Even Week Pretest b.

"You'll have to accept the fact that you're

permanently paralyzed."
c. "It must be hard to accept the permanency of
NEUROLOGIC AND MUSCULOSKELETAL NURSING your paralysis."
d. "You'll first regain use of your legs and then
1. A client with an inflammatory ophthalmic your arms."
disorder has been receiving repeated courses of a
corticosteroid ointment, nurse suspects that these 6. A client with quadriplegia is in spinal shock.
symptoms represent: ½" in the lower conjunctival What should the nurse expect?
sac four times a day as directed. The client reports a. Absence of reflexes along with flaccid
a headache and blurred vision. The nurse suspects extremities
that these symptoms represent: b. Positive Babinski's reflexes along with spastic
extremities
a. Common adverse effects of corticosteroid c. Hyperreflexia along with spastic extremities
therapy d. Spasticity of all four extremities
b. Expected drug effects that should diminish over
time 7. A physician diagnoses a client with myasthenia
c. Incorrect ointment application gravis, prescribing pyridostigmine (Mestinon),
d. Increased intraocular pressure 60mg PO every 3 hours. Before administering this
anticholinesterase agent, the nurse reviews the
2. A client is thrown from an automobile during a client's history. Which pre-existing condition
collision. The nurse knows that the client will be would contraindicate the use of prostigmine?
able to maintain gross arm movements and a. Ulcerative colitis
diaphragmatic breathing if the injury occurs at b. Blood dyscrasia
what vertebral level? c. Intestinal obstruction
a. C4 d. Spinal cord injury
b. C5
с. СЗ 8. A client complains of periorbital aching, tearing,
d. C7 blurred vision, and photophobia in her right eye.
Ophthalmologic examination reveals a small,
3. The nurse is assisting during a lumbar puncture. irregular, nonreactive pupil a condition resulting
How should the nurse position the client for this from acute iris inflammation (iritis). As part of the
procedure? client's therapeutic regimen, the physician
a. Prone, with the head turned to the right prescribes atropine sulfate (Atropisol), two drops
b. Supine, with the knees raised toward the chest of 0.5% solution in the right eye twice daily.
c. Lateral recumbent, with chin resting on Atropine sulfate belongs to which drug
flexed knees classification?
d. Lateral, with right leg flexed a. Parasympathomimetic agent
b. Sympatholytic agent
4. A client who's receiving phenytoin (Dilantin) to c. Adrenergic blocker
control seizures is admitted to the health care d. Cholinergic blocker
facility for therapeutic observation. The physician
orders measurement of the client's serum 9. After a cerebrovascular accident (CVA), a 75-
phenytoin level. Which serum phenytoin level is year old client is admitted to the facility. The client
therapeutic? has left-sided weakness and an absent gag reflex.
a. A level below 5mcg/MI He's incontinent and has a tarry stool. His blod
b. 10 to 20mcg/mL pressure is 90/50mmHg, and his hemoglobin is
c. 25 to 35mcgmL 10g. Which of the following is a priority for this
d. 40 to 50mcg/mL client?
a. Checking stools for occult blood
5. A client with Guillain-Barre syndrome has b. Performing range-of-motion (ROM) exercises to
paralysis affecting the respiratory muscles and the left side
requires mechanical ventilation. When the client c. Keeping the skin clean and dry
asks the nurse about the paralysis, how should the d. Elevating the head of the bed to 30 degrees
nurse respond?
a. "You may have difficulty believing this, but
the paralysis caused by this disease is
temporary."
