Multidimensional Care 1 Exam Part 3 Answers

83. Which is not a risk factor for osteoporosis? a. being male b. small-framed, thin White or Asian women c. being postmenopausal d. family history - a. being male 84. The nurse is asked to explain to the client the age-related processes that contribute to bone loss and osteoporosis. What is the nurse's best response? a. Decrease in estrogen b. Increase in calcitonin c. Decrease in parathyroid hormone d. Increase of vitamin D - a. Decrease in estrogen 85. Which factor inhibits fracture healing? a. Vitamin D b. Exercise c. Local malignancy d. Maximum bone fragment contact - c. Local malignancy 86. A client who has sustained a fracture reports an increase in pain and decreased function of the affected extremity. What will the nurse suspect? a. Infection b. Pulmonary embolism c. Avascular necrosis d. Hypovolemic shock - c. Avascular necrosis 87. Which of the following are associated with compartment syndrome? Select all that apply. a. Trauma from accidents b. Surgery c. Casts d. Tight bandages e. Crushing injuries - a. Trauma from accidents b. Surgery c. Casts d. Tight bandages e. crushing injuries 88. A bone graft may be used for which of the following reasons? Select all that apply. a. Joint stabilization b. Defect filling c. Stimulation of bone healing d. Improvement of motion e. Reduction of a fracture - a. Joint stabilization b. Defect filling c. Stimulation of bone healing 89. A client with metastatic bone cancer sustained a left hip fracture without injury. What type of fracture does the nurse understand occurs without trauma or fall? a. Impacted fracture b. Transverse fracture c. Compound fracture d. Pathologic fracture - d. Pathologic fracture 90. In a client with a dislocation, the nurse should initially perform neurovascular assessments a minimum of every 15 minutes until stable. Which complication does the assessments help the nurse to monitor in the client? a. Disseminated intravascular coagulation b. Compartment syndrome c. Carpal tunnel syndrome d. Fat embolism syndrome - b. Compartment syndrome 91. A client with a recent left above-the-knee amputation states, "I can feel pain in my left toes." Which is the best response by the nurse? a. "Your left toes have been amputated." b. "The pain is really from the nerves in the upper leg." c. "Pain medication usually does not help this type of pain." d. "Describe the pain and rate it on the pain scale." - d. "Describe the pain and rate it on the pain scale." 92. Which statement by a staff nurse on the orthopedic floor indicates the need for further staff education? a. "The client is receiving physical therapy twice per day, so the client doesn't need a continuous passive motion device." b. "The continuous passive motion device can decrease the development of adhesions." c. "Bleeding is a complication associated with the continuous passive motion device." d. "Monitoring skin integrity is important while the continuous passive motion device is in place." - a. "The client is receiving physical therapy twice per day, so the client doesn't need a continuous passive motion device." 93. Which would be contraindicated as a component of self-care activities for the client with a cast? a. Cover the cast with plastic to insulate it b. Cushioning rough edges of the cast with tape c. Elevate the casted extremity to heart level frequently d. Do not attempt to scratch the skin under a cast - a. Cover the cast with plastic to insulate it 94. Which instruction should the nurse include when teaching the client following hip replacement surgery? (Select all that apply.) a. "You may cross your legs at the ankles only." b. "Place pillows between your legs when you lay on your side." c. "Avoid bending forward when sitÝng in a chair." d. "Use a raised toilet seat and high-seated chair." e. "It is okay to briefly flex the hip to put on your clothes." - b. "Place pillows between your legs when you lay on your side." c. "Avoid bending forward when sitÝng in a chair." d." Use a raised toilet seat and high-seated chair." 95. A variety of complications can occur after a leg amputation. Which is not a possibility in the immediate postoperative period? a. osteomyelitis b. hematoma c. hemorrhage d. infection - a. osteomyelitis 96. An unresponsive client had a plaster cast applied to the right lower leg 8 hours ago. When moving the client, the nurse notices an indentation on the posterior lower portion of the cast. What is the best action by the nurse? a. Document the findings. b. Notify the physician. c. Remove the cast immediately. d. Assess for pedal pulse and mobility of toes. - b. Notify the physician. 97. A nurse is caring for a client who's experiencing septic arthritis. This client has a history of immunosuppressive therapy, and the immune system is currently depressed. Which assignment is the most appropriate for the nurse caring for this client? a. The nurse caring for this client is also caring for four other immunosuppressed clients on the medical floor. b. The nurse caring for this client is also caring for four clients receiving chemotherapy for cancer treatment on the oncology floor. c. The nurse caring for this client is also caring for two other immunosuppressed clients on the medical intensive care unit. d. The nurse is caring for this client on the intensive care unit. - d. The nurse is caring for this client on the intensive care unit. 98. A client is diagnosed with carpal tunnel syndrome. Which assessment findings would the nurse expect? a. Pain radiating down the dorsal surface of the forearm b. Tenderness in the affected wrist c. Inability to flex index and middle fingers d. A decrease in grasp strength - c. Inability to flex index and middle fingers 99. The nurse is educating a client with low back pain on proper lifting techniques. The nurse recognizes that the education was effective when the client a. reaches over the head with the arms fully extended. b. places the load close to the body. c. uses a narrow base of support. d. bends at the hips and tightens the abdominal muscles. - b. places the load close to the body. 100. A patient is having low back pain. What position can the nurse suggest to relieve this discomfort? a. High-Fowler's to allow for maximum hip flexion b. Supine, with the knees slightly flexed and the head of the bed elevated 30 degrees c. Prone, with a pillow under the shoulders d. Supine, with the bed flat and a firm mattress in place - b. Supine, with the knees slightly flexed and the head of the bed elevated 30 degrees 101. The nurse has educated a patient with low back pain about techniques to relieve the back pain and prevent further complications. What statement by the patient shows understanding of the education the nurse provided? a. "I will lie prone with my legs slightly elevated." b. "I will bend at the waist when I am lifting objects from the floor." c. "I will avoid prolonged sitÝng or walking." d. "Instead of turning around to grasp an object, I will twist at the waist." - c. "I will avoid prolonged sitÝng or walking." 