Nur 211 Test 3 Practice Questions: Osteoarthritis & Joint Replacements With Complete Solutions

NUR 211 TEST 3 PRACTICE QUESTIONS: OSTEOARTHRITIS & JOINT
REPLACEMENTS WITH COMPLETE SOLUTIONS




Osteoarthritis

*1. A nurse is working with a community group promoting healthy aging. What recommendation is best to he
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn




lp prevent osteoarthritis (OA)?
cn cn cn




a. Avoid contact sports. cn cn




b. Get plenty of calcium. cn cn cn




c. Lose weight if needed. cn cn cn




d. Engage in weight- cn cn




bearing exercise. ANS: C cn cn cn




2. A nurse in the family clinic is teaching a client newly diagnosed with osteoarthritis (OA) about drugs use
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn




d to treat the disease. For which medication does the nurse plan primary teaching?
cn cn cn cn cn cn cn cn cn cn cn cn cn




a. Acetaminophen (Tylenol) cn




b. Cyclobenzaprine hydrochloride (Flexeril) cn cn




c. Hyaluronate (Hyalgan) cn




d. Ibuprofen (Motrin) cn cn




ANS: A cn




3. The clinic nurse assesses a client with diabetes during a checkup. The client also has osteoarthritis (OA).
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn




The nurse notes the client’s blood glucose readings have been elevated. What question by the nurse is most ap
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn




propriate?
a. “Are you compliant with following the diabetic diet?”
cn cn cn cn cn cn cn




b. “Have you been taking glucosamine supplements?” cn cn cn cn cn




c. “How much exercise do you really get each week?” cn cn cn cn cn cn cn cn




d. “You’re still taking your diabetic medication, right?” A cn cn cn cn cn cn cn




NS: B cn




4. The nurse working in the orthopedic clinic knows that a client with which factor has an absolute con
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn




traindication for having a total joint replacement? cn cn cn cn cn cn




a. Needs multiple dental fillings cn cn cn




b. Over age 85 cn cn




c. Severe osteoporosis cn




d. Urinary tract infection cn cn cn




ANS: C cn




5. An older client has returned to the surgical unit after a total hip replacement. The client is confused and restl
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn




ess. What intervention by the nurse is most important to prevent injury?
cn cn cn cn cn cn cn cn cn cn cn




a. Administer mild sedation. cn cn




b. Keep all four siderails up. cn cn cn cn




c. Restrain the client’s hands. cn cn cn




d. Use an abduction pillow. cn cn cn cn




ANS: D cn




6. What action by the perioperative nursing staff is most important to prevent surgical wound infection in a cl
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn




ient having a total joint replacement?
cn cn cn cn cn

,a. Administer preoperative antibiotic as ordered.
cn cn cn cn




b. Assess the client’s white blood cell count.
cn cn cn cn cn cn




c. Instruct the client to shower the night before.
cn cn cn cn cn cn cn




d. Monitor the client’s temperature postoperatively.
cn cn cn cn cn




ANS: A
cn

,7. The nurse on the postoperative inpatient unit assesses a client after a total hip replacement. The client’s sur
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn




gical leg is visibly shorter than the other one and the client reports extreme pain. While a co-
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn




worker calls the surgeon, what action by the nurse is best?
cn cn cn cn cn cn cn cn cn cn




a. Assess neurovascular status in both legs. cn cn cn cn cn




b. Elevate the affected leg and apply ice. cn cn cn cn cn cn




c. Prepare to administer pain medication. cn cn cn cn




d. Try to place the affected leg in abduction. A
cn cn cn cn cn cn cn cn




NS: A cn




8. A client has a continuous passive motion (CPM) device after a total knee replacement. What action does
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn




the nurse delegate to the unlicensed assistive personnel (UAP) after the affected leg is placed in the machine
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn




while the client is in bed? cn cn cn cn cn




a. Assess the distal circulation in 30 minutes. cn cn cn cn cn cn




b. Change the settings based on range of motion. cn cn cn cn cn cn cn




c. Raise the lower siderail on the affected side. cn cn cn cn cn cn cn




d. Remind the client to do quad- cn cn cn cn cn




setting exercises. ANS: C cn cn cn




9. After a total knee replacement, a client is on the postoperative nursing unit with a continuous femoral nerv
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn




e blockade. On assessment, the nurse notes the client’s pulses are 2+/4+ bilaterally; the skin is pale pink, war
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn




m, and dry; and the client is unable to dorsiflex or plantarflex the affected foot. What action does the nurse perf
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn




orm next? cn




a. Document the findings and monitor as prescribed. cn cn cn cn cn cn




b. Increase the frequency of monitoring the client. cn cn cn cn cn cn




c. Notify the surgeon or anesthesia provider immediately. cn cn cn cn cn cn




d. Palpate the client’s bladder or perform a bladder scan. A cn cn cn cn cn cn cn cn cn




