Nclex-Rn Practice Questions-Care Of The Adult - Musculoskeletal Disorders Part 1
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Question 1 |
The nurse is performing an assessment on a client with a diagnosis of osteoarthritis. Which of the following clinical manifestations would the nurse expect to find?
A | Elevated sedimentation rate |
B | Multiple subcutaneous nodules |
C | Asymmetrical joint involvement |
D | Signs and symptoms of inflammation, such as heat, fever, and malaise |
Question 2 |
The client asks the nurse for information about osteoarthritis. What is the most appropriate information for the nurse to include about the disease?
A | It is a systemic inflammatory joint disease. |
B | It is a disease involving fusion of the joints in the hands. |
C | It is an inflammatory joint disease, with degeneration and loss of articular cartilage in synovial joints. |
D | It is a noninflammatory joint disease, with degeneration and loss of articular cartilage in synovial joints. |
Question 3 |
The most appropriate clothing for a client with osteoarthritis would be?
A | Zippered clothing |
B | Tied shoes to promote stability |
C | Velcro clothing, slip-on shoes, and rubber grippers |
D | Buttoned clothing, slip-on shoes, and rubber grippers |
Question 4 |
The nurse is caring for a client with osteoarthritis who is refusing to perform independent care. What is the most important nursing intervention for this client?
A | Perform the care for the client. |
B | Explain to the client the purpose to maintain complete independence. |
C | Encourage and support the client to perform as much self-care that the pain will allow. |
D | Inform the client that once the care has been completed independently, she will receive pain medication. |
Question 5 |
The nurse asks a client in the late stages of osteoarthritis to describe the joint pain the client is currently experiencing. The nurse anticipates that the client will describe the pain as:
A | grating. |
B | a dull ache. |
C | a dull and deep aching pain. |
D | deep aching relieved only with rest. |
Question 6 |
A client is admitted to the medical-surgical unit for osteoarthritis and weakness in the left lower extremity. The client uses a walker at home. The health care provider ordered a cane and physical therapy for the client. The client asks the nurse about the difference between the cane and walker. What is the best response by the nurse?
A | A walker is a better choice than a cane. |
B | The cane should be used on the affected side. |
C | The cane should be used on the unaffected side. |
D | A client with osteoarthritis should be encouraged to ambulate without the cane. |
Question 7 |
The nurse is providing discharge teaching for a client with osteoarthritis. What is the most important information for the nurse to include?
A | Learn to pace activity. |
B | Remain as sedentary as possible. |
C | Return to a normal level of activity. |
D | Include vigorous exercise in your daily routine. |
Question 8 |
Which of the following nursing diagnoses would the nurse select as a priority for this client?
A | Disturbed sleep pattern |
B | Ineffective coping |
C | Risk for infection |
D | Acute pain |
Question 9 |
A client is diagnosed with a herniated nucleus pulposus (herniated disk). Which of the following statements should the nurse include in teaching the client about a herniated disk?
A | The disk slips out of alignment. |
B | The disk shatters, and fragments place pressure on nerve roots. |
C | The nucleus tissue itself remains centralized, and the surrounding tissue is displaced. |
D | The nucleus of the disk puts pressure on the annulus, causing pressure on the nerve root. |
Question 10 |
A client asks the nurse, “What is the difference between rheumatoid arthritis and osteoarthritis?” What is the most appropriate response by the nurse?
A | Osteoarthritis is gender specific; rheumatoid arthritis is not. |
B | Osteoarthritis is a systemic disease; rheumatoid arthritis is localized. |
C | Osteoarthritis is a localized disease; rheumatoid arthritis is systemic. |
D | Osteoarthritis has dislocations and subluxations; rheumatoid arthritis does not. |
Question 11 |
The health care provider prescribed salicylates for a client with osteoarthritis. The nurse assesses the client and determines further intervention is necessary when the client exhibits which of the following?
A | Hearing loss |
B | Increased pain in joints |
C | Decreased calcium absorption |
D | Increased bone demineralization |
Question 12 |
The nurse is caring for a client with osteoarthritis of the knee. The nurse determines that discharge teaching has been effective when the client makes which statement?
A | “I’ll take my ibuprofen (Motrin) on an empty stomach.” |
B | “I’ll try taking a warm shower in the morning.” |
C | “I’ll wear my knee splint every night.” |
D | “I’ll jog at least a mile every morning.” |
Question 13 |
Which of the following are causes of primary osteoarthritis?
A | Overuse of joints, aging, and obesity |
B | Obesity, aging, and diabetes mellitus |
C | Congenital abnormality, aging, overuse of joints |
D | Diabetes mellitus, congenital abnormality, aging |
Question 14 |
The nurse is teaching the client about the primary cause of osteoporosis. What is the most important information for the nurse to provide?
A | “Alcoholism is the primary cause of osteoporosis.” |
B | “Malnutrition is the primary cause of osteoporosis.” |
C | “Hormonal imbalance is the primary cause of osteoporosis.” |
D | “Osteogenesis imperfecta is the primary cause of osteoporosis.” |
Question 15 |
The health care provider has prescribed indomethacin (Indocin) for a client with gout. What is the most important information for the nurse to give the client about nonsteroidal anti-inflammatory drugs (NSAIDs)?
A | “Bleeding is not a problem with NSAIDs.” |
B | “Take NSAIDs with food to avoid an upset stomach.” |
C | “Take NSAIDs on an empty stomach to increase absorption.” |
D | “Don’t take NSAIDs at bedtime because they may cause excitement.” |
Question 16 |
The nurse is teaching a class on primary prevention of osteoporosis. What is the most important information for the nurse to provide?
