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NUR450 - Final Exam - Blackboard posted questions and case studies
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NUR450 - Final Exam - Blackboard posted questions and case studies
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NUR450 - Final Exam - Blackboard posted questions and casestudies
Musculoskeletal System - Blackboard questions - correct answer---
812. A client with cancer is scheduled for a bone scan to determine the presence of
metastasis. The nurse evaluates that the teaching before the scheduled bone scan is
effective when the client states that:
1. "X-rays will be taken to identify where I may have lost calcium from my bones."
2. "Portions of my bone marrow will be removed and examined for cell composition."
3. "A radioactive chemical will be injected into my vein that will destroy cancer cells
present in my bones."
4. "A substance of low radioactivity will be injected into my vein and my body inspected
by an instrument to detect where it is deposited." - correct answerAns: 4
4. A bone scan maps the uptake of a bone-seeking radioactive isotope; an increased
uptake is seen in metastatic bone disease, osteosarcoma, osteomyelitis, and certain
fractures.
813. A nurse explains to a client that stimulation of calcium deposition in the bone after
a distal femoral fracture is best achieved by:
1. Resting the extremity
2. Weight-bearing activity
3. Normal aging processes
4. Ingesting foods high in ca - correct answerAns: 2
2. Weight bearing and the use of antigravity muscles stimulate bone formatiqn or
osteoblastic function.
814. A nurse is performing range-of-motion exercises with a client who had a brain
attack. The nurse places the client's hand in the position exhibited in the picture (open
hand with fingers fully extended). This position is known as:
1. Flexion
2. Extension
3. Adduction
4. Circumduction - correct answerAns: 2
2. The fingers are flared out in the extended, abducted position.
815. A male college basketball player comes to the infirmary complaining of a "click" in
his knee when walking. He states that it occasionally gives way when he is running and
sometimes locks. He does not recall any specific injury. Which condition should the
nurse anticipate that the practitioner primarily will consider when determining the
diagnostic tests to order?
1. Cracked patella
2. Ruptured Achilles tendon
3. Injured cartilage in the knee
4. Stress fracture of the tibial plateau - correct answerAns: 3
3. These adaptations are consistent with a torn cartilage; this injury is common among
basketball players.
,NUR450 - Final Exam - Blackboard posted questions and case
studies
816. A client is scheduled for arthroscopic knee surgery and asks the nurse about the
procedure. The statement by the nurse that best describes the procedure is:
1. "It is surgical repair of a joint under direct visualization using an arthroscope."
2. "It is a radiological procedure that will help diagnose the extent of the knee injury."
3. "The procedure will determine the type of treatments the surgeon will prescribe."
4. "You will be anesthetized so that you do not remember anything about the
procedure." - correct answerAns: 1
1. This describes the procedure in which the surgeon uses a scope to visualize and
operate on the knee.
817. The practitioner orders non-weight bearing with crutches for a client with a leg
injury. Before arnbulation is begun, the most important activity the nurse should teach
the client to facilitate walking with crutches is:
1. Sitting up in a chair to help strengthen back muscles
2. Keeping the unaffected leg in extension and abduction
3. Exercising the triceps, finger flexors, and elbow extensors
4. Using a trapeze frequently to strengthen the bicep muscles - correct answerAns: 3
3 These sets of muscles are used in crutch walking and therefore need strengthening.
818. A client with impaired balance is using a walker to provide support when
ambulating. While observing the client transferring from a sitting to a standing position
and using the walker, the nurse evaluates that further teaching is required when the
client:
1. Slides toward the edge of the seat before standing
2. Holds both handles of the walker while rising to the standing position
3. Moves forward into the walker after transferring from sitting to standing
4. Stands in place holding on to the walker for at least 30 seconds before walking -
correct answerAns: 2
2. Because of the angle of force applied to a walker when a person uses it to move from
a sitting to a standing position, the walker can become unstable and tip over. The arms
of the chair should be used for support when rising from a sitting position.
819. A client with multiple injuries from an automobile collision is now permitted out of
bed to a chair but is not permitted to bear weight on the lower extremities. When using a
mechanical lift to transfer the client, it is essential that the nurse:
1. Fold the client's arms across, the chest
2. Place the sling so that the top is below the client's scapulae
3. Call the practitioner to secure an order to use a mechanical lift
4. Raise the lift so that the sling is at least twelve inches above the mattress - correct
answerAns: 1
1. Folding the arms across the chest maintains both arms in a safe position during the
transfer.
