Deck 13: Mobility

Question 1

Which of the clients described below are at increased risk for back problems? Select all that apply.

A)A 45-year-old man who has played golf three times a week for the past 20 years
B)An 18-year-old woman who has been a distance runner since middle school
C)A 62-year-old man who is a heavy truck mechanic and has a body mass index (BMI)of 30
D)A 12-year-old boy who has a history of cerebral palsy and a current BMI of 21
E)A 78-year-old man with a 40 pack-year smoking history who was recently widowed

Answer 1

A 62-year-old man who is a heavy truck mechanic and has a body mass index (BMI)of 30
A 12-year-old boy who has a history of cerebral palsy and a current BMI of 21
A 78-year-old man with a 40 pack-year smoking history who was recently widowed

Question 2

The cells that produce the matrix for bone formation are known as

A)osteoclasts.
B)sarcomeres.
C)osteoblasts.
D)epiphyseal plates.

Answer 2

osteoblasts.

Question 3

The nurse is caring for an adult client who sustained a right distal radial fracture and a left tibia fracture. Which mobility aid does the nurse anticipate being used for this client?

A)Lofstrand crutches
B)Platform crutches
C)Walker
D)Axillary crutches

Answer 3

Platform crutches

Question 4

A preadolescent client is recovering from spinal fusion surgery for scoliosis. Which nursing interventions should the nurse carry out to address comfort and mobility? Select all that apply.

A)Reposition every 2 hours.
B)Monitor intake and output.
C)Encourage and assist with range of motion (ROM)exercises every 4 hours while awake.
D)Administer pain medication around the clock.
E)Encourage incentive spirometer use every 4 hours while awake.

Question 5

The nurse is providing care to a client who returns to the medical-surgical unit after herniated disc surgery. The client's vitals are as follows: HR 100, RR 22, BP 130/86 mmHg, T 98.8°F, and pain rating of 7 on a scale of 0 to 10. Which nursing diagnosis is the highest priority for this client based on these assessment data?

A)Impaired Physical Mobility
B)Acute Pain
C)Activity Intolerance
D)Chronic Pain

Question 6

A client presents with an alteration in mobility. Which finding would suggest damage to the muscle?

A)Increased PTH levels
B)Decreased PTH levels
C)Decreased CK levels
D)Increased CK levels

Question 7

Within the human body, which type of connective tissue connects bones to other bones to form a joint?

A)Tendon
B)Ligament
C)Cartilage
D)Myelin

Question 8

The nurse is providing care for several clients. For which client should the nurse anticipate an order for administering 1000 mg of aspirin?

A)A 68-year-old client with rheumatoid arthritis who is experiencing hand pain
B)A 5-year-old client who is experiencing ankle pain after a fall from a horse
C)A 38-year-old client who is experiencing headache pain after a skiing accident
D)A 70-year-old client who is experiencing back pain after laminectomy

Question 9

Which score would a nurse select from the muscle function grading scale if the client has full strength and range of motion in a given joint?

A)0
B)5
C)8
D)10

Question 10

The nurse is planning care for a client who is experiencing an alteration in mobility. Which would the nurse include as an independent nursing intervention?

A)Instructing on the importance of proper nutrition and an active lifestyle
B)Administering a prescribed nonsteroidal anti-inflammatory drug (NSAID)
C)Identifying necessary modifications to the home environment
D)Prescribing a skeletal muscle relaxant

Question 11

The nurse is providing care for a client who is experiencing subjective symptoms of carpal tunnel syndrome. Which test should the nurse anticipate being performed by a provider during the physical assessment of this client?

A)Bulge test
B)Ballottement test
C)Phalen test
D)McMurray test

Question 12

The nurse is caring for a client who is experiencing limited mobility related to a musculoskeletal alteration. Which laboratory tests would be useful to diagnose the client appropriately? Select all that apply.

