NRS 3025 FINAL EXAM QUESTIONS ANSWERED CORRECTLY LATEST UPDATE 2026

NRS 3025 FINAL EXAM QUESTIONS ANSWERED CORRECTLY LATEST UPDATE 2026 arthroplasty - Answers surgical removal of a diseased joint due to osteoarthritis, osteonecrosis, rheumatoid arthritis, trauma or congenital anomalies Arthroplasty contraindications - Answers -Recent or active infection -arterial impairment -client inability to follow postsurgical regimen -comorbidities (uncontrolled DM, HTN, advanced osteoporosis, progressive inflammatory condition, unstable cardiac or respiratory conditions) Nursing actions for arthroplasty (preprocedure) - Answers -review diagnostic test results (CBC, urinalysis, electrolytes, BUN Cr) -Chest x ray to rule out pulmonary contraindications -ECG to identify contraindications (dysrhythmia) -Scrub surgical site with antiseptic (infection prophylaxis) Nursing actions for arthroplasty (post procedure) - Answers -Monitor for infection -Monitor for DVT, PE, or bleeding if on anticoagulant -Neurovascular assessments -analgesics -antibiotics -early ambulation arthroplasty complications - Answers -joint dislocation -infection -anemia -neurovascular compromise Osteoporosis - Answers -chronic metabolic bone disorder resulting in low bone density osteoporosis prevention - Answers - consume adequate calcium and vitamin D -weight bearing exercises primary osteoporosis - Answers -caused by natural changes to bone mass and strength that come with age -common in post-menopausal women secondary osteoporosis - Answers -results from medical conditions (hyperparathyroidism, hyperthyroidism, DM, Cushings, RA, bone cancer, female hypogonadism, GH deficiency, chronic airway disorders that affect Ca absorption) -loop diuretics, corticosteroids, thyroid meds, anticonvulsants -lack of weight bearing Osteoporosis RF - Answers -family history, lean body build -low calcium intake -tobacco use -excess caffeine -high phosphorous intake osteoporosis manifestations - Answers -reduced height of 2-3 inches -acute back pain when bending or lifting -restriction in movement or spinal deformity -history of fractures -kyphosis -pain palpating over affected area Osteoporosis Labs - Answers -blood calcium, vitamin D, phosphorous, hematocrit, ESR, and alkaline phosphatase levels to R/O other metabolic bone diseases -24 hr urine can evaluate calcium excretion -bone turnover markers to measure bone formation and resorption Osteoporosis Diagnostics - Answers -Radiography of spine and long bones reveal density and fractures -DXA: screens for early changes in bone density on hip or spine -MRI: provide info about bone density w/o exposing client to radiation, areas show decreased perfusion Osteoporosis nursing care - Answers -instruct on dietary calcium sources -reinforce need for Vit D -encourage weight bearing exercise -assess home environment for safety osteoporosis meds - Answers -Calcium and Vit D can slow or prevent -Calcium carbonate./calcium citrate -Bisphosphonates: decreases number and actions of osteoclasts Other osteoporosis treatments - Answers -orthotic devices -Vertebroplasty or kyphoplasty Osteoarthritis - Answers -noninflammatory degenerative disorder of joints -primary: idiopathic -secondary: resulting from previous joint injury or inflammatory disease Osteoarthritis RF - Answers -Age -Genetics -Joint injury due to acute or repetitive stress -obesity -metabolic disorder (DM, sickle cell) -females osteoarthritis manifestations - Answers -joint pain and stiffness -pain with joint palpation or ROM -crepitus -enlarged joint -inflammation from secondary synovitis -vertebral radiating pain -limping gait -back pain Osteoarthritis nursing care - Answers -assist client with pharm/nonpharm pain relief -have client determine acceptable pain level -determine psychosocial impact of OA -assess need for assistive or adaptive devices OA meds - Answers -acetaminophen (max 3000 mg/24 hr) -NSAIDs for pain not relieved by tylenol and topical agents, and synovitis if present -opioids: tramadol is a weak opioid used for OA -topical capsaicin: provides temp pain relief by blocking impulses (burning feeling normal) -Glucosamine and chondroitin: aid in repair and maintenance of cartilage. Chondroitin can increase risk of bleeding on anticoagulants Other OA treatments - Answers -intra-articular injections: glucocorticoids used to treat inflammation, no more than 4 times a year -total joint arthroplasty Upper extremity amputations - Answers -most common cause are traumas caused by crashes, wars, or other injury Lower extremity amputations - Answers -most common cause is peripheral vascular disease Amputations nursing care - Answers -prevent postoperative complications (hypovolemia, pain, infection) -assess for bleeding and vital signs frequently -monitor perfusion at end of residual limb -compare pulse most proximal to incision with pulse in other extremity Phantom limb pain treatment - Answers -calcitonin during first week of amputation can decrease it -beta blockers can relieve the continual dull, burning sensation -antiepileptics can relieve sharp, stabbing, and