Adult Nursing - Chapter 39: Assessment of Musculoskeletal Function - PrepU

What is the term for a lateral curving of the spine? - Scoliosis - Epiphysis - Diaphysis - Lordosis

- Scoliosis

What is the term for a rhythmic contraction of a muscle? - Hypertrophy - Atrophy - Clonus - Crepitus

- Clonus

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 - Joint - Ligament - Cartilage

- Tendon

Which statement describes paresthesia? - Abnormal sensations - Absence of muscle tone - Involuntary twitch of muscle fibers - Absence of muscle movement suggesting nerve damage

- Abnormal sensations

Which is an indicator of neurovascular compromise? - Warm skin temperature - Capillary refill of more than 3 seconds - Pain upon active stretch - Diminished pain

- Capillary refill of more than 3 seconds

A patient comes to the clinic and informs the nurse of numbness, tingling, and a burning sensation in the arm from the elbow down to the fingers. What type of symptom would this be documented as? - Effusion - Paresthesia - Flaccidity - Atonia

- Paresthesia

The homecare nurse is evaluating the musculoskeletal system of a geriatric client whose previous assessment was within normal limits. The nurse initiates a call to the health care provider and/or emergency services when which change is found? - Decreased right-sided muscle strength - Decreased flexibility - Decreased agility - Increased joint stiffness

- Decreased right-sided muscle strength

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? - Osteoclasts - Cancellous bone - Osteoblasts - Cortical bone

- Osteoblasts

After a fracture, during which stage or phase of bone healing is devitalized tissue removed and new bone reorganized into its former structural arrangement? - Revascularization - Inflammation - Remodeling - Reparative

- Remodeling

Which of the following is an appropriate priority nursing diagnosis for the client following an arthrocentesis? - Activity intolerance - Chronic pain - Deficient knowledge: procedure - Risk for infection

- Risk for infection

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? - ankylosing spondylitis - bursitis - osteoarthritis of the shoulder - a fracture of the clavicle

- bursitis

The nurse is conducting a medication reconciliation with a client admitted with a fracture. What medication predisposes a client for a risk for fractures? - furosemide - digoxin - prednisone - metoprolol

- prednisone

The nurse is assigned to a client admitted with advanced Parkinson's disease. What type of gait correlates with Parkinson's disease? - steppage - spastic hemiparesis - scissors - shuffling

- shuffling

Which of the following diagnostic studies are done to relieve joint pain due to effusion? - Biopsy - Arthrocentesis - Bone scan - Electromyography (EMG)

- Arthrocentesis

The nurse is working on an orthopedic floor caring for a client injured in a football game. The nurse is reviewing the client's chart noting that the client has previously had an injured tendon. The nurse anticipates an injury between the periosteum of the bone and which of the following? - Joint - Ligament - Muscle - Cartilage

- Muscle

Which serum level indicates the rate of bone turnover? - Aspartate aminotransferase - Creatinine kinase - Osteocalcin - Myoglobin

- Osteocalcin

Which of the following describes a muscle that is limp and without tone? - Atonic - Spastic - Paralysis - Flaccid

- Flaccid

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? - Amino acids - Dairy products - Vitamin B6 - Vitamin D

- Vitamin D

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." - "Cardio-training is the best way to build bones." - "Weight-resistance exercises can strengthen bones." - "Range of motion exercises build bone mass."

- "Weight-bearing exercises can strengthen bones."

Which of the following is the most common site of joint effusion? - Shoulder - Elbow - Hip - Knee

- Knee

A nurse practitioner assesses a patient's movement in his left hand after a cast is removed. The nurse asks the patient to turn his wrist so the palm of his hand is facing up. This movement is known as: - Supination. - Extension. - Pronation. - Eversion.

- Supination.