A)Magnetic resonance imaging (MRI)
B)Alkaline phosphatase (ALP)
C)Human leukocyte antigen-B27 (HLA-B27)
D)Rheumatoid factor (RF)
E)Electromyography (EMG)

Question 13

The nurse is planning care for a client with acute back pain who is a single mother of two small children and works part-time as a receptionist. Based on this information, which nursing intervention is the highest priority?

A)Instructing the client in appropriate body mechanics for lifting and ways to modify her work environment
B)Suggesting that the client take time off from work until her back is healed
C)Obtaining an order for nonsteroidal anti-inflammatory drugs (NSAIDs)from the client's healthcare provider
D)Suggesting that the client's children be taken care of by an extended family member until the client's back is healed

Question 14

The nurse is conducting a gait and posture assessment for a client who is experiencing mobility issues. Which action by the nurse is appropriate during this assessment?

A)Assessing the client's muscle mass and strength
B)Measuring the length and circumference of the client's extremities
C)Inspecting the client's spine for curvature
D)Palpating the client for tenderness and pain

Question 15

A preadolescent client who fell from a balance beam in physical education class injured her ankle. Given this information, which action by the nurse is appropriate?

A)Referring the client to physical therapy
B)Placing an ice pack on the client's ankle
C)Planning for a corticosteroid injection
D)Ordering an x-ray of the ankle

Question 16

The nurse is caring for a client who is 28 weeks pregnant. The client says she has recently begun to experience frequent lower back pain and asks the nurse what can be done to control this pain. What is the nurse's best response?

A)"Back pain is common during pregnancy and can usually be managed by taking nonsteroidal anti-inflammatory drugs (NSAIDs)."
B)"Let's talk about some postural adjustments that might help alleviate your pain."
C)"Back pain during pregnancy is often related to kidney infection. Have you experienced any recent urinary problems, including pain when voiding?"
D)"The physician will likely order an x-ray to investigate potential causes of your pain."

Question 17

The nurse is caring for a preadolescent male client who is accompanied by his mother. Which statement by the mother would be consistent with the client experiencing growing pains?

A)"My son often complains that his arms and legs feel sore."
B)"My son seems to get injured very easily, especially broken bones."
C)"My son often doesn't want to walk because his knees hurt."
D)"My son occasionally complains of pain in his lower back."

Question 18

The nurse is planning care for a client who is 1 day postoperative after spinal fusion surgery. Which of the following is an appropriate outcome for this client?

A)The client will remain in prone position.
B)The client will maintain urine output at 20 mL per hour.
C)The client will use the incentive spirometer every 2 hours.
D)The client will void 12 hours after surgery.

Question 19

The nurse is providing care to a client who is experiencing back pain. Which of the following items in the client's history is a known risk factor for disc herniation?

A)49 years of age
B)Female gender
C)Short stature
D)Anorexia

Question 20

An adult client is diagnosed with a degenerative bone disease that is impairing mobility. Based on this information alone, which of the following actions should be the nurse's first priority?

A)Implementing a low-level exercise program for the client
B)Assessing the client's pain management
C)Teaching the client relaxation techniques
D)Referring the client to a dietitian

Question 21

The nurse is planning care for the client with chronic pain from herniated intervertebral discs who is also experiencing constipation. Which intervention should the nurse carry out to address constipation?

A)Restrict foods high in fiber.
B)Avoid the use of stool softeners.
C)Encourage fluid intake of 2500-3000 mL each day.
D)Medicate for pain around the clock.

Question 22

The mother of a preadolescent client meets with the school nurse to discuss the client's recent diagnosis of scoliosis. Which interventions would be appropriate for the nursing diagnosis of Disturbed Body Image related to deformity and brace? Select all that apply.

