N120 MCA 1 Week 4 and 5 Content

Which type of joint is present in between the client's tarsal bones? Pivot Hinge Saddle Gliding

Gliding Rationale: The gliding joint is present in between the tarsal bones. The pivot joint is present in the proximal radioulnar joint. The hinge joint is present in the elbows and knees. The saddle joint is present in between the carpometacarpal joints of the thumb.

Which hormone aids in regulating intestinal calcium and phosphorus absorption? Insulin Thyroxine Glucocorticoids Parathyroid hormone

Glucocorticoids Rationale: Adrenal glucocorticoids aid in regulating intestinal calcium and phosphorous absorption by increasing or decreasing protein metabolism. Insulin acts together with growth hormone to build and maintain healthy bone tissue. Thyroxine increases the rate of protein synthesis in all types of tissues. Parathyroid hormone secretion increases in response to decreased serum calcium concentration and stimulates the bones to promote osteoclastic activity. "Vitamin D functions by stimulating intestinal calcium and phosphorus absorption, by stimulating bone calcium mobilization, and by increasing renal reabsorption of calcium in the distal tubule. These functions on bone and possibly kidney, but not intestine, require the parathyroid hormone." https://link.springer.com/chapter/10.1007/978-1-4684-5101-6_24

Which hormone aids in regulating intestinal calcium and phosphorus absorption? Insulin Thyroxine Glucocorticoids Parathyroid hormone

Glucocorticoids Rationale: Adrenal glucocorticoids aid in regulating intestinal calcium and phosphorus absorption by increasing or decreasing protein metabolism. Insulin acts together with growth hormone to build and maintain healthy bone tissue. Thyroxine increases the rate of protein synthesis in all types of tissues. Parathyroid hormone secretion increases in response to decreased serum calcium concentration and stimulates the bones to promote osteoclastic activity.

The registered nurse (RN) is giving home care instructions to a client who was treated for injuries due to a fall. Which statement made by the client indicates a need for additional instruction? 'I should walk on soft scatter rugs at home.' 'I should drink 3000 mL of water every day.' 'I should eat fruits and vegetables six times a day.' 'I should exercise the joints above and below the case daily.'

'I should walk on soft scatter rugs at home.' Rationale: A client with injuries due to a fall must avoid having throw or scattered rugs at home to reduce the incidence of falls. The registered nurse (RN) would encourage the client to drink 3000 mL of water per day to promote optimal bladder and bowel function. The client would eat six small meals with foods rich in fiber, such as fruits and vegetables, to prevent constipation. The RN has to encourage the client to perform exercise above and below the cast daily for a speedy recovery. Test-Taking Tip: The client must be conscious and avoid slippery surfaces while walking to prevent falls. Select the correct answer that is consistent with this type of thinking.

How would the nurse respond to a client who expresses malignancy fears associated with the pending bone biopsy report? 'Worrying is not going to help the situation.' 'Let's wait until we hear what the biopsy report says.' 'It is very upsetting to have to wait for a biopsy report.' 'Operations are not performed unless there are no other options.'

'It is very upsetting to have to wait for a biopsy report.' Rationale: 'It is very upsetting to have to wait for a biopsy report.,' addresses the fact that the client's feelings of anxiety are valid. Telling the client that operations are not performed unless there are no other options is irrelevant and does not address the client's concerns.

After signing a legal consent for hip replacement surgery and within hours before the surgery, the client states, 'I decided not to go through with the surgery.' Which response would the nurse use initially? 'Then you shouldn't have signed the consent.' 'I can understand why you changed your mind.' 'Tell me why you decided to refuse the operation.' 'Let's talk about your concerns regarding the procedure.'

'Let's talk about your concerns regarding the procedure.' Rationale:

Which muscle-strength rating would the nurse record for a client who can complete range of motion with some resistance? 1 2 3 4

4 Rationale: According to the common scale for grading muscle strength, a client who can complete range of motion with some resistance is given the rating 4. Rating 1 is given to a client with no joint motion and slight evidence of muscle contractility. Rating 2 is given to a client who can complete range of motion with gravity eliminated. Rating 3 is given to a client who can complete range of motion against gravity.

