CH 37 PATHO

A client complains of pain and immobility of the wrist. On assessment, the nurse finds decreased range of motion (ROM), edema, and ecchymosis of the distal radius. The primary health- care provider recommends a neurovascular exam for confirmation. What does the nurse infer from these findings? 1. The client has a Smith fracture. 2. The client has a Colles fracture. 3. The client has a clavicle fracture. 4. The client has a green stick fracture.

1

The nurse is assisting the primary care provider while performing some specific maneuvers in a client with a knee injury. The primary health-care provider stabilizes the client's distal femur with one hand, grasps the proximal tibia with the other hand, and then attempts to sublux the tibia anteriorly. Which maneuver is the primary care provider performing? 1. Lachman test 2. McMurray test 3. Valgus stress test 4. Anterior drawer test

1

The nurse is reviewing the medical records of four clients. Client Description Client 1 Injury to menisci Client 2 Slightly abducted leg Client 3 Sustained a fall on flexed hand Client 4 Sustained a fall on extended hand Which client's medical record indicates the need to perform the McMurray test to assess the condition? 1. Client 1 2. Client 2 3. Client 3 4. Client 4

1

What are the modifiable risk factors for vertebral compression fracture? Select all that apply. 1. Estrogen deficiency 2. Presence of dementia 3. Bilateral ovariectomy 4. Susceptibility to falling 5. Presence of osteoporosis

1 3 5

A client presents with a swollen left thigh and a lower extremity that appears shortened. The primary care provider orders an arteriogram. What is the client's most likely condition? 1. Ulnar nerve injury 2. Femur shaft fracture 3. Tibia/fibula fracture 4. Brachial plexus injury

2

The nurse finds that a client with a musculoskeletal disorder has pain in the malleolar zone. The client is also unable to bear weight for four steps. What does the nurse expect the primary health-care provider to order in this situation? 1. Foot x-ray 2. Ankle x-ray 3. Hawkins test 4. Apprehension test

2

Which cervical root is associated with forearm pronation and supination? C5 C6 C7 C8

2

What are the common predisposing factors that cause cervical strain? Select all that apply. 1. Bruxism 2. Abnormal posture 3. Lifting heavy objects 4. Motor vehicle accidents 5. Fall on a supinated forearm

2 3 4

What are the signs and symptoms of musculoskeletal trauma? Select all that apply. 1. Edema 2. Paresthesia 3. Joint clicking 4. Joint swelling 5. Gait disturbance

2 3 4

After assessing a client with a musculoskeletal disorder, the nurse concludes that the client has skeletal muscle injuries. Which characteristics observed in the client support the nurse's conclusion? Select all that apply. 1. Spasm 2. Crepitus 3. Numbness 4. Clumsiness 5. Tingling sensation

2 3 5

What is the most commonly dislocated joint in the body? 1. Hip 2. Wrist 3. Shoulder 4. Vertebrae

3

Which musculoskeletal disorder is also called adhesive capsulitis? Bursitis Plantar fasciitis Frozen shoulder Carpel tunnel syndrome

3

While assessing a client with a musculoskeletal disorder, the nurse abducts the client's arm to 90 degrees and places anteriorly directed force on the posterior humeral head from behind. Which test is the nurse performing? Hawkins test Relocation test Apprehension test Neer impingement test

3

While teaching a group of student nurses about various musculoskeletal disorders, the nurse states, "This syndrome occurs when tissue pressure exceeds perfusion pressure in a closed anatomic space." Which syndrome is the nurse describing? 1. Horner syndrome 2. Cauda equine syndrome 3. Compartment syndrome 4. Carpel tunnel syndrome

3

The nurse is caring for four clients diagnosed with different musculoskeletal disorders. Client Disorder Client 1 Hip fracture Client 2 Stress fracture Client 3 Femur shaft fracture Client 4 Vertebral compression fracture Which client requires treatment with calcitonin, calcium or vitamin D supplements, analgesics, and muscle relaxants? 1. Client 1 2. Client 2 3. Client 3 4. Client 4

4

The nurse is evaluating the performance of a student nurse while caring for a client with an ankle sprain. Which intervention of the student nurse does the nursing instructor correct while providing care to the client? 1. Administering analgesics 2. Checking dorsalis pedis pulse 3. Checking posterior tibial pulse 4. Keeping the ankle below the heart

