N4 test Musculoskeletal Problems

Ignatavicius & Workman: Medical-Surgical Nursing: Critical Thinking for Collaborative Care, 4th Edition
Chapter 51: Interventions for Clients with Musculoskeletal Problems

1. With which of the following clients would you be alert to the possibility of osteoporosis?

A. Premenopausal, thin woman
B. Postmenopausal, thin woman
C. Premenopausal, obese woman
D. Postmenopausal, obese woman

2. Which of the following exercises for reduction of bone loss should you recommend to the client at risk for osteoporosis?

A. Walking a half mile each day
B. Bowling two hours twice a week
C. Swimming 30 minutes three times a week
D. Participating in abdominal isometrics and deep breathing daily

3. The client is taking sodium fluoride as drug therapy for osteoporosis. Which of the following clinical manifestations alerts the nurse to a complication of this therapy?

A. Severe back and flank pain
B. Joint pain and swelling
C. Calf pain and swelling
D. Epigastric pain

4. Which of the following clients with chronic conditions would be most likely to have osteomalacia?

A. Woman with congestive heart failure taking digoxin and HydroDIURIL
B. Woman with asthma taking cortisol inhalant and oral contraceptives
C. Man with a seizure disorder taking anticonvulsants and barbiturates
D. Man with diabetes mellitus taking insulin and niacin

5. Which of the following assessment findings would you expect to see in a client with Paget’s disease?

A. Cool, dry skin
B. Spider angiomas
C. Enlarged, thick skull
D. Thickened, red tongue

6. The client, a 75-year-old man with diabetes, suffered a broken wrist and deep abrasions on his hand when attempting to break a fall. The client was discharged to his home after his wrist was set and the hand wound cleansed and dressed. On a follow-up visit two days later, you find the client to have greatly increased wrist pain and a fever of 102°. What is your first action?

A. Elevate the wrist.
B. Notify the physician.
C. Administer 800 mg of ibuprofen.
D. Cleanse and redress the hand wound.

7. Which nursing diagnosis would be considered the priority for a client with a diagnosis of bone cancer?

A. Acute and chronic pain
B. Disturbed body image
C. Spiritual distress
D. Fear and anxiety

8. The client who has just had an amputation for bone cancer is crying as the nurse enters the room. When the nurse asks why he is crying the client responds “I know I shouldn’t cry because this surgery may well save my life, but I was always such an athlete before and I know that things will not be the same.” What is your best response?

A. “It is all right to cry. Mourning this loss is important in getting past this point.”
B. “You’re right. It is silly to carry on like this when a prosthesis is available.”
C. “Would you like to talk to someone who also has had an amputation?”
D. “You may still be able to participate in sports even though your leg is gone.”

9. You are preparing the family of a client with metastatic bone cancer to care for the client at home. Which of the following interventions would you recommend the family implement prior to the client’s discharge?

A. Remove all scatter rugs from the floors.
B. Limit the amount of fluids taken with meals.
C. Administer pain medication only when needed.
D. Maintain the client in a supine position as much as possible.

10. Which statement made by the client with metastatic bone cancer indicates an understanding of adequate symptom management? “I will:

A. rest in bed as much as possible.”
B. no longer require physical therapy.”
C. take my pain medication around the clock.”
D. not worry my family by talking about my fears.”

11. The client complains of numbness and pain of the first three fingers and the palm of the right hand. The nurse suspects carpal tunnel syndrome. Which of the following occupations supports this possible diagnosis?

A. Staff nurse on a general medical-surgical nursing unit
B. Postal delivery person
C. Concert pianist
D. Truck driver

12. Which of the following statements made by the client undergoing conservative management for carpal tunnel syndrome alerts the nurse to the need for clarification of the treatment regimen?

A. “I will perform as many tasks as possible using my hands and wrists to maintain muscle strength.”
B. “If my fingers become cool and pale, I will loosen my wrist splint.”
C. “If the numbness increases, I will notify my doctor.”
D. “I will take the prescribed NSAIDs with food.”

13. The 50-year-old client has just been diagnosed with plantar fasciitis. Of the following conditions of her life, which one may have been a contributing factor?

A. Recovering from a viral infection
B. Weighing 50 lbs more than ideal weight
C. Having a sister with the same problem
D. Wearing shoes that are too short or too narrow

14. Which nursing intervention would best assist the client in preventing complications of muscular dystrophy?

A. Placing a pillow between the client’s knees when sleeping
B. Assisting the client with range-of-motion exercises
C. Monitoring the client’s intake and output
D. Administration of corticosteroid