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The parents of a child diagnosed with rheumatic disease are shocked by the diagnosis and tell the nurse that they did not think children could acquire the disease. The best response would be: "Children who acquire rheumatic diseases are more likely to have a higher intelligence level." "Children can be affected with almost all of the rheumatic diseases that occur in adults." "Do not worry; a course of antibiotic therapy will cure the child." "Your child will not be restricted with any activities and will have a normal lifestyle."
"Children can be affected with almost all of the rheumatic diseases that occur in adults."
A client has been diagnosed with rheumatoid arthritis (RA). What will the nurse tell the client about this disorder's etiology? "Genetic predisposition is very likely." "The disease is most common in those under 30." "Environment is the biggest contributing factor to the development of RA." "Exposure to workplace chemicals is a causative agent."
"Genetic predisposition is very likely."
The client asks, "What is reduction?" How will the nurse respond? "It means the fracture is healed." "It means the fracture will be casted." "It refers to realigning the bone." "It is what happens when the fracture is immobilized."
"It refers to realigning the bone."
A nursing instructor is teaching students about skin structure. The instructor evaluates student knowledge of the epidermis based on which statement? "Keratinized epithelial cells formed in the deepest layer of the epidermis migrate to the skin surface to replace cells that are lost during normal skin shedding." "The epidermis contains the blood vessels and nerve fibers that feed the skin cells." "The epidermis is thinnest on the palms of the hands and soles of the feet than elsewhere on the body." "The epidermis is a connective tissue layer that separates the dermis from the underlying subcutaneous fat layer."
"Keratinized epithelial cells formed in the deepest layer of the epidermis migrate to the skin surface to replace cells that are lost during normal skin shedding."
A client sought care because of increasing pain and inflammation in the toe and ankle of one foot. Diagnostic testing has resulted in a diagnosis of gouty arthritis. When educating the client about the treatment and management of the disease, what should the nurse teach the client? "Your doctor will likely prescribe acetaminophen with codeine to manage your pain." "Losing some weight and reducing your alcohol intake will likely be beneficial." "In a lot of cases, clients with gout are able to control their symptoms through physiotherapy." "It's important that you have your bloodwork drawn weekly and that you adjust your diet."
"Losing some weight and reducing your alcohol intake will likely be beneficial."
A nurse is teaching a group of nursing students about the presentation of systemic lupus erythematosus (SLE). Which statement is the nurse likely to make? "More women than men are affected by lupus." "Lupus is a disease of older individuals." "Drug-induced lupus requires lifelong treatment." "Lupus is more common in white people."
"More women than men are affected by lupus."
A nurse is teaching the parent of a child with a diagnosis of Legg-Calvè-Perthes disease about the prescribed treatment. Which statement by the parent indicates adequate understanding? "My child will need to use crutches until the hip heals." "I will allow the kids to wrestle in the house." "My child will need to use careful hand washing." "I will administer the antibiotics twice a day until finished."
"My child will need to use crutches until the hip heals."
A nurse is evaluating the progress of a client with chronic fatigue syndrome. Which statement by the client indicates successful symptom management? "I work until I run out of energy, and then I rest." "My schedule includes yoga and a weekly club meeting." "I often find it is too much work to fix a meal." "My family wants me to volunteer at the animal shelter."
"My schedule includes yoga and a weekly club meeting."
The nurse is caring for a client diagnosed with osteoarthritis (OA). What does the nurse teach the client about the disease? "OA is a genetic disorder." "OA is an autoimmune disorder." "OA is a disease of the weight-bearing joints." "OA typically occurs in clients between 20 and 40 years of age."
"OA is a disease of the weight-bearing joints."
A client with osteomalacia asks, "How can I be deficient in vitamin D?" Which of the following is the nurse's best response? "Tell me about your typical daily food intake." "You do not go out in the sun enough." "You must be deficient in phosphate." "You should ask your doctor."
"Tell me about your typical daily food intake."
A month after surgical repair of a rotator cuff tear of the shoulder, a client tells the nurse, "This is not getting any better. I still have a lot of pain and limited motion." Which response by the nurse is most accurate? "Keep taking your steroid medication and the inflammation will subside." "Schedule an appointment with your surgeon for an evaluation." "The shoulder joint is complex and can take up to 6 months to heal depending on the injury." "Add massage therapy to your exercise routine to stretch tissues."
"The shoulder joint is complex and can take up to 6 months to heal depending on the injury."
A nurse is teaching a client diagnosed with osteoarthritis about the joint capsule. Which statement made by the client indicates that teaching was successful? "A moveable joint is called a synarthrosis." "The bursae are sac-like structures that sit between the articular cartilage surfaces." "The synovial fluid in my joint capsule acts as a lubricant and helps the movement of the joint's articulating surfaces." "The menisci are fibrocartilaginous structures that produce synovial fluid." SUBMIT ANSWER
"The synovial fluid in my joint capsule acts as a lubricant and helps the movement of the joint's articulating surfaces."
Which of the following should the nurse teach a client about syndactyly? "There is no cure for this condition." "This is a simple webbing of the fingers or toes." "This condition can be prevented." "This is a rare abnormality."
"This is a simple webbing of the fingers or toes."
A nurse is caring for a client with a fractured elbow. Which instruction is important to give the client to prevent cartilage degeneration while the elbow is immobilized? "Once the elbow has been casted, you will not be able to exercise that joint for 3-6 months." "It is important to begin with vigorous exercise of the affected area as soon as the cast is removed." "If you take a nonsteroidal anti-inflammatory medication prior to exercise, you will be able regain mobility faster." "To prevent cartilage atrophy, slowly and gradually resume exercising."
"To prevent cartilage atrophy, slowly and gradually resume exercising."
A client with polymyalgia rheumatica (PR) is being discharged on prednisone. What teaching should the nurse include? Select all that apply. "There are many adverse effects with this medication that make it difficult to take." "You will be taught how to titrate the dosing of the drug based on your symptoms." "You should notice rapid improvement in your symptoms with this medication." "It is normal to have fluctuations in your PR symptoms while on this medication." "Stopping the medication abruptly can have very serious health consequences."
"You should notice rapid improvement in your symptoms with this medication." "There are many adverse effects with this medication that make it difficult to take." "Stopping the medication abruptly can have very serious health consequences."
What should the nurse include in the teaching plan for a client with a grade 4 sprain? "You will need to keep your joint immobilized for 4 to 6 weeks." "You will definitely need surgery." "You should be able to walk in 24 hours, but you will have to move slowly." "You will be able to resume normal activities after 24 hours of rest."
"You will need to keep your joint immobilized for 4 to 6 weeks."
A physician is providing care for several clients on a hospital-based medical ward. Which client is most likely to experience chronic fatigue? 45-year-old female paraplegic with a necrotic ischial wound. 68-year-old woman admitted for a rectovaginal fistula. 33-year-old man with cellulitis to his lower leg. 51-year-old woman admitted for exacerbation of her multiple sclerosis.
51-year-old woman admitted for exacerbation of her multiple sclerosis.
Which person is most at risk for hip fractures? 26-year-old white female volleyball player 70-year-old active black woman 66-year-old white female with history of alcohol use disorder 50-year-old Asian male with dementia
66-year-old white female with history of alcohol use disorder
Which client is most at risk for premature osteoporosis? A 6-year-old who does not eat cheese A 16-year-old female athlete who has not had her period A child who is lactose intolerant An 8-year-old who refuses to drink milk
A 16-year-old female athlete who has not had her period
Which individual is at greatest risk for developing a form of reactive arthritis? A 24-year-old male with urethritis who completed treatment for a chlamydia infection a few months ago. A 46-year-old female who has a longstanding diagnosis of systemic lupus erythematosus (SLE). A 79-year-old male who had a total hip replacement 2 months prior. A 3-year-old girl who was born with a 20-degree congenital scoliosis.
A 24-year-old male with urethritis who completed treatment for a chlamydia infection a few months ago.
Which individual is likely to have the highest risk of developing tuberculosis osteomyelitis? A 79-year-old man who is immunocompromised following a bone marrow transplant. A 30-year-old man who has undergone open reduction and internal fixation of his fractured tibia. A 68-year-old woman who had a laminectomy 4 days prior for treatment of her chronic back pain. A 55-year-old female who is in renal failure secondary to poorly controlled type 1 diabetes.
