EAQ Musculoskeletal Mastery Quiz
How would the nurse respond to a client who expresses malignancy fears associated with the pending bone biopsy report? 1 "Worrying is not going to help the situation." 2 "Let's wait until we hear what the biopsy report says." 3 "It is very upsetting to have to wait for a biopsy report." 4 "Operations are not performed unless there are no other options."
3 "It is very upsetting to have to wait for a biopsy report." "It is very upsetting to have to wait for a biopsy report," addresses the fact that the client's feelings of anxiety are valid. Stating, "Worrying is not going to help the situation," or "Let's wait until we hear what the biopsy report says," does not address the client's concerns and may inhibit the expression of feelings. Telling the client that operations are not performed unless there are no other options is irrelevant and does not address the client's concerns. Test-Taking Tip: Come to your test prep with a positive attitude about yourself, your nursing knowledge, and your test-taking abilities. A positive attitude is achieved through self-confidence gained by effective study.
Which instruction would the nurse provide to an older client using ice and heat to treat pain from back strain? Select all that apply. One, some, or all responses may be correct. 1 Switch positions every 4 hours. 2 Use a heating pad for the first 24 hours. 3 Apply for 30-minute time intervals. 4 Place the ice pack directly to injury site. 5 Take ibuprofen every 4 hours PRN.
3 Apply for 30-minute time intervals. To prevent skin damage, ice and heat should only be applied for 20- to 30-minute intervals. Clients should be instructed to shift positions every hour to prevent skin breakdown. Ice should be used the first 24 to 48 hours followed by heat. Ice should never be directly applied to the skin as it can cause injury to the tissue. The client can take ibuprofen if approved by the health care provider.
When would the nurse expect the client who has rheumatoid arthritis to experience the most joint pain and stiffness? 1 After assistive exercise 2 When the room is cool 3 During the evening hours 4 In the morning on awakening
4 In the morning on awakening Inactivity over an extended time increases stiffness and pain in joints. The client typically has morning stiffness, or gel phenomenon. Assistive exercises help maintain joint mobility. Whether the room is cool is not a factor; cold applications may decrease joint discomfort. The pain is not as severe in the evening as in the morning. Test-Taking Tip: After you have eliminated one or more choices, you may discover that two of the options are very similar. This can be very helpful, because it may mean that one of these look-alike answers is the best choice and the other is a very good distractor. Test both of these options against the stem. Ask yourself which one completes the incomplete statement grammatically and which one answers the question more fully and completely. The option that best completes or answers the stem is the one you should choose. Here, too, pause for a few seconds, give your brain time to reflect, and recall may occur.
Which nursing intervention prevents footdrop in a client with osteomyelitis? 1 Elevating the foot with the use of pillows 2 Consistently flexing the affected extremity 3 Encouraging the client to change positions 4 Neutral positioning of the foot with the use of a splint
4 Neutral positioning of the foot with the use of a splint A client with osteomyelitis is at an increased risk for footdrop, which results in an abnormal gait. Neutral positioning of the foot with the use of a splint can reduce the risk of foot drop in the client with osteomyelitis. Elevating the client's foot on pillows can reduce the risk of edema. Asking the client with osteomyelitis to flex the affected extremity can result in flexion contracture. Encouraging the client with osteomyelitis to change positions helps prevent complications associated with immobility and promotes comfort; carefully handle the involved limb and avoid excessive manipulation, which may lead to a pathological fracture.
A student athlete reports muscle pain after a practice session. Which product of muscle metabolism would the nurse explain as being a cause of pain? 1 Lactic acid 2 Acetoacetic acid 3 Hydrochloric acid 4 Beta-hydroxybutyric acid
1 Lactic acid
For which purpose is a goniometer used? 1 To assess range of motion 2 To reduce phantom limb sensation 3 To prevent hip flexion contractures 4 To immobilize a joint during fracture
1 To assess range of motion A goniometer is a device that measures the angle of a joint and is used to assess range of motion. Mirror therapy is used to reduce phantom limb sensation. Buck's traction boot is a type of skin traction used to prevent hip flexion contractures. Splints are used to immobilize a joint after a fracture.
Which clinical manifestation would the nurse expect when a client experiences fat embolism syndrome (FES)? 1 Nausea 2 Dyspnea 3 Orthopnea 4 Paresthesia
2 Dyspnea FES is clinically manifested by dyspnea because of low levels of arterial oxygen. Nausea and orthopnea are not seen in FES. However, tachypnea, headache, and lethargy are seen in clients with FES. Paresthesia occurs with compartment syndrome.
Which image indicates the client has ulnar drift?
3 fingers bent toward the 4th metacarpal (pinky finger)
Which phrase describes a greenstick fracture? 1 More than two fragments 2 Incomplete with one side bent 3 Spontaneous, at the site of bone disease 4 Across the longitudinal axis of the bone shaft
2 Incomplete with one side bent An incomplete fracture with one side splintered and the other side bent indicates a greenstick fracture. A fracture with more than two fragments that appear to be floating is known as a comminuted fracture. A pathological fracture is a spontaneous fracture found at the site of bone disease. A transverse fracture extends across the longitudinal axis of the bone shaft.
Which condition is characterized by infection of a client's bone or bone marrow? 1 Osteomalac 2 Osteomyelitis 3 Herniated disc 4 Spinal stenosis
2 Osteomyelitis Osteomyelitis is infection of bone or bone marrow. Osteomalacia is a condition characterized by softening of bones due to calcium or vitamin D deficiency. Herniated disc is caused by structural damage of the intervertebral discs in which the nucleus pulposus seeps through a torn or stretched annulus. Spinal stenosis is narrowing of the spinal canal.
A client returns from surgery, after a right below-the-knee amputation, with the residual limb straight, but elevated on a pillow to prevent edema. In which position would the nurse place the client after the first postoperative day? 1 Any position, as long as the residual limb remains immobilized 2 Turn client to the prone position for 15 to 20 minutes at least three times a day 3 For short periods, position the client in the right side-lying position 4 Maintain elevation of the residual limb for a total of 3 days
2 Turn client to the prone position for 15 to 20 minutes at least three times a day Positioning the client in the prone position for short periods helps prevent hip flexion contractures. Do not immobilize the client's residual limb, but do not keep the joint bent for prolonged periods. Begin exercises to prevent contractures as soon as possible. Positioning the client in the right side-lying position can cause trauma to the incision site and should be avoided. Do not elevate the client's residual limb for more than 48 hours because hip flexion contractures can result. Test-Taking Tip: Once you have decided on an answer, look at the stem again. Does your choice answer the question that was asked? If the question stem asks "why," be sure the response you have chosen is a reason. If the question stem is singular, then be sure the option is singular, and the same for plural stems and plural responses. Many times, checking to make sure that the choice makes sense in relation to the stem will reveal the correct answer.
Which diagnostic procedure is used to detect muscle weakness? 1 Arthroscopy 2 Radiography 3 Myelography 4 Electromyography
4 Electromyography Electromyography is performed to detect diffuse or localized muscle weakness by determining the electric potential generated in an individual. Arthroscopy is used for the direct visualization of ligaments, menisci, and articular surfaces of a joint. A radiography is performed to detect bone density, alignment, swelling, and intactness of a joint. A Myelography is performed to visualize the vertebral column, intervertebral discs, spinal nerve roots, and blood vessels.
