NSG 320 EXAM 1
A client with a sports injury undergoes a diagnostic arthroscopy of his left knee. After
the procedure, the nurse assesses the client's leg. Which assessment factors are the
priority?
1. Wound and integumentary assessments.
2. Mobility assessment.
3. Vascular and integumentary assessments.
4. Circulatory and neurologic assessments.
4. Following a procedure on an extremity, nursing assessment should focus on
neurovascular status of the extremity. Swelling of the extremity can impair neurologic
and circulatory function of the leg. After the neurovascular stability of the extremity
has been established, the nurse can address the other concerns of skin integrity,
mobility, and pain.
A client undergoes a lumbar puncture for a myelogram. Shortly after the procedure.
he reports a severe headache. What should the nurse do?
1. Increase the client's fluid intake.
2. Administer prescribed antihypertensives.
3. Offer roll lenses to the client.
4. Place cooling packs over the lumbar puncture site.
1. Headache following a lumbar puncture is usually cause by cerebrospinal fluid
leakage. Increased fluid intake will help restore CSF volume. Antihypertensives don't
address the problem. Roll lenses reduce light irritation to the eyes and ice may
,reduce site pain, but neither intervention addresses the problem of reduced CSF
volume, which caused the headache.
A nurse is assessing a client with osteoarthritis of the knees. The nurse would most
likely detect crepitation during:
1. Palpation
2. Percussion
3. Auscultation
4. Inspection
1. Crepitus is a grating sensation associated with degenerative joint disease and can
be felt or heard. It's best detected by palpation of the affected joint.
A client with osteoarthritis develops coagulopathy secondary to long-term
nonsteroidal anti-inflammatory drug use. The coagulopathy is most likely the result
of:
1. Impaired vitamin K synthesis.
2. Blocked prothrombin conversion
3. Decreased platelet adhesiveness.
4. Factor VIII destruction
3. NSAIDs reduce platelet adhesiveness and can impair coagulation. They don't
impair vitamin K synthesis, block prothrombin conversion, or destroy factor VIII.
,A nurse is teaching a client with osteoarthritis about lifestyle changes. Which
lifestyle change will most likely reduce the signs and symptoms associated with
osteoarthritis?
1. Avoiding exercise
2. Restricting caffeine
3. Abstaining from alcohol
4. Reducing weight
4. Osteoarthritis is a disorder caused by wear and tear on the joints. Excess body
weight is a risk factor associated with development and progression of osteoarthritis.
Weight reduction can reduce the manifestations of osteoarthritis. Certain
aggravating exercises may need to be avoided, but exercise can be beneficial.
Caffeine isn't associated with clinical manifestations of osteoarthritis. Alcohol intake
is prohibited.
A client develops L5-S1 herniated nucleus propulsus, which impinges on the left
nerve root. Most likely, the client would experience pain that radiates:
1. Up the spinal column
2. To the lower abdomen
3. Down the left leg
4. Across to the right pelvis
3. The pain associated with herniated nucleus propulses of L5-S1 primarily affects
the lower back, with radiation down one leg.
, A nurse is walking in a local park and witnesses an elderly woman fall. The woman
reports severe pain, has difficulty moving her left leg, and is unable to bear weight on
the affected leg. The nurse notices her left leg appears shorter than her right. The
nurse suspects a femoral fracture. The greatest risk to the client is:
1. Infection
2. Fat embolus
3. Neurogenic shock
4. Hypovolemia
4. The greatest risk to the client with a femoral fracture is hypovolemia from
hemorrhage, which may be covert and can be fatal if not detected. Infection and fat
emboli are potential complications less frequently seen in femoral fracture.
Neurogenic shock isn’t directly associated with femoral fracture.
A client is undergoing rehabilitation following a fracture. As part of his regimen. the
client performs isometric exercises. Which action provides the best evidence that
the client understands the proper technique?
1. Exercising of bilateral extremities simultaneously.
2. Periodic monitoring of his heart rate.
3. Forced resistance against stable objects.
4. Swinging of limbs through full range of motion.
3. Isometric exercises involve applying pressure against a stable object, such as
pressing the hands together or pushing an arm against a wall. Exercising extremities
simultaneously isn't a characteristic of isometrics. Heart rate monitoring is
associated with aerobic exercise. Limb swinging isn't isometric.
