Chapter 36 (Musculoskeletal)

Health education for a woman over age 50 includes providing information about the importance of adequate amounts of calcium and vitamin D to prevent osteoporosis. Select the daily dosage of calcium and vitamin D that the nurse should recommend.

1200 mg

Dupuytren contracture causes flexion of which area(s)?

4 & 5

A client with diabetes punctured the foot with a sharp object. Within a week, the client developed osteomyelitis of the foot. The client was admitted for IV antibiotic therapy. How long does the nurse anticipate the client will receive IV antibiotics?

4 weeks

Which client would the nurse identify as having the greatest risk for osteoporosis?

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

Which term refers to a flexion deformity caused by a slowly progressive contracture of the palmar fascia?

D

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?

I will avoid prolonged sitting or walking

A client visits an orthopedic specialist because of pain beginning in the low back and radiating behind the right thigh and down below the right knee. The doctor suspects a diagnosis of sciatica. The nurse knows that the origin of the pain is between which intervertebral disks?

L4, L5, & S1

On a visit to the family health care provider, a client is diagnosed with a bunion on the lateral side of the great toe at the metatarsophalangeal joint. Which statement should the nurse include in the teaching session?

Some bunions are congenital; others are caused by wearing shoes that are too short or narrow

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?

Supplemental calcium and increased doses of vitamin D

Morton neuroma is exhibited by which clinical manifestation?

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

A client is admitted with acute osteomyelitis that developed after an open fracture of the right femur. When planning this client's care, the nurse should anticipate which measure?

administering large doses of IV antibiotics

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?

after menopause bone density reclines

The nurse is caring for a client with a hip fracture. The physician orders the client to start taking a bisphosphonate. Which medication would the nurse document as given?

alendronate

A client is evaluated for a diagnosis of Paget's disease. Which laboratory value would the nurse find to confirm the diagnosis?

alk phos

A patient is diagnosed with osteogenic sarcoma. What laboratory studies should the nurse monitor for the presence of elevation?

alkaline phosphatase

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?

arthroscopy

A nurse is caring for an elderly female client with osteoporosis. When teaching the client, the nurse should include information about which major complication?

bone fracture

A patient has been diagnosed with osteomalacia. What common symptoms does the nurse recognize that correlate with the diagnosis?

bone pain and tenderness

What food can the nurse suggest to the client at risk for osteoporosis?

broccoli

Which medication directly inhibits osteoclasts, thereby reducing bone loss and increasing BMD?

calcitonin

Which medication directly inhibits osteoclasts, thereby reducing bone loss and increasing bone mass density (BMD)?

calcitonin

Which of the following inhibits bone resorption and promotes bone formation?

calcitonin

A home care nurse assesses for disease complications in a client with bone cancer. Which laboratory value may indicate the presence of a disease complication?

calcium 11.6

Which common problem of the upper extremity results from entrapment of the median nerve at the wrist?

carpal tunnel

When an infection is bloodborne, the manifestations include which symptom?

chills

A nurse is caring for a client with eczema. Which medication would be prescribed when an allergy is a factor causing the skin disorder?

chlorpheniramine

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 estrogen

What clinical manifestation would the nurse expect to find in a client who has had osteoporosis for several years?

decreased height

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?

degenerative joint disease

The client diagnosed with osteosarcoma is scheduled for a surgical amputation. Which nursing diagnosis would be a priority for this client compared with other surgical clients?

disturbed body image

What term refers to a flexion deformity caused by a slowly progressive contracture of the palmar fascia?

dupuytren contracture

A nurse is teaching a client who was recently diagnosed with carpal tunnel syndrome. Which statement should the nurse include?

ergonomic changes can be incorporated into your workday to reduce stress on your wrist

Which group is at the greatest risk for osteoporosis

european american women

Which of the following is the only selective estrogen receptor modulator approved for osteoporosis in post menopausal women?

fosamax

In which deformity does the great toe deviate laterally?

hallux vagus

Which of the following was formerly called a bunion?

hallux vagus

During a routine physical examination of a client, the nurse observes a flexion deformity of the proximal interphalangeal (PIP) joint of two toes on the right foot. How would the nurse document this finding?

hammer toe

The nurse notes that the client's left great toe deviates laterally. This finding would be recognized as

hammertoe

A client has been prescribed alendronate for the prevention of osteoporosis. Which is the highest priority nursing intervention associated with the administration of the medication?

have the patient sit upright for 30 min

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?

