Name:

Section:

1. A client with rheumatoid arthritis asks the nurse why she is taking Prednisone. The nurse’
best response would be that it:
a. enhance the immune system
b. increase bone density
c. reduce inflammation
d. reduce peripheral edema

2. Which of the following nursing diagnoses is a priority for a patient with gout?
a. fatigue
b. pain
c. risk for infection
d. risk for peripheral neurovascular dysfunction

3. A patient had a right total hip arthroplasty with a cemented prosthesis for treatment of
severe osteoarthritis of the hip. What activity should the nurse include on the patient’s first
postoperative day?
a. Transfer from the bed to the chair twice a day only
b. Only turning from the back to both sides every 2 hours
c. Crutch walking with non–weight bearing on the operative leg
d. Ambulation with a walker and limited weight bearing on the right leg
4.During treatment of the patient with an acute attack of gout, which drug should the nurse
expect to administer first?
a. Aspirin
b. Colchicine
c. Probenecid
d. Allopurinol
5. A nurse is conducting health screening for osteoporosis. Which of the following clients is at
greatest risk of developing this disorder?
a. a 25-year old woman who jogs
b. a 36-year old man who has asthma
c. a 70-year old man who consumes excess alcohol
d. a sedentary 65-year old woman who smokes cigarettes
6. A nurse has conducted preoperative teaching for a client scheduled for surgery in 1 week.
The client has a history of arthritis and has been taking acetylsalicylic acid (aspirin). The
nurse determines that the client needs additional teaching if the client states:
a. “Aspirin can cause bleeding after surgery.”
b. “Aspirin can cause my ability to clot blood to abnormal.”
c. “I need to discontinue the aspirin 48 hours before the scheduled surgery.”
d. “I need to continue to take aspirin until the day of surgery.”
7. Which among these clients is at highest risk for developing low back pain?
a. the man working with a drill hammer
b. the man delivering mails in the building
c. the salesman selling truck tires
d. the man washing windows of a building
8. The nurse would instruct the patient which of the following to minimize complications of
gout?
a. drinking a minimum of 3000 ml of fluid per day
b. eating a minimum of 2500 calories per day
c. walking at least three miles per day
d. resting at least three hours per day
9. As an acute episode of rheumatoid arthritis subsides, active and passive range-of-motion
exercises are taught to the client’s spouse. The nurse should teach that direct pressure must
not be applied to the client’s joints because this may precipitate:
a. tophaceous deposits.
b. nodule formation.
c. swelling.
d. pain
10. A female client is admitted to the hospital for intravenous antibiotic therapy and an
incision and drainage of an abscess that developed at the site of a puncture wound. The nurse
should begin teaching wound care to the client:
a. during the first dressing change
b. on the first postoperative day
c. several days before discharge
d. in the preoperative period
11. While performing a physical assessment of a client with gout of the great toe, the nurse
should assess for additional tophi (urate deposits) on the:
a. abdomen.
b. buttocks.
c. chin.
d. ears

12. Which of the following complications does the nurse suspect when a client had fracture of
the femur and is now experiencing respiratory distress?
a. sepsis
b. fat embolism
c. bleeding
d. shock
13. A client who has been using crutches to ambulate for a week now reports pain, fatigue,
and frustration with crutch walking. How should the nurse respond when the client states “ I
feel like I will always be crippled”?
a. “Just remember, you’ll be done with the crutches in another month.”
b. “Why don’t you take a couple of days off of work and rest.”
c. “I know how you feel. I had to use crutches before too.”
d. “Tell me what makes this so bothersome for you.”
14. The nurse is caring for a client who will be taught to ambulate with a cane. Before cane-
assisted ambulation instructions begin, what should the nurse check for as the priority to
assure client safety?
a. Balance, muscle strength, and confidence
b. Full range of motion in lower extremities
c. Self-consciousness about using a cane
d. A high level stamina and energy
15. The nurse is preparing to change a client’s dressing. The statement that best explains the
basis of surgical asepsis that the nurse will perform in this procedure is:
a. keep the number of opportunistic microorganism to a minimum.
b. confine the microorganisms to the surgical incision site.
c. protect self from microorganisms in the wound.
d. keep the area free of microorganisms
16. To which of the following nursing actions would a nurse give priority in the emergency
care of a client who has sustained a compound fracture of the femur?
a. Apply pressure directly over the wound
b. Irrigate the wound with normal saline
c. Place the leg in neutral alignment
d. Splint the leg in its present position
17. The nurse prepares to care for a client with acute cellulitis of the lower leg. The nurse
anticipates that which of the following will be prescribed for the client?
a. cold compress to the affected area
b. warm compress to the affected area
c. intermittent heat lamp treatments four times a day
d. alternating hot and cold compresses continuously
18. A nurse has given instructions to a client returning home after knee arthroscopy. The
nurse determines that the client understands the instructions if the client states that he or
she will:
a. refrain from eating food for the remainder of the day
b. report fever or site inflammation to the physician
c. stay off the leg entirely for the rest of the day
d. resume regular exercise the following day
19. A patient had a right total hip arthroplasty with a cemented prosthesis for treatment of
severe osteoarthritis of the hip. What activity should the nurse include on the patient’s first
postoperative day?
a. Transfer from the bed to the chair twice a day only
b. Only turning from the back to both sides every 2 hours
c. Crutch walking with non–weight bearing on the operative leg
d. Ambulation with a walker and limited weight bearing on the right leg
20. A client has a newly applied long leg cast to stabilize a right proximal fractured tibia.
During rounds at night, the nurse finds the client restless, withdrawn, and unusually quiet.
Which nursing statement would be most appropriate?
a. “I’ll get your pain medication right away.”
 b. “You’ll feel better in the morning.”
c. “Tell me what you are feeling.”
d. “Are you uncomfortable?”