burning pain -some clients have relief from antispasmodics and antidepressants -other treatments include massage, heat, TENS, ultrasound therapy, relaxation therapy Closed fracture - Answers -fracture that does not break through the skin surface Open fracture - Answers -fracture disrupts skin integrity, causing open wound and tissue injury w/ risk of infection -Grade I: minimal skin damage -Grade II: damage includes skin and muscle contusions but w,o extensive soft tissue injury -Grade III: damage is excessive to skin, muscles, nerves, and blood vessels types of fractures - Answers -simple: one fracture line -comminuted: multiple fracture line -fatigue (stress): excess strain occurs during reaction/athletic activity -pathological (spontaneous): bone that is weak from a disease process -compression occurs from loading force pressing on cancellous bone (common in osteoporosis) Fracture RF - Answers -osteoporosis -falls -MVA -substance use disorders -disease - contact sports -abuse -lactose intolerance -age Fracture manifestations - Answers -crepitus -deformity: internal or external rotation, shortened extremity, visible bone, asymmetrical appearance -muscle spasms due to pulling forces when bone not aligned -edema -ecchymosis Fractures diagnostics - Answers -Radiographs -CT -bone scan using radioactive material determines hairline fractures and complications Fractures initial nursing care - Answers -ABCs - stabilize injured area using splints -ask client about cause of injury -assess for bleeding -cover open wounds with sterile dressings -monitor VS -pain assessment -elevate limb above heart and apply ice -neurovascular checks every hour Aspects of neurovascular check - Answers -Pain -sensation -temp -cap refill -pulses -movement Fractures meds - Answers -analgesics -muscle relaxants to relieve muscle spasms -stool softener to prevent constipation -antibiotic: infection prophylaxis Fractures therapeutic procedures - Answers -closed reduction: pulling force applied manually to realign the displaced bone fragments -splints/immobilizers: provide support, control movement, reduce pain, correct deformity, prevent additional injury -casts Types of casts - Answers -short and long arm and leg cast -walking cast -spica cast: portion of trunk and one or two extremities -body casts: encircle the trunk of the body Pin site care - Answers - monitors for manifestations of infection -drainage and redness -loosening of pins -tenting of skin at pin site external fixation - Answers -fracture immobilization using percutaneous wires that are attached to a rigid external frame - used for comminuted or nonunion fractures w/ extensive soft tissue damage. leg length discrepancies from congenital defects, and bone loss related to osteomyelitis Open Reduction Internal Fixation (ORIF) - Answers -open reduction: visualization of fracture through an incision in the skin and internal fixation with plates, screws, pins, rods, and prosthetics as needed Five Ps of compartment syndrome - Answers -pain -paralysis -paresthesia -pallor -pulselessness Fat embolism - Answers -common following hip fracture -adults age 70-80 and males 20-40 -fat globules from bone marrow are released into circulation and travel to small blood vessels, including lungs, resulting in respiratiory deficiency and imparied organ perfusion fat embolism manifestations - Answers Early: -dyspnea, increased RR, decreased SpO2 -headache -decreased mental acuity -resp distress -tachycardia -confusion -chest pain Late and discriminating from PE: cutaneous petechiae Avascular necrosis - Answers -results from circulatory compromise that occurs after a fracture. blood flow disrupted to fracture site and ischemia occurs -common in hip fractures -RF: long term corticosteroids, radiation therapy, RA, sickle cell carpal tunnel syndrome - Answers compression of the median nerve in the wrist from swollen or thickened synovium carapal tunnel RF - Answers -metabolic and connective tissue diseases (RA and DM) -Occupational injury -repetitive sports injury -computer use - growth of space occupying lesion Strokes - Answers -AKA cerebrovascular accidents or brain attacks -disruption in cerebral blood flow secondary to ischemia, hemorrhage, brain attack, or embolism Classification of strokes - Answers -hemorrhagic: occur secondary to ruptured artery or aneurysm, poor prognosis due to amount of ischemia and increased ICP -ischemic-thrombotic: occurs secondary to the development of a blood clot on an atherosclerotic plaque (gradual) -ischemic-embolic: caused by embolus traveling from another part of the body to cerebral artery. (instant) Stroke RF - Answers -cerebral aneurysm -arteriovenous malformation -DM -obesity -HTN -Atherosclerosis -Hyperlipidemia -hypercoaguability -a-fib -oral contraceptives -smoking -cocaine Stroke general manifestations - Answers -transient manifestations (visual disturbances, dizzy, slurred speech, weak extremity) -can indicate a TIA which is a warning of stroke -homonymous hemianopsia (half sided blindness) -facial droop maybed (can be linked to low blood sugar)