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

A physician prescribes raloxifene to a hospitalized client. The client's history includes a right hip fracture, hysterectomy, deep vein thrombosis, and hypertension. Which action by the nurse demonstrates safe nursing care?

hold the r one

A client was seen in the clinic for musculoskeletal pain, fatigue, mood disorders, and sleep disturbances. The physician has diagnosed fibromyalgia. What would not be a part of teaching plan for this condition?

ice

Assessment of a client reveals signs and symptoms of Paget's disease. Which of the following would be most likely?

long bone bowing

Which area of the spinal column is subject to the greatest mechanical stress and degenerative changes?

lower lumbar

Which classic symptom will the nurse assess for to detect the development of plantar fasciitis?

morning heel pain

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?

open nerve release

Which of the following is the most common and most fatal primary malignant bone tumor?

osteogenic sarcoma

A client presents to the emergency department with fever, chills, restlessness, and limited movement of a fractured jaw. What complication should the nurse interpret as the findings?

osteomyelitis

The nurse is collaborating with the health care provider on a plan of care for a 54-year-old male client with osteomyelitis of the left femur secondary to uncontrolled type 1 diabetes.

perform neurovascular checks of lower extremities q8h, administer IV antibiotics based on culture and sensitivity report, administer ibuprofen, make referral to dietitian to discuss nutrition for healing and blood glucose, provide education on self-blood glucose monitoring & insulin

A patient had hand surgery to correct a Dupuytren's contracture. What nursing intervention is a priority postoperatively?

performing hourly neuro assessments for 24 hours

Which of the following positions should be avoided in severe back pain?

prone

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

Which term refers to a disease of a nerve root

radiculopathy

Which term refers to a disease of a nerve root?

radiculopathy

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?

raise the client's arm above the heart

A client with Paget's disease comes to the hospital and reports difficulty urinating. The emergency department health care provider consults urology. What should the nurse suspect is the most likely cause of the client's urination problem?

renal calculi

A nurse is educating a client diagnosed with osteomalacia. Which statement by the nurse is appropriate?

renal failure

A client has Paget's disease. An appropriate nursing diagnosis for this client is:

risk for falls

Which is a strategy for lowering risk for osteoporosis?

smoking cessation

The majority of bone infections are caused by which organism?

staph

The nurse is educating a group of women on the prevention of osteoporosis. The nurse recognizes the education as being effective when the group members make which statement?

sunshine

A patient is having low back pain. What position can the nurse suggest to relieve this discomfort?

supine with knees slightly flexed and the head of the bed elevated 30 degrees

In chronic osteomyelitis, antibiotics are adjunctive therapy in which situation

surgical debridement

In chronic osteomyelitis, antibiotics are adjunctive therapy in which situation?

surgical debridement

A nurse is performing discharge teaching for an elderly client with osteoporosis. Which instruction about a calcium supplement should the nurse include?

take supplement with meals or orange juice

A nurse is caring for a client who's experiencing septic arthritis. This client has a history of immunosuppressive therapy and the immune system is currently depressed. Which assignment is the most appropriate for the nurse caring for this client?

the nurse is caring for this client on the ICU

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?

vitamin d fortified milk

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?

TMJ

While the nurse is performing a physical assessment, the client reports numbness, tingling, and pain when the nurse percusses lightly over the median nerve. What should this assessment indicate to the nurse?

carpal tunnel syndrome

A nurse is teaching a client about preventing osteoporosis. Which teaching point is correct?

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

A nurse is planning discharge teaching regarding exercise for a client at risk for osteoporosis. Which exercise would the nurse be most likely to suggest?

walking

The nurse is assisting a client with removing shoes prior to an examination and observes that the client has a flexion deformity of several toes on both feet of the proximal interphalangeal (PIP) joints. What can the nurse encourage the client to do?

wear properly fitting shoes

A female client is at risk for developing osteoporosis. Which action will reduce the client's risk?

weight bearing

The client with osteoarthritis is seen in the clinic. Which assessment finding indicates the client is having difficulty implementing self-care?

weight gain of 5 lbs

A nurse is planning discharge instructions for the client with osteomyelitis. What instructions should the nurse include in the discharge teaching?

you will receive IV antibiotics for 3 to 6 weeks