A)Including the student and family in a meeting to elicit her feelings about scoliosis and wearing a brace
B)Offering to arrange a meeting for the student with an 8th grader who has scoliosis
C)Encouraging the student and family to register for home schooling to minimize the risk of ridicule
D)Teaching the student and family about clothing that will hide the brace
E)Suggesting that the pediatrician prescribe an anti-anxiety agent for the student

Question 23

On the first postoperative day after spinal fusion, the nurse assesses a client and notes the following vital signs: T 39.2°C, BP 100/50 mmHg, HR 118, and RR 23. Drainage at the client's incision site is clear and tests positive for glucose. Which assessment parameter indicates the highest risk for surgical wound infection?

A)Temperature
B)Incisional drainage positive for glucose
C)Heart rate 118 bpm
D)Presence of incisional drainage

Question 24

During a home care visit, an older adult client begins to cry softly when asked about coping with back pain. The client states, "My back hurts bad all the time. I am so confused about all these tests and scared that the doctor wants me to have surgery." In this scenario, which of the following nursing interventions is the highest priority?

A)Asking the client to rate the pain on a scale of 0 to 10
B)Explaining potential procedures in a way the client will understand
C)Administering all pain medication as ordered
D)Attentively listening to the client's thoughts and fears

Question 25

A client sustained multiple fractures in a motor vehicle crash. Of the various fracture types sustained by the client, which places the client at highest risk for osteomyelitis?

A)Avulsion fracture
B)Open fracture
C)Comminuted fracture
D)Depression fracture

Question 26

Which of the following fractures presents the greatest risk for development of fat embolism syndrome?

A)Open fracture of the fibula
B)Closed fracture of the femur
C)Open fracture of the humerus
D)Closed fracture of the clavicle

Question 27

A client who is hospitalized after a left hip fracture is scheduled for surgery late this afternoon. After receiving report, the nurse evaluates the Buck traction applied by a new physical therapist. Which finding would indicate that the traction is correctly applied?

A)A foam boot covers the right lower leg from the knee down.
B)Twenty-pound weights are connected to the bottom of a foam boot.
C)Weights are supported by a stool at the end of the bed.
D)The left knee and hip are in alignment above a foam boot.

Question 28

The nurse is teaching an older adult client and caregiver about appropriate ways to decrease the client's risk for falls. Which interventions are appropriate for the nurse to include in this teaching session? Select all that apply.

A)Start walking for exercise several times per week.
B)Wear sensible shoes with good support when shopping.
C)Wear socks when walking in the kitchen.
D)Encourage the use of throw rugs throughout the home.
E)Make sure hallways and stairways have adequate lighting, even at night.

Question 29

A client is admitted to your inpatient rehabilitation unit. This client is currently in halo traction. (See exhibit.)Based on this information, which of the following should be the priority nursing diagnosis for the client?

A)Risk for Peripheral Neurovascular Dysfunction related to disruption of traction weights
B)Risk for Infection related to surgical incision and insertion of hardware
C)Risk for Disuse Syndrome related to use of traction to stabilize fracture
D)Acute Pain related to bone and soft tissue damage

Question 30

A client hospitalized with an open reduction and internal fixation of a fractured femur reports right calf pain. The nurse notes that the client's right calf is 3.5 cm larger than the left calf with generalized posterior erythema. The right calf is tender to touch, and the dorsalis pedis pulse is 3/4+ bilaterally. Which of the following is the priority action by the nurse?

A)Use a Doppler stethoscope to confirm pedal pulses.
B)Notify the healthcare provider of the findings.
C)Prepare to apply a cast to the right leg.
D)Prepare to administer intravenous heparin.

Question 31

During which phase of the fracture healing process is woven bone replaced by lamellar bone?

A)Reactive phase
B)Reparative phase
C)Remodeling phase
D)Inflammatory phase

Question 32

Which condition or symptom is most common in clients with a herniated cervical disc?

A)Sciatica
B)Stiff neck and shoulder pain
C)Changes in knee and ankle reflexes
D)Cauda equina syndrome

Question 33

Which region of the spine is the most common location of herniated discs?

