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    Exam Review

    1. A client consults the healthcare provider about persistent joint pain and stiffness. Which laboratory value is used as a diagnostic indicator of rheumatoid arthritis?
      A)
      Uric acid level
      B)
      Rheumatoid factor
      C)
      Myoglobin
      D)
      Erythrocyte sedimentation rate (ESR)
    2. The visiting nurse is seeing a client with bilateral hand pain, boutonniere and swan-neck deformities of bilateral hands. The patient complains about occupational therapy tell her to exercise her hands daily. The LPN should say which of the following to encourage the client to exercise?
      A)
      "Exercise should be vigorous for joint stimulation"
      B)
      "Exercise will allow you to sleep better"
      C)
      "Exercise is unnecessary"
      D)
      "Exercise will keep the joints from 'freezing'"
    3. A nurse is assisting with the care of a client who has impaired mobility. The client is admitted to the rehabilitation unit following a hip arthroplasty. The client has limited mobility and requires assistance to turn and transfer out of bed. Nurses Notes: Client is alert and oriented. Voided 400 mL of clear yellow urine into a bed pan. Hip dressing is dry and intact. Abdomen soft, nondistended, bowel sounds hypoactive. Which words accurately complete this sentence: The client is at highest risk for developing ▾ pressure injuryas evidenced by the client's▾ limited mobility.
      Dropdown 1:
      Option 1: pressure injury
      Option 2: limited mobility
      Option 3: Urinary tract infection
      Option 4: bowel sounds
      Option 5: urine color
      Option 6: Urinary stasis
      Option 7: neuro status
      Option 8: joint contracture
      Dropdown 2:
      Option 1: pressure injury
      Option 2: limited mobility
      Option 3: Urinary tract infection
      Option 4: bowel sounds
      Option 5: urine color
      Option 6: Urinary stasis
      Option 7: neuro status
      Option 8: joint contracture
    4. A nurse is caring for a client who has skeletal traction for treatment of a femur fracture. Which action should the nurse take?
      A)
      Clean the pin sites daily
      B)
      Position the weights on the traction so they are touching the head of the client's bed
      C)
      Encourage isometric exercises every 8 hours
      D)
      Assist the client to shift position every 4 hours
    Page 1 of 13

    Exam Review

    1. A client reports to their primary health care provider with a suspected diagnosis of a herniated disk. The primary health care provider has ordered the patient to have an MRI done. The nurse knows that the patient can not have an MRI due to which of the following?
      A)
      Allergy to contrast dye and shellfish
      B)
      Cardiac pacemaker
      C)
      a recent cancer diagnosis
      D)
      Shortness of breath
    2. A nurse is monitoring a client who has a cast on their right ankle following an open reduction and internal fixation procedure. The nurse should monitor for which findings that indicate compartment syndrome?
      A)
      Decreased oxygen saturation
      B)
      Dyspnea and bibasilar crackles
      C)
      Pain unrelieved by routine medications
      D)
      Elevated leukocyte count
    3. A nurse is caring for a client who has a new cast in place for a fractured tibia. The nurse should recognize that which intervention is a PRIORITY?
      A)
      Assess capillary refill distal to the client's cast
      B)
      Discuss cast care with the client
      C)
      Apply lotion to the skin around the client's cast
      D)
      Inspect the client's cast for cracks
    4. The nurse monitors a client for signs and symptoms of aspirin toxicity. Which assessment finding indicates possible aspirin toxicity?
      A)
      Tinnitus
      B)
      Vertigo
      C)
      Jaundice
      D)
      Proteinuria
    Page 2 of 13

    Exam Review

    1. The following are risk factors for developing osteoporosis (Select all that apply) Multiple options may be correct
      (SATA)
      A)
      high caffeine intake
      B)
      skinny
      C)
      Vitamin D deficiency
      D)
      overweight
      E)
      menstruating
    2. Prevention of osteoporosis can be facilitated by all of the following: Multiple options may be correct
      (SATA)
      A)
      Vitamin E
      B)
      Ibandronate
      C)
      Calcium
      D)
      Vitamin C
      E)
      Phosphorus
      F)
      Magnesium
      G)
      Glucosamine
      H)
      Vitamin D
    3. The client has had lumbar laminectomy and requires pain medication. The licensed prescriber has ordered codeine 60 mg PO q 3 hours PRN moderate to severe pain. The client is reporting a pain score of 8 out of 10. They available drug is codeine 30 mg per tablet. How many tablets whole number. Do not include any labels)
    4. A client has sustained multiple soft tissue injuries from a bicycle accident. Primary medical management for soft tissue injuries includes:
      A)
      Rest and heat to control edema
      B)
      Elevation and ice to control edema
      C)
      Maintain the limb in a dependent position
      D)
      Aspiration of fluid to ease edema
    Page 3 of 13