10. The nurse is assessing a geriatric client with about warning signs and symptoms of
senile dementia. Which neurotransmitter hemorrhage. Which complaint is a possible
condition is most likely to contribute to this indicator of cerebral hemorrhage in this client?
client's cognitive changes? a. Frontal headache
a. Decreased acetylcholine level b. Nausea
b. Increased acetylcholine level c. Vertigo
c. Increased norepinephrine level d. Tinnitus
d. Decreased norepinephrine level
17. When communicating with a client who has
11. The physician suspects myasthenia gravis in a sensory (receptive) aphasia, the nurse should:
client with chronic fatigue, muscle weakness, and a. Allow time for the client to respond
ptosis. Myasthenia gravis is associated with: b. Speak loudly and articulate clearly
a. Thyroid disorders c. Give the client a writing pad
b. Poor nutrition d. Use short, simple sentences
c. Chemotherapy
d. A viral infection 18. A client with idiopathic selzure disorder is
being discharged with a prescription for
12. The nurse is working on the surgical floor. phenytoin (Dilantin), Client teaching about this
The nurse must logroll a client following a: drug should include which instruction?
a. Laminectomy a. "Discontinue this medication after you've been
b. Thoracotomy seizure-free for 2 weeks."
c. Hemorrhoidectomy b. "Do't drive a car or operate machinery while
d. Cystectomy taking this medication."
c. "Schedule follow-up visits with your
13. A client who has been severely beaten is physician for blood tests."
admitted to the emergency department. The nurse d. "Be aware that this drug may make your heart
suspects a basilar fracture after assessing: beat faster."
a. Raccoon's eyes and Battle's sign
b. Nuchal rigidity and Kernig's sign 19. The nurse is preparing a client for a computed
c. Motor loss in the legs that exceeds in the arms tomography (CT) scan that requires infusion of
d. Pupillary changes radiopaque dye. Which question is most important
for the nurse to ask?
14. In a client with amyotrophic lateral sclerosis a. "When did you last have something to eat or
and respiratory distress, which finding is the drink?"
earliest sign of reduced oxygenation? b. "When did you last take any medication?"
a. Decreased heart rate c. "Are you allergic to seafood or lodine?"
b. Increased restlessness d. "How much do you weigh?"
c. Increased blood pressure
d. Decreased level of consciousness (LOC) 20. A client with respiratory complications of
multiple sclerosis (MS) is admitted to the medical-
15. A client has an exacerbation of multiple surgical unit. Which equipment is most important
sclerosis accompanied by leg spasticity. The for the nurse to keep at the client's bed side?
physician prescribes dantrolene sodium a. Sphygmomanometer
(dantrium), 25mg PO dally. How soon after b. Padded tongue blade
administration can the nurse expect to see a c. Nasal cannula and oxygen
sigrifican reduction in spasticity? d. Suction machine with catheters
a.30 to 45 minutes
b. 6 to 12 hours 21. Which nursing intervention can prevent a
c. 2 to 3 days client from experiencing autonomic dysreflexia?
d. 1 to 2 weeks a. Administering chloral hydrate (Noctec)
b. Assessing laboratory test results as ordered
16. A client with hypertension comes to the c. Placing the client in Trendelenburg's position
outpatient department for a routine check-up, d. Monitoring the patency of an indwelling
Because hypertension is a risk factor for cerebral urinary catheter
hemorrhage, the nurse questions the client closely
22. During recovery from a cerebrovascular window undergoes a stapedectomy to remove the
accident (CVA), a client is given nothing by mouth, stapes and replace the impaired bone with
to help prevent aspiration. To determine when the prosthesis. After the stapedectomy, the nurse
client is ready for a liquid diet, the nurse assesses should provide which client instruction?
the client's swallowing ability once each shift. This a. "Lie in bed with your head elevated, and refrain
assessment evaluates: from blowing your nose for 24 hours."
a. Cranial nerves I and II b. "Try to ambulate independently after about 24
b. Cranial nerves III and V hours."
c. Cranial nerves VI and VIII c. "Shampoo your hair every day for 10 days to
d. Cranial nerves IX and X help prevent ear infection."
d. "Don't fly in an airplane, climb to high
23. A 58-year client complaining of difficulty altitudes, make sudden movements, or expose
driving at night states that the "lights bother my yourself to loud sounds for 30 days.”
eyes." The client wears corrective glasses. The
nurse would suspect that the client is experiencing 28. The nurse is assessing a 38 year old client
a deficiency in which of the following diagnosed with multiple sclerosis. Which of the
vitamins? following symptoms would the nurse expect to
a. Vitamin A find?
