Chapter 64 Nursing Management Musculoskeletal Problems

Topics: Pain, Osteoporosis, Nursing Pages: 9 (3275 words) Published: February 23, 2015
Chapter 64: Nursing Management: Musculoskeletal Problems
Test Bank
MULTIPLE CHOICE
1. A patient with acute osteomyelitis of the left femur is hospitalized for regional antibiotic

irrigation. Which intervention will be included in the initial plan of care? a. Immobilization of the left leg
b. Positioning the left leg in flexion
c. Assisted weight-bearing ambulation
d. Quadriceps-setting exercise repetitions
ANS: A

Immobilization of the affected leg helps decrease pain and reduce the risk for pathologic fractures. Weight-bearing exercise increases the risk for pathologic fractures. Flexion of the affected limb is avoided to prevent contractures.

DIF: Cognitive Level: Apply (application)
REF:
1541-1542
TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity
2. A 50-year-old patient is being discharged after a week of IV antibiotic therapy for acute

osteomyelitis in the right leg. Which information will be included in the discharge teaching? a. How to apply warm packs to the leg to reduce pain
b. How to monitor and care for the long-term IV catheter
c. The need for daily aerobic exercise to help maintain muscle strength d. The reason for taking oral antibiotics for 7 to 10 days after discharge ANS: B

The patient will be on IV antibiotics for several months, and the patient will need to recognize signs of infection at the IV site and how to care for the catheter during daily activities such as bathing. IV antibiotics rather than oral antibiotics are used for acute osteomyelitis. Patients are instructed to avoid exercise and heat application because these will increase swelling and the risk for spreading infection.

DIF: Cognitive Level: Apply (application)
REF:
1542
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity
3. A 67-year-old patient is receiving IV antibiotics at home to treat chronic osteomyelitis of the

left femur. The nurse chooses a nursing diagnosis of ineffective health maintenance when the nurse finds that the patient
a. is frustrated with the length of treatment required.
b. takes and records the oral temperature twice a day.
c. is unable to plantar flex the foot on the affected side.
d. uses crutches to avoid weight bearing on the affected leg. ANS: C

Foot drop is an indication that the foot is not being supported in a neutral position by a splint. Using crutches and monitoring the oral temperature are appropriate self-care activities. Frustration with the length of treatment is not an indicator of ineffective health maintenance of the osteomyelitis.

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DIF: Cognitive Level: Apply (application)
REF:
1542
TOP: Nursing Process: Diagnosis
MSC: NCLEX: Physiological Integrity
4. The nurse instructs a patient who has osteosarcoma of the tibia about a scheduled above-the-

knee amputation. Which statement by a patient indicates that additional patient teaching is needed?
a. “I will need to participate in physical therapy after surgery.” b. “I did not have this bone cancer until my leg broke a week ago.” c. “I wish that I did not have to have chemotherapy after this surgery.” d. “I can use the patient-controlled analgesia (PCA) to control postoperative pain.” ANS: B

Osteogenic sarcoma may be diagnosed following a fracture, but it is not caused by the injury. The other patient statements indicate that patient teaching has been effective. DIF: Cognitive Level: Apply (application)

REF:
1543
TOP: Nursing Process: Evaluation
MSC: NCLEX: Physiological Integrity
5. A 23-year-old patient with a history of muscular dystrophy is hospitalized with pneumonia.

Which nursing action will be included in the plan of care?
a. Logroll the patient every 2 hours.
b. Assist the patient with ambulation.
c. Discuss the need for genetic testing with the patient.
d. Teach the patient about the muscle biopsy procedure.
ANS: B

Because the goal for the patient with muscular dystrophy is to keep the patient active for as long as...
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