Musculoskeletal Disorders chapter 4
What is the Nero transmitter for the skeletal muscle tissue?
Acetylcholine
A 56-year-old female patient is being seen for Osteoarthritis of the knee in the clinic. What should the nurse recommend when discussing strengthening exercises?
Bicycling
While teaching the client which of the following explanations provided by the nurse is the purpose of stump bandaging?
It shrinks and shapes the stump
When the patient with rheumatoid arthritis complains about the daily exercise, the nurse encouraged he reminds the patient that exercises
Keep the joint from freezing
A nurse is talking with an older adult client who has osteoarthritis about joint protection strategies. Which of the following recommendation should the nurse reinforced?
Maintain the recommended bodyweight
Client with osteoarthritis may be on bedrest for prolonged periods. Which of the following nursing interventions would be appropriate for these clients?
Turn the client every two hours, and encourage coughing and deep breathing exercises
The nurse has been assigned to care for a post operative client with total knee replacement. The nurse understand that postop care for this client includes
Monitor incision for drainage and infection, perform continuous passive motion for 24 to 48 hours, patient should avoid weight-bearing on affected leg, prevent patient from dangling legs over the bed
What are the vital functions provided by muscle contraction?
Motion, Maintenance of posture, Production of heat
The nurse explained to a patient who had a knee replacement that warfarin is ordered to
Prevent formation of emboli
A client asks why a cast can't get wet. Which of the following responses would be the most appropriate?
A wet cast will weaken or be destroyed
Which of the following are the main purposes of traction?
Align and stabilize a fracture, prevent deformities, relieve muscle spasms
Client has a fiberglass cast on the right arm. Which actions should the nurse include in the Plan of care?
Assessing movement and sensation in the fingers of the right hand
Which instruction should the nurse include in the teaching plan for a person with Gouty arthritis?
Avoid excessive alcohol, maintain a rest and immobility while disease is symptomatic, check your urine and urine output for possible kidney stones, used bed cradle to support linens
A patient who had a hip fracture was placed in a spica cast. The patient complains of abdominal pain and numerous bouts of vomiting. The physician confirms that the patient is showing signs of cast syndrome. which position will relieve the symptoms of cast syndrome?
Prone
What do you connective tissue disease is affect
Bones, ligaments, Cartlidge, tendons
Certain foods may increase the pain associated with gout. Which foods have the highest concentration of purines?
Brain, liver, kidney, seafood platter with scallops and muscles
A nurse is caring for a client with a fractured hip. Which of the following types of traction should the nurse expect the client to have prior to hip surgery?
Bucks traction
How can the nurse best support the webcast while the physician wraps the arm with rolls of white plaster?
By using the palms of her hands
The relationship between phosphorus and calcium is best described by which statement?
Calcium and phosphorus share an inverse relationship. When calcium is elevated, phosphorus levels are reduced
The nurse is assessing the clients circulation in the right leg following an injury. Which finding need further action?
Capillary refill is longer than 3 seconds
Which information is critical to include in the discharge plans for a client leaving the hospital and a leg cast?
Cast care, neurovascular checks, and hygiene measures
Nursing interventions to treat it Musculoskeletal injury may include cold or heat therapy. Cold therapy decrease his pain by which of the following actions?
Causes local vasoconstriction and prevents Edema or muscle spasm
A nurse is caring for a client in skeletal traction who reports pain at the pin insertion site. Which of the following should Be the initial nursing action
Check the pin site for signs of drainage or inflammation
The client tells the nurse that his skin itches terribly beneath the cast which nursing action is Most appropriate at this time?
Collaborate with the physician on prescribing an antipruritic medication
A client has been diagnosed with gout and wants to know why COLCHICINE is used in the treatment of gout. Which of the following actions of COLCHICINE explain why it's affected freak out?
Decreases inflammation
A 50 year old professional tennis instructor is newly diagnosed with osteoarthritis. Which is the nurses best explanation to the patient when asked what this diagnosis means?
Degeneration of articular cartilage
What is the best physiologic reason for a patient with osteoporosis to maintain a regular exercise regimen?
Promotes bone formation and improves strength
The nurse takes into consideration that a healing fracture progress sister several healing stages. Which is the third healing stage?
Development of fibrin meshwork
One month after discharge a client who had a left total hip replacement calls a clinic reporting a cute constant pain in the left groin and hip area and feeling like the left leg is shorter than the right. A nurse advice is the client to come to the clinic immediately suspecting
Dislocation of the prosthesis
A Carpenter is returning to work after being diagnosed and treated for carpal tunnel syndrome. To prevent recurrence, which of the following instructions is best to provide to the Carpenter?
