Question 1

The nurse is caring for a client with pes planus. Which of the following actions should the nurse expect to provide symptom relief for this client?

Accepted Answer

Symptoms of pes planus are usually relieved by use of resilient longitudinal arch supports. Casting of the affected foot, passive manual stretching of the PIP joint, and the administration of a corticosteroid are not part of the treatment for pes planus.

Question 2

The home care nurse is caring for a client who has chronic osteomyelitis of the left femur who is being managed at home with administration of IV antibiotics. Which of the following findings would indicate to the nurse that a nursing diagnosis of ineffective health maintenance is appropriate for this client?

Accepted Answer

Foot drop is an indication that the foot is not being supported in a neutral position by a splint. Using crutches and monitoring the oral temperature are appropriate self-care activities. Frustration with the length of treatment is not an indicator of ineffective health maintenance of the osteomyelitis.

Question 3

The nurse is caring for a client following a laminectomy with a spinal fusion who reports numbness and tingling of the right lower leg. Which of the following actions should the nurse do first?

Accepted Answer

Numbness and tingling should be immediately reported to the surgeon rather than documented and rechecked in two hours. Numbness and tingling are not symptoms associated with hemorrhage at the site. Turning the client will not relieve the numbness.

Question 4

The nurse is caring for a client who has had a surgical reduction of an open fracture of the left tibia. Which of the following assessment findings is most important to report to the health care provider?

Accepted Answer

An elevated temperature is suggestive of possible osteomyelitis. The other clinical manifestations are typical after a repair of an open fracture.

Question 5

The nurse is preparing a client for discharge after 2 weeks of IV antibiotic therapy for acute osteomyelitis in the left leg. Which of the following information should be included in the discharge teaching?

Accepted Answer

The client will be on IV antibiotics for several months, and the client will need to recognize signs of infection at the IV site and how to care for the catheter during daily activities such as bathing. IV antibiotics rather than oral antibiotics are used for acute osteomyelitis. Clients are instructed to avoid exercise and heat application because these will increase swelling and the risk for spreading infection.

Question 6

The nurse is preparing to administer alendronate to a client with osteoporosis. Which of the following actions will the nurse implement initially?

Accepted Answer

To avoid esophageal erosions, the client taking bisphosphonates should be upright for at least 30 minutes after taking the medication. Fosamax should be taken on an empty stomach, not after taking other medications or eating. Leg cramps and hot flashes are not adverse effects of bisphosphonates.

Question 7

The nurse is caring for a client who has acute osteomyelitis and is receiving tobramycin 80 mg IV twice daily. Which of the following actions should the nurse take before administering the gentamicin?

Accepted Answer

Gentamicin is nephrotoxic and can cause renal failure. Monitoring the client's temperature before gentamicin administration is not necessary. Nausea is not a common adverse effect of IV gentamicin. There is no need to change the dressing before gentamicin administration.

Question 8

The nurse is caring for a client who is hospitalized for initiation of regional antibiotic irrigation for acute osteomyelitis of the right femur. Which of the following interventions should be included in the plan of care?

Accepted Answer

Immobilization of the affected leg helps decrease pain and reduce the risk for pathological fractures. Weight-bearing exercise increases the risk for pathological fractures. NSAIDs are frequently prescribed to treat pain. Flexion of the affected limb is avoided to prevent contractures.

Question 9

Which of the following statements by a client who is scheduled for an above-the-knee amputation for treatment of an osteosarcoma of the right tibia indicates that client teaching is needed?

Accepted Answer

Ewing's sarcoma may be diagnosed following a fracture, but it is not caused by the injury. The other client statements indicate that client teaching has been effective.

Question 10

Which of the following menu choices by a client with osteoporosis indicates that the nurse's teaching about appropriate diet has been effective?

Accepted Answer

Skim milk and yogourt are high in calcium. The other choices do not contain any high calcium foods.

Question 11

The nurse is caring for an older female adult client who has a family history of osteoporosis and is diagnosed with osteopenia following densitometry testing. Which of the following explanations should the nurse provide when teaching the client about osteoporosis?

Accepted Answer

Progression of osteoporosis can be slowed by increasing calcium intake and
weight-bearing exercise. Estrogen replacement therapy does help prevent osteoporosis, but it is not the only treatment and is not appropriate for some clients. Corticosteroid therapy increases the risk for osteoporosis.

Question 12

The nurse is planning an educational session related to foot problems at a local seniors club. Which of the following information should the nurse include in the session related to why the older adult is prone to developing foot problems? (Select all that apply.)

Accepted Answer

The older adult is prone to developing foot problems because of poor circulation, atherosclerosis, and decreased sensation in the lower extremities. Inactivity and foot hygiene are personal choices and are not age-related changes.

Question 13

The nurse is caring for a client who has a herniated intravertebral disk who has had a laminectomy and discectomy. Following the surgery, which of the following actions should the nurse implement to position the client on his or her side?

Accepted Answer

The spine should be kept in correct alignment after laminectomy. The other positions will create misalignment of the spine.

Question 14

The nurse is caring for a client who has Paget's disease and is prescribed salmon calcitonin and acetaminophen. Which of the following assessment information will the nurse obtain to evaluate the effectiveness of these medications?

Accepted Answer

Bone pain is one of the common early manifestations of Paget's disease, and the nurse should assess the pain level to determine whether the treatment is effective. The other information will also be collected by the nurse, but will not be used in evaluating the effectiveness of the therapy.

Question 15

The nurse is assessing a client in the foot clinic who has severe heel pain. Which of the following foot disorders should the nurse assess for the presence of in the client?

Accepted Answer

Complaints of severe heel pain will alert the nurse to assess for plantar bursitis, plantar fasciitis, or bone spur in adult. Hallux rigidus, pes cavus, and Morton's neuroma do not have the symptom of severe heel pain.

Question 16

The nurse is caring for a client who has muscle spasms and acute low back pain. Which of the following actions is most appropriate to teach the client to promote comfort?

Accepted Answer

Resting with the hips and knees flexed will reduce the strain on the back and decrease muscle spasms. Twisting from side to side will increase tension on the lumbar area. A pillow placed under the upper back will cause strain on the lumbar spine. Alternate application of cold and heat should be used to decrease pain.

Question 17

The nurse is teaching a client whose work involves lifting and has a history of chronic back pain about proper body mechanics. Which of the following client statements indicates that the teaching has been effective?

Accepted Answer

Exercises can help to strengthen the muscles that support the back. Flexion of the hips and knees places less strain on the back. Modifications in the way the client lifts boxes are needed, but sitting for prolonged periods can aggravate back pain. The client should not lift above the level of the elbows.

Question 18

The nurse is teaching a client with a bunion about how to prevent further problems. Which of the following client statements indicates that more teaching is required?

Accepted Answer

The client can wear shoes that have a wide forefoot. The other client statements indicate that the teaching has been effective.

Question 19

Which of the following assessment findings should alert the nurse to the presence of osteoporosis in an adult client?

Accepted Answer

Osteoporosis occurring in the vertebrae produces a gradual loss of height. Bowed legs are associated with osteomalacia. Low intake of dairy products is a risk factor for osteoporosis, but it does not indicate that osteoporosis is present. Frequent falls increase the risk for fractures but are not an indicator of osteoporosis.

Quiz 66: Nursing Management Musculo-skeletal Problems