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2024 NCLEX BACK PROBLEMS FRACTURE/HIP FRACTURE AND OSTEOARTHRITIS EXAM WITH CORRECT ANSWERS
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2024 NCLEX BACK PROBLEMS FRACTURE/HIP FRACTURE AND OSTEOARTHRITIS EXAM WITH CORRECT ANSWERS
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2024 NCLEX BACK PROBLEMSFRACTURE/HIP FRACTURE AND
OSTEOARTHRITIS EXAM WITH
CORRECT ANSWERS
A nurse is caring for a client with a femoral shaft fracture. Which of the
following assessment findings is serious and warrants immediate
intervention by nurse?
1. Decreased urine output
2. Constipation
3. Hemorrhage
4. Pain - CORRECT ANSWERS-3.
Rationale: Femoral shaft fractures may cause hemorrhage, with as much as
1,000 to 1,500 ml of blood loss. Constipation and decreased urine output
aren't direct complications of a fracture. Pain may occur, but it can be
controlled with analgesia.
The nurse is assessing a client who is admitting for a long bone fracture.
Which assessment finding would be noted as a life-threatening complication?
1. Fat emboli
2. Bone emboli
3. Serous emboli
4. Platelet emboli - CORRECT ANSWERS-1.
Rationale: A life-threatening complication of long bone fractures is the
development of fat emboli. Bone or platelet emboli are rare occurrences and
infrequently associated with long bone fractures. There are no emboli known
as serous emboli.
A 76-year-old woman with a history of osteoporosis experienced a right hip
fracture and is admitted to the hospital. The client had a total hip
replacement. The most important nursing diagnosis for this client would be?
1. Acute pain
2. Self-care deficit
3. Risk for impaired skin integrity
,4. Imbalanced nutrition: Less than body requirements - CORRECT ANSWERS-
1.
Rationale: Relieving pain and making the client comfortable are the highest
priorities. All of the other nursing diagnoses would be lower priorities
The nurse is performing an admission assessment on a client with
osteoarthritis. Which of the following clinical manifestations would the nurse
expect to find?
1. Joint pain after exercise relieved by rest
2. Symmetrical swelling of the joints of both hands
3. Morning stiffness lasting longer than 30 minutes
4. Fever - CORRECT ANSWERS-1.
Rationale: The most common symptom of osteoarthritis is joint pain after
exercise or weight-bearing, usually relieved by rest. The other options are all
symptoms of rheumatoid arthritis.
The nurse is obtaining a health history from a client who has been taking
ibuprofen (Motrin). What is (are) the most important question(s) for the nurse
to ask the client? Select all that apply.
1. "How often do you take this medication?"
2. "Have you had any difficulty with breathing?"
3. "Do you monitor your blood pressure regularly?"
4. "Have you ever had tarry, black stools?"
5. "Have you ever vomited blood?" - CORRECT ANSWERS-1, 2, 4, and 5.
Rationale: Questions 4 and 5 are appropriate for the client who is taking
ibuprofen because the medication can lead to irritation of the
gastrointestinal (GI) mucosa, which can increase the risk of a GI bleed and
vomiting. Knowing how often the client takes the medication is important
because the client should not exceed 3,600 mg/day. If the client exceeds the
medication amount, this can lead to renal failure, which will cause the blood
pressure to increase. If the client has a history of respiratory problems,
ibuprofen can increase the risk for developing hypersensitivity reactions.
A client asks the nurse for information about osteoarthritis. What is the most
appropriate information for the nurse to include?
1. Osteoarthritis is rarely debilitating.
2. Osteoarthritis is a rare form of arthritis.
3. Osteoarthritis afflicts people over age 60.
4. Osteoarthritis is the most common form of arthritis. - CORRECT ANSWERS-
3.
Rationale: Osteoarthritis is the most common form of arthritis and can be
extremely debilitating. It can afflict people of any age, although most are
elderly.
, The health care provider orders 2 g of ampicillin (Omnipen) in 50 ml of D5W
to infuse I.V. piggyback (IVPB) over 30 minutes for a client who had a right
total knee replacement secondary to osteoarthritis.
The nurse will set the I.V. infusion pump at what rate in milliliters per hour?
_________________ ml/hour - CORRECT ANSWERS-100
60/30 = 2 × 50 ml/hour = 100 ml/hour
The health care provider orders heparin 7,500 units subcutaneous for a client
who had a left total hip replacement secondary to osteoarthritis. The
pharmacy sent heparin 5,000 units/0.5 ml to the unit.
How many milliliters would the nurse administer to the client? - CORRECT
ANSWERS-0.75 mL
Which of the following are causes of primary osteoarthritis?
1. Overuse of joints, aging, and obesity
2. Obesity, aging, and diabetes mellitus
3. Congenital abnormality, aging, overuse of joints
4. Diabetes mellitus, congenital abnormality, aging - CORRECT ANSWERS-1.
Rationale: Primary osteoarthritis may be caused by the overuse of joints,
aging, or obesity. Congenital abnormalities and diabetes mellitus can cause
secondary osteoarthritis.
The nurse is caring for a client with osteoarthritis of the knee. The nurse
determines that discharge teaching has been effective when the client
makes which statement?
1. "I'll take my ibuprofen (Motrin) on an empty stomach."
2. "I'll try taking a warm shower in the morning."
3. "I'll wear my knee splint every night."
4. "I'll jog at least a mile every morning." - CORRECT ANSWERS-2.
Rationale: A client with osteoarthritis has joint stiffness that may be partially
relieved with a warm shower on arising in the morning. Ibuprofen should be
taken with food, as should all nonsteroidal anti-inflammatory medications.
Splints are usually used by clients with rheumatoid arthritis. Because the
problem is continued stress on the joint, the client may want to try to an
exercise that puts less strain on the joint, such as swimming.
The health care provider prescribed salicylates for a client with osteoarthritis.
The nurse assesses the client and determines further intervention is
necessary when the client exhibits which of the following?
1. Hearing loss
2. Increased pain in joints
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