Multidimensional Care 1 Exam Part 1

MDC1 EXAM 2 Sample Test 1. A client's left leg is in skeletal traction with a Thomas leg splint and Pearson attachment. Which intervention should the nurse include in this client's care plan? A. Apply the traction straps snugly. B. Assess the client's level of consciousness. C. Remove the traction at least every 8 hours. D. Teach the client how to prevent problems caused by immobility. 2. A nurse is caring for a client placed in traction to treat a fractured femur. Which nursing intervention has the highest priority? A. Assessing the extremity for neurovascular integrity B. Keeping the client from sliding to the foot of the bed C. Keeping the ropes over the center of the pulley D. Ensuring that the weights hang free at all times 3. Which orthopedic surgery is done to correct and align a fracture after surgical dissection and exposure of the fracture? A. Arthrodesis B. Joint arthroplasty C. Total joint arthroplasty D. Open reduction 4. The client displays manifestations of compartment syndrome. What treatment will the nurse expect the client to be scheduled for? A. An open reduction B. A fasciotomy C. A total hip replacement D. A total knee replacement 5. A client who is undergoing skeletal traction reports pressure on bony areas. Which action would be most appropriate to provide comfort for the client? A. Assisting with range-of-motion and isometric exercises. B. Changing the client's position within prescribed limits. C. Administering prescribed analgesics. D. Applying warm compresses. 6. A client's fracture was reduced by surgically exposing the bone and realigning it. What type of treatment does the nurse identity this as? A. Buck's traction B. Skeletal traction C. Internal fixation D. Open reduction 7. The nurse is checking the traction apparatus for a client in skin traction. Which finding would require the nurse to intervene? A. Body aligned opposite to line of traction pull B. Weights hanging and touching the floor C. Pulleys without evidence of the obstruction D. Ropes freely moving over pulleys 8. A group of students is studying for a test on traction. The students demonstrate understanding of the types of traction when they identify which of the following as an example of skin traction? A. Crutchfield tongs B. Thomas splint C. Buck's D. Balanced suspension 9. The nurse is providing instructions to the client who is being prepared for skeletal traction. Which statement by the client indicates teaching was effective? A. "Metal pins will go through my skin to the bone." B."I will wear a boot with weights attached." C."A belt will go around my pelvis and weights will be attached." D The traction can be removed once a day so I can shower." 10. A client is reporting pain following orthopedic surgery. Which intervention will help relieve pain? A. Elevate the affected extremity and use cold applications. B. Breathe deeply and cough every 2 hours until ambulation is possible. C. Do ROM exercises as indicated. D. Apply antiembolism stockings as indicated. 11. A client has severe osteoarthritis in the left hip and is having surgery to replace both articular surfaces of the hip. What type of surgical procedure will the nurse prepare the client for? A. Arthrodesis B. Hemiarthroplasty C. Total arthroplasty D. Osteotomy 12. A client is brought to the emergency department by a softball team member who states the client and another player ran into each other, and the client is having severe pain in the right shoulder. What symptoms of a fractured clavicle does the nurse recognize? A. Client complains of tingling and numbness in the right shoulder. B. Right shoulder is elevated above the left. C. Client complains of pain in the unaffected shoulder. D. Right shoulder slopes downward and droops inward. 13. The nurse is preparing a client to have his cast cut off after having it for 6 weeks to treat a fractured tibia. What should the nurse inform the client prior to the cast being removed? A. The leg will look as it did prior to the cast being applied. B. The leg will look moist and will have small bumps that will go away in a few days. C. The skin may be covered with a yellowish crust that will shed in a few days. D. The leg strength is enforced by the wearing of the cast. 14. A client was playing softball and dislocated four of his fingers when diving for a ball. The physician manipulated the fingers into alignment and applied a splint to maintain alignment. What type of procedure does the nurse document this as? A. Open reduction B. Closed reduction C. Open reduction with internal fixation D. External fixation 15. Which would be consistent as a component of self-care activities for the client with a cast? A. Cover the cast with plastic to insulate it B. Cushion rough edges of the cast with tape C. Frequently place the casted extremity in a dependent position D. Use a plastic hanger wrapped in gauze to scratch under the cast. 16. A client with a long arm cast continues to complain of unrelieved throbbing pain even after receiving opioid pain medication. Which is the priority action by the nurse? A. Assess for complications. B. Assess for previous opioid drug use. C. Reposition the client for comfort. D. Teach relaxation techniques. 17. A client arrives in the emergency department with a suspected bone fracture of the right arm. How does the nurse expect the client to describe the pain? A.A dull, deep, boring ache B. Sharp and piercing C. Similar to "muscle cramps" D. Sore and aching 18. Which is a benefit of a continuous passive motion (CPM) device when applied after knee surgery? A. It provides active range of motion. B. It promotes healing by increasing circulation and movement of the knee joint. C. It promotes healing by immobilizing the knee joint. D. It prevents infection and controls edema and bleeding. 