A 79-year-old man who is immunocompromised following a bone marrow transplant
The first manifestation that a client has osteoporosis is when presenting with which condition? A bone fracture Craving high-calcium foods Bone pain that is not alleviated by rest Decreased range of motion in the hip and knee joints
A bone fracture
A parent brings his child to the emergency department after the child sustains a fall from a tree. The child has severe right arm pain. A radiograph shows a complete break in the humerus with multiple pieces of bone at the fracture line and the skin is not broken. This type of fracture is classified as: A closed, greenstick fracture An open, impacted fracture A closed, comminuted fracture A compound, compression fracture
A closed, comminuted fracture
In a child, the epiphyses and metaphysis are separated by: A growth plate Trabeculae Diaphysis Synarthroses
A growth plate
Which client presenting to the emergency department would most likely be diagnosed with a pathologic stress fracture? A teenager who fell of a ladder and hit the concrete driveway, landing on his hip A weightlifter who, while bench-pressing 200 kg (440 lb), lost balance and fell to the side, landing on his hip A competitive volleyball player diving to retrieve a volley and landing on his hip A postmenopausal female who was diagnosed with breast cancer with metastasis to bone
A postmenopausal female who was diagnosed with breast cancer with metastasis to bone
A man's primary care physician has characterized his skin lesion as being a temporary eruption but has cautioned him against repeated rubbing or scratching to avoid lichenization. What is the most likely categorization of the man's skin lesion? A corn A blister A rash A callus
A rash
In the adult, red blood cell production decreases and red marrow is gradually replaced by yellow bone marrow. Yellow marrow is composed largely of: Osteoprogenitor cells Adipose cells White blood cells Red blood cells
Adipose cells
Nursing students are studying metabolic disorders of the skeletal system and correctly identify which factor to be the major cause of osteoporosis? Heredity Diet Sex Aging process
Aging process
A client who has a fractured ankle is complaining of knee and hip pain. What is the most likely cause of these symptoms? The client is not taking pain medication regularly. All nerves that cross articulations innervate each joint of an extremity. The client is not walking correctly and has pain from poor posture. The client has phantom pain.
All nerves that cross articulations innervate each joint of an extremity.
Which client would be considered high risk for falling and fracturing the hip? A 36-year-old woman whose diet consists of excessive sugar intake A 54-year-old man with obesity and short stature A 77-year-old man with hearing impairment and corrective eye lenses An 81-year-old woman taking medication for osteoporosis
An 81-year-old woman taking medication for osteoporosis
Which best describes metatarsus adductus? An abnormal rotation of the hip A condition of toeing-out caused by external femoral torsion An adducted forefoot that gives the foot a kidney-shaped appearance A condition involving a congenital dislocation at the hip
An adducted forefoot that gives the foot a kidney-shaped appearance
A client with breast cancer reports a profound level of fatigue. Which factors commonly contribute to this symptom? Select all that apply. Leukopenia Therapy with tamoxifen Tumor necrosis factor-alpha (TNF-α) treatments Anemia Stress with inability to concentrate
Anemia Tumor necrosis factor-alpha (TNF-α) treatments Stress with inability to concentrate
A postmenopausal woman is ordered to take calcium supplements daily. Which intervention is essential for this client? Encouraging use of progestin supplements with calcium daily Having the client take the calcium with estrogen supplements Assessing vitamin D levels prior to starting calcium Measuring serum calcium levels weekly
Assessing vitamin D levels prior to starting calcium
A nurse is caring for a client who has systemic lupus erythematosis (SLE). Which of the following causes the disease? Infectious process Genetic disorder Autoimmune process Ischemic response
Autoimmune process
What is the term use to describe a tumor that while growing slowly does not destroy the surrounding tissues? Osteosarcoma Ewing sarcoma Benign Malignant
Benign
The health care provider has evaluated a client diagnosed with osteoporosis and determined that pharmacologic therapy will benefit the client. Select the medication options that the provider may prescribe. Select all that apply. Recombinant parathyroid hormone Bisphosphonates Thyroid hormone replacement RANKL inhibitor denosumab Calcitonin Selective estrogen receptor modulators (SERMs)
Bisphosphonates Selective estrogen receptor modulators (SERMs) Calcitonin RANKL inhibitor denosumab Recombinant parathyroid hormone
What is a priority concern for a client who has a hip dislocation? Edema Blood supply to the femoral head Tendonitis Pain
Blood supply to the femoral head
A nurse is describing the structure of bone to a client. The nurse will explain that one-third of the dry weight of bone is composed of which organic substances? Bone cells, inorganic salts, and blood vessels. Hydroxyapatite, calcium carbonate, and calcium fluoride. Bone cells, blood vessels, and nerves. Organic matter and inorganic salts.
Bone cells, blood vessels, and nerves.
In some diarthrotic joints, the synovial membrane forms sacs filled with synovial fluid that prevent friction on a tendon. These sacs are known as: Lacunae Periosteum Bursae Menisci
Bursae
What are the closed sacs that are formed from the synovial membrane (but are not part of the joint) called? Intra-articular menisci Bursae Tendons Ligaments
Bursae
A child has been diagnosed with myopathic neuromuscular scoliosis. What other concurrent diagnosis may the child have? Down syndrome Epilepsy Cerebral palsy Huntington disease SUBMIT ANSWER
Cerebral palsy
A 70-year-old client has needed to reduce the frequency of bathing due to dry skin. Which factor has resulted in this age-related change in skin function? Dehydration of epidermal cells Change in composition of sebaceous secretions Slower keratinization Increased production of bile salts
Change in composition of sebaceous secretions
A nurse is caring for an adolesecnt female who is undergoing diagnostic studies for systemic lupus erythematosus (SLE). Which assessment findings does the nurse recognize as being consistent with childhood SLE? Select all that apply. Child is of Asian descent. Child is between 8 and 15 years of age. Child has gained 20 lb (9.1 kg). Child is fatigued and generally feels "under the weather." Child has increased serum creatinine.
Child is between 8 and 15 years of age. Child is fatigued and generally feels "under the weather." Child has increased serum creatinine.
Which clients with rheumatoid arthritis (RA) will the nurse prioritize to assess first? Client with a "butterfly" rash on the face Client with systemic lupus erythematosus (SLE) and chest pain Client with articular symptoms of RA Client with RA and vasculitis
Client with systemic lupus erythematosus (SLE) and chest pain
Which type of fracture involves healing of more than two pieces of bone? Transverse fracture Comminuted fracture Oblique fracture Midshaft fracture
Comminuted fracture
The nurse is caring for a client who states that he is suddenly having severe pain at a leg fracture site. The nurse notes increased swelling in the limb and difficulty palpating a pulse. The nurse suspects that the client may have: Fracture blisters Reflex sympathetic dystrophy Compartment syndrome Hematogenous osteomyelitis
Compartment syndrome
The older adult client tells the nurse that she believes she is getting shorter. The nurse explains to the client that height loss is caused by which occurance with aging? Compression of the vertebral column Osteoarthritis Decreased lean body mass Reduction in muscle strength
Compression of the vertebral colum
What is the most serious complication resulting from a hip fracture experienced by an older adult? Immobility Dependency Death Pain
Death
The nurse is caring for a client with several fractures that have been immobilized. Which assessment finding would be most indicative of a potential complication? Peripheral capillary refill 2 seconds Pulses palpable with warm skin Deep, severe, unrelenting pain Pulse 105 bpm, blood pressure 134/86 mm Hg
Deep, severe, unrelenting pain
A client has developed osteomyelitis and asks the health care provider how the problem occurred. Which response is most accurate? Rheumatoid disease Direct contamination of an open wound Deficiency of calcium Excessive vitamin intake
Direct contamination of an open wound
Which cardiovascular response will the nurse assess in order to determine that a client has activity intolerance? Dyspnea during activity Increased blood pressure during activity Increased respiratory rate during activity Increased heart rate during activity
Dyspnea during activity
Which cardiovascular response will the nurse assess in order to determine that a client has activity intolerance? Increased heart rate during activity Dyspnea during activity Increased respiratory rate during activity Increased blood pressure during activity
Dyspnea during activity
The pathophysiology student is reviewing the stages of the healing process following a bone fracture. The student explains that the process follows which order? Early fibrosis; hematoma; remodeling; formation of cartilage and woven bone near the fracture site Formation of fibrin meshwork; death of bone cells; clot becomes organized by invasion of blood vessels; remodeling Inflammatory phase; hematoma formation; reparative phase; remodeling phase Formation of a large clot; new capillary buds; continued formation of the callus; reconstruction of the shaft
Formation of a large clot; new capillary buds; continued formation of the callus; reconstruction of the shaft
Which statement is true regarding the development of juvenile idiopathic arthritis? Surgical intervention can stop the decline associated with the arthritis. Generalized stunted growth can occur. The condition will resolve in adulthood. A diagnosis will be made when two joints are affected.