A)Cervical region
B)Thoracic region
C)Lumbar region
D)Sacral region

Question 34

The nurse in an orthopedic outpatient clinic expects to see several clients with fractures for follow-up. Based on the information provided below, which of the nurse's clients is at highest risk for a delayed union?

A)A 20-year-old college student with type I diabetes mellitus who sustained a fractured tibia in a bicycle accident. The nutrition recall tool completed during the client's last visit was consistent with American Diabetic Association (ADA)guidelines.
B)A 62-year-old bartender with a history of peptic ulcer disease who sustained a fractured clavicle breaking up a fight at work. During his prior visit, the client stated he was upset that his injury required him to abstain from upper body resistance training.
C)A 49-year-old teacher with osteoporosis who sustained an open ulnar fracture in a motor vehicle crash. At her last visit, the client reported that she had cut down smoking to 10 cigarettes per day.
D)A 55-year-old accountant who sustained fractures to the 4th and 5th right metatarsals. The client has a history of hypertension that is well controlled with medication.

Question 35

The x-ray of a client 14 weeks post-ulnar fracture exhibits no callus formation. Based on this data, which collaborative intervention should the nurse anticipate?

A)The physical therapist will set up Buck traction.
B)The surgeon will schedule a consultation with the client.
C)The pharmacist will educate the client on antibiotics.
D)The nurse will counsel the client on starting range-of-motion exercise.

Question 36

The nurse is caring for clients in an assisted living facility. Which resident would the nurse identify as being at the highest risk for the development of fractures from a fall?

A)A resident who participates in resistance training exercises three times a week and takes a calcium supplement
B)A resident who hikes in the woods once a week and smokes 14 cigarettes per day
C)A resident who line dances twice per week and has a glass of wine with dinner
D)A resident who teaches yoga four times per week and is lactose intolerant

Question 37

The nurse is providing care for a client who experienced a fracture requiring a plaster cast. Which nursing intervention is appropriate for this client?

A)Prescribing opioid pain medication
B)Assessing the client's neurovascular status
C)Discouraging client ambulation
D)Encouraging the client to keep the cast damp

Question 38

The nurse is documenting the interdisciplinary team report on an adolescent client who has a 35-degree Cobb angle confirmed by x-ray. What interventions should the nurse anticipate being included in the collaborative plan of care for this client? Select all that apply.

A)Obtaining a physical therapy consult prior to surgical intervention
B)Maintaining the existing curvature with no increase
C)Bracing for 12-23 hours per day and providing a support group referral
D)Administering nonopioid analgesics and a TLSO or Milwaukee brace
E)Instructing the client on exercises and appropriate support groups

Question 39

A nurse is teaching a mother warning signs and symptoms to watch for in her child, who will be discharged with a full leg cast. Which statements by the mother indicate the need for further instruction? Select all that apply.

A)"If her foot turns white and cold, I should call the physical therapist."
B)"I can expect that my child will have some pain, but the medicine should help."
C)"We can use a blow dryer on warm to help with the itching that my child will experience."
D)"We can cut a hole in the cast if my child's foot swells until we get to the doctor's office."
E)"It is okay if the plaster cast gets damp as long as I blow dry it."

Question 40

An adolescent client with scoliosis has a Cobb angle of 32 degrees. Given this information, what treatment will the nurse likely need to prepare the client for?

A)This client will not need specific treatment.
B)The nurse will prepare the client for physical therapy.
C)The nurse will prepare the client for wearing a brace.
D)The nurse will prepare the client for undergoing spinal fusion surgery.

Question 41

A client is undergoing surgery for a fractured hip. The surgeon has stated that careful attention will be paid to preserving the epiphyseal plate. Which client will require this precaution during surgery?

