Musculoskeletal

The child had a cast applied the previous day for a broken tibia. The mother returns the child to the provider to report swelling and significant pain. Upon assessment, the nurse notes pale, cool toes with a capillary refill time of 6 seconds. The child denies feeling the nurse's assessment but screams in pain when the leg is moved. The nurse anticipates which treatment for this patient? 

Which patient is seen first in the emergency department?

About which expected side effect does the nurse educate the patient prescribed colchicine for treatment of gout?

Following an industrial accident, the patient is immobile. The student nurse is creating a care plan for the patient to prevent respiratory decompensation. Which intervention, if included in the care plan for this nursing diagnosis, would prompt the nurse to provide additional education to the student nurse?

The nurse receives report on the patient with amyotrophic lateral sclerosis (ALS) and anticipates to observe which symptoms in the patient? Select all that apply.

Which symptom does the nurse recognize as the first sign of amyotrophic lateral sclerosis?

The nurse is evaluating the patient with amyotrophic lateral sclerosis. Which symptom is most concerning?

The nurse is helping the patient with amyotrophic lateral sclerosis to select food for a meal. Which meal choice is appropriate?

The nurse suspects Guillain-Barré syndrome in the patient with weakness that started in which location?

The patient presents to the emergency department with left leg pain after landing from a transcontinental flight. Which assessments prompt the nurse to suspect a deep vein thrombosis? Select all that apply.

The patient with a sore throat has tested positive for group A beta-hemolytic Streptococcus pyogenes. The nurse educates the patient to complete the entire course of antibiotics in order to prevent which complications? Select all that apply.

The nurse is performing an assessment on the patient with long, thin limbs and fingers who presents for a yearly check-up in no acute distress. The patient is extremely thin and has pectus excavatum. For which assessment finding is the nurse most vigilant in this patient?

The patient presents to the emergency department (ED) after a hard workout lifting weights complaining of chest pain. An electrocardiogram is performed and cardiac enzymes are drawn. The patient’s myoglobin level is found to be elevated. Which interpretation of this result is most appropriate?

Which lab result is best for differentiating between myocardial and skeletal muscle damage?

The nurse is creating a presentation on rickets in the community. The nurse focuses on which group of individuals for this teaching?

The 4-year-old child is brought to the emergency department (ED) with concern for a broken arm after a fall at the playground. The nurse notes the legs are bowed with curved femurs, the abdomen protrudes, and the upper spine is curved forward, giving the child a humpback appearance. The nurse anticipates testing will lead to which diagnosis?

The 5-year-old child is brought to the emergency department (ED) after a fall at school that has resulted in a broken wrist. The nurse notes the child is thin, with curved femurs and kyphosis. Metaphyseal fraying and cupping is noted on x-ray of the wrist. There is evidence of old fractures that healed poorly, as if they hadn’t been set properly. Upon review of the patient’s medical history, it does not appear that the patient has received ongoing well-child care. After laboratory evaluation, the child is diagnosed with rickets. The nurse prepares information on which medication for the family?

The nurse is assigned to care for a large for gestational age neonate with respiratory distress and significant tachypnea that is requiring continuous positive airway pressure at 12 hours of life. The nurse notes the patient has good muscle tone with flexed bilateral legs and a flexed right arm. The left arm is extended and adducted. The nurse is MOST concerned about which condition?

The nurse caring for the patient with rheumatoid arthritis who is scheduled for an operation under general anesthesia advocates for which test prior to the procedure?

Which is an example of an orthopedic injury due to microtrauma?

Which sport does the nurse recommend to the child with osteogenesis imperfecta who is interested in physical fitness?

A six-year-old child presents to a primary care appointment with curved tibias and fibulas, protruding forehead, pigeon chest, and protruding abdomen. Which vitamin deficiency does the nurse immediately suspect?

The nurse is caring for a patient after the surgical amputation of the left leg below the knee. The nurse expects the patient to attain which level of mobility with rehabilitation and prosthesis training?

The nurse is educating the patient with a spinal cord injury on safe wheelchair use. Which important features does the nurse emphasize to the patient? Select all that apply.

The patient with bilateral leg amputations is being fitted for a new wheelchair. The nurse knows that the patient’s center of gravity is offset in which direction?

The nurse recommends removal of which items from the home of the patient who will be discharged home in a wheelchair? 

The older adult patient recently diagnosed with a spinal cord injury and limited mobility is referred to a physical therapist to discuss using a wheelchair for increased mobility. The patient asks the nurse, “Do I really have to see the physical therapist? I broke my leg as a kid and used one then.” Which response by the nurse is appropriate?

The patient with Raynaud’s phenomenon presents with which characteristic during an exacerbation?

The nurse receives report on 4 patients by 0800. Which patient does the nurse assess first?

The nurse preceptor is supervising the graduate nurse during shift handoff. Which statements by the graduate nurse would prompt the veteran nurse to clarify for the oncoming nurse? Select all that apply.

The patient with short stature associated with Noonan syndrome is being considered for somatropin injections. The nurse ensures which test is performed before therapy is started? 

The nurse is supervising the student nurse in performing a cap change for a peripherally inserted central catheter (PICC) in a patient who recently sustained a traumatic brain injury. Which action by the student nurse best indicates effective learning?

The nurse is most concerned with encouraging the patient with multiple myeloma to ambulate frequently to prevent which complication? 

The 8-year-old male patient presents complaining of warm, painful, swollen joints with decreased range of motion. Upon assessment, he is pale and tachycardic. The parent reports easy bruising and frequent nosebleeds. Which does the nurse most anticipate administering? 

The nurse is providing discharge education to the parents of the 7-day-old neonate who required a blood transfusion due to blood loss following circumcision. Which instruction is most important?  

The nurse learns the previously healthy 13-year-old child was walking at school and collapsed; x-ray revealed a broken femur. The nurse is most concerned about which disorder?  

The nurse is preparing the otherwise healthy 54-year-old patient for a right knee replacement surgery and checks to see if the patient is allergic to which medication? 

During the provider’s exam of the 6-hour-old neonate, the provider reports observing a red reflex in the neonate’s right eye, but not the left. The provider observes whiteness at the back of the eye. Enucleation is performed and the diagnosis of retinoblastoma with clear tumor margins is confirmed. No chemotherapy or radiation is required. The infant is ready to be discharged home as a healthy baby. Which health screening information is most relevant to this family? 

The 20-year-old healthy soccer player is brought to the emergency department after collapsing at the end of a summer soccer game. The patient is lethargic and confused about the event. Upon assessment, the nurse notes flushed, dry skin that is warm to the touch. The oral mucosa is dry, as well. Vitals are as follows: temperature 40.7°C, heart rate 122 bpm, respiratory rate 20, and blood pressure 116/64 mmHg. Which lab studies does the nurse obtain? Select all that apply.