b. Vitamin B complex a. Vision changes
c. Vitamin E b. Absent deep tendon reflexes
d. Vitamin C c. Tremors at rest
d. Flaccid muscles
24. Two days after a client undergoes repair of a
ruptured cerebral aneurysm, the physician 29. The client asks the nurse, "How does
prescribes Mannitol (Osmitrol), 1.5mg/kg to be ergotamine (Ergostat) relieve migraine
infused over 60 minutes. The client weighs 175 lb. headaches?" The nurse should respond that it:
The nurse should administer how many a. Dilates cerebral blood vessels
milligrams of Manitol? b. Constricts cerebral blood vessels
a. 263 c. Decreases peripheral vascular resistance
b. 120 d. Decreases the stimulation of baroreceptors
c. 75
d. 60 30. The nurse is caring for a client with L1-L2
paraplegia who is undergoing rehabilitation.
Which of the following goals is appropriate?
a. Establishing an intermittent catheterization
25. The nurse is caring for a client who requires routine every 4 hours
intracranial pressure (ICP) monitoring. The nurse b. Managing spasticity with range-of-motion
should be alert for what major complication of ICP exercises and medications
monitoring? c. Establishing an ambulation program using short
a. Coma leg braces
b. Infection d. Preventing autonomic dysreflexia by preventing
c. High blood pressure bowel impactions
d. Apnea
31. If a male client experienced a cerebrovascular
26. A client who recently experienced a accident (CVA) that damaged the hypothalamus,
cerebrovascular accident (CVA) tells the nurse the nurse would anticipate that the client has
that he has double vision. Which nursing problems with:
intervention is the most appropriate? a. body temperature control.
a. Encouraging the client to close his eyes b. balance and equilibrium.
b. Alternatively patch one eye every 2 hours c. visual acuity.
c. Turn out the lights in the room d. thinking and reasoning.
d. Instill artificial tears
32. A female client admitted to an acute care
27. A client with a conductive hearing disorder facility after a car accident develops signs and
caused by ankylosis of the stapes in the oval symptoms of increased intracranial pressure
(ICP). The client is intubated and placed on 38. Shortly after admission to an acute care
mechanical ventilation to help reduce ICP. To facility, a male client with a seizure disorder
prevent a further rise in ICP caused by suctioning, develops status epilepticus.
the nurse anticipates administering which drug The physician orders diazepam (Valium) 10 mg
endotracheally before I.V. stat. How soon can the nurse administer a
suctioning? second dose of diazepam, if needed and
a. phenytoin (Dilantin) prescribed?
b. mannitol (Osmitrol) a. In 30 to 45 seconds
c. lidocaine (Xylocaine) b. In 10 to 15 minutes
d. furosemide (Lasix) c. In 30 to 45 minutes
d. In 1 to 2 hours
33. After striking his head on a tree while falling
from a ladder, a young man age 18 is admitted to 39. A female client complains of periorbital aching,
the emergency department. He's unconscious and tearing, blurred vision, and photophobia in her
his pupils are nonreactive. Which intervention right eye. Ophthalmologic examination reveals a
would be the most dangerous for the small, irregular, nonreactive pupil - a condition
a. Give him a barbiturate. resulting from acute iris inflammation (iritis). As
b. Place him on mechanical ventilation. part of the client's therapeutic regimen, the
c. Perform a lumbar puncture. physician prescribes atropine sulfate (Atropisol),
d. Elevate the head of his bed. two drops of 0.5% solution in the right eye twice
daily. Atropine sulfate belongs to which drug
34. When obtaining the health history from a male classification?
client with retinal detachment, the nurse expects a. Parasympathomimetic agent
the client to report: b. Sympatholytic agent
a. light flashes and floaters in front of the eye. c. Adrenergic blocker
b. a recent driving accident while changing lanes. d. Cholinergic blocker
c. headaches, nausea, and redness of the eyes.
d. frequent episodes of double vision. 40. Emergency medical technicians transport a 27-
year-old iron worker to the emergency
35. Which nursing diagnosis takes highest priority department. They tell the nurse, "He fell from a
for a client with Parkinson's crisis? two-story building. He has a large contusion on his
a. Imbalanced nutrition: Less than body left chest and a hematoma in the left parietal area.
