Chapter 36- Management of patients with musculoskeletal disorders

During a routine physical examination on an older female client, a nurse notes that the client is 5 feet, 3/8 inches (1.6 m) tall. The client states, "How is that possible? I was always 5 feet and 1/2? (1.7 m) tall." Which statement is the best response by the nurse? "There may be some slight discrepancy between the measuring tools used." "After age 40, height may show a gradual decrease as a result of spinal compression" "After menopause, the body's bone density declines, resulting in a gradual loss of height." "The posture begins to stoop after middle age."

"After menopause, the body's bone density declines, resulting in a gradual loss of height."

A client is scheduled for surgery to fuse a joint. The nurse identifies this as which of the following? Open reduction internal fixation Osteotomy Arthroplasty Arthrodesis

Arthrodesis

The nurse is preparing a client for a surgical procedure that will allow visualization of the extent of joint damage of the knee for a client with rheumatoid arthritis and also obtain a sample of synovial fluid. What procedure will the nurse prepare the client for? Arthroplasty Open reduction Arthroscopy Needle aspiration

Arthroscopy

Which medication directly inhibits osteoclasts, thereby reducing bone loss and increasing bone mass density (BMD)? Calcitonin Vitamin D Teriparatide Raloxifene

Calcitonin

Which of the following inhibits bone resorption and promotes bone formation? Estrogen Parathyroid hormone Calcitonin Corticosteroids

Calcitonin

The nurse is asked to explain to the client the age-related processes that contribute to bone loss and osteoporosis. What is the nurse's best response? Decrease in parathyroid hormone Increase of vitamin D Decrease in estrogen Increase in calcitonin

Decrease in estrogen

A client comes to the emergency department complaining of pain in the right leg. When obtaining the history, the nurse learns that the client has a history of obesity and hypertension. Based on this information the nurse anticipates the client having which musculoskeletal disorder? Muscular dystrophy Scoliosis Degenerative joint disease Paget's disease

Degenerative joint disease

A high school student who was injured in a football game presents with knee pain with internal rotation of the foot. Which interventions are appropriate nursing actions? Select all that apply. Administer morphine sulfate. Apply ice packs to the affected knee. Elevate the affected leg. Apply a knee brace or wrap the affected knee. Assist the client to "walk off" the pain.

Elevate the affected leg. Apply ice packs to the affected knee. Apply a knee brace or wrap the affected knee.

Dupuytren contracture causes flexion of which area(s)? Thumb Fourth and fifth fingers Index and middle fingers Ring finger

Fourth and fifth fingers

The client with osteoarthritis is seen in the clinic. Which assessment finding indicates the client is having difficulty implementing self-care? Has a weight gain of 5 pounds Reports ability to perform ADLs Reports decreased joint pain Shows increased joint flexibility

Has a weight gain of 5 pounds

A female client is at risk for developing osteoporosis. Which action will reduce the client's risk? Living a sedentary lifestyle to reduce the incidence of injury Taking a 300-mg calcium supplement to meet dietary guidelines Stopping estrogen therapy Initiating weight-bearing exercise routines

Initiating weight-bearing exercise routines

Which term refers to a disease of a nerve root? Sequestrum Radiculopathy Involucrum Contracture

Radiculopathy

The health care team is caring for a client with osteomalacia. It has been determined that the osteomalacia is caused by malabsorption. What treatment should the nurse anticipate? Exogenous parathyroid hormone and multivitamins Supplemental potassium and pancreatic enzymes Colony-stimulating factors and calcitonin Supplemental calcium and increased doses of vitamin D

Supplemental calcium and increased doses of vitamin D

A nurse is teaching a client who was recently diagnosed with carpal tunnel syndrome. Which statement should the nurse include? "This condition is associated with various sports." "Surgery is the only sure way to manage this condition." "Ergonomic changes can be incorporated into your workday to reduce stress on your wrist." "Using arm splints will prevent hyperflexion of the wrist."

"Ergonomic changes can be incorporated into your workday to reduce stress on your wrist."

The nurse has educated a patient with low back pain about techniques to relieve the back pain and prevent further complications. What statement by the patient shows understanding of the education the nurse provided? "Instead of turning around to grasp an object, I will twist at the waist." "I will lie prone with my legs slightly elevated." "I will avoid prolonged sitting or walking." "I will bend at the waist when I am lifting objects from the floor."

"I will avoid prolonged sitting or walking."

A nurse is planning discharge instructions for the client with osteomyelitis. What instructions should the nurse include in the discharge teaching? "You need to limit the amount of protein and calcium in your diet." "You need to perform weight-bearing exercises twice a week." "Use your continuous passive motion machine for 2 hours each day." "You will receive IV antibiotics for 3 to 6 weeks."