Which term describes synovial joint movement away from the midline of the body? Inversion Extension Pronation Abduction

Abduction Rationale: Abduction is a synovial joint movement that involves movement of a part away from the midline of the body. Inversion is turning of the sole inward toward the midline of the body. Pronation is a synovial joint movement that involves the turning of the palm downward. Extension is a synovial joint movement that involves a straightening of joint that increases the angle between two bones.

Which client action would the nurse score as 3 on the muscle-strength scale? Active movement against gravity and some resistance Active movement of body part with elimination of gravity Active movement against full resistance without evident fatigue Active movement against gravity only and not against resistance

Active movement against gravity only and not against resistance Rationale: According to the muscle-strength scale, a score of 3 indicates active movement against gravity only and not against resistance. A score of 4 indicates active movement against gravity and some resistance. A score of 2 indicates active movement of a body part with elimination of gravity. A score of 5 indicates active movement against full resistance without evident fatigue.

A 90-year-old resident fell and fractured the proximal end of the right femur. The surgeon plans to reduce the fracture with an internal fixation device. Which general fact about the older adult would the nurse consider when caring for this client? Aging causes a lower pain threshold. Aging reduces the physiological coping defenses. Most confused states result from dementia. Older adults psychologically tolerate changes well.

Aging reduces the physiological coping defenses. Rationale: Aging causes a lowering of the physiological coping reserve of various systems of the body. The pain threshold increases with aging. There are many etiologies for confusion (e.g., medication intolerance, altered metabolic state, unfamiliar surroundings). As individuals age they become more entrenched in ideas, environment, and objects that are familiar, and thus do not tolerate change well.

Which instruction would the nurse provide to an older client using ice and heat to treat pain from back strain? Select all that apply. One, some, or all responses may be correct. Switch positions every 4 hours. Use a heating pad for the first 24 hours. Apply for 30-minute time intervals. Place the ice pack directly to injury site. Take ibuprofen every 4 hours PRN.

Apply for 30-minute time intervals. Rationale: To prevent skin damage, ice and heat should only be applied for 20- to 30-minute intervals. Clients should be instructed to shift positions every hour to prevent skin breakdown. Ice should be used the first 24 to 48 hours followed by heat. Ice should never be directly applied to the skin as it can cause injury to the tissue. The client can take ibuprofen if approved by the health care provider.

Which finding during a home health visit would prompt the nurse to provide a client with home safety instructions? Select all that apply. One, some, or all responses may be correct. Area rugs on the floor Clogged, dirty fireplace Multiple electrical cords Multiple prescribed medications Wheeled walker with uneven legs

Area rugs on the floor Clogged, dirty fireplace Multiple electrical cords Multiple prescribed medications Wheeled walker with uneven legs Rationale: There are multiple potential hazards in the home clients should be educated about to avoid injury. Area rugs and multiple electrical cords on the floor pose a fall risk. A clogged, dirty fireplace could lead to carbon monoxide poisoning. Polypharmacy can cause mental status changes, confusion, and orthostatic blood pressure changes; these can increase the client's fall risk. If the nurse observes a wheeled walker with uneven legs, the physical therapist would be notified as they can follow-up to evaluate the mobility aid's safety.

Which type of joint permits movement in any direction? Pivot Hinge Biaxial Ball-and-socket

Ball-and-socket Rationale: Ball-and-socket joints permit movement in any direction. Pivot joints permit rotation. Hinge joints allow motion in one plane. Biaxial joints permit gliding movement.

Which joint helps in the gliding movement of the wrist? Pivot joint Hinge joint Biaxial joint Ball and socket joint

Biaxial joint Rationale: The biaxial joint helps in the gliding movement of the wrist. Pivot joints permit rotation in the radioulnar area. Hinge joints allow for flexion and extension. Ball and socket joints permit movement in the shoulders and hips.

Which structures protect a client's internal organs, support blood cell production, and store minerals? Joints Bones Muscles Cartilages

Bones Rationale: Bones are the framework of the body; they support and protect internal organs. They also help in stem cell production from bone marrow, and they store minerals. Joints (articulations) help articulate the bones. Muscles are the bundles of fibrous tissue that contract to produce movement and maintain body posture. Cartilage is a hyaline, elastic, and fibrous tissue that often functions as a shock absorber.