21. A client with burns develops a wound infection. The nurse knows that local wound
infections are primarily treated with:
a. intramuscular antibiotics
b. intravenous antibiotics
c. topical antibiotics
d. oral antibiotics
22. An x-ray film of a client’s arm reveals a comminuted fracture of the radial bone. The
nurse understands that with a comminuted fracture:
a. The bone is broken into two parts and the skin may or may not be broken.
b. The bone has broken into several fragments and the skin is intact.
c. Splintering has occurred on one side and bending on the other.
d. There is a break in the skin and the bone is protruding.

23. The nurse is reviewing the discharge instructions for the client who had a skin biopsy.
Which statement by the client indicates a need for further instruction?
a. I will use the antibiotic ointment as prescribed
b. I will return in 7 days to have the sutures removed
c. I will call the physician if I see any drainage from the wound
d. I will remove the dressing as soon as I get home and wash it with water
24.Which of the following will contribute to the development of primary gout?
a. beer and wine
b. eggs and milk
c. vegetables and meat
d. butter and fruits

25. The shirt of a young man starting a barbecue fire ignites. The most effective method for
putting out the flames would be to:
a. Pouring cold liquid over the flame
b. Log-rolling the man on the grass
c. Removing the burning clothes
d. Slapping at the flames

26. The client is placed on allopurinol (Zyloprim) therapy. To monitor effectiveness of the
therapy, the nurse will monitor which the following serum laboratory values?
a. uric acid
b. fasting blood glucose
c. serum calcium
d. alkaline phosphatase

27. REPUBLIC ACT NO. 9173 is also known as:

a. Philippine Nursing Act of 2002

 b. Motorcycle Helmet Act of 2009
c. Magna Carta for Disabled Persons
d. Sanitation Code
28. An advance directive takes effect only if:
a. you are conscious with no hope of recovery.
b. you become terminally ill and can't speak for yourself.
c. you are declared clinically dead.
d. hospitalization bills can’t be settled by your family.

29. A nurse has given instructions to a client returning home after knee arthroscopy. The
nurse determines that the client understands the instructions if the client states that he or
she will:
a. refrain from eating food for the remainder of the day
b. report fever or site inflammation to the physician
c. stay off the leg entirely for the rest of the day
d. resume regular exercise the following day
30. A client asks the nurse to act as a witness for an advance directive. Which is the best
intervention for the nurse to implement?
a. Help the client find an unrelated third party.
b. Notify the provider of the client’s request.
c. Agree to sign the document as a witness.
d. Suggest the nurse manager as a witness.
31. The nurse gives medical information regarding the client’s condition to a person who is
assumed to be a family member. Later the nurse discovers that this person is not a family
member and realizes that this violated which legal concepts of the nurse-client relationship?
a. Duty to comply with nursing standards
b. Client’s right to confidentiality
c. Client’s right of autonomy
d. Duty to provide care
32. A client asks the nurse how to become an organ donor. Which information should the
nurse include in the discussion?
a. A family member must be present when a client consents to organ donation.
b. The donor must be older than 21 years of age.
c. A family member must witness the consent.
d. The client can donate by written consent
33. Which of the following questions would be essential in a cultural assessment of a patient?
a. Are there foods that you cannot eat together?
b. At what time do you take your medication?
c. How many times have you been married?
d. Do you have any siblings?
34. A patient says to the nurse, “I have something important to tell you, but you must
promise not to tell anyone else.” The nurse’s best response would be to
a. commit to keeping the confidence.
b. commit to conditionally keeping the confidence.
c. explain that the patient should share this information with her physician instead.
 d. explain that the information may need to be shared with the treatment but will be
held confidential.
35. The nurse prepares to care for a client with acute cellulitis of the lower leg. The nurse
anticipates that which of the following will be prescribed for the client?
a. cold compress to the affected area
b. warm compress to the affected area
c. intermittent heat lamp treatments four times a day
d. alternating hot and cold compresses continuously

36-41 6 Ps classic sign of compartment syndrome

42-45 In managing sprains/strains, RICE APPROACH simply stands for:

46-50 Identify what type of fracture are these.