Patho Quiz 9- Musculoskeletal
Which of the following pathophysiological phenomena would be most indicative of ankylosing spondylitis?
Loss of motion in the spinal column and eventual kyphosis
A 17-year-old male has been diagnosed with osteosarcoma of the upper tibia following several months of leg pain. Which of the following statements by the client demonstrates that he has an accurate understanding of his diagnosis?
"I'm really nervous about having to get surgery and chemo."
While being tackled, a 20-year-old football player puts out his hand to break his fall to the ground. Because the intense pain in his wrist did not subside by the end of the game, he was brought to an emergency department where diagnostic imaging indicated an incomplete tear of the ligament surrounding his wrist joint. At the time of admission, his wrist was swollen with a severely restricted range of motion. What will his care team most likely tell the player about his diagnosis and treatment?
"It looks like a mild to moderate sprain, and you'll need to keep it immobilized for a few weeks."
A public health nurse is conducting a health promotion teaching session at a seniors' drop-in center. Which of the following teaching points about hip fractures in older adults is most justified?
"Most hip fractures are actually a break at the very top of the thigh bone."
A 70-year-old woman's family physician has recommended a vitamin D supplement. The woman states that she tries hard to take as few pills as possible and questions her physician on the rationale and necessity of the hormone. How can the physician most accurately reply to the client's concerns?
"Vitamin D is important in order for your body to absorb the calcium that you consume in your diet."
A nurse is teaching a wellness group among a group of older adult women. One of the women has asked for advice about preventing osteoporosis, which affects many of her friends. What is the nurse's best response to the woman's query?
"Weight-bearing exercise is helpful, as are calcium supplements."
Following a motorcycle accident that resulted in bilateral femoral fractures, a 42-year-old male has been receiving skeletal traction for the past 8 days. His care providers would recognize that which of the following risks is paramount?
Risk of thromboemboli
Which of the following recent admissions to an emergency department is most likely to be diagnosed with a greenstick fracture?
An 8-year-old boy who fell out of a tree and on to his arm
The nurse knows that which of the following patients listed below is at high risk for developing a hip fracture?
An 82-year-old female with macular degeneration and uses a walker to go to the bathroom.
In which of the following locations would a clinician expect to find a ligament?
Around the capsule that forms the knee joint
A nurse is providing care for a client who has had a cast applied to her fractured arm 6 hours prior. The client is now complaining of severe pain that she describes as "even worse than when I broke my arm." What would be the nurse's best course of action?
Assessment of motor and sensory function with the goal of identifying compartment syndrome
Which of the following measures should a public health nurse recommend to middle-aged women to reduce their chances of developing osteoporosis later in life?
Calcium supplementation and regular physical activity
An elderly resident of an assisted-living facility has had his mobility and independence significantly impaired by the progression of his rheumatoid arthritis (RA). What is the primary pathophysiologic process that has contributed to this patient's decline in health?
Immunologically mediated joint inflammation
A female tennis player has suffered an injury to her shoulder that has affected her bursae in the joint. Which of the following consequences would be most expected from this aspect of her injury?
Increased friction on the tendons of the shoulder joint
A patient with a diagnosis of small cell lung carcinoma has developed bone metastases, a finding that has prompted a series of new interventions. What are the primary goals of the treatment regimen for this patient's bone cancer?
Prevention of pathologic fractures and maximization of function
A patient's clavicular fracture has healed in the weeks following a bicycle accident. Which of the following events takes place in the remodelling stage of bone healing?
Reduction in the size of the callus
A patient asks the nurse why his hip fracture (head of the femur) bone has died (osteonecrosis). The nurse responds based on which of the following pathophysiological principles?
Since the head of the femur has only limited collateral circulation, interruption in the blood flow from the fracture causes necrosis and irreversible damage.
A 71-year-old male with a suspected diagnosis of osteoarthritis is being scheduled for a knee aspiration. The client is surprised to learn that his knee joint contains fluid and asks the physician ordering the procedure what the main role of the fluid is. Which of the following statements best underlies the explanation that the physician will provide?
Synovial fluid allows for joint movement by minimizing friction.
While explaining to the parents of a 5-year-old why the child's fractured femur has so much swelling and bruising, the nurse will include which of the following statements?
This bone is hollowed out, and the inside of the shaft produces marrow where red blood cells are formed."
For many patients, the first indication that they have osteoporosis is:
a bone fracture
A 41-year-old woman has been diagnosed as having a loose body of cartilage in her left knee. What data would most likely lead clinicians to this conclusion?
The woman experiences intermittent, painful locking of her joint.
Premature osteoporosis is being seen increasingly in female athletes because of an increased prevalence of:
amenorrhea
Following prosthetic joint replacement of the knee, the patient continues to complain of pain and discomfort above what would be expected. There is poor incisional healing. The clinic nurse is concerned when she sees that the incision is still draining after 3 weeks post-op. The nurse suspects a prosthetic joint infection. The nurse should anticipate the physician will prescribe
antimicrobial treatment depending on the microbe
Metastatic bone disease is most closely associated with:
breast cancer and prostate cancer
Characteristics of a patient that is at high risk for falling and fracturing a hip include:
chronic osteoporosis.
Osteoarthritis is a degenerative form of joint disease that is often evidenced by:
crepitus and grinding
In contrast to osteoporosis, osteomalacia causes _______ without the loss of bone matrix.
defective mineralization
Factors that may adversely affect bone healing include______ of the bone.
delayed union
In order to initiate the cellular events essential to bone healing, there must be ________ formation at the fracture site.
hematoma
A 55-year-old male patient has reported joint pain in his feet. Which of the following blood work results should prompt further testing to rule out primary gout?
increased serum uric acid
The patient has a fractured tibia. After the cast is applied he is at high risk for compartment syndrome caused by:
inflammation
Following a lengthy series of diagnostic tests, a patient's chronic hip pain has been attributed to advanced osteonecrosis. What treatment is this patient most likely to require?
joint replacement surgery
Following a fall 4 weeks prior that was caused by orthostatic hypotension, an 83-year-old male has fractured his femoral head. His care provider has stated that the healing process is occurring at a reasonable pace and that the man will regain full function after healing and rehabilitation. Which of the following cells is most responsible for restoring the integrity of the man's broken bone?
osteoblast
The condition that contributes to the pathology of all metabolic bone diseases is:
osteopenia
The clinical course of osteoarthritis (OA) culminates in:
osteophyte formation and erosion of cartilage.
A 13-year-old girl and her father come in to the local health clinic hoping to see an orthopedic doctor about the girl's stiff and warm knee. The father reports that she hurt it sliding into base during a softball game, and the daughter concurs, but with further discussion, it becomes clear that the slide made an existing pain worse. Her knee had been stiff, warm, and shiny and had been keeping her awake at night for a week or so before the game. Which of the following might be the cause of the girl's symptoms?
osteosarcoma
Which of the following neoplasms of the skeletal system is likely to require the most timely and aggressive treatment?
osteosarcoma
Rheumatoid arthritis is a systemic inflammatory disease with joint manifestations described as:
polyarticular
A pathologic stress fracture occurs in bones subjected to:
weakening by disease.