A)A postmenopausal woman with paraplegia
B)A 32-year-old man who is a competitive body builder
C)A prepubescent girl who is a vegetarian
D)An 85-year-old woman with osteoporosis

Question 42

A client is recovering from surgery to repair a fractured hip. Which actions by the nurse may reduce this client's risk for osteomyelitis in the postoperative period? Select all that apply.

A)Assess for pain every 1-2 hours.
B)Use sterile technique for dressing changes.
C)Assess wound for size, color, and drainage.
D)Administer antibiotics as prescribed.
E)Administer anticoagulants as prescribed.

Question 43

The nurse is presenting a program at a senior center on how to survive a fall. Which statement by a program participant indicates that this person needs clarification about what emergency actions to take after a fall?

A)"I should crawl to a phone on the affected side to keep it stable against a hard surface."
B)"I should try to cover myself with a blanket while I wait for help to arrive."
C)"To call for help, I can scoot on my bottom to a low wall-mounted phone."
D)"If possible, I can crawl to a stairway and use the stairs to lift up to a standing position."

Question 44

A postmenopausal client asks the nurse what she can do to prevent fracturing her hips, as her mother and grandmother both experienced this health problem. Which response by the nurse is most appropriate?

A)"You should avoid all types of exercise."
B)"You should consider a smoking cessation program."
C)"You should limit your exposure to the sun."
D)"You should use throw rugs throughout your home."

Question 45

A client with multiple sclerosis is prescribed diazepam (Valium). What assessment finding indicates that this medication is effective for the client?

A)Muscle spasticity is reduced.
B)Blood glucose level is within normal limits.
C)The client states that muscles are weak.
D)Ophthalmologic examination shows no evidence of cataracts.

Question 46

The nurse gives discharge instructions to an adult client who sustained a bicycle fall and underwent open reduction and internal fixation of a fractured hip. After the teaching is complete, which statements by the client indicate appropriate understanding of the information presented? Select all that apply.

A)"I will use my abduction pillow while sleeping to maintain proper hip alignment."
B)"I will use a high toilet seat to prevent excess flexion of my hip."
C)"I only need to use my walker during physical therapy appointments."
D)"I will take my prescribed ibuprofen to decrease the risk for deep vein thrombosis."
E)"I might experience bruising because of the warfarin I've been prescribed."

Question 47

For non-elderly adult clients who fracture a hip, why is internal fixation or casting of the fracture generally preferred over hip replacement?

A)Internal fixation or casting is preferred because it does not disturb the client's epiphyseal plate.
B)Internal fixation or casting is preferred because of the lower risk of deep vein thrombosis.
C)Internal fixation or casting is preferred because of the shorter recovery time.
D)Internal fixation or casting is preferred because of the limited longevity of hip prostheses.

Question 48

A client with a history of relapsing-remitting multiple sclerosis (MS)is expecting her first child. Which of the following nursing interventions would be indicated for this client?

A)Suggest the client seek reproductive counseling.
B)Tell the client to expect a period of remission after delivery.
C)Instruct the client to expect an exacerbation of symptoms while pregnant.
D)Discuss the client's options for pain control during labor, as her contractions will be especially severe.

Question 49

A young adult client complains of blurred vision and muscle spasms that have come and gone over the past several months. The physician suspects that the client has multiple sclerosis. What in the client's history would the nurse recognize as a risk factor for MS?

A)The client is a male.
B)The client is of Native American descent.
C)The client is of European descent.
D)The client takes a vitamin D supplement daily.

Question 50

A client with a BMI of 35 is recovering from total hip replacement surgery and experiencing pain that is exacerbated with movement. The client says to the nurse, "I live alone. How will I ever be able to return to my home?" Based on this information, which is the priority nursing diagnosis for this client?

A)Overweight
B)Acute Pain
C)Impaired Physical Mobility
D)Ineffective Coping

Question 51

A hip fracture that occurs in the trochanter region would be classified as a(n)

A)intracapsular fracture.
B)intercapsular fracture.
C)extracapsular fracture.
D)subcapsular fracture.

