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ORTHOPEDICS NCLEX EXAMS QNS AND ANS .
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ORTHOPEDICS NCLEX EXAMSQNS AND ANS
2023/2024
Correct Answer: 1 Your Answer: 1
RATIONALES: A herniated intervertebral disk may compress the spinal nerve roots, causing sciatic nerve inflammation that results in pain radiating
down the leg. Slight knee flexion should relieve, not precipitate, low back pain. If nerve root compression remains untreated, weakness or paralysis
of the innervated muscle group may result; lower leg atrophy may occur if muscles aren't used. Homans' sign is more typical of phlebothrombosis.
The nurse is teaching a client with osteomalacia how to take prescribed vitamin D supplements. The nurse stresses the importance of taking only
the prescribed amount because high doses of vitamin D can be toxic. Early signs and symptoms of vitamin D toxicity include:
1. GI upset and metallic
taste.
2. dry skin, hair loss, and inflamed mucous
membranes.
3. flushing and orthostatic hypotension.
4. sensory neuropathy and difficulty maintaining
balance.
Correct Answer: 1 Your Answer: 1
RATIONALES: GI upset and metallic taste are early signs and symptoms of vitamin D toxicity. Such toxicity also may cause head ache, weakness,
renal insufficiency, renal calculi, hypertension, arrhythmias, muscle pain, and conjunctivitis. Dry skin, hair loss, and inflamed mucous membranes
suggest vitamin A toxicity. Flushing and orthostatic hypotension (effects of vasodilation) may result from nicotinic acid and nicotinamide supplements,
used to correct niacin deficiency. Sensory neuropathy and difficulty maintaining balance suggest pyridoxine toxicity.
A client with osteoarthritis tells the nurse she is concerned that the disease will prevent her from doing her chores. Which suggestion should the nurse
offer?
1. "Do all your chores in the morning, when pain and stiffness are least
pronounced."
2. "Do all your chores after performing morning exercises to loosen
up."
3. "Pace yourself and rest frequently, especially after
activities."
4. "Do all your chores in the evening, when pain and stiffness are least
pronounced."
Correct Answer: 3 Your Answer: 3
RATIONALES: A client with osteoarthritis must adapt to this chronic and disabling disease, which causes deterioration of the joint cartilage. The most
common symptom of the disease is deep, aching joint pain, particularly in the morning and after exercise and weight-bearing activities. Because rest
usually relieves the pain, the nurse should instruct the client to rest frequently, especially after activities, and to pace herself during daily activities.
Option 1 is incorrect because the pain and stiffness of osteoarthritis are most pronounced in the morning. Options 2 and 4 are incorrect because the
client should pace herself and take frequent rests rather than doing all chores at once.
1
, A 51-year-old client with Paget's disease comes to the hospital and complains of difficulty urinating. The emergency department physician consults
urology. What would the nurse suspect is the most likely cause of the client's urination problem?
1. Renal calculi
2. Urinary tract
infection
3. Benign prostatic hyperplasia
4. Dehydration
Correct Answer: 1 Your Answer: 1
RATIONALES: Renal calculi commonly occur with Paget's disease, causing pain and difficulty when urinating. A urinary tract infection (UTI)
commonly causes fever, urgency, burning, and hesitation with urination. Benign prostatic hyperplasia is common in men older than age 50; however,
because the client has Paget's disease, the nurse should suspect renal calculi, not benign prostatic hyperplasia. Dehydration causes a decrease in
urine production, not a problem with urination.
A common bone disease that usually affects middle-aged and elderly people. It's marked by inflammation of the bones, softening and thickening of the
bones, excessive bone destruction, and unorganized bone repair; the result is bowing of the long bones. The cause is unknown.
A client has acute, painful muscle spasms. The physician prescribes chlorzoxazone (Paraflex), 500 mg P.O. t.i.d. A centrally acting skeletal muscle
relaxant, chlorzoxazone commonly is used to treat:
1. muscle spasm caused by cerebral palsy.
2. chronic musculoskeletal disorder.
3. lower extremity
spasticity.
4. severe muscle
spasm.
Correct Answer: 4 Your Answer: 4
RATIONALES: Chlorzoxazone is used to treat acute, painful musculoskeletal conditions or severe muscle spasm. Centrally acting skeletal muscle
relaxants like chlorzoxazone are ineffective in treating spasticity associated with chronic neurologic disease, such as cerebral palsy. They can
treat acute musculoskeletal disorders, not chronic ones. Chlorzoxazone and the other relaxants are used to treat spasticity of any extremity.
A client who has just been diagnosed with mixed muscular dystrophy asks the nurse about the usual course of this disease. How should the nurse
respond?
1. "You should ask your physician about
that."
2. "The strength of your arms and pelvic muscles will decrease gradually, but this should cause only slight
disability."
3. "You may experience progressive deterioration in all voluntary
muscles."