A | Maintain the optimal calcium intake. |
B | Place items within reach of the client. |
C | Install bars in the bathroom to prevent falls. |
D | Use a professional alert system in the home in case a fall occurs when the client is alone. |
Question 17 |
Which of the following statements by a client diagnosed with gout indicates that the client understands the discharge instructions?
A | “I’ll increase my fluids so that the inflammation will be reduced.” |
B | “Increasing fluid intake will increase the calcium my body absorbs.” |
C | “Increasing fluid intake will cause my body to excrete more uric acid.” |
D | “Increasing fluids will help provide a cushion for my bones.” |
Question 18 |
The health care provider informs the client diagnosed with gout that his Xrays are normal. Which of the following statements by the health care provider would be most appropriate when the client asks if he still has gout?
A | “No, you’re cured.” |
B | “Yes, X-rays are unreliable.” |
C | “Yes, X-rays are normal in the early stages of gout.” |
D | “Yes, X-ray changes are only seen with acute attacks.” |
Question 19 |
The nurse is providing discharge teaching for a client who was hospitalized with gout. The nurse determines that teaching was effective when the client states the need to reduce the intake of:
A | tofu. |
B | liver. |
C | tomatoes. |
D | blackberries. |
Question 20 |
The nurse has provided teaching to a client who has been newly diagnosed with gout. The nurse evaluates that teaching has been effective when the client makes which statement?
A | “Weight loss will decrease purine levels.” |
B | “Weight loss will decrease inflammation.” |
C | “Weight loss will increase uric acid levels and decrease stress on joints.” |
D | “Weight loss will decrease uric acid levels and decrease stress on joints.” |
Question 21 |
A nurse is interviewing a client who has a pattern of nonchronic gout. Which statement by the client best describes the pattern of nonchronic gout?
A | Frequent painful attacks |
B | Generally painful joints at all times |
C | Painful attacks with pain-free periods |
D | Painful attacks with less painful periods, but pain never subsides |
Question 22 |
The nurse is planning interventions for a client with an acute gout attack. What would the priority intervention for this client be?
A | Instruct the client on relaxation techniques and promote bed rest. |
B | Instruct the client about relaxation techniques. |
C | Administer prescribed analgesics. |
D | Force fluids. |
Question 23 |
A nurse is caring for the client who is 2 days postoperative and complaining of severe pain in the left leg. The nurse administers the prescribed morphine sulfate, 2 mg I.V. The client continues to complain of severe pain. The nurse assesses the client’s left leg and finds the extremity cool to touch with absent pulses and a capillary refill greater than 3 seconds. What is the priority action of the nurse?
A | Notify the health care provider. |
B | Document the clinical findings. |
C | Readminister the prescribed morphine sulfate. |
D | Reassess the left lower extremities within 1 hour. |
Question 24 |
A client was prescribed an anti-inflammatory drug for osteoarthritis 5 days ago. The client says the pain has decreased a little but not completely. Which of the following nursing interventions would be the most appropriate?
A | Notify the health care provider and suggest increasing the dose. |
B | Notify the health care provider and suggest stopping the medication. |
C | Notify the health care provider and suggest adding another medication. |
D | Continue the present dose and offer other pain relief measures. |
Question 25 |
The nurse is performing an admission assessment on a client with osteoarthritis. Which of the following clinical manifestations would the nurse expect to find?
A | Joint pain after exercise relieved by rest |
B | Symmetrical swelling of the joints of both hands |
C | Morning stiffness lasting longer than 30 minutes |
D | Fever |
Question 26 |
A 42-year-old client recently had a total hysterectomy and bilateral oophorectomy. Which of the following responses by the client indicates that the nurse’s teaching about osteoporosis has been effective?
A | “Osteoporosis affects only women over 65 years.” |
B | “My risk for osteoporosis is low because I still have my thyroid gland.” |
C | “I’m still producing hormones, so I don’t have to worry about osteoporosis.” |
D | “I need to take precautions to protect myself from osteoporosis because I have had surgically induced menopause.” |
Question 27 |
A client asks the nurse for information about osteoarthritis. What is the most appropriate information for the nurse to include?
A | Osteoarthritis is rarely debilitating. |
B | Osteoarthritis is a rare form of arthritis. |
C | Osteoarthritis afflicts people over age 60. |
D | Osteoarthritis is the most common form of arthritis. |
Question 28 |
A 69-year-old client is admitted to the medical-surgical unit for osteoarthritis. During the health history, the nurse learns that the client has been on prolonged bed rest. What is the most appropriate nursing intervention for this client?
A | Encourage and educate coughing and deep breathing and limit fluid intake. |
B | Turn the client every 2 hours and encourage coughing and deep breathing. |
C | Provide only passive range of motion (ROM) and decrease stimulation. |
D | Have the client lie as still as possible and give adequate pain medicine. |
Question 29 |
A 70-year-old female client complains of lower back pain and is diagnosed with osteoporosis. The nurse is aware that this client is most at risk for which condition?
A | Pain |
B | Fracture |
C | Hardening of the bones |
D | Increased bone matrix and remineralization |
Question 30 |
A 76-year-old woman with a history of osteoporosis experienced a right hip fracture and is admitted to the hospital. The client had a total hip replacement. The most important nursing diagnosis for this client would be?
A | Acute pain |
B | Self-care deficit |
C | Risk for impaired skin integrity |
D | Imbalanced nutrition: Less than body requirements |
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