A client with a sports injury undergoes a diagnostic arthroscopy of his left knee. After
the procedure, the nurse assesses the client's leg. Which assessment factors are the
priority?
1. Wound and integumentary assessments.
2. Mobility assessment.
3. Vascular and integumentary assessments.
4. Circulatory and neurologic assessments.
4. Following a procedure on an extremity, nursing assessment should focus on
neurovascular status of the extremity. Swelling of the extremity can impair neurologic
and circulatory function of the leg. After the neurovascular stability of the extremity
has been established, the nurse can address the other concerns of skin integrity,
mobility, and pain.
A client undergoes a lumbar puncture for a myelogram. Shortly after the procedure.
he reports a severe headache. What should the nurse do?
1. Increase the client's fluid intake.
2. Administer prescribed antihypertensives.
3. Offer roll lenses to the client.
4. Place cooling packs over the lumbar puncture site.
1. Headache following a lumbar puncture is usually cause by cerebrospinal fluid
leakage. Increased fluid intake will help restore CSF volume. Antihypertensives don't
address the problem. Roll lenses reduce light irritation to the eyes and ice may
,reduce site pain, but neither intervention addresses the problem of reduced CSF
volume, which caused the headache.
A nurse is assessing a client with osteoarthritis of the knees. The nurse would most
likely detect crepitation during:
1. Palpation
2. Percussion
3. Auscultation
4. Inspection
1. Crepitus is a grating sensation associated with degenerative joint disease and can
be felt or heard. It's best detected by palpation of the affected joint.
A client with osteoarthritis develops coagulopathy secondary to long-term
nonsteroidal anti-inflammatory drug use. The coagulopathy is most likely the result
of:
1. Impaired vitamin K synthesis.
2. Blocked prothrombin conversion
3. Decreased platelet adhesiveness.
4. Factor VIII destruction
3. NSAIDs reduce platelet adhesiveness and can impair coagulation. They don't
impair vitamin K synthesis, block prothrombin conversion, or destroy factor VIII.
,A nurse is teaching a client with osteoarthritis about lifestyle changes. Which
lifestyle change will most likely reduce the signs and symptoms associated with
osteoarthritis?
1. Avoiding exercise
2. Restricting caffeine
3. Abstaining from alcohol
4. Reducing weight
4. Osteoarthritis is a disorder caused by wear and tear on the joints. Excess body
weight is a risk factor associated with development and progression of osteoarthritis.
Weight reduction can reduce the manifestations of osteoarthritis. Certain
aggravating exercises may need to be avoided, but exercise can be beneficial.
Caffeine isn't associated with clinical manifestations of osteoarthritis. Alcohol intake
is prohibited.
A client develops L5-S1 herniated nucleus propulsus, which impinges on the left
nerve root. Most likely, the client would experience pain that radiates:
1. Up the spinal column
2. To the lower abdomen
3. Down the left leg
4. Across to the right pelvis
3. The pain associated with herniated nucleus propulses of L5-S1 primarily affects
the lower back, with radiation down one leg.
, A nurse is walking in a local park and witnesses an elderly woman fall. The woman
reports severe pain, has difficulty moving her left leg, and is unable to bear weight on
the affected leg. The nurse notices her left leg appears shorter than her right. The
nurse suspects a femoral fracture. The greatest risk to the client is:
1. Infection
2. Fat embolus
3. Neurogenic shock
4. Hypovolemia
4. The greatest risk to the client with a femoral fracture is hypovolemia from
hemorrhage, which may be covert and can be fatal if not detected. Infection and fat
emboli are potential complications less frequently seen in femoral fracture.
Neurogenic shock isn’t directly associated with femoral fracture.
A client is undergoing rehabilitation following a fracture. As part of his regimen. the
client performs isometric exercises. Which action provides the best evidence that
the client understands the proper technique?
1. Exercising of bilateral extremities simultaneously.
2. Periodic monitoring of his heart rate.
3. Forced resistance against stable objects.
4. Swinging of limbs through full range of motion.
3. Isometric exercises involve applying pressure against a stable object, such as
pressing the hands together or pushing an arm against a wall. Exercising extremities
simultaneously isn't a characteristic of isometrics. Heart rate monitoring is
associated with aerobic exercise. Limb swinging isn't isometric.
