Brunner-Suddarth Med-Surg 13th Ed. Ch. 40
What areas of the body may be examined when bone densitometry is done? Select all answers that are correct.
Hip Spine Wrist
The nurse is caring for a client who experienced a crushing injury of the lower extremities. Which of the following symptoms is essential to be reported to the physician?
Pulselessness
Which medication taken by the client in the previous 24 hours would be of greatest concern to the nurse caring for a client undergoing a bone biopsy?
aspirin
The nurse is preparing the client for magnetic resonance imaging for complaints of low back pain. Which statement by the client requires action by the nurse?
"I didn't remove my Transderm-Nitro patch."
The older client asks the nurse how best to maintain strong bones. The best response by the nurse is:
"Weight-bearing exercises can strengthen bones."
The nurse is conducting a community education program on hip fracture risk. The nurse evaluates that the participants understand the program when the program determines that the person at highest risk for a hip fracture is which of the following?
80-year-old recently widowed
Which of the following describes an osteon?
A microscopic functional bone unit
The nurse reading a patient's chart notices that the patient is documented to have paresthesia. The nurse plans care for a patient with which of the following?
Abnormal sensations
Which of the following statements describes paresthesia?
Abnormal sensations
Which body movement involves moving toward the midline?
Adduction
The nurse is providing care to a client following a knee arthroscopy. Which of the following would the nurse expect to include in the client's plan of care?
Administering the prescribed analgesic.
A client is experiencing muscle weakness in the upper extremities. The client raises an arm above the head but then loses the ability to maintain the position. Muscular dystrophy is suspected. Which diagnostic test would evaluate muscle weakness or deterioration?
An electromyography
A client has undergone arthroscopy. After the procedure, the site where the arthroscope was inserted is covered with a bulky dressing. The client's entire leg is also elevated without flexing the knee. What is the appropriate nursing intervention required in caring for a client who has undergone arthroscopy?
Apply a cold pack at the insertion site.
Which of the following is useful in identifying acute or chronic tears of the joint capsule or supporting ligaments of the knee, shoulder, ankle, hip or wrist?
Arthrography
The nurse is performing a musculoskeletal assessment of a patient in a nursing home who had a stroke 2 years ago and who has right-sided hemiplegia. The nurse notes that the girth of the patient's right calf is 2 inches less in diameter than the left calf. The nurse attributes the decreased girth to which of the following?
Atrophy of right calf muscle
Which hormone inhibits bone reabsorption and increases calcium deposit in the bone?
Calcitonin
Which hormone inhibits bone resorption and increases the deposit of calcium in the bone?
Calcitonin
What is the term for a rhythmic contraction of a muscle?
Clonus
Which of the following is a neurovascular problem caused by pressure within a muscle area that increases to such an extent that microcirculation diminishes?
Compartment syndrome
The homecare nurse is evaluating the musculoskeletal system of a geriatric patient whose previous assessment was within normal limits. The nurse initiates a call to the health care provider and/or emergency services when which of the following changes are found?
Decreased right-sided muscle strength
The nurse working in the ER receives a call from the x-ray department communicating that the patient the nurse is caring for has a fracture in the shaft of the tibia. The nurse tells the physician that the patient's fracture is which of the following?
Diaphysis
The nurse would expect which of the following diagnostic tests to be ordered for a patient with lower extremity muscle weakness?
Electromyograph (EMG)
A patient has had a stroke and is unable to move the right upper and lower extremity. During assessment the nurse picks up the arm and it is limp and without tone. How would the nurse document this finding?
Flaccidity
Which assessment finding would cause the nurse to suspect compartment syndrome in the client following a bone biopsy?
Increased diameter of the calf
Which of the following is an example of a hinge joint?
Knee
The nurse is performing an assessment on an older adult patient and observes the patient has an increased forward curvature of the thoracic spine. What does the nurse understand this common finding is known as?
Kyphosis
The client presents with an exaggeration of the lumbar spine curve. The nurse interprets these findings as indicative of:
Lordosis
After a person experiences a closure of the epiphyses, which statement is true?
No further increase in bone length occurs.
A nurse is caring for a client with an undiagnosed bone disease. When instructing on the normal process to maintain bone tissue, which process transforms osteoblasts into mature bone cells?
Ossification and calcification
An instructor is describing the process of bone development. Which of the following would the instructor describe as being responsible for the process of ossification?
Osteoblasts
Which serum level indicates the rate of bone turnover?
Osteocalcin
The nurse observes the client and notes a shuffling gait. The nurse recognizes this finding is consistent with:
Parkinson's disease
Red bone marrow produces which of the following? Select all that apply.
Platelets White blood cells (WBCs) Red blood cells (RBCs)
A 10-year-old boy who was brought to the emergency room after a skiing accident is diagnosed with a fracture of the distal end of the femur. The nurse understands that this type of fracture is significant because:
Potential growth problems may result from damage to the epiphyseal plate.
A patient has a fracture of the right femur sustained in an automobile accident. What process of fracture healing does the nurse understand will occur with this patient?
Reactive phase, reparative phase, remodeling phase
Which of the following would be most important for the nurse to include in the teaching plan for a client who has undergone arthrography?
Report joint crackling or clicking noises occurring after the second day.
What is the term for a lateral curving of the spine?
Scoliosis
Which of the following deformities causes a lateral curving deviation of the spine?
Scoliosis
A patient has a fracture that is being treated with open rigid compression plate fixation devices. How will the progress of bone healing be monitored?
Serial x-rays
Which type of gait correlates with Parkinson's disease?
Shuffling
A patient is scheduled for a bone marrow biopsy. The nurse explains to the family that the bone marrow is located mainly in four areas. She tells the family that the site to be used would be the:
Sternum
A nurse practitioner assesses a patient's movement in his left hand after a cast is removed. The nurse asks the patient to turn his wrist so the palm of his hand is facing up. This movement is known as:
Supination
The nurse working in the orthopedic surgeon's office is asked to schedule a shoulder arthrography. The nurse determines that the surgeon suspects which of the following findings?
Tear in the joint capsule
A client experiences a musculoskeletal injury that involves the structure that connects a muscle to the bone. The nurse understands that this injury involves which of the following?
Tendon
A 16-year-old patient is seen in the emergency room for a knee injury that happened during a basketball game. Diagnostic tests reveal torn cords of fibrous connective tissue that connect muscles to bones. The nurse knows that the patient had sustained a tear of the:
Tendon.
The nurse is conducting an admission history of a client admitted with a fracture. The nurse recognizes that which of the client's medications placed the client at risk for fractures?
prednisone (Deltasone)
Which laboratory study indicates the rate of bone turnover?
Serum osteocalcin