The nurse is preparing the client with a right neck mass for magnetic resonance imaging (MRI). Which question should the nurse ask? Select all that apply. - "Do you have a pacemaker?" - "Have you removed your hearing aid?" - "When is the last time you had food or drink?" - "Did you take your medications this morning?" - "Are you wearing any jewelry?"

- "Do you have a pacemaker?" - "Have you removed your hearing aid?" - "Are you wearing any jewelry?"

The primary functions of cartilage are to reduce friction between articular surfaces, absorb shocks, and reduce stress on joint surfaces. Where in the human body is cartilage found? - between the ribs - All options are correct. - between the vertebrae - covering elbow joints

- All options are correct.

The nurse is performing a neurovascular assessment of a client's injured extremity. Which would the nurse report? - Dusky or mottled skin color - Positive distal pulses - Capillary refill of 3 seconds - Skin warm to touch

- Dusky or mottled skin color

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? - Fracture of the clavicle - Decreased bone density - Tear in the joint capsule - Injury to the radial nerve

- Tear in the joint capsule

A client is diagnosed with a fracture of a diarthrosis joint. What is an example of this type of joint? - Skull - Fifth thoracic vertebrae - Symphysis pubis - Elbow

- Elbow

After a person experiences a closure of the epiphyses, which statement is true? - The bone grows in length but not thickness. - The bone increases in thickness and is remodeled. - Both bone length and thickness continue to increase. - No further increase in bone length occurs.

- No further increase in bone length occurs.

A nurse is caring for a client with an undiagnosed bone disease. When instructing on the normal process to maintain bone tissue, which process transforms osteoblasts into mature bone cells? - Epiphyses and diaphysis formation - Ossification and calcification - Resorption - Remodeling

- Ossification and calcification

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? - The yellow marrow is responsible for manufacturing red blood cells. - Osteocytes are transformed into osteoblasts or mature bone cells. - Osteoclasts are involved in the destruction and remodeling of bone. - Long bones typically contain more red bone marrow than yellow.

- Osteoclasts are involved in the destruction and remodeling of bone.

A client has just undergone arthrography. What is the most important instruction for the nurse to include in the teaching plan? - Gently massage joints with any crackling or clicking joint noises. - Avoid intake of dairy products. - Avoid sunlight or harsh, dry climate. - Report joint crackling or clicking noises occurring after the second day.

- Report joint crackling or clicking noises occurring after the second day.

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? - An arthroscopy will be performed. - The bone will heal on its own without intervention. - The plate will be removed to determine if the bone is growing back. - Serial x-rays will be taken.

- Serial x-rays will be taken.

The nurse is assessing the client for scoliosis. What will the nurse have the client do to perform the assessment? - Stand in front of the client and ask the client to bend forward at the waist. - Stand behind the client and ask the client to walk a short distance away. - Stand to the side of the client and observe the client's spinal curvatures. - Stand behind the client and ask the client to bend forward at the waist.

- Stand behind the client and ask the client to bend forward at the waist.

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? - Ligament - Bursa - Tendon - Fascia

- Tendon

Which assessment finding would cause the nurse to suspect compartment syndrome in the client following a bone biopsy? - Toes move freely without pain - Capillary refill < 3 seconds - Bounding dorsalis pedis pulses - Increased diameter of the calf

- Increased diameter of the calf

Which diagnostic test would the nurse expect to be ordered for a client with lower extremity muscle weakness? - Bone scan - Arthrocentesis - Electromyograph (EMG) - Biopsy

- Electromyograph (EMG)

A patient has had a stroke and is unable to move the right upper and lower extremity. During assessment the nurse picks up the arm and it is limp and without tone. How would the nurse document this finding? - Atonic - Flaccidity - Tetanic - Rigidity

- Flaccidity

Which of the following is an example of a hinge joint? - Carpal bones in the wrist - Hip - Joint at base of thumb - Knee

- Knee

The nurse is performing an assessment on an older adult patient and observes the patient has an increased forward curvature of the thoracic spine. What does the nurse understand this common finding is known as? - Osteoporosis - Lordosis - Scoliosis - Kyphosis

- Kyphosis

A client is having repeated tears of the joint capsule in the shoulder, and the health care provider orders an arthrogram. What intervention should the nurse provide after the procedure is completed? Select all that apply. - Actively exercise the area immediately after the procedure. - Inform the client that a clicking or crackling noise in the joint may persist for a couple of days. - Administer a mild analgesic. - Apply heat to the area for 48 hours. - Apply a compression bandage to the area.