When performing a physical assessment on a client, which term would the nurse use to describe a flat, poorly defined mass on the sole over a bony prominence and caused by pressure? Plantar wart Callus Ingrown nail Hypertrophic ungual labium

Callus Rationale: In foot problems, a callus description is a flat, poorly defined mass on the sole over a bony prominence that is caused by pressure. Plantar wart is a painful papillomatous growth caused by a virus. A sliver of toenail penetrating the skin and causing inflammation results in ingrown nail. A hypertrophic ungual labium is a chronic hypertrophy of the nail lip caused by improper nail trimming.

Which condition can be identified in a client using Phalen's test? Atrophy Bone tumor Rotator cuff injury Carpal tunnel syndrome

Carpal tunnel syndrome Rationale: Phalen's test is used to detect carpal tunnel syndrome. A muscle biopsy is done for the diagnosis of atrophy. A computed tomography scan is done to diagnose a bone tumor. The drop arm test is performed to detect rotator cuff injuries.

Which ethnic group has a greater incidence of osteoporosis due to musculoskeletal differences? Irish Americans African Americans Chinese Americans Egyptian Americans

Chinese Americans Rationale: Chinese Americans have an increased incidence of osteoporosis because they have shorter and smaller bones with lower bone density. Irish Americans have taller and broader bones than other Euro-Americans. African Americans have a decreased incidence of osteoporosis. Egyptian Americans are shorter in stature than Euro-Americans and African Americans.

Which client's joint fluid examination report indicates a normal finding? Client A Presence of uric acid crystals in the fluid Client B Floating fat globules in the fluid Client C Thick, purulent fluid Client D Transparent, straw-colored fluid

Client D Rationale: Joint fluid is normally transparent and colorless or straw-colored. Client D's joint fluid is normal. The presence of uric acid crystals in client A's fluid suggests gout. Floating fat globules in client B's joint fluid indicate a bone injury. The thick, purulent joint fluid found in client C indicates infection.

When developing the plan of care for a client with rheumatoid arthritis, which client consideration would the nurse include? Surgery Comfort Education Motivation

Comfort Rationale: Because pain is an all-encompassing and often demoralizing experience, the nurse would want to keep the client as pain-free as possible. Surgery corrects deformities and facilitates movement, which is not an immediate need. Concentration and motivation are difficult when a client is in severe pain.

Which foot disorder is caused by continual pressure over bony prominences? Corn Wart Hammertoe Hallux rigidus

Corn Rationale: A corn is a foot disorder caused by continual pressure over bony prominences. A plantar wart is a foot disorder caused by a virus. Hammertoe is a foot disorder caused by flexion and deformity in the joints. Hallux rigidus is caused by osteoarthritis.

Which medication is used in the treatment of a client with intervertebral disc disease? Etidronate Zoledronic acid Cyclobenzaprine Salmon calcitonin

Cyclobenzaprine Rationale: Intervertebral disc disease often causes myalgia. Muscle relaxants, such as cyclobenzaprine, are used in its treatment. Etidronate, zoledronic acid, and salmon calcitonin are effective in the treatment of osteoporosis.

Which medication is used in the treatment of a client with intervertebral disc disease? Etidronate Zoledronic acid Cyclobenzaprine Salmon calcitonin

Cyclobenzaprine Rationale: Intervertebral disc disease often causes myalgia. Muscle relaxants, such as cyclobenzaprine, are used in its treatment. Etidronate, zoledronic acid, and salmon calcitonin are effective in the treatment of osteoporosis.

Which diagnostic study is used to detect deep vein thrombosis in the client's lower extremities? Thermography Plethysmography Duplex venous Doppler Somatosensory evoked potential

Duplex venous Doppler Rationale: Duplex venous Doppler records an ultrasound of the veins, including blood flow abnormalities of the lower extremities, aiding detection of deep vein thrombosis. Thermography, which measures the heat radiating from the skin surface, is used to determine client response to anti-inflammatory medication therapy and inflamed joints. Plethysmography is used to record variations in volume and pressure of blood passing through tissues; the test is nonspecific. Somatosensory evoked potential is used to identify subtle dysfunction of lower motor neuron and primary muscle disease.

Which nursing interventions would the nurse implement when providing postoperative care for a client who had a below-the-knee amputation? Maintain strict bed rest for 2 days postprocedure to reduce dependent edema. Elevate residual leg slightly while keeping the knee joint straight for first 24 hours. Hemorrhage rarely occurs during the early postoperative period. The surgeon will change the dressing within 48 hours after the procedure.