Generalized stunted growth can occur.
Using Oestern and Tscherne's classification, how would a closed fracture that presented superficial abrasions and a mild fracture pattern be graded? Grade 1 Grade 0 Grade 2 Grade 3
Grade 1
The client develops osteomyelitis that has originated from infectious organisms that reach the bone through the bloodstream. This is known as which type of osteomyelitis? Hematogenous Direct penetration Chronic Vascular insufficiency
Hematogenous
Which factor is genetically determined and primarily responsible for dark skin tone? Superficial distribution of melanocytes High levels of tyrosinase Dense distribution of melanosomes High production of melanin
High production of melanin
An older adult client has had mobility and independence significantly impaired by the progression of rheumatoid arthritis (RA). What is the primary pathophysiologic process that has contributed to this client's decline in health? Cytokine release following mechanical joint injury A mismatch between bone resorption and remodeling Immunologically mediated joint inflammation Excessive collagen production and deposition
Immunologically mediated joint inflammation
An older adult client has been diagnosed with metastatic bone disease. Which aspect of the client's care plan most directly addresses a common complication of this disease? Assessing the client's skin integrity twice per shift Implementing falls prevention measures Closely monitoring the client's serum potassium levels Monitoring the client's neurologic vital signs
Implementing falls prevention measures
An older adult is being evaluated for chronic fatigue. Which assessment data by the nurse would support the diagnosis? Reports experiencing complex visual hallucinations Inability to concentrate; awakens after a few hours of sleep and cannot return to sleep Uses a limited vocabulary, and often searches for words Unable to find the correct answer for simple questions like "What did you eat for lunch?"
Inability to concentrate; awakens after a few hours of sleep and cannot return to sleep
Which assessment finding indicates a positive respiratory response to exercise? Decreased oxygenation of cells in the periphery Increased alveolar perfusion Decreased tolerance to exercise Decreased respiratory rate
Increased alveolar perfusion
Which assessment finding indicates a positive respiratory response to exercise? Decreased tolerance to exercise Increased alveolar perfusion Decreased respiratory rate Decreased oxygenation of cells in the periphery
Increased alveolar perfusion
Which of the following should the nurse teach about secondary osteoporosis? It is not preventable. It cannot be treated with conventional therapy. It is not as severe as other types of osteoporosis. It is secondary to many conditions.
It is secondary to many conditions.
Disuse of a muscle and muscle atrophy contribute to the weakening and wasting of muscle tissue. What else do they contribute to? Gastrointestinal hyperactivity Joint contractures Neural decompensation Venous hyperresponsiveness
Joint contractures
The family of an older adult client is concerned about injuries from falls. The nurse providing discharge teaching would best minimize this risk by encouraging the family to perform which intervention? Cover the kitchen's tiled floor with several scatter rugs. Keep walkways free of clutter since alteration in vision happens with aging. Place exposed extension cords under decorative carpet runners. Discourage the client from wearing rubber-soled shoes.
Keep walkways free of clutter since alteration in vision happens with aging.
A client has dry skin, and scratching the dry regions causes some skin flakes to become dislodged. Which cell type makes up the dry skin? Melanocytes Merkel cells Keratinocytes Langerhans cells
Keratinocytes
A nurse is caring for a client with ankylosing spondylitis. For which associated symptom does the nurse assess? Kyphosis Syndactyly Tremors Tachycardia
Kyphosis
What is a physiologic basis for albinism? Lack of tyrosinase Accelerated keratinization Lichenification Separation of the epidermis from the dermis
Lack of tyrosinase
Among the skin's protective functions is the fact that it serves as an immunologic barrier. What cells are responsible for detecting foreign antigens? Langerhans cells Melanocytes Keratinocytes Merkel cells
Langerhans cells
A nursing instructor is teaching students about skin structure. The instructor evaluates student knowledge of the Langerhans cells based on which statement? Langerhans cells serve as touch receptors. Langerhans cells are involved in relaying signals between the skin systems. Langerhans cells are a layer of intercellular and extracellular matrices that serves as an interface between the dermis and the epidermis. Langerhans cells are the immunologic cells responsible for recognizing foreign antigens harmful to the body.
Langerhans cells are the immunologic cells responsible for recognizing foreign antigens harmful to the body.
The health care provider has just completed a skin assessment on a client. The client asks what causes the numerous freckles that she has. The best response is: They are inherited. If you develop freckles, you will note develop moles. They are more prominent in males rather than females. Localized collections of eumelanin contribute to the development.
Localized collections of eumelanin contribute to the development.
The nurse is assessing a client with ankylosing spondylitis (AS). What does the nurse expect to find? Facial butterfly rash Lower back pain Joint contractures Bruises on the lower extremities
Lower back pain
Osteosarcoma is an aggressive malignancy of the bone. What is the primary clinical feature of osteosarcoma? Erythema in the overlaying skin Pain, worse during the day Soreness in nearest joint Nighttime awakening from pain
Nighttime awakening from pain
A child, diagnosed with juvenile idiopathic arthritis, should receive education about commonly prescribed medications. Which other priority aspect(s) of care should the nurse assess during regular clinic visits? Select all that apply.
Nutiritonal status/issues Achieving growth and development milestones
When a nurse is assessing a client with osteoarthritis, which factor poses a risk for the disease? Hypertension Obesity Sedentary life style Smoking
Obesity
A client sustains a musculoskeletal injury of the wrist. Which manifestation would the nurse expect to accompany the strain? Pain and stiffness Catching and limited motion Joint deformity and swelling False motion and discoloration
Pain and stiffness
The nurse should rely on verbal history when assessing for which condition in clients with dark skin color? Select all that apply. Cyanosis Erythema Pallor Acne
Pallor Cyanosis Erythema
The client with a suspected diagnosis of osteoarthritis asks the health care provider, "How will this diagnosis be confirmed?" Which response is most appropriate? Physical examination and x-ray studies Bone marrow aspiration of the pelvis Aspiration of the joint with biopsy sent to laboratory Exercise trials to monitor angle of joint movements
Physical examination and x-ray studies
After a week in which a client worked four 12-hour shifts and went home to two children with the flu, the client is feeling fatigued. How should this client's fatigue be categorized? Pathologic Idiopathic Psychological Physiologic
Physiologic
Magnetic resonance imaging of a client's knee has revealed the presence of bursitis. The nurse should anticipate performing which intervention for bursitis? Administering an antihistamine like diphenhydramine to minimize inflammation Obtaining a surgical permit to repair the bursae Placing an ice pack on the knee to decrease swelling Applying Buck's traction with 10-pound weights
Placing an ice pack on the knee to decrease swelling
When vitamin D is metabolized, it breaks down into various metabolites. 1,25(OH)2D3 is the most potent of the vitamin D metabolites. What is the function of this metabolite of vitamin D? Promotes actions of parathyroid hormone on resorption of calcium and phosphate from bone Decreases intestinal absorption of calcium Decreases absorption of phosphate and increases absorption of calcium by bone Promotes absorption of calcium and phosphate by bone
Promotes actions of parathyroid hormone on resorption of calcium and phosphate from bone
The nurse assessing a client with scleroderma with CREST variant would include an assessment for: Raynaud's phenomenon. leukocytosis. butterfly rash. thrombocytopenia.
Raynaud's phenomenon.
