Chapter 45: Concepts of Care for Patients
with Musculoskeletal Problems
Ignatavicius: Medical-Surgical Nursing, 10th Edition
MULTIPLE CHOICE
1. An older client with diabetes is admitted with a heavily draining leg wound. The
client’s white blood cell count is 38,000/mm3 (38 109/L) but the client is afebrile.
Which nursing action is most appropriate at this time?
a. Administer acetaminophen as needed.
b. Educate the client on amputation.
c. Place the client on Contact Precautions.
d. Refer the client to the wound care nurse.
ANS: C
In the presence of a heavily draining wound, the nurse would place the client on
Contact Precautions. If the client has discomfort, acetaminophen can be used, but this
client has not reported pain and is afebrile. The client may or may not need an
amputation in the future. The wound care nurse may be consulted but not as the most
appropriate action.
DIF: Applying TOP: Integrated Process: Nursing Process: Planning and
Implementation KEY: Musculoskeletal disorders, Transmission-Based
Precautions MSC: Client Needs Category: Safe and Effective Care
Environment: Safety and Infection Control
2. A nurse is caring for four clients. After the hand-off report, which client would the
nurse see first?
, a. Client with osteoporosis and a white blood cell count of 27,000/mm3 (27
109/L)
b. Client with osteoporosis and a bone fracture who requests pain medication
c. Post-microvascular bone transfer client whose distal leg is cool and pale
d. Client with suspected bone tumor who just returned from having a spinal CT
ANS: C
This client is the priority because the assessment findings indicate a critical lack of
perfusion. A high white blood cell count is an expected finding for the client with
osteoporosis. The client requesting pain medication should be seen second. The client
who just returned from a CT scan is stable and needs no specific postprocedure care.
DIF: Analyzing TOP: Integrated Process: Nursing Process: Analysis
KEY: Musculoskeletal disorders, Nursing assessment MSC:
Client Needs Category: Safe and Effective Care Environment: Management of
Care
3. A client has a metastatic bone tumor in the left leg. What action by the nurse is
appropriate?
a. Administer pain medication as prescribed.
b. Elevate the extremity and apply moist heat.
c. Teach the client about amputation care.
d. Place the client on protective precautions.
ANS: A
Pain medication should be given to control metastatic bone pain. Elevation and heat
may or may not be helpful. Protective precautions are not needed for this client.
DIF: Applying TOP: Integrated Process: Nursing Process: Planning and
Implementation KEY: Musculoskeletal disorders, Cancer MSC:
Client Needs Category: Physiological Integrity: Basic Care and Comfort
with Musculoskeletal Problems
Ignatavicius: Medical-Surgical Nursing, 10th Edition
MULTIPLE CHOICE
1. An older client with diabetes is admitted with a heavily draining leg wound. The
client’s white blood cell count is 38,000/mm3 (38 109/L) but the client is afebrile.
Which nursing action is most appropriate at this time?
a. Administer acetaminophen as needed.
b. Educate the client on amputation.
c. Place the client on Contact Precautions.
d. Refer the client to the wound care nurse.
ANS: C
In the presence of a heavily draining wound, the nurse would place the client on
Contact Precautions. If the client has discomfort, acetaminophen can be used, but this
client has not reported pain and is afebrile. The client may or may not need an
amputation in the future. The wound care nurse may be consulted but not as the most
appropriate action.
DIF: Applying TOP: Integrated Process: Nursing Process: Planning and
Implementation KEY: Musculoskeletal disorders, Transmission-Based
Precautions MSC: Client Needs Category: Safe and Effective Care
Environment: Safety and Infection Control
2. A nurse is caring for four clients. After the hand-off report, which client would the
nurse see first?
, a. Client with osteoporosis and a white blood cell count of 27,000/mm3 (27
109/L)
b. Client with osteoporosis and a bone fracture who requests pain medication
c. Post-microvascular bone transfer client whose distal leg is cool and pale
d. Client with suspected bone tumor who just returned from having a spinal CT
ANS: C
This client is the priority because the assessment findings indicate a critical lack of
perfusion. A high white blood cell count is an expected finding for the client with
osteoporosis. The client requesting pain medication should be seen second. The client
who just returned from a CT scan is stable and needs no specific postprocedure care.
DIF: Analyzing TOP: Integrated Process: Nursing Process: Analysis
KEY: Musculoskeletal disorders, Nursing assessment MSC:
Client Needs Category: Safe and Effective Care Environment: Management of
Care
3. A client has a metastatic bone tumor in the left leg. What action by the nurse is
appropriate?
a. Administer pain medication as prescribed.
b. Elevate the extremity and apply moist heat.
c. Teach the client about amputation care.
d. Place the client on protective precautions.
ANS: A
Pain medication should be given to control metastatic bone pain. Elevation and heat
may or may not be helpful. Protective precautions are not needed for this client.
DIF: Applying TOP: Integrated Process: Nursing Process: Planning and
Implementation KEY: Musculoskeletal disorders, Cancer MSC:
Client Needs Category: Physiological Integrity: Basic Care and Comfort
