Deck 64: Nursing Management: Musculoskeletal Problems

Question 1

Which action will the nurse take first when a patient is seen in the outpatient clinic with neck pain?

A) Provide information about therapeutic neck exercises.
B) Ask about numbness or tingling of the hands and arms.
C) Suggest that the patient alternate the use of heat and cold to the neck to treat the pain.
D) Teach about the use of nonsteroidal antiinflammatory drugs such as ibuprofen (Advil).

Answer 1

Ask about numbness or tingling of the hands and arms.

Question 2

Which nursing action included in the care of a patient after laminectomy can the nurse delegate to experienced unlicensed assistive personnel (UAP)?

A) Check ability to plantar and dorsiflex the foot.
B) Determine the patient's readiness to ambulate.
C) Log roll the patient from side to side every 2 hours.
D) Ask about pain control with the patient-controlled analgesia (PCA).

Answer 2

Log roll the patient from side to side every 2 hours.

Question 3

An appropriate nursing intervention for a patient who has acute low back pain and muscle spasms is to teach the patient to

A) keep both feet flat on the floor when prolonged standing is required.
B) twist gently from side to side to maintain range of motion in the spine.
C) keep the head elevated slightly and flex the knees when resting in bed.
D) avoid the use of cold packs because they will exacerbate the muscle spasms.

Answer 3

keep the head elevated slightly and flex the knees when resting in bed.

Question 4

Which menu choice by a patient with osteoporosis indicates that the nurse's teaching about appropriate diet has been effective?

A) Pancakes with syrup and bacon
B) Whole wheat toast and fresh fruit
C) Egg-white omelet and a half grapefruit
D) Oatmeal with skim milk and fruit yogurt

Question 5

Which action should the nurse take before administering gentamicin (Garamycin)to a patient who has acute osteomyelitis?

A) Ask the patient about any nausea.
B) Review the patient's creatinine level.
C) Obtain the patient's oral temperature.
D) Change the prescribed wet-to-dry dressing.

Question 6

Following laminectomy with a spinal fusion to treat a herniated disc,a patient reports numbness and tingling of the right lower leg.The first action that the nurse should take is to

A) report the patient's complaint to the surgeon.
B) check the chart for preoperative assessment data.
C) check the vital signs for indications of hemorrhage.
D) turn the patient to the side to relieve pressure on the right leg.

Question 7

A patient with acute osteomyelitis of the left femur is hospitalized for regional antibiotic irrigation.Which intervention will be included in the initial plan of care?

A) Immobilization of the left leg
B) Positioning the left leg in flexion
C) Assisted weight-bearing ambulation
D) Quadriceps-setting exercise repetitions

Question 8

The nurse instructs a patient who has osteosarcoma of the tibia about a scheduled above-the-knee amputation.Which statement by a patient indicates that additional patient teaching is needed?

A) "I will need to participate in physical therapy after surgery."
B) "I did not have this bone cancer until my leg broke a week ago."
C) "I wish that I did not have to have chemotherapy after this surgery."
D) "I can use the patient-controlled analgesia (PCA) to control postoperative pain."

Question 9

A 50-year-old patient is being discharged after a week of IV antibiotic therapy for acute osteomyelitis in the right leg.Which information will be included in the discharge teaching?

A) How to apply warm packs to the leg to reduce pain
B) How to monitor and care for the long-term IV catheter
C) The need for daily aerobic exercise to help maintain muscle strength
D) The reason for taking oral antibiotics for 7 to 10 days after discharge

Question 10

The nurse will determine that more teaching is needed if a patient with discomfort from a bunion says,"I will

A) give away my high-heeled shoes."
B) take ibuprofen (Motrin) if I need it."
C) use the bunion pad to cushion the area."
D) only wear sandals, no closed-toe shoes."

Question 11

A 23-year-old patient with a history of muscular dystrophy is hospitalized with pneumonia.Which nursing action will be included in the plan of care?

A) Logroll the patient every 2 hours.
B) Assist the patient with ambulation.
C) Discuss the need for genetic testing with the patient.
D) Teach the patient about the muscle biopsy procedure.

Question 12

When administering alendronate (Fosamax)to a patient with osteoporosis,the nurse will

A) ask about any leg cramps or hot flashes.
B) assist the patient to sit up at the bedside.
C) be sure that the patient has recently eaten.
D) administer the ordered calcium carbonate.

Question 13

Which assessment finding for a patient who has had a surgical reduction of an open fracture of the right radius is most important to report to the health care provider?