    Exam Review

    1. A client comes to the orthopedic physician's office with a complaint of "water on the knee" the physician has told the LPN in the office to prepare the client for an arthrocentesis. What statement by the nurse is incorrect for patient education of arthrocentesis?
      A)
      "Medication can be infused into the joint during this procedure
      B)
      "This procedure will relieve the pressure in your knee
      C)
      "There is a risk of infection after this procedure"
      D)
      "You will need to increase your fluid intake to clear your kidneys of the dye"
    2. The LPN knows that a patient with which type of fracture is at the highest risk of infection?
      A)
      Comminuted
      B)
      Displaced
      C)
      Open
      D)
      Greenstick
    3. The visiting nurse is seeing a patient with osteomyelitis that is being treated with antibiotics. Which statement by the patient does not indicate the need for more teaching?
      A)
      "I can stop taking the antibiotics once the pain and redness are gone"
      B)
      "I will need to take these antibiotics for a long time, maybe 12 weeks"
      C)
      “This is a superficial infection that is easy to treat"
      D)
      "Once the swelling goes down my antibiotics can be switched from IV to oral"
    4. A client has returned from a myelogram. The LPN caring for the patient knows that which of the following interventions is the MOST important after this procedure?
      A)
      Providing the patient with pain medication
      B)
      Apply a new dressing over the puncture site
      C)
      Allowing the patient to laydown and rest
      D)
      Increasing PO fluid intake
    Page 4 of 13

    Exam Review

    1. A client who sustained a fall at a long-term care facility is suspected of having a fractured right hip. Which assessment findings support the belief that the client has a fractured hip? (Select all that apply)
      A)
      The right leg is longer than the left
      B)
      The right leg is shorter than the left
      C)
      The client's right leg is abducted
      D)
      The client's right foot is externally rotated
      E)
      The right hip is bruised and swollen
    2. Treatment for rheumatoid arthritis includes all of the following? Multiple options may be correct
      A)
      corticosteroids
      B)
      Disease modifying antirheumatic drugs
      C)
      Methotrexate
      D)
      Allopurinol
      E)
      Alendronate
      F)
      Doxycycline
    3. A client mentions that they are postmenopausal and not taking estrogen supplements. A review of their normal dietary intake reveals high caffeine consumption. Based on this history, the nurse knows the client faces an increased risk of what condition?
      A)
      Osteomyelitis
      B)
      Osteoarthritis
      C)
      Rheumatoid arthritis
      D)
      Osteoporosis
    4. A client with a hip fracture asks the nurse what is involved with Buck's traction, which is being applied before surgery. The nurse would provide which information to the client?
      A)
      Provides rigid immobilization of the fracture site and involves pulleys and wheels
      B)
      Allows bony healing to begin before surgery and involves pins and screws
      C)
      Lengthens the fractured leg to prevent severing of blood vessels and involves pins and screws
      D)
      Provides comfort by reducing muscle spasms, provides fracture immobilization, and involves pulleys and wheels
    Page 5 of 13

    Exam Review

    1. A neurovascular exam includes: (Select all that apply)
      A)
      petechia
      B)
      increased pain
      C)
      edema
      D)
      cold and pale
      E)
      numbness/tingling
      F)
      warmth
    2. A visiting nurse is reviewing with a patient hip replacement precautions. What statement by the patient demonstrates the need for further teaching?
      A)
      "I need to use this annoying wedge pillow between my legs when I sleep"
      B)
      "I can cross my legs if it is comfortable and doesn't hurt"
      C)
      "I can walk a little bit every day, it is good for me"
      D)
      "I need to use a toilet riser"
    3. The LPN is caring for a patient with a femur fracture from a fall that occurred 18 hours ago. The patient is in Bucks traction awaiting surgery in the morning. At the 4 am assessment of the patient they are newly confused, anxious, with dyspnea. The LPN suspects what complication?
      A)
      COPD exacerbation
      B)
      Acute asthma attack
      C)
      Compartment syndrome
      D)
      Fat embolism
    4. A nurse is talking about joint protection strategies with an older adult client who has osteoarthritis. Which recommendation should the nurse reinforce?
      A)
      Jog or run three times a week
      B)
      Reduce the amount of purine in the diet
      C)
      Choose soft, pillowed chairs for sitting
      D)
      Maintain the recommended body weight
    Page 6 of 13