A client with a compound fracture of the femur is in balanced skeletal traction. Which assessment data must be reported immediately? Uses trapeze to shift position Redness and heat at fracture site Wiggles toes every few minutes Clear drainage around pin insertion sites
Redness and heat at fracture site
A 16-month-old boy has a normal weight for his age but a height far below the normal range. His list of symptoms includes a protruding abdomen, lethargy, bow legs, muscle weakness, and irritability. His teeth have not yet developed and he has difficulty standing. What is the child's most likely diagnosis? Paget disease Developmental dysplasia of the hip Rachitic rosary Rickets
Rickets
A 16-month-old boy has a normal weight for his age but a height far below the normal range. His list of symptoms includes a protruding abdomen, lethargy, bow legs, muscle weakness, and irritability. His teeth have not yet developed and he has difficulty standing. What is the child's most likely diagnosis? Paget disease Rickets Developmental dysplasia of the hip Rachitic rosary
Rickets
Sebaceous glands excrete a mixture of lipids that lubricates the hair and skin. What is this mixture called? Sweat Cerumen Chalasia Sebum
Sebum
The joint capsule consists of an outer fibrous layer and an inner synovium. What does the inner synovium do to facilitate movement? Senses position Connects to tendons Secretes synovial fluid Covers articular cartilage
Secretes synovial fluid
Which teaching will the nurse provide for parents of a child who has clubfoot, or talipes? Serial manipulations and casting of the affected extremity Chemotherapy Bilateral hip spica cast Immediate corrective surgery
Serial manipulations and casting of the affected extremity
in contrast to synarthrosis joints, which synovial joints allow for movement in all directions? Vertebrocostal joints Shoulder joints Knee joints Elbow joints
Shoulder joints
Fall prevention in older adults should focus on which types of exercise? Swimming and running Strength building and balance Brisk walking and tai chi Stretching and toning
Strength building and balance
Most of the skin's blood vessels are innervated by which component of the nervous system? Oculomotor nerve Vagus nerve Parasympathetic nervous system Sympathetic nervous system
Sympathetic nervous system
The provider diagnoses the client with a rheumatic disorder after the client states he is having joint pain. The provider explains that which joint is most frequently affected by this disorder? Synovial Synostoses Synchondroses Syndesmoses
Synovial
Which substance helps maintain a smooth surface in joint cartilage? Uric acid Cytokines Surfactants Synovial fluid
Synovial fluid
The joint capsule in a diarthrodial joint consists of two layers. Which of the following is one of these layers? Endosteum Pericondrium Periosteum Synovium
Synovium
A nurse is caring for a client admitted with a malar rash on the nose and cheeks. The nurse recognizes that this rash is characteristic of which disease process? Systemic lupus erythematosus (SLE) Sarcoidosis Rheumatoid arthritis (RA) Scleroderma
Systemic lupus erythematosus (SLE)
The nurse notices that a child appears to have flatfoot and determines that additional assessment is needed. Which assessment finding would meet criteria for flatfoot? Heel is inverted Talus points medially Forefoot is everted Talus points laterally
Talus points medially
A client has experienced trauma of the musculoskeletal structure that connects muscle to bone. The nurse would document this as which type of injury? Tendon Ligament Periosteum Metaphysis
Tendon
A nurse is caring for a client who injured her knee while playing basketball. Tests reveal a torn connective tissue that connects muscles to bones. Based on this finding, the nurse prepares to teach the client about which anatomical structure that is injured? Bursae Synovial joint Ligaments Tendons
Tendons
How will the nurse teach the client to utilize metabolic equivalents when starting an exercise routine? As metabolic equivalents increase, activity decreases. The client should understand that activities with higher metabolic equivalents have higher workloads. Metabolic equivalents tell the client to stop activity. The client should strive to keep metabolic equivalents in activity to a minimum.
The client should understand that activities with higher metabolic equivalents have higher workloads.
Which client needs screening for osteoporosis? The client who has pain in the back The client who seems to have "shrunk" in height The client who reports "stomach pains" The client who is under 30 years old
The client who seems to have "shrunk" in height
Which client should be seen first? The client with a grade 1 sprain The client with an avulsion The client with a grade 3 sprain The client with a severe strain
The client with an avulsion
Which joint is classified as a being a syndesmosis? The joint between the symphysis pubis The joint between two vertebrae An interphalangeal joint of the hand (knuckle) The joint between the femur and the pelvis
The joint between two vertebrae
What statement is true concerning the skin? The skin does not contain veins. The skin is not part of the immune response. The skin is the largest organ of the body. The skin is not susceptible to infection.
The skin is the largest organ of the body.
The client has an extra-articular condition. How does the nurse explain this diagnosis? There is a problem outside of a joint. There is a problem in the joint. There is a fracture of a joint. There is a fracture of a long bone.
There is a problem outside of a joint.
Magnetic resonance imaging of a client's knee reveals the presence of bursitis. What is the primary purpose of bursae? To maintain close articulation between the two long bones at a synovial joint To strengthen the integrity of the articulating capsule To strengthen the attachment between skeletal muscles and bones To prevent friction at a tendon in a synovial joint
To prevent friction at a tendon in a synovial joint
Which statement is true about treatment of developmental dysplasia of the hip? All infants will need surgery for this condition. Treatment needs to be individualized. Subluxation never resolves on its own. Treatment needs to be completed within 2 weeks.
Treatment needs to be individualized.
Which statement is true about treatment of developmental dysplasia of the hip? Treatment needs to be completed within 2 weeks. Treatment needs to be individualized. All infants will need surgery for this condition. Subluxation never resolves on its own.
Treatment needs to be individualized.
A client with pale skin, white hair, and pink eyes comes to the clinic for a routine physical exam. Based on the client's appearance, the nurse knows this client has a genetic lack of which enzyme? Melanosome Tyrosinase Laminin Pheomelanin SUBMIT ANSWER
Tyrosinase
When explaining why some children have albinism, the science teacher explains that which enzyme is needed for synthesis of melanin? Laminin Tyrosinase Pheomelanin Bradykinin
Tyrosinase
When teaching a client recently diagnosed with systemic lupus erythematosus (SLE), what does the nurse teach the client to avoid to prevent exacerbations? Calcium supplements Ultraviolet light (UV) Raw or undercooked shellfish Corticosteroid medications
Ultraviolet light (UV)
Which skin disorder is likely to result from the localized lack of melanin production by melanocytes? Rash Bullae Vitiligo Melasma
Vitiligo
An older adult client has recently been diagnosed with rheumatoid arthritis. The nurse should focus assessment on which aspects? Cognition and coping skills Weight and nutritional status Sodium and potassium levels Oxygenation and respiratory status
Weight and nutritional status
Ankylosing spondylitis is a disease that typically manifests in late adolescence and early adulthood. What is the characteristic of the pain in ankylosing spondylitis? Worse when active Worse when sitting Worse when standing Worse when lying down
Worse when lying down
The nurse is providing care for an adult client whose current medication regimen includes calcitonin and a bisphosphonate. The nurse should recognize the likely need for: orthopedic surgery. bone density testing on a scheduled basis. assessment for the presence of genu varum or genu valgum. limitations on weight-bearing exercise.
bone density testing on a scheduled basis.
The physician is reviewing lab results for his client with cancer and finds the client to be hypercalcemic. What will the physician prescribe? Parathyroid hormone (PTH) Estrogen Potassium chloride Calcitonin
calcitonin
When trying to explain the advantages of using an emollient over other products to a client suffering from dry skin, the nurse will emphasize that emollients: will contain some form of numbing agent like lidocaine to help with the itching. will draw water out from the deeper skin layers. can replenish the oils on the skin surface because they contain fatty acids. provide moisture-proof material to the skin by providing a thick cream layer as a barrier.
can replenish the oils on the skin surface because they contain fatty acids
The student is studying the types of mature bones. The spongy bone found in the interior of bones and composed of spicules is: Cancellous Irregular Compact Flat
cancellous
A client with a fractured clavicle is told that the bone will heal well if immobilized for the next 6 to 8 weeks, but there will be a large "bump" where the break occurred. This bump will be caused by: formation of scar tissue. accumulation of dead white cells. localized infection. formation of a bony callus.
formation of a bony callus.
When caring for a client with ankylosing spondylitis, the nurse tells the client that stiffness may be relieved by which intervention? Acetaminophen Calcium supplements Gentle exercise Bed rest
gentle exercise
A client tells the nurse she is very concerned because the health care provider informed her that her fractured arm is healing with malunion. The nurse recognizes this as: an expected outcome as the client is obese. healing with deformity, angulation, or rotation that is visible on x-ray films. failure of a fracture to unite within the normal period. failure to produce union and cessation of the processes of bone.
healing with deformity, angulation, or rotation that is visible on x-ray films.
The elderly nursing home resident has a fractured humerus. In order to promote healing, the physician recommends: including fish in the diet on a routine basis. sitting outside in the sunlight, making sure that all skin surfaces are covered. a diet high in fruits and vegetables. avoiding milk and dairy products.
including fish in the diet on a routine basis.
A daughter is concerned because her elderly parent has been diagnosed with osteomalacia. The daughter asks the nurse why this happened. The best response would be that: her parent is consuming a diet high in calcium. her parent is not using any sunscreens to help with absorption. there is an absorption of too much vitamin D. intestinal absorption slows as natural aging occurs.
intestinal absorption slows as natural aging occurs.
The nurse is assessing a client with darker skin. The nurse is aware that: Select all that apply. cyanosis will be easily observed. erythema will be difficult to observe. it will be difficult to assess skin pallor. verbal histories are important in skin assessment. normal variations in skin tone will not alter the evaluation.
it will be difficult to assess skin pallor. erythema will be difficult to observe. verbal histories are important in skin assessment.
