 68-year-old patient with osteoporosis given a new orthotic device whose knowledge of its use must be assessed 4. A 72-year-old patient with Paget disease who has just returned from surgery for total knee replacement 6.) The nurse delegates the measurement of vital signs to an experienced unlicensed assistive personnel (UAP). Osteomyelitis has been diagnosed in a patient. Which vital sign value would the nurse instruct the UAP to report immediately for this patient? 1. Temperature of 101°F (38.3°C) 2. Blood pressure of 136/80 mm Hg 3. Heart rate of 96 beats/min 4. Respiratory rate of 24 breaths/min 7.) The nurse is working with unlicensed assistive person- nel (UAP) to provide care for six patients. At the beginning of the shift, the nurse carefully tells the UAP what patient interventions and tasks he or she is expected to perform. Which “Four Cs” guide the nurse’s communication with the UAP? Select all that apply. 1. Clear 2. Comprehensive 3. Concise 4. Credible 5. Correct 6. Complete 8.) The nurse is caring for a patient with carpal tunnel syndrome (CTS) who has been admitted for surgery. Which intervention should be delegated to the unlicensed assistive personnel (UAP)? 1. Initiating placement of a splint for immobilization during the day 2. Assessing the patient’s wrist and hand for discoloration and brittle nails 3. Assisting the patient with daily self-care measures such as bathing and eating 4. Testing the patient for painful tingling in the four digits of the hand 9.) The nurse observes the unlicensed assistive personnel (UAP) performing all of these interventions for a patient with carpal tunnel syndrome (CTS). Which action requires that the nurse intervene immediately? 1. Arranging the patient’s lunch tray and cutting his meat 2. Providing warm water and assisting the patient with his bath 3. Replacing the patient’s splint in hyperextension position 4. Reminding the patient not to lift very heavy objects 10.) A patient is scheduled for endoscopic carpal tunnel release surgery in the morning. What would the nurse be sure to teach the patient? 1. Pain and numbness are expected to be experienced for several days to weeks. 2. Immediately after surgery, the patient will no longer need assistance. 3. After surgery, the dressing will be large, and there will be lots of drainage. 4. The patient’s pain and paresthesia will no longer be present. 11.) The charge nurse assigns the nursing care of a patient who has just returned from open carpal tunnel release surgery to an experienced LPN/LVN, who will perform under the supervision of an RN. Which instructions would the RN provide for the LPN/LVN? Select all that apply. 1. Check the patient’s vital signs every 15 minutes in the first hour. 2. Check the dressing for drainage and tightness. 3. Elevate the patient’s hand above the heart. 4. The patient will no longer need pain medication. 5. Check the neurovascular status of the fingers every hour. 6. Instruct the patient to perform range of motion on the affected wrist. 12.) The nurse is preparing a patient who had carpal tunnel release surgery for discharge. Which information is important to provide for this patient? 1. The surgical procedure is a cure for carpal tunnel syndrome (CTS). 2. Do not lift any heavy objects. 3. Frequent doses of pain medication will no longer be necessary. 4. The health care provider should be notified immediately if there is any pain or discomfort. 13.) The nurse is providing care for a patient with a rotator cuff tear. What treatment does the nurse expect the health care provider will prescribe first for this patient? 1. Arthroscopic repair of the rotator cuff tear 2. Elimination of movements in the affected shoulder 3. Conservative therapies such as nonsteroidal anti- inflammatory drugs (NSAIDs) and physical therapy 4. Pendulum exercises that start slow and progress over 2 weeks 14.) The emergency department nurse receives a call about a patient with a traumatic finger amputation. What instructions does the nurse provide to the patient’s wife? Select all that apply. 1. Wrap the completely severed finger in dry sterile gauze (if available) or a clean cloth. 2. Put the finger in a watertight, sealed plastic bag. 3. Place the bag directly on ice. 4. Elevate the affected extremity above the patient’s heart. 5. Examine the amputation site and apply direct pressure with layers of dry gauze. 6. After performing these steps, call 911 and check the patient for breathing 15.) When receiving discharge instructions, a patient with osteoporosis makes all of these statements. Which statement indicates to the nurse that the patient needs additional teaching? 1. “I take my ibuprofen every morning as soon as I get up.” 2. “My daughter removed all of the throw rugs in my home.” 3. “My husband helps me every afternoon with range- of-motion exercises.” 4. “I rest in my reclining chair every day for at least an hour.” 16.) A patient has a fractured femur. Which finding would the nurse instruct the unlicensed assistive personnel (UAP) to report immediately? 1. The patient reports pain. 2. The patient appears confused. 3. The patient’s blood pressure is 136/88 mm Hg. 4. The patient voided using the bedpan. 17.) After the nurse receives change-of-shift report, which patient should be assessed first? 1. A 42-year-old patient with carpal tunnel syndrome who reports pain 2. A 64-year-old patient with osteoporosis awaiting discharge 3. A 28-year-old patient with a fracture who reports that the cast is tight 4. A 56-year-old patient with a left leg amputation who reports phantom pain