Exam Review

A nurse in a community clinic is caring for a 20-month-old toddler who has spiral fractures of the right ulna and radius. Which of the following findings should the nurse recognize as a potential indication of abuse?
A)
The child begins to cry when her arm is examined by the provider.
B)
The child's examination shows a single injury.
C)
The child was brought to the facility 30 min after the injury occurred.
D)
The parents report that the child injured herself by falling off the couch.
A nurse is assisting with the care of a client who has a femur fracture and is in skeletal traction. Which of the following actions should the nurse take?
A)
Loosen the knots on the ropes if the client is experiencing pain.
B)
Check the client's bony prominences every 12 hr.
C)
Cleanse the client's pin sites with povidone-iodine.
D)
Ensure the client's weights are hanging freely from the bed.
While collecting data from a client who has a cast on his right leg, a nurse locates an area on the cast that feels warm to the touch. Which of the following findings should the nurse identify as a complication to the client's condition?
A)
Uneven cast drying
B)
Pressure from the cast
C)
Infection
D)
Poor circulation
A nurse is reinforcing teaching with a client who is to start taking methotrexate to treat rheumatoid arthritis. Which of the following instructions should the nurse include in the teaching?
A)
Drink at least 2 L (66.7 oz) of water per day.
B)
Use a commercial mouthwash after each meal.
C)
Take the medication every day.
D)
Avoid eating foods high in vitamin K.

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Exam Review

An older adult client on an orthopedic unit has an intracapsular fracture of the right hip following a fall. The client is in Buck's traction and will have hip prosthesis surgery in the morning. The nurse should reinforce with the client that this type of traction promotes which of the following outcomes?
A)
Support for moving the extremity
B)
Reduction of the fracture
C)
Alignment of the pins
D)
Relief from muscle spasms
A nurse is reviewing the health history of a client who has osteoporosis. Which of the following medications in the client's history contributes to osteoporosis?
A)
Glucocorticoid
B)
NSAID
C)
Oral antidiabetic
D)
Cardiac glycoside
A nurse in a clinic is reinforcing teaching to a client who is postmenopausal about the prevention of osteoporosis. Which of the following statements by the client requires clarification of the teaching?
A)
"I will eat a moderate amount of high-fiber foods."
B)
"I will decrease the amount of sodium in my diet."
C)
"I will decrease the number of cups of coffee I drink daily."
D)
"I will include vitamin E rich foods in my diet."
A nurse is reinforcing teaching with a client who is about to start taking allopurinol to treat gout. Which of the following statements by the client indicates an understanding of the teaching?
A)
"I should take the medicine on an empty stomach.
B)
"I will expect to develop a fever while taking this medicine."
C)
"I need to drink at least 3 quarts of water a day."
D)
"If I get a rash, I will take my usual antihistamine."

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Exam Review

A nurse in a long-term care facility finds an older adult client lying on the floor next to the bed. Which of the following actions should the nurse take?
A)
Check the client for injuries.
B)
Assist the client back into bed and apply restraints.
C)
Obtain a prescription for medication to sedate the client.
D)
Call the family and ask them to make arrangements for someone to sit with the client.
A nurse is collecting data from a client who has multiple fractures in his left leg and reports severe pain and tingling in the extremity. The nurse should suspect which of the following complications?
A)
Fat embolism syndrome
B)
Pulmonary embolism
C)
Acute compartment syndrome
D)
Osteomyelitis
A nurse is assisting a client with range-of-motion exercises of the hands and wrists. Which of the following terms should the nurse use when documenting the client making a fist with her hand?
A)
Flexion
B)
Adduction
C)
Extension
D)
Abduction
A nurse is caring for four clients on a surgical unit. Which of the following tasks should the nurse delegate to the assistive personnel (AP)?
A)
Collect health history data from a client in Buck's traction for a fracture of the right hip.
B)
Reinforce discharge teaching with a client who is 1 day postoperative following a total knee arthroplasty
C)
Assist a client to a chair who is 2 days postoperative following a cervical laminectomy.
D)
Administer pain medication to a client who has skeletal traction of the tibia

