NU144- Chapter 39: Assessment of Musculoskeletal Function
The nurse is conducting a medication reconciliation with a client admitted with a fracture. What medication predisposes a client for a risk for fractures?
prednisone
cartilage
tough, elastic, avascular tissue at ends of bone
osteogenesis
bone formation
callus
cartilaginous/fibrous tissue at fracture site
atonic
without tone; denervated muscle that atrophies
The nurse is conducting the admission assessment for a client who is to undergo an arthrogram. What is the priority question the nurse should ask?
"Do you have any allergies?"
What is the term for a rhythmic contraction of a muscle?
Clonus
Which term refers to the shaft of the long bone?
Diaphysis
A client is diagnosed with a fracture of a diarthrosis joint. What is an example of this type of joint?
Elbow
Which of the following describes a muscle that is limp and without tone?
Flaccid
Which assessment finding would cause the nurse to suspect compartment syndrome in the client following a bone biopsy?
Increased diameter of the calf
A client is scheduled to undergo an electromyography. When performed, what will this test evaluate?
Muscle weakness
A nurse knows that a person with a 3-week-old femur fracture is at the stage where angiogenesis is occurring. What are the characteristics of this stage?
New capillaries producing a bridge between the fractured bones.
Which of the following is the final stage of fracture repair?
Remodeling
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 structure?
Tendon
A client 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. What type of tear has this client sustained?
Tendon
The nurse understands that bone maintenance requires a balance between forming and dissolving bone. What is a correct statement about the function of osteoblasts?
They secrete a matrix that consists of collagen.
paresthesia
abnormal sensation (e.g., burning, tingling, numbness)
contracture
abnormal shortening of muscle, joint, or both; fibrosis
osteoclast
bone resorption cell
osteoblast
bone-forming cell
epiphysis
end of long bone
isotonic contraction
muscle is shortened without a change in its tension; a joint is moved as a result
isometric contraction
muscle tension is increased without changing its length; there is no associated joint motion
clonus
rhythmic contractions of a muscle
ligament
ropelike bundles of collagen fibrils connecting bones
The nurse is employed at a long-term care facility caring for geriatric clients. Which assessment finding is characteristic of an age-related change?
Loss of height
The nurse is assessing a new client with a musculoskeletal problem. What is the best question by the nurse to elicit more information related to the injury?
"Do you have any chronic disorder or recent injury?"
A patient tells the nurse, "I was working out and lifting weights and now that I have stopped, I am flabby and my muscles have gone!" What is the best response by the nurse?
"Your muscles were in a state of hypertrophy from the weight lifting but it will persist only if the exercise is continued."
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
The nurse is performing an assessment for a patient who may have peripheral neurovascular dysfunction. What signs does the patient present with that indicate circulation is impaired? (Select all that apply.)
Pale, cyanotic, or mottled color Cool temperature of the extremity More than 3-second capillary refill
crepitus
grating or crackling sound or sensation; may occur with movement of ends of a broken bone or irregular joint surface
diaphysis
shaft of long bone
The nurse is assessing a client's gait. What assessments indicate the client has a normal gait? Select all that apply.
smoothness knee flexion
cancellous bone
latticelike bone structure; trabecular bone
Which statement describes paresthesia?
Abnormal sensations
The nurse is planning care for a client with a musculoskeletal injury. Which nursing diagnosis would be the highest priority?
Acute Pain
Which hormone inhibits bone reabsorption and increases calcium deposit in the bone?
Calcitonin
Which of the following is an example of a hinge joint?
Knee
Which of the following is the most common site of joint effusion?
Knee
Which cells are involved in bone resorption?
Osteoclasts
A client is recovering from a fractured hip. What would the nurse suggest that the client increase intake of to facilitate calcium absorption from food and supplements?
Vitamin D
hypertrophy
enlargement; increase in the size of a muscle
lamellae
mature compact bone structures that form concentric rings of bone matrix; lamellar bone
Choose the correct statement about the endosteum, a significant component of the skeletal system:
Covers the marrow cavity of long bones
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
A client undergoes an invasive joint examination of the knee. What will the nurse closely monitor the client for?
