Ch.18 Musculoskeletal System

Upon examination of an elderly client, the nurse finds hard, painless nodules over the distal interphalangeal joints. What is the appropriate term the nurse should use to document this finding in the client's medical records?

Heberden's nodes

When the client performs straight leg flexion, the client complains of pain that radiates down his leg. The nurse understands that this may indicate what?

Herniated disc

What range of motion is the nurse testing by asking a client to stoop to pick an object off the floor?

flexion

The nurse is performing an assessment of a client's musculoskeletal system. What would the nurse examine first?

gait

Skeletal muscles are attached to bones by

tendons

Assessment reveals that a client has slight weakness with active range of motion against some resistance. How would the nurse document this finding?

4/5

What is an appropriate question by the nurse to ask a client about the presence of temporomandibular joint dysfunction?

"Have you noticed a popping or grating sound when you chew?"

A previously healthy 64-year-old man has been recently diagnosed with osteoarthritis. The client is motivated to maintain his quality of life and slow the progression of his new health problem. What advice can the nurse provide for the client in his efforts to minimize the effects and progression of osteoarthritis?

"It's important for you to maintain a healthy body weight."

When assessing muscle tone and strength, the nurse would document expected findings as

"upper and lower extremity muscle strength is 5/5 bilaterally"

A client diagnosed with rheumatoid arthritis exhibits edema, redness, and tenderness of the fingers. What is the nurse's priority action?

Administer prescribed anti-inflammatory.

Pain, swelling, loss of both active and passive motion, locking, and deformity would be consistent with which of the following?

Articular joint pain

A client visits the health care facility with reports of lumbar back pain that radiates down the back. The nurse performs the straight leg test to determine the origin of the pain. Which techniques should the nurse use to perform this test?

Ask the client to raise the leg to the point of pain and then dorsiflex the foot

The nurse is preparing to palpate the anatomic snuffbox. At which location would the nurse palpate?

At the back of the wrist and extended thumb

A client presents to the emergency department after falling off a ladder while doing some outside painting at home. The client's ankle appears swollen, out of alignment, and is painful to touch. What is the nurse's first action?

Check for a pulse, color, temperature, and capillary refill.

A nurse notices that a client has decreased range of motion with lateral bending of the cervical spine to the left side. What should the nurse do next in relation to this finding?

Compare this finding to the range of motion to the right side

When determining a client's strength, it is necessary to implement what assessment?

Comparing one side to the other

The client is the pitcher of the high school baseball team. He is brought to the clinic by his mother with a complaint of pain in his right elbow. Where would the nurse expect to locate his tenderness?

Distal to the right medial epicondyle

A college age athlete presents to the clinic with pain in the tibiotalar joint. It is a hinge joint limited to flexion and extension. The terms used to describe these movements are what?

Dorsiflexion and plantar flexion

During palpation of the client's knee, the nurse compresses the suprapatellar pouch against the client's femur with one hand while feeling on each side of the patella with the opposite hand. For which of the following problems is the nurse assessing?

Effusion in the knee joint

A client presents at the clinic with an enlarged, swollen, hot, and red metatarsophalangeal joint and bursa of the great toe. What medical diagnosis would the nurse suspect?

Gouty arthritis

Mary started a job 2 weeks ago that requires carrying heavy buckets. She presents with elbow pain worse on the right. On examination, it hurts her elbows to dorsiflex her hands against resistance when her palms face the floor. What condition does she have?

Lateral epicondylitis (tennis elbow)

A client expresses to the nurse that he has a "giving in" or "locking" sensation in the knee. Which test should the nurse perform to elicit related findings of a possible tear in the meniscus of the client's knee?

McMurray's

A nurse obtains an order to measure a client's leg length. How should a nurse correctly implement this order?

Measure from the anterior superior iliac spine to the medial malleolus

A nurse notices that a client's flexibility of the right elbow is less than the left elbow. What is an appropriate action by the nurse in regard to this finding?

Measure movement with a goniometer

The nurse is planning a presentation on osteoporosis to a group of high school students. Which of the following should the nurse plan to include in the presentation?

Moderate strenuous exercise tends to increase bone density.

A 32-year-old warehouse worker presents for evaluation of low back pain. He notes a sudden onset of pain after lifting a heavier-than-usual set of boxes. He also states that he has numbness and tingling in the left leg. What test should the nurse perform to assess for a herniated disc?