102. A client is exhibiting diminished range of motion, loss of flexibility, stiffness, and loss of height. The history and physical findings are associated with age-related changes of which area? a. Joints b. Bones c. Muscles d. Ligaments - a. Joints 103. A client has undergone arthroscopy. After the procedure, the site where the arthroscope was inserted is covered with a bulky dressing. The client's entire leg is also elevated without flexing the knee. What is the appropriate nursing intervention required in caring for a client who has undergone arthroscopy? a. Apply a cold pack at the insertion site. b. Apply warm compresses to the insertion site. c. Provide a gentle massage. d. Assist with performing ROM exercises. - a. Apply a cold pack at the insertion site. 104. A client has just been diagnosed with early glaucoma. During a teaching session, the nurse should: a. provide instructions on eye patching. b. assess the client's visual acuity. c. demonstrate eyedrop instillation. d. teach about intraocular lens cleaning. - c. demonstrate eyedrop instillation. 105. A client accidentally splashes chemicals into one eye. The nurse knows that eye irrigation with plain tap water should begin immediately and continue for 15 to 20 minutes. What is the primary purpose of this first aid treatment? a. To hasten formation of scar tissue b. To prevent vision loss c. To eliminate the need for medical care d. To serve as a stopgap measure until help arrives - b. To prevent vision loss 106. The nurse is reviewing the medical record of a client with glaucoma. Which of the following would alert the nurse to suspect that the client was at increased risk for this disorder? a. Age younger than 40 years b. Hyperopia since age 20 years c. History of respiratory disease d. Prolonged use of corticosteroids - d. Prolonged use of corticosteroids 107. The nurse is giving a visual field examination to a 55-year-old male client. The client asks what this test is for. What would be the nurse's best answer? a. "This test measures visual acuity." b. "This test measures how well your eyes move." c. "This test is to see how well your eyes are aging." d. "This test measures peripheral vision and detects gaps in the visual field." - d. "This test measures peripheral vision and detects gaps in the visual field." 108. The nurse admits a client to the emergency department who has been referred by the eye clinic. Which condition is an emergency where the nurse should refer the client for medical treatment immediately? a. Chalazion b. Acute angle-closure glaucoma c. Hordeolum d. Blepharitis - b. Acute angle-closure glaucoma 109. The nurse realizes that a client understands how to correctly instill ophthalmic medications when the client: a. pulls the tissue near the cheek downward to instill medication. b. wipes the lids and lashes prior to instillation in a direction toward the nose with moistened, soft gauze. c. allows the tip of the container to touch the eyelid while administering the medication. d. rubs the eye after administering medication. - a. pulls the tissue near the cheek downward to instill medication. 110. The client with chronic open-angle glaucoma is receiving timolol (Timoptic) eye drops. Which evaluation finding would indicate to the nurse the treatment is working? a. Intraocular pressure 15 mm Hg b. Reduced peripheral vision c. Halos around lights d. Decrease in nausea and vomiting - a. Intraocular pressure 15 mm Hg 111. A nurse conducted a history and physical for a newly admitted patient who states, "My arms are too short. I have to hold my book at a distance to read." The nurse knows that the patient is most likely experiencing: a. Opacity in the lens. b. Loss of accommodative power in the lens. c. Shrinkage of the vitreous body. d. Decreased eye muscle tone. - b. Loss of accommodative power in the lens. 112. The ophthalmologist tells a patient that he has increased intraocular pressure (IOP). The nurse understands that increased pressure resulting from optic nerve damage is indicated by a reading of: a. 0 to 5 mm Hg. b. 6 to 10 mm Hg. c. 11 to 20 mm Hg. d. >21 mm Hg. - d. >21 mm Hg. 113. On ocular examination, the health care provider notes severely elevated IOP, corneal edema, and a pupil that is fixed in a semi-dilated position. The nurse knows that these clinical signs are diagnostic of the type of glaucoma known as: a. Chronic open-angle. b. Normal tension. c. Acute angle-closure. d. Chronic angle-closure. - c. Acute angle-closure. 114. There are four major types of ophthalmic procedures to complete a glaucoma examination. If the health care provider wants to inspect the optic nerve, the nurse would prepare the patient for: a. Tonometry. b. Ophthalmoscopy. c. Gonioscopy. d. Perimetry. - b. Ophthalmoscopy. 115. Assessment of visual acuity reveals that the client has blurred vision when looking at distant objects but no difÏculty seeing near objects. The nurse documents this as which of the following? a. Myopia b. Astigmatism c. Hyperopia d. Emmetropia - a. Myopia 116. An aging client is brought to the eye clinic by the son. The son states he has seen his parent holding reading materials at an increasing distance to focus properly. What age-related changes does this indicate? a. Cataract b. Presbyopia c. Myopia d. Macular degeneration - b. Presbyopia 117. Which of the following is the role of the nurse toward a patient who is to undergo eye examinations and tests? a. Ensuring that the patient receives eye care to preserve his or her eye function and prevent further visual loss b. Conducting various tests to determine the function and the structure of the eyes c. Determining if further action is warranted d. Advising the patient on the diet and exercise regimen to be followed -a. Ensuring that the patient receives eye care to preserve his or her eye function and prevent further visual loss