- Inform the client that a clicking or crackling noise in the joint may persist for a couple of days. - Administer a mild analgesic. - Apply a compression bandage to the area.

During a general musculoskeletal assessment, what would help the nurse determine the client's muscle strength? - Asking the client to lift specified amounts of weights. - Applying force to the client's extremity as the client pushes against that force. - Examining extremities for symmetry, size, and contour. - Palpating each of the client's muscles and joints.

- Applying force to the client's extremity as the client pushes against that force.

A client is scheduled to have an x-ray examination of the shoulder in which the synovial fluid will be aspirated and sent to the laboratory for analysis. This will be followed by administration of a contrast medium and x-rays. What procedure will the nurse prepare the client for? - Bone densitometry - Arthrogram - Arthrocentesis - Arthroscopy

- Arthrogram

Which clinical manifestation would the nurse recognize as an indicator of peripheral neurovascular dysfunction? Select all that apply. - Complaints of pins and needles in feet - Capillary refill less than 3 seconds - Absence of pain - Toes mottled and cool - Dorsiplantar flexion strong

- Complaints of pins and needles in feet - Toes mottled and cool

A client undergoes an arthroscopy at the outpatient clinic. After the procedure, the nurse provides discharge teaching. Which response by the client indicates the need for further teaching? - "I may notice some bruising or swelling in my knee." - "My physician may prescribe pain pills after the procedure." - "Elevating my leg will reduce swelling after the procedure." - "I should use my heating pad this evening to reduce some of the pain in my knee."

- "I should use my heating pad this evening to reduce some of the pain in my knee."

A client with a sports injury undergoes a diagnostic arthroscopy of the left knee. What comment by the client following the procedure will the nurse address first? - "My knee aches." - "My foot is swollen." - "My toes are numb." - "My feet are cold."

- "My toes are numb."

The nurse is preparing the client for computed tomography. Which information should be given by the nurse? - "A small bit of tissue will be removed and sent to the lab." - "A radioisotope will be given through an IV." - "You must remain very still during the procedure." - "Fluid will be removed from you affected joint."

- "You must remain very still during the procedure."

The nurse is performing a neurological assessment. What will this assessment include? - Inspect the foot for edema. - Observe for capillary refill of the great toe. - Ask the client to plantar flex the toes. - Palpate the dorsalis pedis pulse.

- Ask the client to plantar flex the toes.

A patient has a fracture of the right femur sustained in an automobile accident. What process of fracture healing does the nurse understand will occur with this patient? - Reactive phase, reparative phase, remodeling phase - First intention, secondary intention, third intention - Active phase, dormant phase, restructure phase - Primary phase, secondary phase, third phase

- Reactive phase, reparative phase, remodeling phase

The nurse is employed at a long-term care facility caring for geriatric clients. Which assessment finding is characteristic of an age-related change? - Cognitive decline - Loss of height - Increased muscle mass - Depressive symptoms

- Loss of height

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. - Inflammation and the stimulation of osteoblasts and osteoclasts. - The formation of a hematoma and fibrin. - Cartilage cells forming matrix villa that regulate calcification of the cartilage.

- New capillaries producing a bridge between the fractured bones.

Which medication taken by the client in the previous 24 hours would be of greatest concern to the nurse caring for a client undergoing a bone biopsy? - NPH insulin - digoxin - aspirin - furosemide

- aspirin