NCLEX ADULT MED SURG EXAM TESTBANK 600

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NCLEX ADULT MED SURG EXAM TESTBANK 600

ACTUAL EXAM QUESTIONS AND ANSWERS WITH

RATIONALES GRADED A( ORTHOPEDICS) 1 / 4

2 A client has acute, painful muscle spasms. The physician prescribes chlorzoxazone (Paraflex), 500 mg P.O. t.i.d. A centrally acting skeletal muscle

relaxant, chlorzoxazone commonly is used to treat:

1.muscle spasm caused by cerebral palsy.

2.chronic musculoskeletal disorder.

3.lower extremity spasticity.

4.severe muscle spasm.Correct Answer: 4 Your Answer: 4 RATIONALES: Chlorzoxazone is used to treat acute, painful musculoskeletal conditions or severe muscle spasm. Centrally acting skeletal muscle relaxants like chlorzoxazone are ineffective in treating spasticity associated with chronic neurologic disease, such as cerebral palsy. They can treat acute musculoskeletal disorders, not chronic ones. Chlorzoxazone and the other relaxants are used to treat spasticity of any extremity.A client who has just been diagnosed with mixed muscular dystrophy asks the nurse about the usual course of this disease. How should the nurse respond?

1."You should ask your physician about that."

2."The strength of your arms and pelvic muscles will decrease gradually, but this should cause only slight disability." 3."You may experience progressive deterioration in all voluntary muscles." 4."This form of muscular dystrophy is a relatively benign disease that progresses slowly." Correct Answer: 3 Your Answer: 3 RATIONALES: Muscular dystrophy causes progressive, symmetrical wasting of skeletal muscles, without neural or sensory defects. The mixed form of the disease typically strikes between ages 30 and 50 and progresses rapidly, causing deterioration of all voluntary muscles. Because the client asked the nurse this question directly, the nurse should answer and not simply refer the client to the physician. Limb-girdle muscular dystrophy causes a gradual decrease in arm and pelvic muscle strength, resulting in slight disability. Facioscapulohumeral muscular dystrophy is a slowly

A common bone disease that usually affects middle-aged and elderly people. It's marked by inflammation of the bones, softening and thickening of the bones, excessive bone destruction, and unorganized bone repair; the result is bowing of the long bones. The cause is unknown.

A 51-year-old client with Paget's disease comes to the hospital and complains of difficulty urinating. The emergency department physician consults urology. What would the nurse suspect is the most likely cause of the client's urination problem?

1.Renal calculi

2.Urinary tract infection

3.Benign prostatic hyperplasia

4.Dehydration Correct Answer: 1 Your Answer: 1 RATIONALES: Renal calculi commonly occur with Paget's disease, causing pain and difficulty when urinating. A urinary tract infection (UTI) commonly causes fever, urgency, burning, and hesitation with urination. Benign prostatic hyperplasia is common in men older than age 50; however, because the client has Paget's disease, the nurse should suspect renal calculi, not benign prostatic hyperplasia. Dehydration causes a decrease in urine production, not a problem with urination. 2 / 4

3 The nurse is caring for a client who complains of lower back pain. Which instructions should the nurse give to the client to prevent back injury?

1."Bend over the object you're lifting."

2."Narrow the stance when lifting."

3."Push or pull an object using your arms." 4."Stand close to the object you're lifting." Correct Answer: 4 Your Answer: 4 RATIONALES: Standing close to an object when lifting moves the body's center of gravity closer to the object, allowing the legs, rather than the back, to bear the weight. No one should bend over an object when lifting; instead, the back should be straight, and bending should be at the hips and knees. When lifting, spreading the legs apart widens the base of support and lowers the center of gravity, providing better balance. Pushing or pulling an object using the weight of the body, rather than the arms or back, prevents back strain. Using a larger number of muscle groups distributes the workload.A client is diagnosed with osteoporosis. Which statements should the nurse include when teaching the client about the disease?

1."It's common in females after menopause."

2."It's a degenerative disease characterized by a decrease in bone density."

3."It's a congenital disease caused by poor dietary intake of milk products."

4."It can cause pain and injury."

5."Passive range-of-motion exercises can promote bone growth."

6."Weight-bearing exercise should be avoided." Correct Answer: 1,2,4 Your Answer: 1,2,4 RATIONALES: Osteoporosis is a degenerative metabolic bone disorder in which the rate of bone resorption accelerates and the rate of bone formation decelerates, thus decreasing bone density. Postmenopausal women are at increased risk for this disorder because of the loss of estrogen.The decrease in bone density can cause pain and injury. Osteoporosis isn't a congenital disorder; however, low calcium intake does contribute to the disorder. Passive range-of-motion exercises may be performed but they won't promote bone growth. The client should be encouraged to participate in weight-bearing exercise because it promotes bone growth.The nurse is caring for a client with burns on his legs. Which nursing intervention will help to prevent contractures?

1.Applying knee splints

2.Elevating the foot of the bed

3.Hyperextending the client's legs progressive, relatively benign form of muscular dystrophy; it usually arises before age 10.A group of degenerative genetic diseases characterized by weakness and the progressive atrophy of skeletal muscles with no evidence of nervous system involvement.

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4 Correct Answer: 1 Your Answer: 1 RATIONALES: Applying knee splints prevents leg contractures by holding the joints in a functional position. Elevating the foot of the bed doesn't prevent contractures. Hyperextending a body part for any length of time is inappropriate; it can cause contractures. Performing shoulder ROM exercises can prevent contractures in the shoulders but not in the legs.Following a boating accident, a 30-year- old client with multiple fractures is admitted to a semiprivate room in a progressive care unit. The client, who was driving the boat, is unaware that his girlfriend's 9-year-old son was killed in the accident. The client's parents instruct the nurse to prohibit phone calls and to withhold information about the accident. During an assessment of the client, the nurse notices that the television is on and the

news is starting. It would be most appropriate for the nurse to:

1.turn the television off and tell the client it interferes with the assessment.

2.allow the client to view the television and deal with any questions as they come.

3.instruct the client to change the channel to a station that isn't televising the news.

4.attempt to distract the client from watching the television.Correct Answer: 2 Your Answer: 1 RATIONALES: The nurse-client relationship is built on trust, so the nurse can't withhold information from her client. She may refer the client to another source for the information, but she can't prohibit the client from seeking information. It would be most appropriate to deal with the client's questions as they come. Turning the television off, changing the channel, and distracting the client are all deceitful practices, which can damage a therapeutic nurse-client relationship.A client is diagnosed with gout. Which foods should the nurse instruct the client to avoid?

1.Green, leafy vegetables

2.Liver

3.Cod

4.Chocolate

5.Sardines

6.Eggs Correct Answer: 2,3,5 Your Answer: 2,3,5 RATIONALES: Clients with gout should avoid foods that are high in purines, such as liver, cod, and sardines. They should also avoid anchovies, kidneys, sweetbreads, lentils, and alcoholic beverages especially beer and wine. Green, leafy vegetables; chocolate; and eggs aren't high in purines.

• Performing shoulder range-of-motion (ROM)

exercises

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