Elevate residual leg slightly while keeping the knee joint straight for first 24 hours. Rationale: Elevation of the residual limb helps prevent edema; however, slight elevation during the first 24 hours as continued elevation may lead to hip contractures. The knee joint is kept extended, not flexed during this time. The client usually is out of bed on the second postoperative day. Hemorrhage and infection are the two most common complications. The dressing usually is a pressure dressing, and the surgeon does not change the pressure dressing this soon postoperatively. Sometimes the pressure dressing has a cast in place to shape the residual leg for a prosthesis.

Which synovial joint movement is described as turning the sole away from the midline of the body? Pronation Eversion Adduction Supination

Eversion Rationale: Eversion is a synovial joint movement that describes turning the sole outward away from the midline of the body. Pronation is a synovial joint movement that describes turning the palm downward. Adduction is a synovial joint movement that describes movement toward midline of the body. Supination is a synovial joint movement that describes turning the palm upward.

Which type of cast or splint will the nurse expect to see on a child with a fractured femur? Cylinder Hip spica Prefabricated knee Robert Jones

Hip spica Rationale: A hip spica cast is now mainly used for femur fractures in children. A cylinder cast is used for knee fractures because it extends from the groin to the malleoli of the ankle. A prefabricated knee splint is a commonly used cast for lower extremity injuries. A Robert Jones dressing is composed of bulky padding materials, splints, and elastic wrap or stockinette used for lower extremity injuries.

Which phrase describes a greenstick fracture? More than two fragments Incomplete with one side bent Spontaneous, at the site of bone disease Across the longitudinal axis of the bone shaft

Incomplete with one side bent Rationale: An incomplete fracture with one side splintered and the other side bent indicates a greenstick fracture. A fracture with more than two fragments that appear to be floating is known as a comminuted fracture. A pathological fracture is a spontaneous fracture found at the site of bone disease. A transverse fracture extends across the longitudinal axis of the bone shaft.

A student athlete reports muscle pain after a practice session. Which product of muscle metabolism would the nurse explain as being a cause of pain? Lactic acid Acetoacetic acid Hydrochloric acid Beta-hydroxybutyric acid

Lactic acid Rationale: The ache in muscles that have been vigorously worked without adequate oxygen supply is caused in part by the buildup of lactic acid. During rest, the lactic acid is oxidized completely to carbon dioxide and water, providing adenosine triphosphate for further muscular contraction. Beta-hydroxybutyric acid and acetoacetic acid are not products of muscle contraction; they are ketone bodies resulting from incomplete oxidation of fatty acids. Hydrochloric acid is not a product of muscle contraction; it is present in the stomach to facilitate the digestive process.

Which tissue connects the client's tibia to the femur at the knee joint? Fascia Bursae Tendons Ligaments

Ligaments Rationale: A ligament is a dense, fibrous connective tissue that connects bone to bone, such as the tibia to the femur at the knee joint. Ligaments provide stability while permitting controlled movement at the joint. Fascia is a connective tissue that can withstand limited stretching; it provides strength to muscle tissues. Bursae are small sacs of connective tissue lines with synovial membrane and synovial fluid that are located at bony prominences and joints to relieve pressure. A tendon is a dense, fibrous connective tissue that attaches muscle to bone.

Which position would the nurse use for placement of the affected extremity of a client who is recovering from an open reduction and internal fixation (ORIF) of a fractured hip? External rotation Slight hip flexion Moderate abduction Anatomic body alignment

Moderate abduction Rationale: Abduction reduces stress on anatomic structures and maintains the head of the femur in the acetabulum. External rotation places stress on the acetabulum and the head of the femur. Hip flexion may dislodge the head of the femur from the acetabulum. Functional alignment places stress on the bone, soft tissue, and nail plate; it can cause damage and dislocation of the head of the femur.

Which element would the nurse focus on when teaching crutch-walking to a client who has a casted leg fracture? Establishing a schedule for pain medication Maintaining a fixed schedule of daily activities Modifying the home environment to prevent accidents Understanding that a more sedentary lifestyle is necessary

Modifying the home environment to prevent accidents Rationale: Modifications in the home may be needed to permit safe use of crutches. Pain medications should not be required on a regular basis. The client may vary the schedule of activities based on abilities and responses to activities. The client does not have to be sedentary; crutches are used for ambulation.