The nurse is caring for several clents with symptoms of chronic fatigue. Which manifestation does not correlate with a diagnosis of chronic fatigue syndrome (CFS)? Insomnia and night sweats Cough with blood-tinged sputum Memory loss and impaired concentration Joint pain without swelling
Cough with blood-tinged sputum
The nurse is caring for several clents with symptoms of chronic fatigue. Which manifestation does not correlate with a diagnosis of chronic fatigue syndrome (CFS)? Insomnia and night sweats Memory loss and impaired concentration Joint pain without swelling Cough with blood-tinged sputum
Cough with blood-tinged sputum
The nurse performing a musculoskeletal assessment of a client with osteoarthritis would evaluate the presence of which finding as being a normal expectation? Cartilage hypertrophy Crepitus and grinding Spongy joints Systemic inflammation
Crepitus and grinding
A 55-year-old client has reported joint pain in the feet. Which laboratory result should prompt further testing to rule out primary gout? Increased serum cortisol Increased C-reactive protein (CRP) Increased polymorphonuclear leukocytes Increased serum uric acid
Increased serum uric acid
In a client diagnosed with osteomalacia, what would be recommended to aid with improvement of the condition? Decreasing exposure to the natural UV radiation of the sun Undergoing a bone marrow transplant Increasing dietary consumption of vitamin D Losing 5 to 10 pounds of weight
Increasing dietary consumption of vitamin D
In a client diagnosed with osteomalacia, what would be recommended to aid with improvement of the condition? Losing 5 to 10 pounds of weight Undergoing a bone marrow transplant Increasing dietary consumption of vitamin D Decreasing exposure to the natural UV radiation of the sun
Increasing dietary consumption of vitamin D
Which symptoms does the nurse identify as supporting a diagnosis of chronic fatigue syndrome (CFS) when assessing a client with fatigue? Select all that apply. Joint pain with redness and inflammation Increasing fatigue that is not due to ongoing exertion Tender lymph nodes in neck and axillae Short-term memory loss and short attention span Increased need for sleep, awakes refreshed
Increasing fatigue that is not due to ongoing exertion Short-term memory loss and short attention span Tender lymph nodes in neck and axillae
Which assessment finding is a negative cardiac response to exercise? The client's venous return increases. The client's diastolic blood pressure increases. The client's heart rate increases. The client's stroke volume increases.
The client's diastolic blood pressure increases.
Which statement about nevi (common moles) is true? They are closely related to dermatofibroma. They are an elevated, palpable, solid mass with a circumscribed border. They are tumors of basal cells. They have a high risk for developing into malignant melanoma.
They are an elevated, palpable, solid mass with a circumscribed border.
Most of the body's hair follicles are paired with which anatomical part? A nerve ending A sebaceous gland A Langerhans cell An eccrine sweat gland
A sebaceous gland
A nurse assesses a client with multiple, flat brown macules on the face and arms. Which term would best describe this lesion? Freckles Blister Wheal Warts
Freckles
An instructor is explaining the pilosebaceous unit when one student stated, "If I have fats and wax on my skin, then I need to scrub harder." Which function(s)/purpose(s) of sebum will the teacher explain to the students? Select all that apply. Lubricates the hair and skin Prevents drying and breaking of hair follicles Promotes good bumps formation Prevents evaporation of moisture in cold weather to conserve body heat SUBMIT ANSWER
Lubricates the hair and skin Prevents evaporation of moisture in cold weather to conserve body heat
The nurse is assessing a female client's risk for osteoporosis. Which factor places this client at greatest risk? Male gender Menopause Black race Obesity
Menopause
Which are the sparsest cells in the epidermis? Merkel cells Melanocytes Pigment cells Keratinocytes
Merkel cells
Lamellar bone is the bone tissue that is found in the adult body. What is lamellar bone largely composed of? Spicules Macrocrystalline cells Hematopoietic cells Osteons
Osteons
Which bone cell is responsible for continual replacement of worn out bone tissue?
Osteoprogenitor
Which statement most accurately describes cartilage? Approximately 20% of the wet weight of cartilage is water held in its gel structure. Elastic cartilage is the most abundant type of cartilage. Fibrocartilage is found where flexibility of the joint is important. Pure cartilage is pearly white.
Pure cartilage is pearly white.
Which type of bone is the major component of tubular bones? Compact bone Cancellous bone Woven bone Spongy bone SUBMIT ANSWER
compact bone
Which food items are considered an important dietary source of vitamin D? Select all that apply. Cottage cheese Mozzarella cheese sticks Apples Irradiated milk Fish
fish irradiated milk
The skin is richly supplied with arteriovenous anastomoses in which blood flows directly between an artery and a vein, bypassing the capillary circulation. This particular vascular structure allows a client to: prevent localized hypoxia. maximize skin perfusion. regulate body temperature. form "goose bumps" when cold.
regulate body temperature.
The skin is richly supplied with arteriovenous anastomoses in which blood flows directly between an artery and a vein, bypassing the capillary circulation. This particular vascular structure allows a client to: regulate body temperature. maximize skin perfusion. form "goose bumps" when cold. prevent localized hypoxia. SUBMIT ANSWER
regulate body temperature.
A client presents with arthralgia and arthritis. Which is the priority nursing intervention? Assessing the client's vital signs Assessing the client's electrocardiogram Assessing the client's pain and history of treating it Performing range-of-motion exercises
Assessing the client's pain and history of treating it
In what anatomical areas are irregularly shaped bones located? Select all that apply. Wrists Rib cage Ankles Lower extremities Upper extremities
ankles wrists
A client recently diagnosed with rheumatoid arthritis (RA) tells the nurse she is glad there is nothing "really wrong with her" besides some joint swelling. Which information should the nurse tell the client about RA? "Extra-articular manifestations may include anemia and deformities of the affected joints." "Joint involvement is typically the only manifestation of the disease in most clients." "Myocardial infarction develops in clients who have had the disease for an extended period." "The disease can be reversed with medication and exercise."
"Extra-articular manifestations may include anemia and deformities of the affected joints."
A child arrives to the outpatient clinic with a high fever of 103°F (39.5°C). The parents have the child wrapped in many blankets to "keep thim warm, since the child is shivering." What is the rationale for the health care provider to educate the parents that less blankets will help the child more? "We know you want to keep your child comfortable, but blankets will not help lower your child's fever." "Fever dilates vessels and results in sweating, the purpose of the eccrine sweat glands. Too many blankets are counterproductive and will actually help the temperature to go higher." "Let's remove the blankets and place ice packs under your child's arms instead." "Since your child is not coughing or throwing up, I think you just need to take him home and give him liquid acetaminophen."
"Fever dilates vessels and results in sweating, the purpose of the eccrine sweat glands. Too many blankets are counterproductive and will actually help the temperature to go higher."
A grandchild asks the grandparent, "Why is your hair so gray?" Which response by the grandparent gives the physiologic reason for hair turning gray with aging? "I have fewer red blood cells now so my hair follicles receive less oxygen." "I have the beautician dye my hair this color." "I have a decreased number of melanosome-producing melanocytes." "When I was younger, I had a high fever that killed my 'hair-color' cells."
"I have a decreased number of melanosome-producing melanocytes."
The nurse has just finished teaching a client newly diagnosed with rheumatoid arthritis about the disease. The nurse determines that teaching is effective when the client states: "Only upper extremity diarthrodial joint can be involved." "Rheumatoid arthritis is a chronic autoimmune system disease that affects a single joint." "The disease will not fluctuate in occurrence." "Rheumatoid arthritis includes joint involvement that is usually symmetric and polyarticular."
"Rheumatoid arthritis includes joint involvement that is usually symmetric and polyarticular."
A client is concerned about bone strength and development and asks the nurse if dietary sources of vitamin D will cause immediate activity within the skeletal system. The bestresponse by the nurse would be: "It is important to contact your health care provider before consuming any food with vitamin D." "Vitamin D has little or no activity until it has been converted to physiologically active compounds." "Results will begin immediately after you consume milk." "Dietary consumption is not necessary; the body has stored supplies."
"Vitamin D has little or no activity until it has been converted to physiologically active compounds."
The nurse determines that additional client education is needed when a client with gout makes which statement? "When I have an exacerbation of my symptoms, a glass of red wine will be helpful." "I should avoid eating shellfish to decrease the risk of an episode." "I will plan to eat more white meat rather than red meat." "Increasing my intake of water each day will help stop the symptoms."
"When I have an exacerbation of my symptoms, a glass of red wine will be helpful."