4

The nurse is performing a physical examination on a client with a suspected musculoskeletal disorder. What is the first nursing intervention during the examination? 1. Testing sensation using perception 2. Measuring muscle girth for symmetry 3. Evaluating peripheral vascular integrity 4. Assessing general appearance, contour, and symmetry

4

The nursing instructor is teaching a group of student nurses about skeletal muscles. Which statement by a student nurse indicates effective learning? 1. "The thick filaments of sarcomeres are made up of a protein called actin." 2. "The thin filaments of sarcomeres are made up of a protein called myosin." 3. "The fascicles contain 10 to 30 muscle fibers encased in connective tissue called epimysium." 4. "The individual muscle fibers of skeletal muscle are arranged in bundles called fascicles."

4

The registered nurse is evaluating the performance of student nurse performing a valgus stress test on a client whose leg is slightly abducted. Which intervention of the student nurse does the registered nurse correct? 1. Placing one hand at the lateral aspect of the knee joint 2. Placing the one hand at the medial aspect of the distal tibia 3. Applying valgus stress with the knee at 30 degrees of flexion 4. Applying valgus stress with the knee at 90 degrees of flexion

4

When assessing a client with a musculoskeletal disorder, the nurse finds lack of sensation in the dermatome areas of the lower extremity L5. The nurse suspects lumbar sprain /strain. What does the nurse expect the primary care provider to order in this situation? 1. Anticoagulant therapy 2. Intravenous injection of muscle relaxants 3. X-ray and dual energy x-ray absorptiometry scan of the spine 4. Complete blood count with erythrocyte sedimentation rate and C-reactive protein

4

When assessing a client's muscle strength using the Lovett scale, the nurse finds that the client has no joint motion with palpable contraction of the muscle. What grade does the nurse assign to the client based on this finding? Fair Poor Good Trace

4

When obtaining the health history of a client with a suspected musculoskeletal disorder, why does the nurse ask the client about travel destinations within the past year? 1. To check if the client has osteoporosis 2. To check if the client has recent allergies 3. To identify the loading forces involved 4. To evaluate for exposure to Lyme disease

4

While teaching a group of student nurses about different types of fractures, the nursing instructor says, "This fracture is characterized by the crushing of cancellous bone." Which type of fracture is the nursing instructor describing? Complete Transverse Comminuted Compression

4

Why is a dual energy x-ray absorptiometry scan used for a client with a musculoskeletal disorder? It detects soft tissue abnormalities. It identifies stress fractures and bony metastases. It determines mechanical derangement of the knee. It visualizes the bone mineral density (BMD) of the hip and lumbar vertebrae.

4

Diagnostic imaging reveals a complete tear in a ligament. How will this be classified? Strain Grade I sprain Grade II sprain Grade III sprain

Grade III sprain

A patient's chart lists in the history section that the patient has experienced a meniscal tear. Which area of the body has been injured? Elbow Shoulder Knee Ankle

Knee

A patient with ankle sprain does not require crutches or a brace. The patient is wondering what he can do to help the healing process. Which of the following acronyms may help the patient remember what to do? RICE therapy ACL therapy ECT therapy HRT therapy

RICE therapy

A nurse uses the acronym "RICE" with a patient. Which of the following is the correct understanding of its meaning? Range of motion, Immobility, Casting, Elevation Rest, Immobility, Compression, Elevation Range of motion, Immobility, Compression, Ergonomic aids Rest, Ice, Compression, Elevation

Rest ice compression elevation

A patient learns that she is to be scheduled for a dual energy x-ray absorptiometry (DEXA) scan. Which of the following should the nurse explain to the patient? A DEXA scan will help us see the osteoarthritis in your joints. A DEXA scan can be used to measure your bone mineral density. A DEXA scan help us evaluate whether you have a ligament tear in your knee. A DEXA scan will help us evaluate whether you have deep vein thrombosis.

