Nokea
The nurse is working on an orthopedic floor caring for a client injured in a football game. The nurse is reviewing the client's chart noting that the client has previously had an injured tendon. The nurse anticipates an injury between the periosteum of the bone and which of the following?
- A. Joint
- B. Muscle
- C. Ligament
- D. Cartilage
Correct Answer: B
Rationale: Tendons attach muscles to the periosteum of bone. Joints are a junction between two or more bones. Ligaments connect two freely movable bones. Cartilage is a dense connective tissue used to reduce friction between two structures.
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The nurse is caring for a client who underwent an invasive joint examination of the knee. The nurse would closely monitor the client for what complication?
- A. Lack of sleep and appetite
- B. Serious drainage
- C. Signs of depression
- D. Signs of shock
Correct Answer: B
Rationale: When the client undergoes an invasive knee joint examination, the nurse should inspect the knee area for swelling, bleeding, and serious drainage. An invasive joint examination does not cause lack of sleep or appetite, depression, or shock. The client may be in shock due to the injury itself.
The physician orders an opioid analgesic for a client with a traumatic musculoskeletal injury. What is the most important complication the nurse should watch for in this client?
- A. Allergic reactions
- B. Hypotension
- C. Respiratory depression
- D. Joint inflammation
Correct Answer: C
Rationale: The nurse should observe for signs of respiratory depression in a client susceptible to shock after a traumatic injury because opioids may cause respiratory depression and lead to sedation. Although hypotension or allergic reactions can occur, the priority here is to monitor for respiratory depression. Joint inflammation may be due to the injury itself, it is not likely to be a result of administering narcotic analgesics.
An instructor is describing the process of bone development. What would the instructor describe as being responsible for the process of ossification?
- A. Osteoblasts
- B. Cortical bone
- C. Osteoclasts
- D. Cancellous bone
Correct Answer: A
Rationale: Osteoblasts secrete bone matrix (mostly collagen), in which inorganic minerals, such as calcium salts, are deposited. This process of ossification and calcification transforms the blast cells into mature bone cells, called osteocytes, which are involved in maintaining bone tissue. Cortical bone is dense hard bone found in the long shafts; cancellous bone is spongy bone found in the irregular rounded edges of bone.
A nurse is preparing a presentation for a health class about ways to ensure bone health, including the need for an adequate calcium intake. The participants are high school-aged girls. The nurse would encourage them to consume adequate calcium to maximize peak bone mass by which age?
- A. 20 years
- B. 30 years
- C. 40 years
- D. 50 years
Correct Answer: B
Rationale: Peak bone mass is attained sometime around 30 years of age. An adequate calcium intake before that time helps to maximize peak bone mass. This would result in denser bones that would be less susceptible to fracture. Bone mass begins to decrease after age 30.
The client who is about to undergo arthroscopy of the knee begins to describe the procedure to the nurse. What statement(s) indicate to the nurse that the client understands the procedure?
- A. This procedure does not require an anesthetic.
- B. A needle will be inserted into the joint space.
- C. A special scan may be done to verify the placement of the needle.
- D. Fluid is taken from the joint for laboratory analysis.
- E. It is normal to hear crackling or clicking noises in the joint for about a week after the procedure.
Correct Answer: B,C,D
Rationale: If the client describes the procedure as one in which a needle is inserted into the joint space, with a special scan possibly being done to verify needle placement, to take fluid from the joint for laboratory analysis, the nurse can confirm that the client understands the arthroscopy procedure. Before the procedure, the provider first injects a local anesthetic. The client should expect the crackling or clicking noises to resolve after 2 days. Noises beyond this time are abnormal, the client should report them.