requirements He has a compound fracture of his left
b. Ineffective airway clearance femur and he's comatose. We intubated him and
c. Impaired urinary elimination he's maintaining an arterial oxygen saturation of
d. Risk for injury 92% by pulse oximeter with a manual-
resuscitation bag." Which intervention by the
36. To encourage adequate nutritional intake for a nurse has the highest priority?
female client with Alzheimer's disease, the nurse a. Assessing the left leg
should: b. Assessing the pupils
a. stay with the client and encourage him to c. Placing the client in Trendelenburg's position
eat. d. Assessing level of consciousness
b. help the client fill out his menu.
c. give the client privacy during meals. 41. An auto mechanic accidentally has battery acid
d. fill out the menu for the client. splashed in his eyes. His coworkers irrigate his
eyes with water for 20 minutes, and then take him
37. The nurse is performing a mental status to the emergency department of a nearby hospital,
examination on a male client diagnosed with where he receives emergency care for corneal
subdural hematoma. This test assesses which of injury. The physician prescribes dexamethasone
the following? (Maxidex Ophthalmic Suspension), two drops of
a. Cerebellar function 0.1% solution to be instilled initially into the
b. Intellectual function conjunctival sacs of both eyes every hour; and
c. Cerebral function polymyxin B sulfate (Neosporin Ophthalmic),
d. Sensory function 0.5% ointment to be placed in the conjunctival
sacs of both eyes every 3 hours. Dexamethasone d. Steppage
exerts its therapeutic effect by:
a. increasing the exudative reaction of ocular 46. A client, age 22, is admitted with bacterlal
tissue. meningitis. Which hospital room would be the
b. decreasing leukocyte infiltration at the site best choice for this client?
of ocular inflammation. a. A private room down the hall from the nurses'
c. inhibiting the action of carbonic anhydrase. station
d. producing a miotic reaction by stimulating and b. An isolation room three doors from the
contracting the sphincter muscles of the iris. nurses' station
c. A semiprivate room-with a 32-year-old client
42. Nurse April is caring for a client who who has viral meningitis
underwent a lumbar laminectomy 2 days ago. d. A two-bed room with a client who previously
Which of the following findings should the nurse had bacterial meningitis
consider abnormal?
a. More back pain than the first postoperative day 47. A physician diagnoses a client with myasthenia
b. Paresthesia in the dermatomes near the wounds gravis, prescribing pyridostigmine (Mestinon), 60
c. Urine retention or incontinence mg P.O. every 3 hours. Before administering this
d. Temperature of 99.2° F (37.3° C) anticholinesterase agent, the nurse reviews the
client's history. Which preexisting condition
43. After an eye examination, a male client is would contraindicate the use of pyridostigmine?
diagnosed with open-angle glaucoma. The a. Ulcerative colitis
physician prescribes pilocarpine ophthalmic b. Blood dyscrasia
solution (Pilocar), 0.25% gtt i, OU q.i.d. Based on c. Intestinal obstruction
this prescription, the nurse should teach the client d. Spinal cord injury
or a family member to administer the drug by:
a. instilling one drop of pilocarpine 0.25% into 48. A female client is admitted to the facility for
both eyes dally. investigation of balance and coordination
b. instilling one drop of pilocarpine 0.25% into problems, including possible Ménière's disease.
both eyes four times daily. When assessing this client, the nurse expects to
c. instilling one drop of pilocarpine 0.25% into the note:
right eye daily. a. vertigo, tinnitus, and hearing loss.
d. instilling one drop of pilocarpine 0.25% Into the b. vertigo, vomiting, and nystagmus
left eye four times daily. c. vertigo, pain, and hearing impairment.
d. vertigo, blurred vision, and fever.