820. A nurse performs full range of motion on a client's extremities. When putting an
ankle through range of motion, the nurse must perform:
,NUR450 - Final Exam - Blackboard posted questions and case
studies
1. Flexion, extension, and rotation
2. Abduction, flexion, adduction, and extension
3. Pronation, supination, rotation, and extension
4. Dorsiflexion, plantar flexion, eversion, and inversion - correct answerAns: 4
4. These movements include all possible range of motion for the ankle joint.
821. An x-ray film of a client's arm reveals a comminuted fracture of the radial bone.
The nurse expects that with a comminuted fracture:
1. Bone protrudes through a break in the skin
2. The bone has broken into several fragments and the skin is intact
3. The bone is broken into two parts and the skin mayor may not be broken
4. Splintering has occurred on one side of the bone and bending on the other - correct
answerAns: 2
2. In a comminuted fracture, the bone is splintered or crushed.
822. Clients who have casts applied to an extremity must be monitored for
complications. The most significant complication for which the nurse should assess the
client's extremity is:
1. Warmth
2. Numbness
3. Skin desquamation
4. Generalized discomfort - correct answerAns: 2
2. Numbness is a neurological sign because it indicates pressure on the nerves and
blood vessels and should be reported immediately.
1. Warmth is a sign of adequate circulation.
3. Skin desquamation results from inadequate skin care and can be managed with
lotion or oil.
4. Some degree of discomfort is expected after cast application.
823. A nurse is providing teaching about self-care to a client who had a cast applied for
a fracture of the right ulna and radius. For which occurrence should the nurse instruct
the client to immediately notify the practitioner?
1. Slight stiffness of the fingers
2. Increasing pain at the injury site
3. Small amount of bloody drainage on the cast
4. Bounding radial pulse in the affected extremity - correct answerAns: 2
2 This may indicate cast pressure on a nerve and should be investigated further.
824. A client's right tibia is fractured in an automobile collision, and a cast is applied. For
which manifestation related to damage to major blood vessels by the fractured tibia
should the nurse assess?
1. Increased blood pressure
2. Prolonged edema in the thigh
3. Increased skin temperature of the foot
4. Prolonged reperfusion of the toes after blanching - correct answerAns: 4
, NUR450 - Final Exam - Blackboard posted questions and case
studies
4. Damage to the blood vessels may decrease circulatory perfusion of the toes.
825. Three days after a cast is applied to a client's fractured tibia, the client reports that
there is a burning pain over the ankle. The cast over the ankle feels warm to the touch,
and the pain is not relieved when the client changes position. The nurse's priority action
is to:
1. Obtain an order for an antibiotic
2. Report the client's concern to the practitioner
3. Administer the prescribed medication for pain
4. Explain that this is typical after a cast is applied - correct answerAns: 2
2. This indicates tissue hypoxia or breakdown and should be reported to the
practitioner.
826. After a long leg cast is removed, the client should be instructed to:
1. Elevate the leg when sitting
2. Report stiffness of the ankle
3. Perform full range of motion once a day
4. Cleanse the leg by scrubbing with a washcloth - correct answerAns: 1
1. Elevation will help control the edema that usually occurs after an injury or if the
injured part is left in a dependent position.
827. While a woman with a fractured femur is being prepared for surgery, she exhibits
cyanosis, tachycardia, dyspnea, and restlessness. What should the nurse do first?
1. Call the practitioner
2. Administer oxygen by mask
3. Place her in the high Fowler's position
4. Lower her to the Trendelenburg position - correct answerAns: 2
2. The client probably has a fat embolus; oxygen reduces surface tension of the fat
globules and reduces hypoxia.
828. A nurse is assisting a client with a full leg cast to use crutches. Which clinical
manifestations alert the nurse that the client can no longer tolerate the crutch walking?
1. Pulse of 100 and deep respirations
2. Flushed skin and slowed respirations
3. Profuse diaphoresis and rapid respirations
4. Blood pressure of 150/88 mm Hg and shallow respirations - correct answerAns: 3
3. Diaphoresis and tachypnea indicate that the client has exceeded tolerance for the
activity.
829. A client with chronic osteomyelitis in a leg is to have a debridement of the infected
bone. When planning for postoperative care the nurse expects that:
1. Frequent range-of-motion exercises are needed
2. Septicemia is a common postoperative complication
3. The client will be allowed out of bed after the first day
4. The client's leg may be immobilized in a cast or splint - correct answerAns: 4
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