Do hand and wrist stretching exercises and take frequent breaks
A patient had an open reduction with internal fixation for a compound fracture of the left tibia and has been placed in a long leg cast. The assessment by the nurse are: left foot warm/pink, Pedal pulse weaker than right, capillary refill three seconds, and small 1 cm area of blood on cast. What should the nurse do
Document all assessments are within normal limits
A patient has been casted to stabilize a fracture of the right radius and owner. The nurse assesses a capillary refill of five seconds and cold finger of the right hand. Which initial intervention should the nurse deploy?
Elevate the right hand to heart level to maintain arterial pressure
The doctor orders non-weight bearing with crutches for a client with leg injury. In preparation for the use of crutches, the nurse should instruct the client to
Exercise the triceps, finger flexors and elbow extensors
The nurse after discovering that a patient with a recently place cast has signs of compartment syndrome knows that treatment of compartment syndrome includes which of the following measures?
Fasciotomy
What should the nurse include in the teaching plan for patient who is taking alendronate (fosamax)
Take drug first thing in the morning
It is a chronic syndrome of unknown origin that causes pain in the muscles, joints, bones
Fibromyalgia
While performing an educational session with a client, which of the following conditions is the primary complication of osteoporosis
Fractures
A condition where there is an accumulation of uric acid in the blood due to a defect in purine metabolism
Gout
A nurse is caring for a client who is two days post operative following and above the knee amputation. Which of the following is an appropriate nursing intervention for this client at this time?
Have the client lie prone several times a day
A nurse is collecting a health history for a patient with a connective tissue disease. What is the most important inquiry by the nurse
History of prior injury to a specific body part
To promote the safe use of a cane as an assistive device for a client who is recovering from a musculoskeletal injuries of the left lower extremity's, which of the following instructions should the nurse provided
Hold the cane on the right side
A nurse is caring for a client who has osteoporosis and is prescribed 7 mg of alendronate (fosamax) to take by mouth weekly. The nurse recognizes 34 reinforced teaching with The client when she states
I take my alendronate at the same day every week with an 8 ounce glass of milk
Two days after total hip replacement a patient is being discharged. Which statement indicates that the patient understands the discharge teaching?
I will ask my husband to tie my shoes for me
A nurse witnesses a client sustained a fall and suspects that the clients leg may be fractured. Which nursing action is the priority?
Immobilize the leg before moving the client
The community health nurse found an elderly female client lying in the snow, unable to move her right leg because of a fracture. What's the nurses first priority?
Immobilized a fracture in its present position
A patient with osteoarthritis in both knees and shoulders states that she cannot manage her household tasks without pain. Which is the most appropriate nursing diagnosis for this patient?
Impaired physical mobility related to pain
A nurse is collecting data from a client who has a left lower arm fracture. Which of the following findings indicate impaired venous return to the affected farm?
Increasing edema
What should the nurse do when a patient with osteomyelitis is admitted with an open wound that is draining?
Initiate drainage and secretion precautions
A nurse is caring for a client who has a fractured femur. Which of the following techniques should the nurse use when collecting data about the clients circulatory status?
Instruct the client to wiggle his toes.
The diagnostic procedure that is used to detect abnormalities of the spinal cord or selected areas, such as the cervical or lumbar areas, it's called
Myelography
Mr. cross, age 51, is suffering from rheumatoid arthritis. He asked if there is a cure for rheumatoid arthritis. The most appropriate response is
No, but new drugs being developed can interfere with the body's reaction to inflammation and better control the disease process
A goal for a client who has difficulty with the physical aspects of feeding herself due to rheumatoid arthritis is to use adaptive devices to enhance her capabilities. The nurse caring for the client should initiate a referral to which of the following members of the interprofessional healthcare team?
Occupational therapist
The first priority nursing intervention for an impending fat embolism is to administer
Oxygen
A nurse is monitoring a client who has a cast on her right ankle following an open reduction and internal fixation procedure. The nurse should monitor for which of the following Findings to identify compartment syndrome?
Pain unrelieved by routine medication
A nurse is collecting data from a client following the application of a leg cast for the treatment of a fracture. Which of the following should the nurse expect to find first if the cast is to take?
Pallor of the toes
A nurse is caring for an adolescent client who has a fractured tibia. Following the application of a fiberglass cast, which of the following is the nurses priority action?
Perform a neurovascular check.
You are performing an educational session with female clients and one asks you why are females more proud than males in developing osteoporosis?