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Exam Review

A nurse is contributing to the plan of care for an older adult client who is postoperative following a right hip arthroplasty. Which of the following interventions should the nurse include in the plan?
A)
Perform the client's personal care activities for her.
B)
Limit the client's fluid intake.
C)
Maintain abduction of the right hip.
D)
Monitor the Homan's sign.
A home health nurse is caring for a client who has emphysema and has difficulty with mobility. The client spends most of his day in a reclining chair. Which of the following physiological responses to prolonged immobility should the nurse expect?
A)
Increased calcium excretion
B)
Decreased sodium excretion
C)
Increased insulin production
D)
Decreased RBC production
A nurse is completing a neurovascular check for a client who had an open reduction internal fixation surgery. Which of the following findings should the nurse identify as possible manifestations of compartment syndrome? (Select all that apply.)
A)
Altered sensation of the toes
B)
Absence of pulse
C)
Pain relieved by narcotics
D)
Cool skin
E)
Capillary refill 1 second
A nurse is reinforcing dietary teaching to a client who is at risk for osteoporosis about increasing her calcium intake. Which of the following foods should the nurse recommend the client consume frequently?
A)
Carrots
B)
Collards
C)
Zucchini
D)
Potatoes

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Exam Review

A nurse is reinforcing teaching about cast care to a school-age child following application of a fiberglass cast for a radius fracture. Which of the following statements by the child indicates an understanding of the teaching?
A)
"I should expect some tingling in my fingertips the first few days."
B)
"I can put an ice pack on the areas of my cast that itch."
C)
"I should expect the cast to be dry in 2 days."
D)
"I can let my arm hang down for 1 hour at a time every 4 hours."
A nurse is caring for a client who has been placed in halo traction to immobilize his cervical spine. Which of the following actions should the nurse take?
A)
Place the client in a supine position.
B)
Apply a pelvic girdle.
C)
Elevate the head of the bed.
D)
Elevate the foot of the bed.
A nurse is reinforcing teaching with a client who has a new diagnosis of gout. Which of the following information should the nurse include in the teaching?
A)
Limit fluids to 1500 mL per day.
B)
Aspirin is used in the treatment of gout pain.
C)
Avoid consuming shellfish.
D)
Increase exercises to the affected joint.
A nurse in an urgent care center is caring for a child who has a forearm fracture. The parent tells the nurse that the provider said it was a greenstick fracture and asks what that means. Which of the following descriptions should the nurse provide?
A)
"Fragments of bone have splintered into the surrounding tissue."
B)
"The bone ends have been forced toward each other."
C)
"The sharp edge of the bone has broken through the skin."
D)
"The bone cracked lengthwise but didn't break all the way through."

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Exam Review

A nurse is contributing to the plan of care for a client to achieve the outcome of functional healing of a fracture. Which of the following nursing interventions is the highest priority to assist in meeting this outcome?
A)
Maintain immobilization and alignment for the client.
B)
Provide optimal nutrition and hydration for the client.
C)
Promote independence in activities of daily living for the client.
D)
Provide relief from pain and discomfort for the client.
A nurse is collecting data from a client following the application of a leg cast for the treatment of a fracture. Which of the following findings should the nurse expect to find first if the cast is too tight?
A)
Toes cool to touch
B)
Edema of the toes
C)
Inability to move toes
D)
Pallor of the toes
A nurse should reinforce teaching about how to use a three-point gait for which of the following clients requiring crutches?
A)
A client who is able to bear full weight on both lower extremities
B)
A client who has bilateral leg braces due to paralysis of the lower extremities
C)
A client who has bilateral knee replacements with partial weight bearing on both legs
D)
A client who has a right femur fracture with no weight bearing on the affected leg
A nurse is collecting data on a client who has a femur fracture. Which of the following findings is a manifestation of fat embolism syndrome?
A)
A drop in the client's temperature
B)
Swelling below the client's injury
C)
Petechiae over the client's chest
D)
Reduced pulses distal to the client's fracture

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