While explaining to a client about the various forms and function of connective tissue, the nurse gives the example of a repair of a torn anterior cruciate ligament (ACL), which is due to which tissue problem? A reticular fiber problem that interrupted the framework for capillaries Irregular filling of spaces between tissues to facilitate keeping of joints and tendons in their proper place A dense, regular connective tissue tear that is usually rich in collagen fibers that allows ligaments to join bone to bone An irregular, dense connective tissue tear of loose connective tissue that is located in the perichondrium
A dense, regular connective tissue tear that is usually rich in collagen fibers that allows ligaments to join bone to bone
When a nurse is assessing a client with osteoarthritis, which assessment findings does the nurse consider consistent with this disorder? Select all that apply. Limited range of motion Grinding sensation palpated upon movement Aching diffuse pain in the involved area Size of joint small and "mushy" Pain relieved by movement
Aching diffuse pain in the involved area Grinding sensation palpated upon movement Limited range of motion
We have both red and yellow bone marrow in our bodies. What is yellow bone marrow largely composed of? Hematopoietic cells Adipose cells Cancellous cells Osteogenic cells
Adipose cells
A client is experiencing severe pain in his back to the point of being immobile and running a temperature. The client also has swelling in his lower back (vertebrae). Following biopsy, the results show spinal tuberculosis. The nurse will anticipate explaining which priorityintervention to this client? Administer the four-drug antimicrobial medications Log-roll the client while he is on bed rest Locate a chiropractor for pain control Drain the abscess in the lower back
Administer the four-drug antimicrobial medications
The nurse is assessing a client's risk for osteoarthritis. Which factor places the client at greatest risk for this condition? Exposure to smoke Injury Social status Age
Age
Which clients should the nurse assess to determine if they have premature osteoporosis? Clients who run daily. Anyone with an eating disorder. Anyone under the age of 20. Anyone over the age of 70.
Anyone with an eating disorder.
A client suffers a musculoskeletal injury while participating in a sporting event. Which treatment is most appropriate initially? Applying a splint after straightening the limb Applying an elastic wrap and returning to the game Applying heat and massaging the limb Applying ice and sitting out the rest of the game
Applying ice and sitting out the rest of the game
Which structure would likely be present in a hair follicle in a man's groin but not in a follicle on his face? Aprocrine gland Sebaceous gland Hair papilla Arrector pili muscle
Aprocrine gland
A child presents to the emergency room with suspected trauma to the growth plate in the ankle during a soccer game. Which step is the best intervention? Tell the parents to make an appointment with a specialist. Take the child to an orthopedist. Tell the parents to take the child to their family physician. Assess the child for pain and prepare for diagnostic studies.
Assess the child for pain and prepare for diagnostic studies.
While taking a client history, which finding may lead the nurse to suspect the client is at risk for developing osteonecrosis? Previous stress fracture in the hips Bone marrow ischemia due to radiation therapy for cancer Synovial inflammation with painful swelling and warm to touch Bacterial infection in the knee following total knee replacement
Bone marrow ischemia due to radiation therapy for cance
Which statement about bone mass and older adults is accurate? Bone mass is increased with aging due to all the wear and tear of the joints. Hormones, like parathyroid hormone, are much slower to be released as one ages. Bone resorption and formation are no longer perfectly coupled, and bone mass is lost. Once skeletal growth has been attained, there is no longer any replacement or repair.
Bone resorption and formation are no longer perfectly coupled, and bone mass is lost.
While discussing hormonal control of bone formation, one should note that which hormone lowers blood calcium levels and decreases bone resorption? Prolactin Phosphate Vitamin D Calcitonin
Calcitonin
A female athlete has been diagnosed with amenorrhea due to intense training for a spot on the Olympic swimming team. As a health care provider, which of the following should be implemented to prevent premature osteoporosis? Increase dietary intake of protein and iron. Calcium/vitamin D supplements to support bone mineral density. Watch sodium intake and eat a carb-consistent diet with lots of fruits. Encourage a minimum of 10 hours of sleep/night.
Calcium/vitamin D supplements to support bone mineral density.
A female athlete has been diagnosed with amenorrhea due to intense training for a spot on the Olympic swimming team. As a health care provider, which of the following should be implemented to prevent premature osteoporosis? Watch sodium intake and eat a carb-consistent diet with lots of fruits. Encourage a minimum of 10 hours of sleep/night. Calcium/vitamin D supplements to support bone mineral density. Increase dietary intake of protein and iron.
Calcium/vitamin D supplements to support bone mineral density.
The nurse has completed an assessment of a client and noted a hyperkeratotic plaque of skin that resulted from chronic pressure or friction. The nurse would document this as: Corn Blister Rash Callus
Callus
A group of student nurses are reviewing the bones in the human body. What is the term for spongy bone? Cartilage Compact Cancellous Densely calcified
Cancellous
A gymnastics student hurts the ankle and is diagnosed with a torn cartilage. The health care worker states it may take months for this injury to heal. What is the basic physiologic reason behind the prolonged recovery of cartilage? Cartilage lacks blood vessels. Cartilage lacks minerals. Cartilage has low tensile strength. Cartilage is the main secretor of an extracellular matrix.
Cartilage lacks blood vessels.
A 16-year-old male football player suffered a fracture of his radius and ulna. Assessment of the fracture includes the following data: (1) the fracture does not protrude through the skin, and (2) both bones broke completely through into two pieces. Select the best description of the injury. Open spiral fracture Closed greenstick fracture Thromboemboli Closed comminuted fracture
Closed comminuted fracture
Which of the following statements is true about congenital clubfoot? Clubfoot is not treatable. Clubfoot may be associated with congenital syndromes. Clubfoot only occurs in severe genetic defects. Clubfoot affects girls more than boys.
Clubfoot may be associated with congenital syndromes.
A basketball player collided hard with another player and suffered a soft tissue injury to the forearm from the impact. The injury did not break the skin. The nurse should recognize the presence of which type of injury? Strain Ecchymosis Contusion Sprain
Contusion
What term describes an injury to the soft tissue of the body? Contusion Ligament tear Fracture Tendon rupture
Contusion
Which diagnostic finding has been strongly linked to systematic lupus erythematosus (SLE)? Decreased rheumatoid factor Low red blood cell count Elevated anti-nuclear antibodies (ANA) An abnormal serum SLE assay
Elevated anti-nuclear antibodies (ANA)
Fat emboli syndrome can occur after a fracture of a long bone. What is a clinical feature of this syndrome? Respiratory insufficiency Petechiae on soles of feet and palms of hands Global neurologic deficits Encephalopathy
Encephalopathy
A client from a nursing facility arrives with fever of unknown origin. On assessment, the nurse notes a wound on the coccyx documented as: Full thickness tissue loss with exposed bone, tendon, or muscle. Which skin lesion description is most appropriate to report to the health care provider? Dermal fissure with cracking into the skin Erosion of superficial epidermis Extensive damage with tissue loss due to a pressure injury Rupture of a cyst SUBMIT ANSWER
Extensive damage with tissue loss due to a pressure injury
A client from a nursing facility arrives with fever of unknown origin. On assessment, the nurse notes a wound on the coccyx documented as: Full thickness tissue loss with exposed bone, tendon, or muscle. Which skin lesion description is most appropriate to report to the health care provider? Rupture of a cyst Dermal fissure with cracking into the skin Extensive damage with tissue loss due to a pressure injury Erosion of superficial epidermis
Extensive damage with tissue loss due to a pressure injury
Which activity is most likely to create a spiral fracture? Slipping on ice and landing on one side Stopping a fall by landing on a straightened arm Falling on a ski hill with bindings that do not release Running 10 miles per day training for a marathon
Falling on a ski hill with bindings that do not release
A nursing student who is studying about disorders of the skeletal system is heard making the following statement, "Many skeletal disorders of early infancy are caused by intrauterine positions and need to be surgically fixed." Is this statement true or false? True False
False
The nurse is caring for a client with a fracture in his appendicular skeleton. Which bone is in this skeleton? Femur Ribs Mandible Vertebral disc
Femur
The nurse notes a blister on a client's skin. Which description best defines this area? Fluid-filled papule Elevated petechiae Raised lesion Flat macular rash
Fluid-filled papule
A client is being discharged after successful treatment of an acute episode of gout. What information will the nurse include in discharge teaching? Select all that apply. Take the prescribed allopurinol at the first sign of a flare. If consuming alcohol, be sure to do so in moderation. Avoid eating salty foods such as pretzels and sardines. Avoid eating organ meats such as liver and sweetbreads. For the continued pain, over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) may help
For the continued pain, over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) may help Avoid eating organ meats such as liver and sweetbreads. If consuming alcohol, be sure to do so in moderation.
