Nokea
Which statement made by the client to the nurse provides the best evidence that the client understands the therapeutic plan?
- A. I should keep my hand as still as possible.
- B. I should stop playing golf for the time being.
- C. I can substitute playing miniature golf.
- D. I can wear a tight leather glove when golfing.
Correct Answer: B
Rationale: Tenosynovitis involves inflammation of the tendon sheath, often exacerbated by repetitive wrist motion. The physician recommends avoiding such motions temporarily. Stopping golf, which involves repetitive wrist actions, directly aligns with this plan, unlike miniature golf, which still requires wrist movement, or wearing a glove, which does not address motion.
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When reviewing the chart of a 25-year-old male, the nurse reads that the client was diagnosed with an osteosarcoma of the distal femur. Which statement indicates the nurse's correct interpretation of the client's diagnosis?
- A. The tumor originated elsewhere in the client's body and metastasized to the bone.
- B. Osteosarcoma is the most common and most often fatal primary malignant bone tumor.
- C. The only treatment for osteosarcoma is a leg amputation well above the tumor growth.
- D. The tumor is nonmalignant;it can be excised and the bone replaced with a bone graft.
Correct Answer: B
Rationale: B. Osteosarcoma is a malignant primary tumor of the bone, appearing most frequently in males between 10 and 25 years (when bones grow rapidly). Prognosis depends on whether the tumor has metastasized to the lungs, but it is often fatal.
The nurse is teaching a class to pregnant teenagers. Which information is most important when discussing ways to prevent osteoporosis?
- A. Take at least 1,200 mg of calcium supplements a day.
- B. Eat foods low in calcium and high in phosphorus.
- C. Osteoporosis does not occur until around age 50 years.
- D. Remain as active as possible until the baby is born.
Correct Answer: D
Rationale: Staying active (weight-bearing exercise) during pregnancy builds bone density, preventing future osteoporosis. Calcium supplements are secondary, low-calcium diets are harmful, and age misconception ignores prevention.
A cast has just been applied to a client's left forearm, and he has 10 lbs of Russell's traction on his left leg. Which of the following nursing concerns takes priority in the care of this client?
- A. The casted extremity may swell, and the cast will become a tourniquet.
- B. Heat conduction from the wet cast can cause burning to the skin below.
- C. Muscle atrophy of the areas involved can lead to decreased muscle tone.
- D. Skin irritation from the cast edges can cause abrasions.
Correct Answer: A
Rationale: Swelling in a newly casted extremity can cause the cast to act as a tourniquet, compromising circulation, which is the priority concern. Heat from a wet cast does not burn skin, muscle atrophy is a long-term issue, and skin irritation is less urgent.
After the client's total hip replacement surgery, which nursing actions are essential? Select all that apply.
- A. Keeping the client's knees apart at all times
- B. Avoiding flexing the client's hips more than 90 degrees
- C. Having the client use a raised toilet seat
- D. Raising the head of the client's bed 90 degrees
- E. Placing two pillows beneath the client's knees
- F. Keeping the client's legs internally rotated
Correct Answer: A,B,C
Rationale: To prevent dislocation after total hip replacement, keep knees apart (using an abductor pillow), avoid hip flexion beyond 90 degrees, and use a raised toilet seat to maintain safe hip angles. Raising the bed 90 degrees or placing pillows under knees risks dislocation, and internal rotation is contraindicated.
The nurse is caring for clients on an orthopedic floor. Which client should be assessed first?
- A. The client diagnosed with back pain who is complaining of a '4' on a 1-to-10 scale.
- B. The client who has undergone a myelogram who is complaining of a slight headache.
- C. The client two (2) days post-disk fusion who has T 100.4, P 96, R 24, and BP 138/78.
- D. The client diagnosed with back pain who is being discharged and whose ride is here.
Correct Answer: C
Rationale: Fever, tachycardia, and tachypnea post-disk fusion suggest infection or complications, requiring urgent assessment. Mild pain, headache, and discharge are lower priority.