Question 52

The first day after surgery to repair a fractured hip sustained from a fall, an older adult client refuses to ambulate but states, "I will consider it tomorrow." In this situation, which is the priority action by the nurse?

A)Coordinate personnel to assist with ambulation
B)Document the client's refusal
C)Assess why the client is refusing to ambulate
D)Notify the healthcare provider

Question 53

A client with relapsing-remitting multiple sclerosis (MS)tells the nurse that even though her primary symptoms of exacerbation are leg spasms and blurred vision, her greatest struggle is getting through the day because she is always tired. Which diagnosis should the nurse identify as a priority for this client?

A)Fatigue
B)Disturbed Sensory Perception
C)Impaired Physical Mobility
D)Self-Care Deficit

Question 54

The nurse is caring for a client admitted with an exacerbation of multiple sclerosis (MS). The client is demonstrating frustration with eating because he is experiencing hand and arm spasms that prevent the proper use of utensils. Which intervention should the nurse implement to best assist this client?

A)Consult with the occupational therapist regarding assistive devices for meals.
B)Counsel the client to select finger foods for meals.
C)Plan time to feed the client.
D)Consult with the physical therapist regarding hand and arm exercises.

Question 55

The nurse is evaluating care provided to a client recovering from hip replacement surgery. Which piece of documentation in the medical record indicates that the client has achieved the expected outcome for pain management?

A)The client states pain is a 6 on a numeric pain scale of 0 to 10 prior to evening care.
B)The client is crying and requesting pain medication prior to morning care.
C)The client is using a PCA pump around the clock and rates pain as a 2 on a numeric pain scale of 0 to 10.
D)The client refuses pain medication prior to physical therapy. Pain is rated as a 7 on a numeric pain scale of 0 to 10.

Question 56

An older adult client experiences a hip fracture. Prior to the injury, the client had an active lifestyle. Based on this information, which surgical procedure should the nurse anticipate?

A)Total hip replacement
B)Open reduction and external fixation
C)Arthroplasty
D)Open reduction and internal fixation

Question 57

The nurse is providing discharge instructions to an older adult client who is recovering from a fractured hip. The client is planning to stay with an adult child, who is included in the discharge teaching. Which statements on the part of the client indicate appropriate understanding of the information presented by the nurse? Select all that apply.

A)"I have signed a contract with Lifeline."
B)"We are removing the area rugs in the hallway."
C)"I've borrowed a toilet seat riser from the equipment closet."
D)"I will be sure to take oxycodone before I go downstairs in the morning."
E)"I can help with housework while I'm staying at my child's house."

Question 58

The nurse is assessing an older adult client in a long-term care facility after a fall. Which finding requires priority action?

A)The injured leg is shortened and externally rotated.
B)Redness and severe swelling are found at the hip joint.
C)Pain is relieved by moving the affected extremity.
D)The client is repeatedly flexing the injured leg at the hip.

Question 59

A client with multiple sclerosis (MS)is observed transferring from the bed to a motorized wheelchair and applying splints to the lower extremities before entering the bathroom to perform morning self-care. What could the nurse conclude regarding this observation?

A)The client uses assistive devices to optimize autonomy.
B)The client should be instructed to conduct morning care before applying splints to the lower extremities.
C)The client is dependent on assistive devices.
D)The client should be advised to avoid use of a motorized wheelchair when possible.

Question 60

A client diagnosed with multiple sclerosis has an acute onset of visual changes, fatigue, and leg weakness. The client states that the last time this happened, she recovered in a few weeks. Which classification of multiple sclerosis is the client experiencing?

A)Progressive-relapsing
B)Secondary-progressive
C)Relapsing-remitting
D)Primary-progressive

Question 61

The nurse is planning care for a client with multiple sclerosis. Which intervention would address the nursing diagnosis of Fatigue?