Serous drainage
The nurse is assessing the client for scoliosis. What will the nurse have the client do to perform the assessment?
Stand behind the client and ask the client to bend forward at the waist.
The nurse working in the orthopedic surgeon's office is asked to schedule a shoulder arthrography. The nurse determines that the surgeon suspects which finding?
Tear in the joint capsule
joint
area where bone ends meet; provides for motion and flexibility
effusion
excess fluid in joint
lordosis
increase in concave curvature of the lumbar spine
flaccid
limp; without muscle tone
tone (tonus)
normal tension (resistance to stretch) in resting muscle
Patient education for musculoskeletal conditions for the aging is based on the understanding that there is a gradual loss of bone after a peak of bone mass at age:
30 years.
A client arrives at the orthopedic physician's office stating knee pain sustained while playing soccer. A history and physical assessment is completed. The knee appears reddened with edema. Which other diagnostic testing would the nurse anticipate?
An arthroscopy
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
Which of the following factors would the nurse need to keep in mind about the focus of the initial history when assessing a new client with a musculoskeletal problem?
Any chronic disorder or recent injury
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.
A patient is scheduled for a procedure that will allow the physician to visualize the knee joint in order to diagnose the patient's pain. What procedure will the nurse prepare the patient for?
Arthroscopy
The nurse is performing a neurological assessment. What will this assessment include?
Ask the client to plantar flex the toes.
Which term refers to mature compact bone structures that form concentric rings of bone matrix?
Lamellae
A group of students are reviewing information about bones in preparation for a quiz. Which of the following indicates that the students have understood the material?
Osteoclasts are involved in the destruction and remodeling of bone.
A client comes to the emergency department with reports of pain in the left ankle. The client states, "I missed a step coming down the stairs, and landed funny." The ankle is swollen and tender to the touch. What will the nurse do to help control the swelling?
Raise the left leg above the level of the heart.
A client has a fracture that is being treated with open rigid compression plate fixation devices. What teaching will the nurse reinforce to the client about how the progress of bone healing will be monitored?
Serial x-rays will be taken.
The nurse is reviewing the client's admission assessment and notes that crepitus of the right knee joint was documented. What assessment will the nurse find as described by crepitus?
a grating sound when a joint is put through range of motion
periosteum
fibrous connective tissue covering bone
fascia (epimysium)
fibrous tissue that covers, supports, and separates muscles
joint capsule
fibrous tissue that encloses bone ends and other joint surfaces
bursa
fluid-filled sac found in connective tissue, usually in the area of joints
spastic
having greater-than-normal muscle tone
fasciculation
involuntary twitch of muscle fibers
scoliosis
lateral curving of the spine
trabeculae
latticelike bone structure; cancellous bone
osteocyte
mature bone cell
synovium
membrane in joint that secretes lubricating fluid
osteon
microscopic functional bone unit
There are thousands of components of the musculoskeletal system that facilitate mobility and independent function. The function of skeletal muscle is promoting:
movement of skeletal bones.
ossification
process in which minerals (calcium) are deposited in bone matrix
remodeling
process that ensures bone maintenance through simultaneous bone resorption and formation
osteopenic
refers to a reduction in bone mass to below normal levels
resorption
removal/destruction of tissue, such as bone
A client reports being consistently tired, with no energy. The client's CBC indicates low hemoglobin. Where is hemoglobin manufactured?
ribs
kyphosis
increase in the convex curvature of the thoracic spine
endosteum
a thin, vascular membrane covering the marrow cavity of long bones and the spaces in cancellous bone
atrophy
decrease in the size of a muscle
tendon
cord of fibrous tissue connecting muscle to bone
The older client asks the nurse how best to maintain strong bones. What is the nurse's best response?
"Weight-bearing exercises can strengthen bones."
Which is useful in identifying acute or chronic tears of the joint capsule or supporting ligaments of the knee, shoulder, ankle, hip, or wrist?
Arthrography
cortical bone
compact bone
A client tells the health care provider about shoulder pain that is present even without any strenuous movement. The health care provider identifies a sac filled with synovial fluid. What condition will the nurse educate the client about?
bursitis