Chapter 64: Nursing Management: Musculoskeletal Problems

Chapter 64: Nursing Management: Musculoskeletal Problems

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE
1. A patient is hospitalized for initiation of regional antibiotic irrigation for acute
osteomyelitis of the right femur. Which intervention will be included in the plan of care?
a. Immobilization of the right leg
b. Frequent weight-bearing exercise
c. Avoiding administration of nonsteroidal anti-inflammatory drugs (NSAIDs)
d. Support of the right leg in a flexed position
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. NSAIDs are
frequently prescribed to treat pain. Flexion of the affected limb is avoided to prevent
contractures.
DIF: Cognitive Level: Application REF: 1625 TOP: Nursing Process:
Planning
MSC: NCLEX: Physiological Integrity
2. A patient is being discharged after 2 weeks of IV antibiotic therapy for acute
osteomyelitis in the left leg. Which information will be included in the discharge
teaching?
a. How to apply warm packs safely to the leg to reduce pain
b. How to monitor and care for the long-term IV catheter site
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: Application REF: 1625
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
3. A patient has chronic osteomyelitis of the left femur, which is being managed at home
with administration of IV antibiotics. The nurse chooses a nursing diagnosis of
ineffective health maintenance when the nurse finds that the patient
a. takes and records the oral temperature twice a day.
b. is unable to plantar flex the foot on the affected side.
Test Bank 64-2
c. uses crutches to avoid weight bearing on the affected leg.
d. is irritable and frustrated with the length of treatment required.
ANS: B
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.
DIF: Cognitive Level: Application REF: 1625 TOP: Nursing Process:
Diagnosis
MSC: NCLEX: Physiological Integrity
4. Which statement by a patient who is scheduled for an above-the-knee amputation for
treatment of an osteosarcoma of the right tibia indicates that patient teaching is needed?
a. “I did not have this bone cancer until my leg broke a week ago.”
b. “I wish that I did not have to have chemotherapy after this surgery.”
c. “I know that I will need to participate in physical therapy after surgery.”
d. “I will use the patient-controlled analgesia (PCA) to control postoperative pain.”
ANS: A
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: Application REF: 1625-1627 TOP: Nursing Process:
Evaluation
MSC: NCLEX: Physiological Integrity
5. A 20-year-old patient with a history of muscular dystrophy is hospitalized with a
respiratory tract infection. Which nursing action will be included in the plan of care?
a. Assist the patient with ambulation.
b. Logroll the patient every 1 to 2 hours.
c. Discuss the need for genetic testing with the patient.
d. Teach the patient about the muscle biopsy procedure.
ANS: A
Since the goal for the patient with muscular dystrophy is to keep the patient active for as
long as possible, assisting the patient to ambulate will be part of the care plan. The patient
will not require logrolling. Muscle biopsies are necessary to confirm the diagnosis but are
not necessary for a patient who already has a diagnosis. There is no need for genetic
testing since the patient already knows the diagnosis.
DIF: Cognitive Level: Application REF: 1627-1628 TOP: Nursing Process:
Planning
MSC: NCLEX: Physiological Integrity