Musculoskeletal Problems Lewis:
Medical-Surgical Nursing, 10th Edition
A patient with acute osteomyelitis of the left femur is hospitalized for
regional antibiotic
irrigation. Which intervention will the nurse include in the initial
plan
a. of care?
Quadriceps-setting
exercises
b. Immobilization of the
leftPositioning
c. leg the left leg in
flexion
d. Assisted weight-bearing ambulation correct answers
ANS: B
Immobilization of the affected leg helps to decrease pain and reduce
the risk for
pathologi
c
fracture. Weight-bearing exercise increases the risk for pathologic fractures.
Flexion of
th
e
affected limb is avoided to prevent
contractures.
DIF: Cognitive Level: Apply (application) REF:
1499
TOP: Nursing Process: Planning MSC: NCLEX: Physiological
Integrity
A patient is being discharged after 1 week of IV antibiotic therapy for acute
osteomyelitis
i
n
the right leg. Which information will be included in the discharge
teaching?
a. How to apply warm packs to the leg to
reduce
b. How pain
to monitor and care for a long-term IV
catheter
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
correct answers
ANS:
The patient will be taking IV antibiotics for several months. The patient
B
will need to
recogniz
e
signs of infection at the IV site and know how to care for the catheter
during daily
activiti
es
such as bathing. IV antibiotics rather than oral antibiotics are used
for acute
osteomyeliti
Patients are instructed to avoid exercise and heat application because
s.
these will
increas
e
swelling and the risk for spreading
infection.
DIF: Cognitive Level: Apply (application) REF:
1499
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological
Integrity
A patient is receiving IV antibiotics at home to treat chronic
osteomyelitis of the left
femur
.The nurse identifies a need for additional teaching related to health
maintenance when
th
e
, nurse finds that the
patient
a. is frustrated with the length of treatment
required.
b. takes and records the oral temperature twice
a day.
c. is unable to plantar flex the foot on the
affected
d. side.
uses crutches to avoid weight bearing on the affected leg. correct
answers
Foot dropANS:
is anCindication that the foot is not being supported in a neutral
position by a
splin
t.
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
maintenan
ce
of the
osteomyelitis.
DIF: Cognitive Level: Apply (application) REF:
1499
TOP: Nursing Process: Analysis MSC: NCLEX: Physiological
Integrity
The nurse instructs a patient who has osteosarcoma of the tibia about a
scheduled
above-the-knee amputation. Which statement by a patient indicates
additional patient
teachin
g
is
needed?
a. "I will need to participate in physical therapy after
surgery."
b. "I wish I did not need to have chemotherapy after this
surgery."
c. "I did not have this bone cancer until my leg broke a
week
d. ago."
"I can use the patient-controlled analgesia (PCA) to manage
postoperative
correct answerspain."
ANS:
C
Osteogenic sarcoma may be diagnosed following a fracture, but it is not
caused by the
injury
.The other statements indicate patient teaching has been
effective.
DIF: Cognitive Level: Apply (application) REF:
1501
TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological
Integrity
A patient with muscular dystrophy is hospitalized with pneumonia. Which
nursing action
wil
lbe included in the plan of
care?
a. Logroll the patient every 2
hours.
b. Assist the patient with
ambulation.
c. Discuss the need for genetic testing with the
d. Teach the patient about the muscle biopsy procedure. correct
patient.
answers ANS:
Because B for the patient with muscular dystrophy is to keep the
the goal
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
no
tnecessary for a patient who already has a diagnosis. There is no need
for genetic
testin
g
because the patient already knows the
diagnosis.
Medical-Surgical Nursing, 10th Edition
A patient with acute osteomyelitis of the left femur is hospitalized for
regional antibiotic
irrigation. Which intervention will the nurse include in the initial
plan
a. of care?
Quadriceps-setting
exercises
b. Immobilization of the
leftPositioning
c. leg the left leg in
flexion
d. Assisted weight-bearing ambulation correct answers
ANS: B
Immobilization of the affected leg helps to decrease pain and reduce
the risk for
pathologi
c
fracture. Weight-bearing exercise increases the risk for pathologic fractures.
Flexion of
th
e
affected limb is avoided to prevent
contractures.
DIF: Cognitive Level: Apply (application) REF:
1499
TOP: Nursing Process: Planning MSC: NCLEX: Physiological
Integrity
A patient is being discharged after 1 week of IV antibiotic therapy for acute
osteomyelitis
i
n
the right leg. Which information will be included in the discharge
teaching?
a. How to apply warm packs to the leg to
reduce
b. How pain
to monitor and care for a long-term IV
catheter
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
correct answers
ANS:
The patient will be taking IV antibiotics for several months. The patient
B
will need to
recogniz
e
signs of infection at the IV site and know how to care for the catheter
during daily
activiti
es
such as bathing. IV antibiotics rather than oral antibiotics are used
for acute
osteomyeliti
Patients are instructed to avoid exercise and heat application because
s.
these will
increas
e
swelling and the risk for spreading
infection.
DIF: Cognitive Level: Apply (application) REF:
1499
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological
Integrity
A patient is receiving IV antibiotics at home to treat chronic
osteomyelitis of the left
femur
.The nurse identifies a need for additional teaching related to health
maintenance when
th
e
, nurse finds that the
patient
a. is frustrated with the length of treatment
required.
b. takes and records the oral temperature twice
a day.
c. is unable to plantar flex the foot on the
affected
d. side.
uses crutches to avoid weight bearing on the affected leg. correct
answers
Foot dropANS:
is anCindication that the foot is not being supported in a neutral
position by a
splin
t.
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
maintenan
ce
of the
osteomyelitis.
DIF: Cognitive Level: Apply (application) REF:
1499
TOP: Nursing Process: Analysis MSC: NCLEX: Physiological
Integrity
The nurse instructs a patient who has osteosarcoma of the tibia about a
scheduled
above-the-knee amputation. Which statement by a patient indicates
additional patient
teachin
g
is
needed?
a. "I will need to participate in physical therapy after
surgery."
b. "I wish I did not need to have chemotherapy after this
surgery."
c. "I did not have this bone cancer until my leg broke a
week
d. ago."
"I can use the patient-controlled analgesia (PCA) to manage
postoperative
correct answerspain."
ANS:
C
Osteogenic sarcoma may be diagnosed following a fracture, but it is not
caused by the
injury
.The other statements indicate patient teaching has been
effective.
DIF: Cognitive Level: Apply (application) REF:
1501
TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological
Integrity
A patient with muscular dystrophy is hospitalized with pneumonia. Which
nursing action
wil
lbe included in the plan of
care?
a. Logroll the patient every 2
hours.
b. Assist the patient with
ambulation.
c. Discuss the need for genetic testing with the
d. Teach the patient about the muscle biopsy procedure. correct
patient.
answers ANS:
Because B for the patient with muscular dystrophy is to keep the
the goal
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
no
tnecessary for a patient who already has a diagnosis. There is no need
for genetic
testin
g
because the patient already knows the
diagnosis.