A)Encourage increased activity.
B)Schedule physical therapy three times a day.
C)Plan activities with sufficient rest periods between them.
D)Group activities together so care will not be interrupted.

Question 62

The nurse is caring for a client with osteoarthritis. Which factor in the client's history and physical assessment would the nurse recognize as a risk factor for developing this condition?

A)Body mass index of 36.5
B)History of esophageal reflux disease
C)Client plays tennis three times each week
D)Blood pressure of 136/78 mmHg

Question 63

Which category of multiple sclerosis (MS)is characterized by a slow but nearly continuous worsening of the disease from the time of onset with no distinct remissions?

A)Relapsing-remitting
B)Progressive-relapsing
C)Primary-progressive
D)Secondary-progressive

Question 64

A client with osteoarthritis (OA)of the knees and hips returns for a 3-month follow-up visit with the provider. The nurse calculates that the client's body mass index (BMI)is now 22. The client reports starting a water aerobics and running program three times per week. The client is also using hot packs for edema for 20 minutes and cold packs for pain for 40 minutes daily. After evaluating the client's actions, which follow-up interventions should the nurse plan? Select all that apply.

A)Reinforce the correct use of hot packs.
B)Suggest the client replace running with a lower impact exercise.
C)Explain the risk of injury associated with use of cold packs.
D)Advise the client to continue weight loss.
E)Congratulate the client on starting water aerobics.

Question 65

A nurse is teaching the parents of a client who was recently diagnosed with multiple sclerosis (MS)about what to expect as their child's condition progresses. Which statement by the parents indicates the need for further instruction?

A)"My child is at increased risk for seizures because of the MS diagnosis."
B)"It's not unusual for kids with MS to have problems with their schoolwork."
C)"MS usually progresses faster in children than in adults."
D)"Making friends may be more difficult for our child because of the MS."

Question 66

An adult client recently diagnosed with multiple sclerosis (MS)reports engaging in vigorous exercise on a regular basis. Which statements contain the correct information to give this client when answering specific questions about lifestyle? Select all that apply.

A)"Hyperbaric oxygen treatment is recommended prior to vigorous physical exercise."
B)"You will tolerate exercise better in an air-conditioned room."
C)"Acupuncture may benefit some of your symptoms."
D)"Drinking cold water is recommended during exercise."
E)"You will be able to maintain your current exercise schedule."

Question 67

A client with multiple sclerosis (MS)is said to be experiencing an exacerbation when he or she experiences symptoms that:

A)last at least 1 week and are separated from a previous attack by at least 30 days.
B)last at least 24 hours and are separated from a previous attack by at least 30 days.
C)last at least 2 weeks and are separated from a previous attack by at least 2 months.
D)last at least 30 days and are separated from a previous attack by at least 2 months.

Question 68

A client with osteoarthritis tells the nurse she has difficulty walking to the bathroom first thing in the morning. Which nursing action would assist this client?

A)Suggesting a family member provide the client with a bedpan
B)Discussing the option of residing in an assisted-living facility
C)Consulting with physical therapy for an assistive walking device such as a walker or cane
D)Suggesting the client use a bedside commode at home

Question 69

During an outpatient clinic follow-up appointment, a client with multiple sclerosis (MS)has lab tests completed. The results show elevated levels of aspartate aminotransferase (AST), serum glutamic-oxaloacetic transaminase (SGOT), alanine aminotransferase (ALT), serum glutamic-pyruvic transaminase (SGPT), and alkaline phosphatase (ALP). The nurse recognizes that these elevated enzyme levels are a potential adverse effect of which medications? Select all that apply.

A)Interferon beta-1a (Avonex)
B)Teriflunomide (Aubagio)
C)Glatiramer acetate (Copaxone)
D)Mitoxantrone (Novantrone)
E)Fingolimod (Gilenya)

Question 70

The nurse is providing teaching to the client recently diagnosed with osteoarthritis. Which statement by the nurse is correct?