A) Serous wound drainage
B) Right arm muscle spasms
C) Right arm pain with movement
D) Temperature 101.4° F (38.6° C)

Question 14

The nurse should reposition the patient who has just had a laminectomy and diskectomy by

A) instructing the patient to move the legs before turning the rest of the body.
B) having the patient turn by grasping the side rails and pulling the shoulders over.
C) placing a pillow between the patient's legs and turning the entire body as a unit.
D) turning the patient's head and shoulders first, followed by the hips, legs, and feet.

Question 15

An assessment finding for a 55-year-old patient that alerts the nurse to the presence of osteoporosis is

A) a measurable loss of height.
B) the presence of bowed legs.
C) the aversion to dairy products.
D) a statement about frequent falls.

Question 16

A 67-year-old patient is receiving IV antibiotics at home to treat chronic osteomyelitis of the left femur.The nurse chooses a nursing diagnosis of ineffective health maintenance when the nurse finds that the patient

A) is frustrated with the length of treatment required.
B) takes and records the oral temperature twice a day.
C) is unable to plantar flex the foot on the affected side.
D) uses crutches to avoid weight bearing on the affected leg.

Question 17

A 54-year-old woman who recently reached menopause and has a family history of osteoporosis is diagnosed with osteopenia following densitometry testing.In teaching the woman about her osteoporosis,the nurse explains that

A) estrogen replacement therapy must be started to prevent rapid progression to osteoporosis.
B) continuous, low-dose corticosteroid treatment is effective in stopping the course of osteoporosis.
C) with a family history of osteoporosis, there is no way to prevent or slow gradual bone resorption.
D) calcium loss from bones can be slowed by increasing calcium intake and weight-bearing exercise.

Question 18

Which action will the nurse take when caring for a patient with osteomalacia?

A) Teach about the use of vitamin D supplements.
B) Educate about the need for weight-bearing exercise.
C) Discuss the use of medications such as bisphosphonates.
D) Emphasize the importance of sunscreen use when outside.

Question 19

A 39-year-old patient whose work involves frequent lifting has a history of chronic back pain.After the nurse has taught the patient about correct body mechanics,which patient statement indicates that the teaching has been effective?

A) "I will keep my back straight to lift anything higher than my waist."
B) "I will begin doing exercises to strengthen the muscles of my back."
C) "I can try to sleep with my hips and knees extended to prevent back strain."
D) "I can tell my boss that I need to change to a job where I can work at a desk."

Question 20

The nurse evaluating effectiveness of prescribed calcitonin (Cibacalcin)and ibandronate (Boniva)for a patient with Paget's disease will consider the patient's

A) pain level.
B) oral intake.
C) daily weight.
D) grip strength.

Question 21

Which information will the nurse include when teaching a patient with acute low back pain ?

A) Sleep in a prone position with the legs extended.
B) Keep the knees straight when leaning forward to pick something up.
C) Avoid activities that require twisting of the back or prolonged sitting.
D) Symptoms of acute low back pain frequently improve in a few weeks.
E) Ibuprofen (Motrin, Advil) or acetaminophen (Tylenol) can be used to relieve pain.

Question 22

A patient with osteomyelitis is to receive vancomycin (Vancocin)500 mg IV every 6 hours.The vancomycin is diluted in 100 mL of normal saline and needs to be administered over 1 hour.The nurse will set the IV pump for how many mL/minute? (Round to the nearest hundredth.)

Question 23

Which actions will the nurse include in the plan of care when caring for a patient with metastatic bone cancer of the left femur ?

A) Monitor serum calcium level.
B) Teach about the need for strict bed rest.
C) Avoid use of sustained-release opioids for pain.
D) Support the left leg when repositioning the patient.
E) Support family as they discuss the prognosis of patient

Question 24

In which order will the nurse implement these collaborative interventions prescribed for a patient being admitted who has acute osteomyelitis with a temperature of 101.2° F (Put a comma and a space between each answer choice [A,B,C,D].)

A) Obtain blood cultures from two sites.
B) Send to radiology for computed tomography (CT) scan of right leg.
C) Administer gentamicin (Garamycin) 60 mg IV.
D) Administer acetaminophen (Tylenol) now and every 4 hours PRN for fever.

Question 25

A nurse who works on the orthopedic unit has just received the change-of-shift report.Which patient should the nurse assess first?

A) Patient who reports foot pain after hammertoe surgery
B) Patient with low back pain and a positive straight-leg-raise test
C) Patient who has not voided 10 hours after having a laminectomy
D) Patient with osteomyelitis who has a temperature of 100.5° F (38.1° C)