A client has fractured the sternum when the chest hit the steering wheel during an accident. Which statement most accurately describes the physiologic function of bone marrow? Yellow bone marrow is hematopoietically active in infants, but not in adults. Hematopoiesis takes place in red bone marrow. Yellow bone marrow predominates in infants. By adulthood, all red bone marrow has been replaced by yellow bone marrow.
Hematopoiesis takes place in red bone marrow.
What should the nurse teach a client who is on bed rest ? Immobility will allow muscles to rest. It is possible to increase muscle endurance during immobility. Immobility has no effect on muscles. Immobility will lead to deconditioning of muscles. SUBMIT ANSWER
Immobility will lead to deconditioning of muscles.
What should the nurse teach a client who is on bed rest ? It is possible to increase muscle endurance during immobility. Immobility has no effect on muscles. Immobility will lead to deconditioning of muscles. Immobility will allow muscles to rest.
Immobility will lead to deconditioning of muscles.
An older adult client has had mobility and independence significantly impaired by the progression of rheumatoid arthritis (RA). What is the primary pathophysiologic process that has contributed to this client's decline in health? A mismatch between bone resorption and remodeling Immunologically mediated joint inflammation Excessive collagen production and deposition Cytokine release following mechanical joint injury
Immunologically mediated joint inflammation
An older adult client has been diagnosed with metastatic bone disease. Which aspect of the client's care plan most directly addresses a common complication of this disease? Closely monitoring the client's serum potassium levels Assessing the client's skin integrity twice per shift Monitoring the client's neurologic vital signs Implementing falls prevention measures
Implementing falls prevention measures
On the advice of the primary health care provider, a client has begun taking vitamin D supplements on a daily basis for which possible outcome? Reduced parathyroid hormone (PTH) levels. Increased calcium absorption from the digestive tract. Increased joint flexibility. Increased synthesis of calcium by the skin cells.
Increased calcium absorption from the digestive tract.
The client has a cast applied for a fractured tibia. Which physiologic response to the fracture places this client at risk for compartment syndrome? Inflammation causes increase in volume but cast limits compartment size Joint immobility due to the cast placement Extremity elevation on pillows makes it hard for blood to circulate Muscle atrophy from lack of ability to exercise
Inflammation causes increase in volume but cast limits compartment size
The nurse is explaining to a client that there are "cushions" in his back to absorb any jarring movement of the spine. Which anatomical structure is the nurse referring to? Tendons Spinal fluid Intervertebral disks Vertebral foramen
Intervertebral disks
Which distinguishing characteristic is most commonly seen in cases of chronic osteomyelitis? Involucrum, a lesion forming a sheath around necrotic sequestrum Severe bone pain caused by poor incisional healing External drainage of purulent exudate Subperiosteal abscess formation
Involucrum, a lesion forming a sheath around necrotic sequestrum
When assessing a client with rheumatoid arthritis, which statement about joint involvement is most accurate? Involvement usually attacks the entire spinal column with the lumbar region being the most involved area. If the hands are involved, it usually only occurs in the dominant hand in the distal intraphalangeal joint. Involvement is symmetric and polyarticular, initially starting in the fingers, hands, and wrists. The joint involvement is usually diagnosed at the time of a fracture following an accident.
Involvement is symmetric and polyarticular, initially starting in the fingers, hands, and wrists.
A client has tendonitis. What will the nurse teach the client about this disorder? It is caused when tendons rupture It is caused by ligaments rubbing on tendons. It is caused by a bone fracture. It is caused by overuse.
It is caused by overuse.
Which signs and symptoms should prompt a young woman's primary care provider to assess for systemic lupus erythematosus (SLE)? Chronic nausea and vomiting that is unresponsive to antiemetics A history of thromboembolic events and varicose veins Dysmenorrhea and recent spontaneous abortion Joint pain and proteinuria
Joint pain and proteinuria
Following a lengthy series of diagnostic tests, a client's chronic hip pain has been attributed to advanced osteonecrosis. What treatment is this client most likely to require? Intravenous antibiotics Transfusion of packed red blood cells Joint replacement surgery Injections of corticosteroids into the synovial space
Joint replacement surgery
Which disease in children presents with an inflammatory myopathy primarily involving skin and muscle with a heliotrope rash around the eyes? Juvenile spondyloarthropathies Systematic lupus erythematous Juvenile dermatomyositis Juvenile arthritis
Juvenile dermatomyositis
What would be the best treatment option for a soft tissue contusion on the right ankle? Apply heat compresses for 15 minutes at a time for 24 hours. Surgery will be the expected treatment and we need to have a consent form signed. Keep the ankle elevated for the first 24 hours Administration of pain medications as needed.
Keep the ankle elevated for the first 24 hours
Athletic injuries fall into two types: acute or overuse injuries. Where do overuse injuries commonly occur? Neck Fingers Wrist Knee
Knee
A 6-year-old child has developed idiopathic osteonecrotic disease of the proximal (capital) femoral epiphysis. The health care provider would document this finding as which diagnosis? Sever disease Blount disease Osgood-Schlatter disease Legg-Calvé-Perthes disease
Legg-Calvé-Perthes disease
A client expresses concern to the nurse about an area of skin on the chest that has recently turned white and was diagnosed as vitiligo. Which principle best explains the cause of vitiligo to the client? Vitiligo is a bacterial infection that can be treated with an ointment. Melanocytes are destroyed, leading to a complete absence of melanin pigment. Smaller amounts of melanosomes are being produced due to aging. There is an increased production of eumelanin.
Melanocytes are destroyed, leading to a complete absence of melanin pigment.
A client has sought care for a serious sunburn that resulted from falling asleep at the beach. What physiologic process was involved in the client's overexposure to ultraviolet radiation? Melanocytes were unable to sufficiently protect that client Merkel cells became inflamed from excessive sun exposure The Langerhans cells produced an adaptive response The client's keratinocytes became overwhelmed by radiation
Melanocytes were unable to sufficiently protect that client
The nurse is caring for a client with newly diagnosed systemic lupus erythematosus (SLE). Which over-the-counter medication does the nurse recognize is useful in treating inflammation, arthritis, and pleuritis? Hydroxychloroquine Cyclophosphamide Nonsteroidal anti-inflammatory drugs (NSAIDs) Belimumab
Nonsteroidal anti-inflammatory drugs (NSAIDs)
The nurse is conducting a health promotion class on osteoarthitis (OA). Which statement should the nurse include? Young women have a higher risk than young men of developing OA. Eating a diet low in calcium is the only contributing risk factor to OA. There is no hereditary link to the development of OA. Obesity is a strong risk factor for developing OA.
Obesity is a strong risk factor for developing OA.
An older adult female is admitted with a hip fracture. Her lab test reveals an increase in serum levels of alkaline phosphatase. The nurse determines which physiologic activity is causing this lab level to rise? Osteocytes maintaining the bony matrix Osteoblast activity Increase in bone density Osteoclasts removing the mineral content of boneh
Osteoblast activity
Following a fall, 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 cells are most responsible for restoring the integrity of the man's broken bone? Osteoblasts Osteocytes Osteoclasts Osteomas
Osteoblasts
What type of cell is responsible for building bone in the body? Osteoprogenitor cells Red blood cells Osteoblasts Osteocytes
Osteoblasts
A client has developed increased resorption of bone with removal of mineral content. This is most likely the result of: Osteoblasts Osteoprogenitors Osteoclasts Osteocytes
Osteoclasts
Which statement correctly describes osteogenesis imperfecta, or brittle bone disease? Osteogenesis imperfecta is not a hereditary disorder. Osteogenesis imperfecta is an extremely rare disease, with only about 2,000 cases in the United States. Osteogenesis imperfecta is caused by deficiencies in the synthesis of type I collagen. Osteogenesis imperfecta results in a thickening of the bones.
Osteogenesis imperfecta is caused by deficiencies in the synthesis of type I collagen.
A 75-year-old female has been admitted to the hospital with a hip fracture. She states, "All I did was fall into my chair, not even very hard." Upon diagnostic testing, the client's bones shows loss of trabeculae from cancellous bone and thinning of the cortex. Which diagnosis is mostlikely? Osteomalacia Osteomyelitis Osteonecrosis Osteoporosis
Osteoporosis
An older adult client is admitted for the treatment of pneumonia. The nurse notes the home medications include nasal calcitonin, vitamin D, and calcium chloride. Which disease process is this client likely treating with these medications? Osteoporosis Rheumatoid arthritis Osteoarthritis Scleroderma
Osteoporosis
The nurse is giving a talk to a woman's group on osteoporosis. What should the nurse tell this group concerning the development of osteoporosis? "Bone absorption is not important in osteoporosis." "With osteoporosis there is an increase in bone formation." "Osteoporosis mainly affects younger people." "Osteoporosis involves a loss of bone mass."