19. A client with a musculoskeletal injury is instructed to alter the diet. The objective of altering the diet is to facilitate the absorption of calcium from food and supplements. Considering the food intake objective, which food item should the nurse encourage the client to include in the diet? A. Red meat B. Bananas C. Vitamin D-fortified milk D. Green vegetables 20. The nurse is screening children for scoliosis. What nursing assessment finding is indicative of scoliosis? A. lateral curvature of the spine B. loss of 1 inch (2.5 cm) in height C. contracture of the wrists D. crepitus of the knee joint 21. The nurse is conducting the admission assessment for a client who is to undergo an arthrogram. What is the priority question the nurse should ask? .A. "Do you have any allergies?" B. "When did you last eat?" C. "When did you last urinate?" D. "Are you claustrophobic?" 22. Which client would the nurse identify as having the greatest risk for osteoporosis? A. A 40-year-old overweight African American woman B. A 16-year-old male with a history of asthma C. A small-framed, thin 45-year-old white woman D. A 20-year-old male athlete with repeated injuries 23. Which diagnostic test would the nurse expect to be ordered for a client with lower extremity muscle weakness? A.Electromyograph (EMG) B. Arthrocentesis C. Bone scan D. Biopsy 24. A client has had surgical repair of a hip injury after joint manipulation was unsuccessful. After surgery, the nurse implements measures to prevent complications. Which complications is the nurse seeking to prevent? Select all that apply. A. skin breakdown B. wound infection C. pneumonia D. diarrhea 25. Radiographic evaluation of a client's fracture reveals that a bone fragment has been driven into another bone fragment. The nurse identifies this as which type of fracture? A. Comminuted B. Compression C. Impacted D. Greenstick 26. A client is experiencing muscle weakness in the upper extremities. The client raises an arm above the head but then loses the ability to maintain the position. Muscular dystrophy is suspected. Which diagnostic test would evaluate muscle weakness or deterioration? A. A serum calcium test B. An electromyography C. An arthroscopy D. A magnetic resonance imaging (MRI) 27. A client asks the nurse why his residual limb cannot be elevated on a pillow. What is the best response by the nurse? A. "Elevating the leg might lead to a flexion contracture." B. "You need to turn yourself side to side. If your leg is on a pillow, you would not be able to do that." C. "Elevating the extremity may increase your chances of compartment syndrome." D. "I am sorry. We ran out of pillows. I can elevate it on a few blankets." 28. A client with a fractured ankle is having a fiberglass cast applied. The client starts yelling, "My leg is burning, take it off." What action by the nurse is most appropriate? A. Explain that the sensation being felt is normal and will not burn the client. B. Remove the cast immediately, notifying the physician. C. Administer antianxiety and pain medication. D. Call for assistance to hold the client in the required position until the cast has dried. 29. The nurse is caring for a patient who had a total hip replacement. What lethal postoperative complication should the nurse closely monitor for? A. Atelectasis B. Hypovolemia C. Pulmonary embolism D. Urinary tract infection 30. A patient sustains a fracture of the arm. When does the nurse anticipate pendulum exercise should begin? A.As soon as tolerated, after a reasonable period of immobilization B. In 2 to 3 weeks, when callus ossification prevents easy movements of bony fragments C. In about 4 to 5 weeks, after new bone is well established D. In 2 to 3 months, after normal activities are resumed 31. Which of the following is the most important nursing diagnosis for an elderly patient diagnosed with osteoporosis? A. Deficient knowledge about osteoporosis and the treatment regimen B. Acute pain related to fracture and muscle spasm C. Risk for constipation related to immobility D. Risk for injury related to fractures due to osteoporosis 32. A client with a right leg fracture is returning to the orthopedist to have the cast removed. During cast removal, it is important for the nurse to assure: A. the client that he or she won't be cut. B. that the cast cutter blade is new. C. that pedal pulses are present. D. that the leg will be as good as new. 33. After a person experiences a closure of the epiphyses, which statement is true? A. The bone grows in length but not thickness. B. The bone increases in thickness and is remodeled. C. Both bone length and thickness continue to increase. D. No further increase in bone length occurs. 34. Which statement describes paresthesia? A. Absence of muscle movement suggesting nerve damage B. Involuntary twitch of muscle fibers C. Abnormal sensations D. Absence of muscle tone 35. What is the term for a rhythmic contraction of a muscle? A. Atrophy B. Clonus C. Hypertrophy D. Crepitus 36. The client presents with an exaggeration of the lumbar spine curve. How does the nurse interpret this finding? A. Lordosis B. Scoliosis C. Kyphosis D. Dowager's hump 37. The older client asks the nurse how best to maintain strong bones. What is the nurse's best response? A. "Weight-bearing exercises can strengthen bones." B. "Range-of-motion exercises build bone mass." C. "Cardio training is the best way to build bones." D. "Weight-resistance exercises can strengthen bones." 38. Which assessment finding would cause the nurse to suspect compartment syndrome in the client following a bone biopsy? A. Increased diameter of the calf B. Capillary refill < 3 seconds C. Toes move freely without pain D. Bounding dorsalis pedis pulses 39. A client has just undergone arthrography. What is the most important instruction for the nurse to include in the teaching plan? A. Avoid sunlight or harsh, dry climate. B. Avoid intake of dairy products. C. Report joint crackling or clicking noises occurring after the second day. D. Gently massage joints with any crackling or clicking joint noises. 40. The nurse is providing care to a client following a knee arthroscopy. What would the nurse expect to include in the client's plan of care? A. Keeping the affected knee flexed. B. Applying warm packs to the insertion site. C. Maintaining the client's NPO status. D. Administering the prescribed analgesic. 41. The nurse is performing a neurovascular assessment of a client's injured extremity. Which would the nurse report? A. Positive distal pulses B. Capillary refill of 3 seconds C. Dusky or mottled skin color D. Skin warm to touch