44. A female client who's paralyzed on the left side
has been receiving physical therapy and attending 49. A male client with a conductive hearing
teaching sessions about safety. Which behavior disorder caused by ankylosis of the stapes in the
indicates that the client accurately understands oval window undergoes a stapedectomy to
safety measures related to paralysis? remove the stapes and replace the impaired bone
a. The client leaves the side rails down. with a prosthesis. After the stapedectomy, the
b. The client uses a mirror to inspect the skin. nurse should provide which client instruction?
c. The client repositions only after being reminded a. "Lie in bed with your head elevated, and refrain
to do so. from blowing your nose for 24 hours."
d. The client hangs the left arm over the side of the b. "Try to ambulate independently after about 24
wheelchair. hours."
c. "Shampoo your hair every day for 10 days to
45. A male client in the emergency department has help prevent ear infection."
a suspected neurologic disorder. To assess gait, d. "Don't fly in an airplane, climb to high
the nurse asked the client to take a few steps; with altitudes, make sudden movements, or expose
each step, the client's feet make a half circle. To yourself to loud sounds for 30 days.”
document the cilent's gait, the nurse should use
which term? 50. Nurse Oliver is monitoring a client for adverse
a. Ataxic reactions to dantrolene (Dantrium). Which
b. Dystrophic adverse reaction is most common?
c. Helicopod a. Excessive tearing
b. Urine retention d. Take long strides to maintain maximum
c. Muscle weakness mobility.
d. Slurred speech
56. Which of the following structures is seldom
MUSCULOSKELETAL DISORDER dislocated?
a. knee
51. A client has acute, painful muscle spasms. The b. Shoulder
physician prescribes chlorzoxazone (Paraflex), c. Foot
500 mg P.O. t.i.d. A centrally acting skeletal muscle d. Elbow
relaxant, chlorzoxazone commonly used to treat:
a. muscle spasm caused by cerebral palsy 57. A client seeks care for low back pain of 2
b. chronic musculoskeletal disorder week's duration. Which assessment finding
c. lower extremity spasticity suggests a herniated intervertebral disk?
d. severe muscle spasm a. pain radiating down the posterior thigh
b. Back pain when the knees are flexed
52. The nurse is caring for a client who complains c. Atrophy of the lower leg muscles
of lower back pain. Which instructions should the d. Homan's sign
nurse give to the client to prevent back injury?
a. Bend over the object you're lifting. 58. Following a boat accident, a 30-year old client
b. Narrow the stance when lifting. with multiple fractures is admitted to a
c. Push or pull an object using your arms. semiprivate room in a progressive care unit. The
d. Stand to move all toes client, who was driving the boat, is unaware that
his girlfriend's 9-year-old son was killed in the
53. The nurse is caring for a client with a cast on accident. The client's parents instruct the nurse to
the left leg. Which assessment finding is most prohibit phone calls and to withhold information
significant for this client? about the accident. During an assessment of the
a. Normal capillary refill in the great toe client, the nurse notices that the television is on
b. Presence of a normal popliteal pulse and the news is starting. It would be most
c. Intact skin around the cast edges appropriate for the nurse to:
d. Ability to move all toes a. turn the television off and tell the client it
interferes with the assessment.
54. A client recently had a right total hip b. allow the client to view the television and
replacement. As a result of intraoperative blood deal with any questions as they come.
loss, postoperative serum hemoglobin levels and c. instruct the client to change the channel to a
hematocrit are low. The physician prescribes two station that isn't televising the news.
units of packed red blood cells. During the infusion d. attempt to distract the client from watching the
of the first unit of blood, the client develops a television.
transfusion reaction and experiences urticaria,
itching, and bronchospasm. The nurse 59. The nurse is teaching a female client about
discontinues the transfusion and notifies the preventing osteoporosis. Which of the following
physician. Which antihistamine would the teaching points is correct?
physician most likely prescribe to treat this type I a. Obtaining an X-ray of the bones every 3 years is
hypersensitivity reaction? recommended to detect bone loss.
a. tripelenamine citrate (PBZ) b. To avoid fractures, the client should avoid
b. astemizole (Hismanal) strenuous exercise.
c. cyclizine (Marezine) c. The recommended daily allowance of
d. chlorpheniramine maleate (Chlor-Trimeton) calcium may be found In a wide variety of
foods.