A)"Osteoarthritis is most commonly seen in thin, small-built female clients."
B)"Osteoarthritis is a result of joint inflammation."
C)"Osteoarthritis occurs due to erosion of cartilage in the joints."
D)"Osteoarthritis is a metabolic bone disease."

Question 71

Which of the following would be classified as a secondary symptom of multiple sclerosis (MS)?

A)Pressure sores
B)Urinary retention
C)Depression
D)Unsteady gait

Question 72

A client seeking treatment for severe knee pain has worked in a factory for 30 years in a position requiring repetitive lifting and carrying of 20- to 40-pound boxes. Based on the client's history, the nurse should anticipate which initial recommendation from the multidisciplinary healthcare team?

A)Joint replacement surgery
B)Pharmacologic therapy
C)Referral for a disability application
D)Intermittent use of a cane

Question 73

A client with chronic hip pain is diagnosed with osteoarthritis. Which instruction regarding home safety is most appropriate for the nurse to provide to this client?

A)Walk up and down the steps at home as much as possible.
B)Rest in a recliner.
C)Place scatter rugs in high-traffic areas.
D)Install grab bars in the bathroom near the commode and in the shower.

Question 74

The nurse is planning care for a client with osteoarthritis. Which nursing diagnosis would have the highest priority?

A)Fatigue
B)Chronic Pain
C)Ineffective Coping
D)Disturbed Body Image

Question 75

Lab results are back for a client who has limiting joint pain. Synovial fluid analysis shows no uric acid crystals or bacteria. The client asks what the test results mean. How should the nurse respond?

A)"These test results mean that your joint pain is likely not caused by gout or septic arthritis."
B)"These test results mean that your joint pain is likely not related to any form of arthritis."
C)"These test results mean that your joint pain is likely caused by either rheumatoid arthritis or septic arthritis."
D)"These test results mean that your joint pain is likely caused by either cancer of the joint or gout."

Question 76

Which of the following medications is used to treat tertiary symptoms of multiple sclerosis (MS)?

A)Bupropion
B)Ciprofloxacin
C)Magnesium hydroxide
D)Glatiramer acetate

Question 77

The nurse is planning care for a client with osteoarthritis of the hip. Which intervention would be appropriate for this client?

A)Provide moist heat packs to the affected joint 3 times each day.
B)Instruct the client on the importance of strict bedrest.
C)Provide nonsteroidal anti-inflammatory drugs (NSAIDs)when pain becomes severe.
D)Provide opioid pain medication as prescribed.

Question 78

The nurse is evaluating care provided to a client with osteoarthritis (OA). Which client statement indicates to the nurse that interventions for OA have been successful?

A)"I had to take early retirement and now stay at home all day and rest my legs."
B)"I am sleeping throughout the night and have not missed any work because of knee pain."
C)"I am moving from my two-story house into the first floor of my daughter's home so I won't have to walk steps anymore."
D)"I changed my work hours so now I work part time and have a nursing assistant who helps me bathe twice a week at home."

Question 79

An older adult client with bilateral osteoarthritis of the knees tells the nurse, "I know I need to lose weight, but exercising makes my knees ache." What instruction should the nurse provide to this client?

A)"You should discuss knee replacement surgery with your physician."
B)"Exercising the muscles in your legs might be hard now, but over time, it will help protect your knees."
C)"Try eating a reduced-calorie diet for several months before attempting exercise."
D)"You need to stretch your muscles, because stretching is the only form of exercise that improves osteoarthritis."

Question 80

The nurse is caring for several clients from various cultural backgrounds. Which client would the nurse assess as having the highest risk for multiple sclerosis?

A)A Brazilian woman with chronic parasitic infestation
B)A Hispanic man with colonized methicillin-resistant Staphylococcus aureus (MRSA)
C)A Northern Canadian woman who has smoked for 25 years
D)An African man in his 20s who has a vitamin D deficiency