4. "This form of muscular dystrophy is a relatively benign disease that progresses
slowly."
Correct Answer: 3 Your Answer: 3
RATIONALES: Muscular dystrophy causes progressive, symmetrical wasting of skeletal muscles, without neural or sensory defects. The mixed form
of the disease typically strikes between ages 30 and 50 and progresses rapidly, causing deterioration of all voluntary muscles. Because the client
asked the nurse this question directly, the nurse should answer and not simply refer the client to the physician. Limb-girdle muscular dystrophy
causes a gradual decrease in arm and pelvic muscle strength, resulting in slight disability. Facioscapulohumeral muscular dystrophy is a slowly
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, progressive, relatively benign form of muscular dystrophy; it usually arises before age 10.
A group of degenerative genetic diseases characterized by weakness and the progressive atrophy of skeletal muscles with no evidence of nervous system
involvement.
The nurse is caring for a client who complains of lower back pain. Which instructions should the nurse give to the client to prevent back
injury?
1. "Bend over the object you're
lifting."
2. "Narrow the stance when lifting."
3. "Push or pull an object using your
arms."
4. "Stand close to the object you're
lifting."
Correct Answer: 4 Your Answer: 4
RATIONALES: Standing close to an object when lifting moves the body's center of gravity closer to the object, allowing the legs, rather than the back,
to bear the weight. No one should bend over an object when lifting; instead, the back should be straight, and bending should be at the hips and
knees. When lifting, spreading the legs apart widens the base of support and lowers the center of gravity, providing better balance. Pushing or pulling
an object using the weight of the body, rather than the arms or back, prevents back strain. Using a larger number of muscle groups distributes the
workload.
A client is diagnosed with osteoporosis. Which statements should the nurse include when teaching the client about the
disease?
1. "It's common in females after menopause."
2. "It's a degenerative disease characterized by a decrease in bone density."
3. "It's a congenital disease caused by poor dietary intake of milk products."
4. "It can cause pain and injury."
5. "Passive range-of-motion exercises can promote bone growth."
6. "Weight-bearing exercise should be avoided."
Correct Answer: 1,2,4 Your Answer: 1,2,4
RATIONALES: Osteoporosis is a degenerative metabolic bone disorder in which the rate of bone resorption accelerates and the rate of bone
formation decelerates, thus decreasing bone density. Postmenopausal women are at increased risk for this disorder because of the loss of estrogen.
The decrease in bone density can cause pain and injury. Osteoporosis isn't a congenital disorder; however, low calcium intake does contribute to the
disorder. Passive range-of-motion exercises may be performed but they won't promote bone growth. The client should be encouraged to participate
in weight-bearing exercise because it promotes bone growth.
The nurse is caring for a client with burns on his legs. Which nursing intervention will help to prevent
contractures?
1. Applying knee splints
2. Elevating the foot of the
bed
3. Hyperextending the client's legs
3
, 4. Performing shoulder range-of-motion (ROM)
exercises
Correct Answer: 1 Your Answer: 1
RATIONALES: Applying knee splints prevents leg contractures by holding the joints in a functional position. Elevating the foot of the bed doesn't
prevent contractures. Hyperextending a body part for any length of time is inappropriate; it can cause contractures. Performing shoulder ROM
exercises can prevent contractures in the shoulders but not in the legs.
Following a boating accident, a 30-year- old client with multiple fractures is admitted to a semiprivate room in a progressive care unit. The client,
who was driving the boat, is unaware that his girlfriend's 9-year-old son was killed in the accident. The client's parents instruct the nurse to prohibit
phone calls and to withhold information about the accident. During an assessment of the client, the nurse notices that the television is on and the
news is starting. It would be most appropriate for the nurse to:
1. turn the television off and tell the client it interferes with the
assessment.
2. allow the client to view the television and deal with any questions as they
come.
3. instruct the client to change the channel to a station that isn't televising
the news.
4. attempt to distract the client from watching the
television.
Correct Answer: 2 Your Answer: 1
RATIONALES: The nurse-client relationship is built on trust, so the nurse can't withhold information from her client. She may refer the client to
another source for the information, but she can't prohibit the client from seeking information. It would be most appropriate to deal with the client's
questions as they come. Turning the television off, changing the channel, and distracting the client are all deceitful practices, which can damage a
therapeutic nurse-client relationship.
A client is diagnosed with gout. Which foods should the nurse instruct the client to
avoid?
1. Green, leafy vegetables
2. Liver
3. Cod
4. Chocolate
5. Sardines
6. Eggs
Correct Answer: 2,3,5 Your Answer: 2,3,5
RATIONALES: Clients with gout should avoid foods that are high in purines, such as liver, cod, and sardines. They should also avoid anchovies,
kidneys, sweetbreads, lentils, and alcoholic beverages — especially beer and wine. Green, leafy vegetables; chocolate; and eggs aren't high in
purines.
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