Clinical Scenario:

A nurse is assessing a patient who reports joint pain, morning stiffness, and difficulty gripping objects. The nurse observes bony enlargements at the distal and proximal interphalangeal joints of both hands.

Which of the following findings should the nurse document in the patient's assessment?

Tophi deposits and podagra

Heberden's nodes and Bouchard's nodes

Ulnar deviation and joint subluxation

Swan-neck deformity and Boutonnière deformity

Answer and Explanation

The Correct Answer is B

A. Tophi deposits and podagra: These findings are associated with gout, not osteoarthritis. Tophi are urate crystal deposits, and podagra refers to gout affecting the big toe.

B. Heberden's nodes and Bouchard's nodes: Heberden’s nodes are bony growths at the distal interphalangeal (DIP) joints, while Bouchard’s nodes affect the proximal interphalangeal (PIP) joints. These are characteristic of osteoarthritis.

C. Ulnar deviation and joint subluxation: Ulnar deviation and joint subluxation are commonly seen in rheumatoid arthritis, not osteoarthritis.

D. Swan-neck deformity and Boutonnière deformity: These deformities are typical of rheumatoid arthritis, not osteoarthritis.

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Correct Answer is D

Explanation

A. Fat embolism syndrome: Fat embolism syndrome (FES) typically presents with respiratory symptoms, such as dyspnea, petechiae, and confusion. Gastrointestinal symptoms like nausea and bloating are not characteristic of FES.

B. Deep vein thrombosis (DVT): DVT primarily presents with unilateral leg swelling, pain, and warmth, rather than gastrointestinal symptoms. While immobilization increases the risk of DVT, the patient’s symptoms do not align with this condition.

C. Compartment syndrome: Compartment syndrome involves severe pain, pallor, paresthesia, pulselessness, and paralysis in an affected limb. Gastrointestinal symptoms are not associated with compartment syndrome.

D. Cast syndrome (Superior Mesenteric Artery Syndrome - SMAS): SMAS occurs when the full-body cast compresses the superior mesenteric artery, leading to nausea, bloating, abdominal pain, and weight loss due to gastric obstruction. This condition is common in patients immobilized for prolonged periods.

A. “I can bend my hip beyond 90 degrees as long as I feel comfortable." B. “I should avoid turning onto my operative side to prevent hip dislocation." C. “I don't need to use a pillow or abduction device between my legs when turning." D. “I should cross my legs when sitting to keep my hip stable."

Correct Answer is B

Explanation

A. “I can bend my hip beyond 90 degrees as long as I feel comfortable." Flexing the hip beyond 90 degrees increases the risk of hip dislocation.

B. “I should avoid turning onto my operative side to prevent hip dislocation." Lying on the operative side increases pressure on the hip joint and can lead to dislocation or delayed healing.

C. “I don't need to use a pillow or abduction device between my legs when turning." An abduction pillow or device is necessary to keep the legs apart and prevent hip adduction, which can lead to dislocation.

D. “I should cross my legs when sitting to keep my hip stable." Crossing the legs can cause internal rotation and hip dislocation.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is D

Explanation

Which of the following statements by the patient is correct regarding postoperative positioning after total hip arthroplasty?

Correct Answer is B

Explanation

A nurse is assessing a bedridden patient and notes a reddened area on the sacrum that does not blanch when pressed. The skin is intact. Based on this finding, which stage of pressure ulcer should the nurse document?

Which of the following statements by the patient indicates correct understanding of postoperative hip precautions?

A patient with chronic gout is prescribed allopurinol. Which statement by the patient indicates a correct understanding of the medication's purpose?

A nurse is caring for a client who has a new short-leg cast on his lower leg to treat an ankle fracture. Which of the following findings requires immediate notification of the provider?

A nurse is caring for a client who is postoperative following an open reduction and internal fixation of a fractured femur. Which of the following actions is the most important for the nurse to complete in the postoperative period?

A nurse is providing teaching for a client who is postoperative following below-the-knee amputation. The nurse should instruct the client that which of the following nutrients is necessary for wound healing?

A 45-year-old male patient arrives at the emergency department with partial-thickness burns on his entire right arm, the front of his right leg, and the entire front of his torso. Using the Rule of Nines, what is the estimated Total Body Surface Area (TBSA) burned?

A nurse is reviewing the diagnostic test results of an older adult female client who is preoperative for a knee arthroplasty. The nurse should notify the surgeon of which of the following results?