Condyloid joint

Movement: Flexion, extension; abduction, adduction; circumduction Examples: Wrist joint (between radial and carpals)

Saddle joint

Movement: Flexion, extension; abduction, adduction; circumduction, thumb-finger opposition Examples: Carpometacarpal joint of thumb

Ball and socket (spheroidal) joint

Movement: Flexion, extension; adduction, abduction; circumduction Examples: Shoulder, hip

Gliding joint

Movement: One surface moves over another surface Examples: Between tarsal bones, sacroiliac joint, between articular processes of vertebrae, between carpal bones

Pivot (rotary) joint

Movement: Rotation Examples: Atlas-axis, proximal radioulnar joint

Hinge joint

Movement: Flexion, extension Examples: Elbow joint, interphalangeal joints, knee joint

Which nursing intervention prevents footdrop in a client with osteomyelitis? Elevating the foot with the use of pillows Consistently flexing the affected extremity Encouraging the client to change positions Neutral positioning of the foot with the use of a splint

Neutral positioning of the foot with the use of a splint Rationale: A client with osteomyelitis is at an increased risk for footdrop, which results in an abnormal gait. Neutral positioning of the foot with the use of a splint can reduce the risk of footdrop in the client with osteomyelitis. Elevating the client's foot on pillows can reduce the risk of edema. Asking the client with osteomyelitis to flex the affected extremity can result in flexion contracture. Encouraging the client with osteomyelitis to change positions helps prevent complications associated with immobility and promotes comfort; carefully handle the involved limb and avoid excessive manipulation, which may lead to a pathological fracture.

Which bursae are between the client's elbow and the skin? Olecranon Prepatellar Subacromial Trochanteric

Olecranon Rationale: Bursae are small sacs of connective tissue lined with synovial membrane and synovial fluid that decrease the friction between moving parts. Olecranon bursae are found between the olecranon process of the elbow and the skin. Prepatellar bursae are found between the head of the humerus and the acromion process of the scapula. Trochanteric bursae are found between the greater trochanter of the proximal femur and the skin.

What is the first-line treatment for Paget's disease? Oral alendronate Oral calcium Intravenous pamidronate Intravenous zoledronic acid

Oral alendronate Rationale: Oral alendronate, a bisphosphonate, is the first-line treatment for Paget's disease. Clients with Paget's disease also are given 1500 mg of calcium daily as a supplement to reduce the risk for hypocalcemia. When oral medications are ineffective, pamidronate and zoledronic acid are administered intravenously.

Which condition is characterized by infection of a client's bone or bone marrow? Osteomalacia Osteomyelitis Herniated disc Spinal stenosis

Osteomyelitis Rationale: Osteomyelitis is infection of bone or bone marrow. Osteomalacia is a condition characterized by softening of bones due to calcium or vitamin D deficiency. Herniated disc is caused by structural damage of the intervertebral discs in which the nucleus pulposus seeps through a torn or stretched annulus. Spinal stenosis is narrowing of the spinal canal.

When teaching a client about their disease process, which term would the nurse use to describe bone loss greater than normal but less than that caused by osteoporosis? Osteopenia Osteomyelitis Osteomalacia Osteoarthritis

Osteopenia Rationale: The definition of osteopenia is bone loss that is more than normal but not yet at the level for a diagnosis of osteoporosis. Osteomyelitis is infection of bone or bone marrow. Osteomalacia is softening of bones due to calcium or vitamin D deficiency. Osteoarthritis is cartilage deterioration in the joints.

Which hormone promotes bone resorption in a client and potentially leads to decreased bone densities? Estrogen Calcitonin Growth hormone Parathyroid hormone (PTH)

Parathyroid hormone (PTH) Rationale: When serum calcium levels lower, secretion of PTH increases and stimulates bones to promote osteoclastic activity, which promotes bone resorption. Estrogens stimulate osteoblastic (bone-building) activity and inhibit PTH. Calcitonin inhibits bone resorption and increases the renal excretion of calcium and phosphorus as needed to maintain balance in the body. Growth hormones secreted by the anterior lobe of the pituitary gland are responsible for increasing bone length.

When a client injures the amphiarthrodial joint, which joint did the client injure? Knee joint Pelvic joint Elbow joint Cranial joint

Pelvic joint Rationale: Amphiarthrodial joints are those that permit slight movements. The pelvic joint is an example of amphiarthrodial joint. Knee and elbow joints are the examples of diarthrodial joints, which are freely movable. A cranial joint is an example of a synarthrodial joint, which is immovable.

