Question 1

A patient has undergone a bipolar hip repair (hemiarthroplasty). She should be instructed to

Accepted Answer

Instructing the patient not to cross the legs is important because crossing the legs can adduct the affected extremity and dislocate the hip.

Question 2

A 71-year-old patient is manifesting signs and symptoms of gout. When assessing him for signs and symptoms of gout, the nurse should pay particular attention to

Accepted Answer

Tophi (calculi containing sodium urate deposits that develop in periarticular fibrous tissue, typically in patients with gout) result in inflammation of the joint; it is unclear why this occurs. Typically the big toes are involved, but other joints can also be affected. Particular attention should be paid to foods high in purines.

Question 3

Calcium is a mineral found in many foods that can slow bone loss during the aging process. The following are high in calcium:

Accepted Answer

Fresh oranges, bananas, and eggs are not good calcium choices. Broccoli and green vegetables, as well as yogurt, are considered calcium-rich foods.

Question 4

The office nurse has noted the presence of an increase in lumbar curvature in a 20-year-old female patient. This condition is known as

Accepted Answer

Common deformities include an increase in the curve at the lumbar space region that throws the shoulder back, making the "lordly or kingly" appearance that is known as lordosis. Scoliosis involves the S curvature of the spine. Kyphosis is the rounding of thoracic spine.

Question 5

A patient's patellar-femoral cartilage has deteriorated due to arthritis. The medial and lateral cartilage is undamaged. This patient is likely to undergo _________ knee replacement surgery.

Accepted Answer

The answer of A patient's patellar-femoral cartilage has deteriorated due...

Question 6

A patient, age 72, has a left intertrochanteric fracture as a result of a fall. In planning ways to increase her safety, the nurse realizes it is most important to determine

Accepted Answer

The patient's medical and surgical history is significant, as well as any family history of bone disease. Although pain level, nutritional status, and psychosocial history are important, they are not the most important.

Question 7

The immediate medical management of any fracture is:

Accepted Answer

Immediate management includes splinting and elevation of the involved part to prevent edema. After the immediate management, analgesic for pain, application of cold to prevent edema, and observing for signs of shock must be part of the plan of care.

Question 8

Certain foods may increase the pain associated with gout. Which foods have the highest concentration of purines?

Accepted Answer

Foods high in purines, such as brain, kidney, liver and heart, should be avoided, as well as alcohol.

Question 9

When caring for the patient who is in shock, the nurse should provide

Accepted Answer

Respiratory assistance may be given by administering oxygen. IV fluids are required for rapid access to blood volume. Shock causes altered level of consciousness and does not require medication to decrease anxiety or apprehension.

Question 10

A patient, age 45, has had a left intramedullary rod placed into his left femur. He is presenting with signs and symptoms of postoperative shock. The recommended position for a person going into shock is

Accepted Answer

The patient should remain flat in bed. Avoid the Trendelenburg position because it pushes the abdominal organs against the diaphragm, affecting the lung and heart.

Question 11

Which ethnic group is at a highest risk of developing osteoporosis?

Accepted Answer

Caucasian and Asian women have a higher incidence of osteoporosis than African American women or Hispanic women.

Question 12

A 28-year-old male patient has a fractured left humerus. He has a cast on his arm. The nurse observes pallor, coolness, and a decrease in capillary refill time to his left hand and fingers. These observations are likely to indicate

Accepted Answer

Collection of objective data involves assessment of the patient's ability to flex the fingers or toes, coolness of the extremity, and absence of pulse in the affected extremity all of which indicate the impaired circulation symptomatic of compartment syndrome. Assessment of skin color for signs of pallor or cyanosis is made.

Question 13

In gangrene, there is an acute infection to the skeletal muscle. If untreated, _________ will destroy the tissue.

Accepted Answer

The answer of In gangrene, there is an acute infection...

Question 14

Rheumatoid arthritis is distinguished from osteoarthritis in that:

Accepted Answer

RA is thought to be an autoimmune disorder. Degenerative joint disease is also known as osteoarthritis.

Question 15

A patient, age 44, has chronic osteomyelitis. He should be taught to

Accepted Answer

The patient must avoid trauma to the affected bone because pathological fracture is common.

Question 16

The patient, age 58, is diagnosed with osteoporosis after densitometry testing. She has been menopausal for 5 years and has been concerned about her risk for osteoporosis because her mother has osteoporosis. In teaching her about her osteoporosis, which information does the nurse include?

Accepted Answer

To prevent osteoporosis, women are advised to have an adequate daily intake of calcium and vitamin D; exercise regularly; avoid smoking; decrease coffee intake; decrease excess protein in the diet; and engage in regular moderate activity such as walking, bike riding, or swimming at least 3 days a week. A contributing factor may be use of steroids.

Question 17

A patient, age 64, has osteoarthritis of the left hip. He has had a left total hip replacement. The nurse should

Accepted Answer

The use of incentive spirometers is valuable in assisting the patient to perform adequate respiratory ventilation to prevent pneumonia.

Question 18

Prolonged bed rest puts the older adult at risk for

Accepted Answer

Immobilization results in bone resorption, and the bone tissue becomes less dense. Prolonged bed rest puts the patient at risk for pathological fracture. This is a serious concern for an older adult in terms of regaining mobility.

Question 19

A 76-year-old female patient is being seen for osteoarthritis of the knee in the clinic. In discussing strengthening exercises, which exercises would you recommend?

Accepted Answer

Bicycling or swimming is recommended for osteoarthritis of the hip or knee. Jogging would put undue stress on knee joints. Climbing stairs should be avoided. Walking should be done on level ground, not up or down elevations.

Question 20

The patient is a 20-year-old who has suffered a compound fracture of the femur. The nurse would expect the physician to order ____ intramuscularly.

Accepted Answer

Administration of tetanus toxoid is an additional medical measure for compound fracture of the femur.

Quiz 4: Care of the Patient With a Musculoskeletal Disorder

A patient has undergone a bipolar hip repair (hemiarthroplasty) . She should be instructed to