NS: C cn




10. A nurse is discharging a client to a short-
cn cn cn cn cn cn cn cn




term rehabilitation center after a joint replacement. Which action by the nurse is most important?
cn cn cn cn cn cn cn cn cn cn cn cn cn cn




a. Administering pain medication before transport cn cn cn cn




b. Answering any last-minute questions by the client cn cn cn cn cn cn




c. Ensuring the family has directions to the facility cn cn cn cn cn cn cn




d. Providing a verbal hand- cn cn cn




off report to the facility ANS: D
cn cn cn cn cn cn




24. A client in the orthopedic clinic has a self-reported history of osteoarthritis. The client reports a low-
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn




grade fever that started when the weather changed and several joints started “acting up,” especially both hip
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn




s and knees. What action by the nurse is best?
cn cn cn cn cn cn cn cn cn




a. Assess the client for the presence of subcutaneous nodules or Baker’s cysts.
cn cn cn cn cn cn cn cn cn cn cn




b. Inspect the client’s feet and hands for podagra and tophi on fingers and toes.
cn cn cn cn cn cn cn cn cn cn cn cn cn




c. Prepare to teach the client about an acetaminophen (Tylenol) regimen. cn cn cn cn cn cn cn cn cn




d. Reassure the client that the problems will fade as the weather changes again. A cn cn cn cn cn cn cn cn cn cn cn cn cn




NS: A cn




25. A nurse is caring for a client after joint replacement surgery. What action by the nurse is most imp
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn




ortant to prevent wound infection?
cn cn cn cn




a. Assess the client’s white blood cell count. cn cn cn cn cn cn




b. Culture any drainage from the wound. cn cn cn cn cn




c. Monitor the client’s temperature every 4 hours. cn cn cn cn cn cn

, d. Use aseptic technique for dressing changes.
cn cn cn cn cn cn




ANS: D cn




26. A nurse is discharging a client after a total hip replacement. What statement by the client indicates goo
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn




d potential for self-management?
cn cn cn




a. “I can bend down to pick something up.”
cn cn cn cn cn cn cn




b. “I no longer need to do my exercises.”
cn cn cn cn cn cn cn




c. “I will not sit with my legs crossed.”
cn cn cn cn cn cn cn




d. “I won’t wash my incision to keep it dry.” A
cn cn cn cn cn cn cn cn cn




NS: C cn




27. The nurse is caring for a client using a continuous passive motion (CPM) machine and has delegated som
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn




e tasks to the unlicensed assistive personnel (UAP). What action by the UAP warrants intervention by the nurs
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn




e?
a. Checking to see if the machine is working cn cn cn cn cn cn cn




b. Keeping controls in a secure place on the bed cn cn cn cn cn cn cn cn




c. Placing padding in the machine per request cn cn cn cn cn cn




d. Storing the CPM machine under the bed after removal A cn cn cn cn cn cn cn cn cn




NS: D cn




29. A client is scheduled to have a hip replacement. Preoperatively, the client is found to be mildly anemic and
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn




the surgeon states the client may need a blood transfusion during or after the surgery. What action by the pre
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn




operative nurse is most important? cn cn cn cn




a. Administer preoperative medications as prescribed. cn cn cn cn




b. Ensure that a consent for transfusion is on the chart. cn cn cn cn cn cn cn cn cn




c. Explain to the client how anemia affects healing. cn cn cn cn cn cn cn




d. Teach the client about foods high in protein and iron. A
cn cn cn cn cn cn cn cn cn cn




NS: B cn




30. An older client is scheduled to have hip replacement in 2 months and has the following laboratory val
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn




ues: white blood cell count: 8900/mm3, red blood cell count: 3.2/mm3, hemoglobin: 9 g/dL, hematocrit
cn cn cn cn cn cn cn cn cn cn cn cn cn cn




: 32%. What intervention by the nurse is most appropriate?
cn cn cn cn cn cn cn cn cn




a. Instruct the client to avoid large crowds. cn cn cn cn cn cn




b. Prepare to administer epoetin alfa (Epogen). cn cn cn cn cn




c. Teach the client about foods high in iron. cn cn cn cn cn cn cn




d. Tell the client that all laboratory results are normal. A
cn cn cn cn cn cn cn cn cn




NS: B cn




31. A client is getting out of bed into the chair for the first time after an uncemented hip replacement. Wh
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn




at action by the nurse is most important?
cn cn cn cn cn cn cn




a. Have adequate help to transfer the client.
cn cn cn cn cn cn




b. Provide socks so the client can slide easier. cn cn cn cn cn cn cn




c. Tell the client full weight bearing is allowed.
cn cn cn cn cn cn cn




d. Use a footstool to elevate the client’s leg. A
cn cn cn cn cn cn cn cn




NS: A cn




36. A client comes to the family medicine clinic and reports joint pain and stiffness. The nurse is asked to asse
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn




ss the client for Heberden’s nodules. What assessment technique is correct?
cn cn cn cn cn cn cn cn cn cn




a. Inspect the client’s distal finger joints. cn cn cn cn cn




b. Palpate the client’s abdomen for tenderness. cn cn cn cn cn




c. Palpate the client’s upper body lymph nodes. cn cn cn cn cn cn