Which key factor assists the nurse in assessing how a client will cope with the body image change after an above-the-knee amputation? Extent of the change Suddenness of the change Obviousness of the change Personal perception of the change

Personal perception of the change Rationale: The reality of a situation is not he important issue at this time, but the client's feelings or perceptions about the change are the most important determinant of the client's ability to cope. The extent of change is not relevant; what is relevant is whether the client perceives the change as enormous or less important. Although suddenness of the change may influence a person's coping ability, this is not the primary factor influencing a client's coping mechanisms with body image changes. Although obviousness of the change may influence a person's coping ability, this is not the primary factor influencing coping mechanisms with body image changes.

Which factor may cause neck pain in a client? Headache Poor posture Low body weight Sedentary lifestyle

Poor posture Rationale: Poor posture may affect the nerves innervating the neck, thereby causing pain in the neck. Headache may be associated with neck pain, but it does not precipitate neck pain. Low body weight and sedentary lifestyle may cause osteoporosis.

Which synovial joint movement is involved in turning a client's palm downward? Eversion Inversion Pronation Supination

Pronation Rationale: Pronation is the movement involved in turning the palm downward. Eversion involves turning the sole outward away from the midline of the body. Inversion involves turning the sole inward toward the midline of the body. Supination involves turning the palm upward.

The nurse advises a client recovering from a musculoskeletal injury to increase intake of which nutrient? Fat Protein Sodium Vitamin A

Protein Rationale: People suffering from a musculoskeletal injury should be advised to increase their intake of protein to promote tissue healing and recovery. Also important are adequate intake of fluids, fiber, and minerals such as calcium, phosphorus, and magnesium. Fat, sodium, and vitamin A are not specifically beneficial for musculoskeletal injuries.

Which estrogen antagonist would the health care provider prescribe a client for the prevention and treatment of osteoporosis in postmenopausal women? Raloxifene Denosumab Alendronate Zoledronic acid

Raloxifene Rationale: Raloxifene prevents and treats osteoporosis in postmenopausal women by increasing bone mineral density, reducing bone desorption, and reducing incidences of osteoporotic vertebral fractures. Denosumab is a monoclonal antibody used to treat osteoporosis when other medications are not effective. Alendronate and zoledronic acid are commonly used for the prevention and treatment of osteoporosis.

Which joint is an example of a gliding joint? Wrist Elbow Shoulder Sacroiliac

Sacroiliac Rationale: The sacroiliac joint connects the sacrum with the pelvis. It is a type of gliding joint, because one surface of the bone moves over another surface. The wrist joint is an example of a condyloid joint. The elbow joint is an example of a hinge joint. The shoulder joint is an example of a ball-and-socket joint.

Which bones are examples of a client's flat bones? Select all that apply. One, some, or all responses may be correct. Sacrum Scapula Sternum Humerus Mandible

Scapula Sternum Rationale: Flat bones such as the scapula and sternum are compact bones separated by a layer of cancellous bone that contains bone marrow. Bones such as the sacrum and mandible are irregular bones; they appear in a variety of shapes and sizes. The humerus is a long bone with a central shaft and two widened ends.

Which musculoskeletal condition is illustrated in the figure? Scoliosis Kyphosis Torticollis Pes planus

Scoliosis Rationale: Scoliosis is a lateral S-shaped curvature of the thoracic and lumbar spine. A client with scoliosis has unequal shoulder and scapular height when observed from the back. Kyphosis is an excessive outward curvature of the spine. Torticollis is the twisting of the neck in an unusual position to one side. Pes planus is an abnormal flatness of the sole and arch of the foot.

Which information indicates a nursing student's accurate understanding about skeletal muscles? Skeletal muscle account for about half of a human being's body weight. Skeletal muscle contraction propels blood through the circulatory system. Skeletal muscle contraction is modulated by neuronal and hormonal influences. Skeletal muscle occurs in the walls of hollow structures such as airways and arteries.

Skeletal muscle account for about half of a human being's body weight. Rationale: Skeletal muscle is a type of striated voluntary muscle that accounts for about half of a human being's body weight. Cardiac muscle contraction propels blood through the circulatory system. Skeletal muscle contraction requires neuronal stimulation only. Smooth muscle, not skeletal, is found in the walls of hollow structures such as airways and arteries.