Straight leg raise test

The nurse is conducting a musculoskeletal assessment of an older adult client. What aspect of the client's medical history requires the nurse to alter the usual sequence or content of this assessment?

The client had a total hip replacement 2 years ago.

After assessing the client for posture and body alignment, how would the nurse document head position in relation to the spine if alignment is normal with noticeable defect?

The head is midline and aligned with the spine

A nurse is inspecting a client's gait. Which of the following would indicate an abnormal finding?

Toes point out

A 50-year-old woman presents with "left hip pain" of several weeks duration. She is exquisitely tender when the nurse presses over her proximal lateral thigh. What is her most likely health problem?

Trochanteric bursitis

A nurse is testing the range of motion of a client's wrist for supination. Which movement will this involve?

Turning the palm of the hand upward

The nurse is performing the bulge test during the assessment of a client's knee. This test will allow the nurse to make what determination?

Whether the client's swollen knee is caused by tissue swelling or by fluid accumulation

A client visits the clinic and tells the nurse that she has joint pain in her hands, especially in the morning. The nurse should assess the client further for signs and symptoms of

arthritis.

A nurse is caring for a client who is recovering from a stroke. The nurse assesses the muscle strength of the client's arm and finds that the joint exhibits active motion against gravity. Which of the following should the nurse document to classify muscle strength based on this finding?

average weakness

Which nutrient deficiency should a nurse recognize as placing a client at risk for osteoporosis?

calcium

A nurse is providing health education about osteoporosis to a community group. What ethnicity is considered to be an independent risk factor for osteoporosis?

caucasian

A client presents to the health care clinic with reports of onset of neck pain 3 days ago. The nurse recognizes that the most common cause of neck pain is what condition?

cervical strain

During the nursing history of a newly admitted client, the nurse is reviewing a client's current medication regimen. What medication category creates a risk for decreased bone density?

corticosteroids

When assessing the client's upper extremities, the nurse instructs the client to put the hands behind the neck with the elbows pointed laterally. This positioning facilitates assessment of which of the following functions?

externally rotate shoulder

A client has osteoarthritis of the elbow. Which assessment approach should the nurse expect to be impacted by this health problem?

flexion

Articulation between the head of the femur and the acetabulum is in the

hip joint

A client presents to the health care clinic with reports of pain in the hands and right wrist. Additional history reveals that the client is a factory worker who spends all day performing the same repetitive task. The nurse performs Phalen's test and Tinel's test with positive results. The hand grips are unequal, with the right weaker than the left. What nursing diagnosis can the nurse confirm from this data?

impaired physical mobility

A school age client has been diagnosed with genu valgum. What is the other name for this disease?

knock knee

The nurse is assessing an elderly client and finds an exaggerated thoracic curve. This would be documented as what?

kyphosis

A nurse is preparing a program on osteoporosis for a local women's group. Which of the following would the nurse include as a modifiable risk factor?

low estrogen levels

While sitting a client raises both legs while the nurse holds the lower legs below the knee. What does this finding indicate?

normal quadriceps muscle strength

The nurse is testing a client for carpal tunnel syndrome. The client flexes the wrists at an angle of 90° and holds the backs of the hands to each other for 60 seconds. The client tells the nurse that he is experiencing a burning pain as a result. Which test is the nurse performing on this client?

phalens

When assessing the elbow, a nurse asks a client to hold the arm out and turn the palm down. The nurse is testing which of the following?

pronation

A client is unable to externally rotate the left shoulder. What health problem should the nurse suspect is occurring with this client?

rotator cuff tear

While assessing the range of motion in an adult client's shoulders, the client expresses pain and exhibits limited abduction and muscle weakness. The nurse plans to refer the client to a physician for possible

rotator cuff tear.

The nurse is assessing the spine of an adult client and detects lateral curvature of the thoracic spine with an increase in convexity on the left curved side. The nurse suspects that the client is experiencing

scoliosis.

The subacromial bursae are contained in the

shoulder joint.

A nurse is preparing a program on osteoporosis for a local women's group. What would the nurse cite as a risk factor?

smoking

The nurse is going to test range of motion in a client. To test extension of the triceps muscle, the nurse would instruct the client to

straighten the elbow