55. The nurse is teaching a client with a left d. Obtaining the recommended daily allowance of
fractured tibia how to walk with crutches. Which calcium requires taking a calcium supplement.
instruction is
a. Use the axillae to help carry the weight. 60. A client, age 50, visits the physician for a
b. All weight should be on the hands. routine checkup. The history reveals that the
c. Keep feet 12" (30 cm) apart to provide stability client was diagnosed with a spinal curvature at
and a wide base of support. age 45. The nurse knows that life-threatening
complications can occur if the progressive spinal 66. Which of the following is a priority nursing
curvature exceeds 65 degrees. To assess the diagnosis for the client with an amputated
client's risk for such a complication, the nurse extremity?
should evaluate the severity of the curvature in a. Impaired skin integrity related to effects of the
which region of the spine? injury
a. Cervical b. Anticipatory grieving related to the loss of a
b. Thoracic limb
c. Lumbar c. Disturbed body image related to changes in
d. Sacral the structure of a body part
d. Ineffective peripheral tissue perfusion related
61. A client is diagnosed with osteoporosis. Which to injury and amputation.
electrolytes are involved in the development of
this disorder? 67. A client who recently had a cerebrovascular
a. Calcium and sodium accident (CVA) requires a cane to ambulate. When
b. Calcium and phosphorous teaching about cane use, explain that the reason
c. Phosphorous and potassium for holding a cane on the uninvolved side is to:
d. Potassium and sodium a. prevent leaning
b. distribute weight away from the involved
62. A client has sustained a right tibial fracture side.
and has just had a cast applied. Which instruction c. maintain stride length
should the nurse provide in his cast care? d. prevent edema.
a. Cover the cast with a blanket until the cast dries.
b. Keep your right leg elevated above heart 68. A client is admitted with severe pain in the
level. knees. Which form of arthritis is characterized by
c. Use a knitting needle to scratch itches inside the urate deposits and joint pain, usually in the feet
cast. and legs, and occurs primarily in men over age 30?
d. A foul smell from the cast is normal. a. Septic arthritis
b. Traumatic arthritis
63. During a senior citizen health screening, the c. Intermittent arthritis
nurse observes a 75-year-old female with a d. Gouty arthritis
severely increased thoracic curve, or "humpback".
What is this condition called? 69. A client undergoes a total hip replacement.
a. Lordosis Which statement made by the client would
b. Kyphosis indicate to the nurse that the client requires
c. Scoliosis further teaching?
d. Genus varum a. "I'll need to keep several pillows between my
legs at night."
64. The nurse is giving instructions to a client b. "I need to remember not to cross my legs. It's
who's going home with a cast on his leg. Which such a habit.”
point is most critical? c. "The occupational therapist is showing me how
a. Using crutches properly to use a sock puller to help me get dressed."
b. Exercising joints above and below the cast, as d. "I don't know if I'll be able to get off that low
ordered toilet seat at home by myself."
c. Avoiding walking on a leg without the
physician's permission 70. The nurse should monitor the client with a
d. Reporting signs of impaired circulation pelvic fracture receiving an opium derivative, such
as morphine, for what common adverse reaction?
65. After hip replacement, a client is receiving a. Respiratory
epidural analgesia to relieve pain. Which of the b. Diarrhea
following is a nursing priority for this client? c. High fever
a. Changing the catheter site dressing every shift d. Pupil dilation
b. Assessing capillary refill time
c. Assessing for sensation in the legs 71. A client undergoes hip-pinning surgery to treat
d. keeping the client flat in bed an interrochanteric fracture of the right hip. The
nurse should include which intervention in the b. x / Serum uric acid level
postoperative plan of care? c. Hemoglobin level
a. Performing passive range-of-motion (ROM) d. Serum potassium level
exercises on the client's legs once each shift
b. Keeping a pillow between the client's legs at 78. A client who has just been diagnosed with
all times mixed muscular dystrophy asks the nurse about
c. Turning the client from side every 2 hours the usual course of this disease. How should the
d. Maintaining the client in semi-Fowler's position nurse respond?