Postmenopausal women are at high risk related to loss of female hormone estrogen
A nurse assigned assistive personnel to apply a foot plate to the bed of a client who has his left leg in bucks traction. The nurse correctly explained that the purpose of this action is to
Prevent foot drop
What should the nurse stress to a patient who has had a hip replacement and is beginning strengthening exercises for the unaffected lake?
Push foot down against the footboard for a count of five
A home health nurse is visiting a patient after a total hip replacement. What should the nurse include when teaching a patient how to protect the new joint?
Put an extension on the toilet seat
The nurse realize is that a client needs further teaching on the use of crutches when he
Puts weight on the auxiliary when ambulating
A nurse is caring for a patient immediately after a total knee replacement surgery. What assessment requires priority?
Quality of pulses in the affected limb
A client, with a lower leg amputation, is experiencing Edema, so a nursing assistant elevates the clients residual left limb on pillows. What is the most appropriate action by the nurse when I'm serving that the clients leg has been elevated with pillows?
Remove the pillows, raise the foot of the bed, and inform the nursing assistant that the limb should not be elevated on pillows because it could cause a flexion contracture
A client who has a compound fracture of the right tibia has had a long leg fiberglass cast apply. To reinforced teaching for the client on how to observe and manage his casted extremity at home, the nurse should include which of the following instructions?
Report any worsening or unrelieved pain
A nurse is administering meperidine 100mg IM For a client who is admitted with a pelvic fracture. Following the injection, which of the following data is the priority for the nurse to check?
Respiratory rate
Rheumatoid arthritis can best be distinguished from osteoarthritis by which of the following?
Rheumatoid arthritis is an autoimmune, systemic disease; osteoarthritis is a degenerative disease of the articular cartilage.
Which nursing diagnosis has the highest priority after surgery for the open reduction and external fixation of an ankle?
Risk for infection
The term that describes a lateral curvature of the spine is
Scoliosis
A 20-year-old male client has just had a plaster cast applied to his right forearm following reduction of a closed radius fracture due to an in-line skating accident. The most importantFor the nurse to check which of the following?
Sensation and movement of the fingers
The Clinical manifestation of hip fractures include which of the following
Severe pain and tenderness, and ability to move the leg voluntarily, external rotation of the leg
Bursitis is defined as inflammation of a bursa, a fibrous sack that is lined with synovial fluid. Your client asks you: " where are the common sites that bursitis occurs in"? You reply by saying
Shoulder, elbow, knee joint,
Calcium is a mineral found in many foods that can slow bone loss during the aging process. Which foods high in calcium?
Spinach
A client has hyper extension of the proximal interphalangeal joint with fixed flexion of the distal interphalangeal joint. Which of the following signs of rheumatoid arthritis does the patient have?
Swan neck deformity
This crutch gait will be instructed when nonweightbearing is allowed on both legs
Swing through
A make client with a fractured femur is in Russell's traction. He asked the nurse to help him with back here. which nursing action is most appropriate?
Tell the client to use the trapeze to lift his back off the bed
The nurse instruct the patient who is to have a Unicompartmental knee replacement that a major advantage of the partial knee replacement is that
The patient will be up and walking 2 to 3 hours after operation
A nurse is reinforcing teaching for a family of a client who is receiving treatment for a spinal cord injury with halo fixation device. Which of the following statements by the nurse is appropriate?
The purpose of this device is to mobilize the cervical spine
When assessing for tinels sign in a patients with possible right sided carpal tunnel syndrome, the nurse will ask the patient about :
Tingling in the right thumb and fingers
Nursing care for a client post spine surgery
Turn client as a unit using logroll technique
A cloth like deformity of the hand, rest, fingers, and atrophy of the form that can happen as a result of compartment syndrome
Volkmann's contracture
The characteristics of osteoarthritis that should be included in a teaching plan
Will cause the formation of heberden nodes , Results from where in tear, may affect only one side of the body
The client is rushed to surgery where his arm is amputated above the elbow. Postoperatively, the client says, I know my arm isn't there, but I feel it throbbing. Which response by the nurse would be the most accurate?
You may be experiencing phantom pain from the amputated site
What does prolonged bed rest put the older adult at risk for?
pathologic fractures
A nurse is collecting data on a client who has a femur fracture which of the following findings is a manifestation of fat embolism syndrome?
petechiae over the clients chest
Pain management for the client with rheumatoid arthritis include
salicylates, Cox-2 inhibitor (Celebrex), physical mobility, NSAID's