"You will receive IV antibiotics for 3 to 6 weeks."

Which area of the spinal column is subject to the greatest mechanical stress and degenerative changes? Lower lumbar Thoracic Upper lumbar Cervical

Lower lumbar

A client with carpal tunnel syndrome has had limited improvement with the use of a wrist splint. The nurse knows that which procedure will show the greatest improvement in treatment for this client? Injection of lidocaine Open nerve release Ultrasound therapy Laser therapy

Open nerve release

Which of the following is the most common and most fatal primary malignant bone tumor? Enchondroma Rhabdomyoma Osteogenic sarcoma (osteosarcoma) Osteochondroma

Osteogenic sarcoma (osteosarcoma)

A nurse is caring for a client following foot surgery. Which nursing intervention is most important for the nurse to include in the nursing care plan? Perform neuromuscular assessment every hour. Administer pain medication per client request. Examine the surgical dressing every hour. Monitor vital signs every 4 hours.

Perform neuromuscular assessment every hour.

Morton neuroma is exhibited by which clinical manifestation? Inflammation of the foot-supporting fascia Swelling of the third (lateral) branch of the median plantar nerve Longitudinal arch of the foot is diminished High arm and a fixed equinus deformity

Swelling of the third (lateral) branch of the median plantar nerve

The nurse is educating a client with low back pain on proper lifting techniques. The nurse recognizes that the education was effective when the client reaches over the head with the arms fully extended. bends at the hips and tightens the abdominal muscles. uses a narrow base of support. places the load close to the body.

places the load close to the body

Which client would the nurse identify as having the greatest risk for osteoporosis? A 16-year-old male with a history of asthma A 40-year-old overweight African American woman A small-framed, thin 45-year-old white woman A 20-year-old male athlete with repeated injuries

A small-framed, thin 45-year-old white woman

The nurse is educating the patient with low back pain about the proper way to lift objects. What muscle should the nurse encourage the patient to maximize? Quadriceps Latissimus dorsi Gastrocnemius Rectus abdominis

Quadriceps

A client diagnosed with carpal tunnel syndrome (CTS) asks the nurse about numbness in the fingers and pain in the wrist. What is the best response by the nurse? "CTS is a neuropathy that is characterized by flexion contracture of the fourth and fifth fingers." "CTS is a neuropathy that is characterized by pannus formation in the shoulder." "CTS is a neuropathy that is characterized by bursitis and tendinitis." "CTS is a neuropathy that is characterized by compression of the median nerve at the wrist."

"CTS is a neuropathy that is characterized by compression of the median nerve at the wrist."

A healthcare provider asks a nurse to test a client for Tinel's sign to diagnose carpal tunnel syndrome. What should the nurse do to perform this assessment? Have the client make a fist and open the hand against resistance. Have the client stretch the fingers around a ball and squeeze with force. Have the client pronate the hand while the nurse palpates the radial nerve. Have the client hold the palm of the hand up while the nurse percusses over the median nerve.

Have the client hold the palm of the hand up while the nurse percusses over the median nerve

A nurse notices a client lying on the floor at the bottom of the stairs. The client is alert and oriented and denies pain other than in the arm, which is swollen and appears deformed. After calling for help, what should the nurse do? Place the client in a sitting position. Help the client walk to the nearest nurses' station. Immobilize the client's arm. Raise the client's arm above the heart.

Immobilize the client's arm.

Which of the following presents with an onset of heel pain with the first steps of the morning? Hallux valgus Ganglion Morton's neuroma Plantar fasciitis

Plantar fasciitis

A client has been treated for migraine headaches for several months and comes to the clinic reporting no improvement. The nurse is talking with the client and hears an audible click when the client is moving the jaw. What does the nurse suspect may be happening? Trigeminal neuralgia Dislocated jaw Loose teeth Temporomandibular disorder

Temporomandibular disorder

A nurse is teaching a client about preventing osteoporosis. Which teaching point is correct? Obtaining the recommended daily allowance of calcium requires taking a calcium supplement. To prevent fractures, the client should avoid strenuous exercise. The recommended daily allowance of calcium may be found in a wide variety of foods. Obtaining an X-ray of the bones every 3 years is recommended to detect bone loss.

The recommended daily allowance of calcium may be found in a wide variety of foods

A client with a musculoskeletal injury is instructed to alter the diet. The objective of altering the diet is to facilitate the absorption of calcium from food and supplements. Considering the food intake objective, which food item should the nurse encourage the client to include in the diet? Green vegetables Bananas Red meat Vitamin D-fortified milk

Vitamin D-fortified milk