a. "You should ask your physician about that"
73. A client is admitted to the orthopedic unit for b. "The strength of your arms and pelvic muscles
treatment of a fractured right femur caused by a will decrease gradually, but this should cause only
motor vehicle crash. He is scheduled to undergo slight disability."
an open reduction internal-fixation of the right c. "You may experience progressive
femur. The night before surgery, the nurse deterioration in all voluntary muscles"
administers 250mg glutethimide (Doriden) as d. "This form of muscular dystrophy is a relatively
prescribed. Which statement regarding usage of benign disease that progresses slowly"
glutethimide is correct?
a. The nurse should store the drug in a tight, 79. The nurse is caring for a client who recently
light-resistant container. underwent a total hip replacement. The nurse
b. the nurse should dilute it in fruit juice to should:
improve absorption. a. Ease the client onto a low toilet seat.
c. The nurse shouldn't use the liquid if it becomes b. Allow the client's legs to be crossed at the knees
slightly darkened. when out of bed.
d. The nurse should discard unused portions of the c. Use soft chairs when the client is sitting out of
drug immediately after use. bed.
d. Limit client hip flexion when sitting.
74. To help prevent osteoporosis, what should the
nurse advise a young woman to do? 80. A client has a Fiberglas cast on the right arm.
a. Avoid trauma to the affected bone. Which action should the nurse include in the plan
b. Encourage the use of a firm mattress. care?
c. Consume at least 1000mg of calcium daily. a. Keeping the casted arm by covering in with a
d. Keep the serum uric acid level in the normal light blanket
range. b. Avoiding handling the cast for 24 hours or until
it is dry
75. When caring for a client experiencing an acute c. Evaluating pedal and posterior tibial pulses
gout attack, the nurse anticipates administering every 2 hours
which medication d. Assessing movement and sensation in the
a. allopurinol (Zyloprim) fingers of the right hand
b. colchicine
c. prednisone (Deltasone) 1. of care?
d. propoxyphene hydrochoride (Darvon) a. removing the weights once every shift
b. Maintaining the bed in the knee-gatch
76. A client with gouty arthritis is prescribed a position
low-purine diet. The nurse should instruct the c. keeping the client in semi-Fowler's position
client to avoid: d. maintaining the client in semi-Fowler's
a. organ meats Position
b. citrus fruits
c. green vegetables 82. A client with muscle weakness and an
d. fresh fish abnormal gait is being evaluated for muscular
dystrophy. Which of the following confirms
77. A client with gout is receiving probe with gout muscular dystrophy?
is receiving probenecid (Benemid), When caring a. Electromyography
for this client, the nurse should monitor which b. Muscle biopsy
laboratory value? c. family history of muscular dystrophy
a. Red blood cell count d. Gram stain of muscle tissue
 b. Greenstick fracture
83. For a client with osteoporosis, the nurse c. Comminuted fracture
should provide which dietary instruction? d. Impacted fracture
a. "Decrease your intake of red meat"
b. "Decrease your intake of popcorn, nuts, and 89. A client comes to the emergency department
seeds." complaining of a pain in the right leg. When
c. "Eat more fruits to increase your potassium obtaining the history, the nurse learns that the
intake" client was diagnosed with diabetes mellitus at age
d. "Eat more dairy products to increase your 12. The nurse knows that this disease predisposes
calcium intake." the client to which musculoskeletal disorder?
a. Degenerative joint disease
84. the nurse is assessing a client with possible b. Muscular dystrophy
osteoarthritis. The most significant risk factor for c. Scoliosis
osteoarthritis is: d. jayspaget's disease
a. Congenital Deformity.
b. Age. 90. A client undergoes a muscle biopsy. After the
c. Trauma. procedure, the nurse must keep the biopsy site
d. Obesity. elevated for:
a. 2 to 4 hours
85. A client is on bed rest after sustaining injuries b. 6 to 8 hours.
in a car accident. Which nursing action would help c. 12 hours
the client avoid complications of immobility? d. 24 hours
a. Decreasing fluid intake to ease dependent
edema 91. A client is admitted to an acute care facility
b. Turning the client every 2 hours and with osteomyelitis. Which organism usually
massaging bony prominences causes this infection?