Which musculoskeletal abnormality would the nurse suspect in a client who exhibits short steps and drags a foot? Torticollis Pes planus Spastic gait Steppage gait

Spastic gait Rationale: Spastic gait is a musculoskeletal abnormality, caused by cerebral palsy, that results in short steps and dragging of the foot. Torticollis is a twisting of the client's neck to one side. Pes planus, also called flatfoot, is an abnormal flatness of the sole and arch of the foot. Steppage gait is an increase in hip and knee flexion to clear the foot from the floor; footdrop will be evident in the affected client.

Which type of joint is present in the client's shoulders? Pivotal Saddle Condyloid Spheroidal

Spheroidal Rationale: The spheroidal joint is a ball and socket joint that provides flexion, extension, adduction, abduction, and circumduction in the shoulders and hips. The pivotal joint provides rotation in the atlas and axis, and at the proximal radioulnar joint. The saddle joint, which is at the carpometacarpal joint of the thumb, provides flexion, extension, abduction, adduction, and circumduction of the thumb-finger. The condyloid joint is a wrist joint between the radial and carpals; it provides flexion, extension, abduction, adduction, and circumduction.

Several minutes after the start of a red blood cell infusion, the client reports itching. The nurse observes hives on the client's chest. Which action would the nurse take? Administer an antihistamine. Flush the red blood cells with 5% dextrose. Slow the rate of infusion. Stop the transfusion.

Stop the transfusion. Rationale: The client is experiencing an allergic reaction to the transfusion. The nurse would stop the transfusion immediately. The health care provider then should be notified. An antihistamine may be indicated but must be prescribed. Flushing red blood cells with dextrose will cause hemolysis and will not be effective in stopping the reaction. Slowing down the rate but continuing the infusion will make the situation worse.

Which surgery is used as a prophylactic measure and as a palliative treatment for clients with rheumatoid arthritis (RA)? Osteotomy Arthrodesis Synovectomy Debridement

Synovectomy Rationale: Synovectomy is a type of joint surgery that involves the removal of thickened synovial membrane. It is used as a prophylactic measure and as a palliative treatment for rheumatoid arthritis (RA) because it prevents the serious destruction of joint surfaces. Osteotomy involves removing a wedge of bone to correct deformity and relieve pain. Arthrodesis is the surgical fusion of a joint. Debridement involves the surgical removal of degenerative debris from a joint.

Which action by a 70-year-old female client would best limit further progression of osteoporosis? Taking supplemental calcium and vitamin D Increasing the consumption of eggs and cheese Taking supplemental magnesium and vitamin E Increasing the consumption of milk products

Taking supplemental calcium and vitamin D Rationale: Research demonstrates that women past menopause need at least 1500 mg of calcium a day, which is almost impossible to obtain through dietary sources because the average daily consumption of calcium is 300 to 500 mg. Vitamin D promotes the deposition of calcium into the bone. Consumption of eggs and cheese does not contain adequate calcium to meet requirements to prevent osteoporosis; these foods do not contain vitamin D unless fortified. If large amounts of magnesium are present, calcium absorption is impeded because magnesium and calcium absorption are competitive; vitamin E is unrelated to osteoporosis. Milk and milk products may not be consumed in quantities adequate to meet requirements to prevent osteoporosis.

Which is an example of a short bone? Tibia Femur Tarsals Humerus

Tarsals Rationale: Tarsals are short bones, unlike the tibia, femur, and humerus, which are long bones. Short bones do not have epiphysis and diaphysis.

While providing care for a client with a second-degree left ankle sprain, the nurse raises the injured part above heart level. Which statement provides the reason behind this nursing intervention? To promote bone density To prevent further edema To reduce pain perception To increase muscle strength

To prevent further edema Rationale: A client with a second-degree sprain may have a deeply torn ankle ligament with swelling and tenderness. Elevation of the injured lower limb above heart level helps mobilization of the excess fluid from the area and prevents further edema. Strengthening exercises help build bone density and muscle strength and significantly reduce the risk of sprains and strains. Cryotherapy and adequate rest help reduce pain by reducing the transmission and perception of pain impulses.