a DEXA scan can be used to measure your bone mineral density

A nurse is recording a patient's signs and symptoms. If the patient has classic carpal tunnel syndrome, which area of the body will the patient's complaint be centered on? Elbow Thumb and first finger At least two of first three fingers 4th and 5th fingers

at least two of first three fingers

A patient suffered a fracture of the distal humerus. She also has an autoimmune condition. Which of the following medications being used by the patient may be of concern relative to the healing of her arm? Antihistamines Corticosteroids NSAIDs Angiotensin-receptor blockers

corticosteroids

A patient states that, whenever she stands up, her knees and sometimes her ankles make a clicking noise. Which of the following is an appropriate term for the clinician to use to describe this process? Osteoarthritis Osteophyte formation Crepitus Joint malunion

crepitus

Please place the following events in the proper order to describe how menopausal women may be at increased risk for bone loss. Decreased ovarian function Decreased antiresorptive activity by estrogen Reduced bone mineral density Increased osteoclast activity Decreased estrogen levels

decreased ovarian function decreased estrogen levels decreased antiresorptive activity by estrogen increased osteoclast activity reduced bone mineral density

A patient has suffered a fracture of the distal radius. Please place the following steps for fracture repair in the correct order for bone fracture healing. Lamellar bone deposition Granular tissue formation Inflammatory phase Callus formation Bone remodeling

inflammatory phase granular tissue formation callus formation lamellar bone deposition bone remodeling

A patient presents in the emergency department. The patient had completed a long, intense workout and has developed rhabdomyolysis. Which organ function is most likely compromised? Liver Intestine Spleen Kidney

kidney

An elderly woman with severe osteoporosis has suffered thoracic vertebrae compression fractures. Which of the following is she most likely to develop? Scoliosis Kyphosis Lumbar lordosis No signs or symptoms

kyphosis

A patient had a prior fracture of a phalangeal bone of the foot. The patient did not seek medical care. The patient now presents with the healed fracture, but the bone is abnormally shaped and looks "crooked." Which term can be applied? Nonunion Compression fracture Malunion Stress fracture

malunion

A patient appears with a primary complaint of pain in the sole of his right foot. He states that it is the worst in the morning upon rising but gets a little better during the day. Which of the following is the likely diagnosis? Stress fracture Metatarsal misalignment Grade II sprain Plantar fasciitis

plantar fasciitis

please place the following treatment steps for a dislocated shoulder in the proper order. Improvement of mobility by 10 degrees per week Reduction of joint dislocation Rehabilitation therapy when patient out of sling Sling for one to three weeks Six to eight weeks to restore full range of motion

reduction of joint dislocation sling for one to three weeks rehabilitation therapy when patient out of sling improvement of mobility by 10 degrees per week six to eight weeks to restore full range of motion

A patient has developed bursitis in her elbow from playing tennis. Which of the following applies to this condition? Developed due to a severe pulling action on the arm Tear of the elbow ligament Repetitive overuse injury Due to a genetic, anatomical abnormality

repetitive overuse injury

A patient, while bending down, immediately feels pain in the muscles of his lower back. Any movement involving those back muscles causes soreness. Which of the following would be the correct classification? Strain Grade I sprain Grade II sprain Grade III sprain

strain

A patient is discharged after orthopedic knee surgery. Which signs and symptoms may appear if deep vein thrombosis (DVT) has developed? Select all that apply. Tenderness in the area "Ropiness" of the vein Appearance of white patches on the skin Warm to the touch Red skin rash

tenderness in the area ropiness of the vein warm to the touch

A patient is presenting with pain and tenderness in the middle of the 2nd metatarsal. The nurse is speaking to the patient about her recent health history. Which of the following may the nurse want to note? The patient has lost 15 pounds over the past year. The patient recently began training for a marathon. The patient takes a multivitamin supplement. The patient has a bunion on the opposite foot.

the patient recently began training for a marathon

A patient complains that the "little" and "ring" fingers on the right hand (4th and 5th fingers) fall asleep and tingle. Which of the following may likely be leading to this development? Median nerve injury Rotator cuff injury Sciatica Ulnar nerve injury

ulnar nerve injury

A child needs open reduction with internal fixation for a tibia fracture. How would the nurse explain this process to the parents? Your child will have hardware inserted internally to aid in the healing of the bone. Your child will wear an immobilization cast. Your child will have surgery to insert hardware to help bone healing; portions of the hardware will remain outside the body. Your child will have a removable splint to aid in healing.

your child will have hardware inserted internally to aid in the healing of the bone