c. Raising the head of the bed to maximize the a. Escherichia coli
client's lung inflation b. Klebsiella
d. Bathing and feeding the client to decrease c. Pseudomonas.
energy expenditure. d. Staphylococcus aureus

86. The nurse is managing the care of a client with 92. client is prescribed diazepam (Valium) to treat
osteoarthritis. Appropriate treatment strategies severe skeletal muscle spasms. During this
for osteoarthritis include: therapy, the nurse monitors the client closely for
a. Administration of narcotics for pain control. adverse reactions. Which adverse reaction is most
b. Bed rest for painful exacerbations. likely to occur?
c. Administration of nonsteroidal anti- a. Bradycardia
inflammatory drugs (NSAIDS). b. 2/Skin rash
d. Vigorous physical therapy for the joints. c. Hypotension
d. Sedation
87. the nurse is caring for a client with lower back
pain who is scheduled for myelography using 93. A client is scheduled for a laminectomy to
metrizamide (a water-soluble contrast dye). After repair a herniated Intervertebral disk. When
the test, the nurse should place the client in which developing the postoperative plan of care, the
position? nurse should include which action?
a. Head of the bed elevated 45 degrees a. Keeping a pillow under the client's knees at all
b. prone times
c. Supine with feet raised b. Placing the client in semi-Fawler's position
d. Supine with the head lower than the trunk c. Maintaining bed rest for 72 hours after the
laminectomy
88. An X-ray of the left femur shows a fracture d. Turning the client from side to side, using
than extends through the midshaft of the bone and the logroll technique
multiple splintering fragments. What is this type
of fracture called? 94. X-rays reveal a leg fracture in a client who was
a. Compression fracture brought to the emergency department after falling
on ice. After a cast is applied and allowed to dry, 99. Which of these findings best correlates with a
the nurse teaches the client how to use crutches. diagnosis of osteoarthritis?
Which instruction should the nurse provide about a. joint stiffness that decreases with activity
climbing stairs? b. Erythema and edema over the affected joint
a. "Place both crutches on the first step and swing c. Anorexia and weight loss
both legs upward to this step." d. Fever and malaise
b. "Place the unaffected leg on the first step,
followed by the crutches and the injured leg, 100. A client with possible osteoarthritis is having
which should move together.” X-rays performed on both knees. X-ray of an
c. "Place the crutches and injures leg on the first osteoarthritis joint reveal:
step, followed by the unaffected leg." a. enlargement of the joint space or margin.
d. "Place the injured leg and the crutch on the b. fluid deposition in joint spaces
unaffected side on the first step; the unaffected leg c. osteophyte formation.
and crutch on the injured side follow." d. cartilage growths at weight-bearing joints

95. A client is admitted with acute osteomyelitis

that developed after an open fracture of the right
femur. When planning this client's care, the nurse
should include which measure?
a. Administering large doses of oral antibiotics as
prescribed
b. Instructing the client to ambulate twice daily
c. Withholding all oral intake
d. Administering large doses of I.V. antibiotics
as prescribed

96. The nurse is teaching a client with a long leg

cast how to use crutches properly while
descending a staircase. The nurse should tell the
client to:
a. advance both legs first.
b. advance the unaffected leg first.
c. advance the affected leg first.
d. advance both crutches first

97. A client to the outpatient department with

suspected carpal tunnel syndrome. When
assessing the affected area, the nurse expects to
find which abnormality typically associated with
this syndrome?
a. Positive Tinel's sign
b. Negative Phalen's sign
c. positive Chostek's sign
d. negative Trousseau's sign

98. A client's leg is in skeletal with a Thomas leg

splint and Pearson attachment. Which
intervention should the nurse include in this
client's plan of care?
a. Apply the traction straps snugly.
b. Assess the client's level of consciousness.
c. Remove the traction at least every 8 hours.
d. Teach the client how to prevent problems
caused by immobility.
EVEN WEEK POST TEST AND ODD WEEK
PRETEST