Which diagnostic study would the health care provider use to investigate the cause of an inflamed joint and determine a client's response to anti-inflammatory medication therapy? Duplex venous Doppler Plethysmography Thermography Somatosensory evoked potential

Thermography Rationale: Thermography uses an infrared detector that measures the degree of heat radiating from the skin's surface. Therefore it is used to investigate the cause of an inflamed joint and in determining the client's response to anti-inflammatory drug therapy. Plethysmography is used to record variations in volume and pressure of blood passing through tissues. Duplex venous Doppler records blood flow abnormalities to the lower extremities, which helps to detect deep vein thrombosis. Somatosensory evoked potential is used to identify subtle dysfunction of lower motor neuron and primary muscle disease.

Which treatment is beneficial for a client with muscle spasm? Thermotherapy Muscle massage Frequent position changes Muscle-strengthening exercise regimen

Thermotherapy Rationale: Thermotherapy, the use of heat therapy, eases pain and muscle contraction; therefore, it is useful in treating muscle spasms. Muscle massage stimulates muscle tissue contraction and may worsen a muscle spasm. Frequent position changes are beneficial for a client with contracture. A muscle-strengthening exercise regimen is beneficial for a client with muscle atrophy.

Which treatment is beneficial for a client with muscle spasm? Thermotherapy Muscle massage Frequent position changes Muscle-strengthening exercise regimen

Thermotherapy Rationale: Thermotherapy, the use of heat therapy, eases pain and muscle contraction; therefore, it is useful in treating muscle spasms. Muscle massage stimulates muscle tissue contraction and may worsen a muscle spasm. Frequent position changes are beneficial for a client with contracture. A muscle-strengthening exercise regimen is beneficial for a client with muscle atrophy.

Which hormone increases the rate of protein synthesis? Estrogen Thyroxine Parathormone Vitamin D

Thyroxine Rationale: Thyroxine increases the rate of protein synthesis in all the body tissues. Estrogen stimulates bone-building, which is known as osteoblastic activity. Parathormone promotes osteoclastic activity in a state of hypocalcemia. Vitamin D and its metabolites are produced in the body and transported in the blood to promote the absorption of calcium and phosphorus from the small intestine.

For which purpose is a goniometer used? To assess range of motion To reduce phantom limb sensation To prevent hip flexion contractures To immobilize a joint during fracture

To assess range of motion Rationale: A goniometer is a device that measures the angle of a joint and is used to assess range of motion. Mirror therapy is used to reduce phantom limb sensation. Buck's traction boot is a type of skin traction used to prevent hip flexion contractures. Splints are used to immobilize a joint after a fracture.

A client returns from surgery, after a right below-the-knee amputation, with the residual limb straight, but elevated on a pillow to prevent edema. In which position would the nurse place the client after the first postoperative day? Any position, as long as the residual limb remains immobilized Turn client to the prone position for 15 to 20 minutes at least three times a day For short periods, position the client in the right side-lying position Maintain elevation of the residual limb for a total of 3 days

Turn client to the prone position for 15 to 20 minutes at least three times a day Rationale: Positioning the client in the prone position for short periods helps prevent hip flexion contractures. Do not immobilize the client's residual limb, but do not keep the joint bent for prolonged periods. Begin exercises to prevent contractures as soon as possible. Positioning the client in the right side-lying position can cause trauma to the incision site and should be avoided. Do not elevate the client's residual limb for more than 48 hours because hip flexion contractures can result.

The nurse is preparing to initiate antibiotic therapy for a client who developed an incisional infection. Which task would the nurse ensure has been completed before starting the first dose of intravenous antibiotics? Red blood cell count Wound culture Knee x-ray Urinalysis

Wound culture Rationale: A wound culture always should be completed before the first dose of antibiotic. A wound culture is obtained to determine the organism that is growing. A broad spectrum antibiotic often is given first; after the organism has been identified an organism-specific antibiotic can be given. There is no indication that a red blood cell count is needed; however, a white blood cell count would be beneficial. A urinalysis is not needed, because data gathered during the assessment indicate an incisional infection. At the early stage of the infection, there is no need to obtain a knee x-ray.

Which joint is an example of a condyloid joint? Wrist joint Elbow joint Shoulder joint Sacroiliac joint

Wrist joint Rationale: The wrist joint is an example of a condyloid joint. It is a joint between the radial and carpals. The elbow joint is an example of a hinge joint. The shoulder joint is an example of a ball and socket joint. The sacroiliac joint is an example of a gliding joint.

footdrop

difficulty lifting the front part of the foot