Osteoporosis involves a loss of bone mass."
A client presents with sudden onset of deep, localized pain and swelling in the proximal femur while undergoing diagnostic workup for suspected lung cancer. The nurse suspects the client may have developed which type of neoplasm of the skeletal system? Exostosis Osteosarcoma Endochondroma Osteochondroma
Osteosarcoma
How are the oxygenation needs of the articulating areas in a synovial joint met? The cartilage of the articulating areas uses anaerobic metabolism exclusively. Oxygen is provided to the articulating areas indirectly by synovial fluid. The epiphyses of long bones provide oxygen to the articulating areas. Capillaries release oxygenated blood into the synovial cavity at a controlled rate.
Oxygen is provided to the articulating areas indirectly by synovial fluid.
The nurse recognizes that parathyroid hormone (PTH) has what relationship to bone formation? PTH increases phosphate levels. PTH is a regulator of calcium and phosphate. PTH blocks bone growth. PTH causes bone breakdown.
PTH is a regulator of calcium and phosphate.
A 42-year-old client is admitted to the hospital with severe back pain, intermittent tinnitus, constant headache, and vertigo. He states that the back pain has been a problem for a number of years, but the other symptoms are quite new. Upon further examination, it is noted that he has unexplained hearing loss, and his femur and tibia have begun to bow. What condition does this client most likely have? Osteoporosis Paget disease Osteomyelitis RicketsA 42-year-old client is admitted to the hospital with severe back pain, intermittent tinnitus, constant headache, and vertigo. He states that the back pain has been a problem for a number of years, but the other symptoms are quite new. Upon further examination, it is noted that he has unexplained hearing loss, and his femur and tibia have begun to bow. What condition does this client most likely have? Osteoporosis Paget disease Osteomyelitis Rickets
Paget disease
Which hormones or ion concentrations influence the regulation of vitamin D activity? Select all that apply. Sodium Potassium Prolactin Parathyroid hormone (PTH) Estrogen
Parathyroid hormone (PTH) Prolactin Potassium
A client with a closed reduction of a wrist fracture has a plaster cast applied. Which nursing intervention is the highest priority immediately after the procedure? Elevating the extremity on a pillow Handling the cast with the palms of the hands Performing a peripheral circulation assessment Immobilizing the arm in a sling
Performing a peripheral circulation assessment
Select the correct statements that describe the function of PTH (parathyroid hormone). Select all that apply. Maintains serum calcium by bone resorption Maintained by serum levels of ionized calcium Regulated by positive feedback mechanism Stimulates tubular reabsorption of phosphate Prevents serum calcium from decreasing and phosphate from increasing above normal
Prevents serum calcium from decreasing and phosphate from increasing above normal Maintained by serum levels of ionized calcium Maintains serum calcium by bone resorption
The nurse caring for a child with a deficiency of vitamin D knows that the deficiency places the child at risk for: Paget diseae Scurvy Hip dysplasia Rickets
Rickets
The nurse caring for a child with a deficiency of vitamin D knows that the deficiency places the child at risk for: Scurvy Rickets Paget diseae Hip dysplasia
Rickets
When assessing a child for clinical manifestations of oligoarticular arthritis, the health care provider will base the diagnosis on which clinical findings? Right knee is warm and painful when putting it through normal range of motion. Intermittent temperature is elevated daily. Rash is diffuse with severe itching. Faint, red macular rash noted over entire body.
Right knee is warm and painful when putting it through normal range of motion.
When teaching a group of nursing students about rheumatic disorders, a nurse emphasizes which important differences when caring for the older adult? Stiffness in the morning Need for pain relief Muscle weakness Risk for falls
Risk for falls
Select the statement that best describes skin disorders. Itching, infection, or the effects of self-treatment will not influence the appearance of a skin disorder. Skin disorders are always caused by the same agent. Skin color may influence the appearance of the skin disorder. Skin disorders are easily identified, as they look exactly alike despite the native skin color of the individual.
Skin color may influence the appearance of the skin disorder.
Pruritis, or the itch sensation, is a by-product of almost all skin disorders. However, we can itch without having a skin disorder. Itch then can be local or central in our bodies. Where is it postulated that a central "itch center" exists? Sensory area of the cerebrum Pons Medulla oblongata Somatosensory cortex
Somatosensory cortex
The health care provider is assessing a client with a history of ankylosing spondylitis to note progression of the disease. On which area of the body will the provider focus the assessment? Ankles Spine All joints (polyarticular) Elbows
Spine
Tuberculosis can spread from the lungs into the musculoskeletal system. What is the most common site in the skeletal system for tuberculosis to be found? Shoulders Ankles Spine Hips
Spine
A nurse educator is teaching students about the layers of the skin. Which layer is commonly referred to as prickle cells? Stratum spinosum Stratum lucidum Stratum corneum Stratum granulosum
Stratum spinosum
If a child with genu valgum does not self-correct after he or she begins weight-bearing, what condition could result? Subluxation Metatarsus adductus Gait awkwardness Radial torsion
Subluxation
A nurse educator is preparing an education module on the dermis layer of the skin for the nursing staff. Which statements should be included in the module? Select all that apply. The pink color of light skin results primarily from blood in the vessels of the dermis. The dermis is replaced every 4 weeks. The dermis is the connective tissue layer. The glandular structures are embedded in this layer. The dermis consists of three distinct zones or layers.
The dermis is the connective tissue layer. The pink color of light skin results primarily from blood in the vessels of the dermis. The glandular structures are embedded in this layer.
A child's history and a subsequent physical document that the child has a grade I metatarsus adductus deformity. When assessing the child, the nurse anticipates finding which result? A rigid deformity of the foot that cannot be straightened.. The foot is directed inward when walking. Only the lateral border of the foot can be straightened. The foot can be manipulated into a straight position.
The foot can be manipulated into a straight position.
The nurse is providing client education related to intra-articular corticosteroid injections. Which instruction should the nurse include? There will be minimal discomfort because the injections are placed in the subcutaneous tissue. The client or a family member will be taught to administer the injections daily. The injections will be given only 3 to 4 times per year because they can increase joint destruction. There will be immediate relief with one injection and daily running can be resumed.
The injections will be given only 3 to 4 times per year because they can increase joint destruction.
The nurse is teaching a client with rheumatoid arthritis about pannus, which develops in the affected joint area. What does the nurse include to describe pannus? Muscles in the area that atrophy from disuse Vascular granulation tissue that destroys cartilage and bone Microorganisms that attack the joint space causing stiffness Reversible calcium deposits affecting the joints
Vascular granulation tissue that destroys cartilage and bone
Which clients should the nurse assess to determine if they have premature osteoporosis? Anyone under the age of 20. Anyone over the age of 70. Clients who run daily. Anyone with an eating disorder.
anyone with an eating disorder.
When describing the covering on bones to the students, the instructor asks, "Why is periosteum an important part of the bone covering?" The student responses should mention which of the following? It: is the site of red blood cell development. contains blood vessels that assist with providing nutrition to bone tissue. supplies yellow bone marrow to assist with adipose cell production. is composed of a single layer of osteoprogenitor cells.
contains blood vessels that assist with providing nutrition to bone tissue.
A major complication of prolonged bed rest is an increased risk of kidney stones. The nurse knows that this is most likely related to: saturation of urine with calcium salts. frequency of urination. a limited access to fluids while hospitalized. increased urine levels of citrate.
saturation of urine with calcium salts.
The nurse is providing teaching for parents of a 2-week-old infant just diagnosed with clubfoot. The nurse includes that the first treatment option is: percutaneous tendoachilles lengthening. surgical relaxation of foot ligaments and tendons. full-time wearing of Denis Brown splint. serial manipulations and casting.
serial manipulations and casting.
A biology class is discussing blood flow directions and the role of arteries and veins. The professor says, "The skin is the only place where there is a direct anastomosis between an artery and a vein." What is the purpose for this type of blood flow in the skin? Nutrient delivery Temperature regulation Assist in elimination of toxins from the air Higher need for direct oxygenation
temperature regulation
A client reporting bone pain has sought care. Diagnostic testing reveals that the client has developed osteonecrosis. When addressing the most likely cause of this complication, the nurse should focus on: any weight bearing that the client has performed in recent days. the client's red cell, hemoglobin, and hematocrit levels. the quality and quantity of blood flow to the site. the client's recent use of nonsteroidal anti-inflammatory drugs (NSAIDs).
the quality and quantity of blood flow to the site.