NU144- Chapter 39: Assessment of Musculoskeletal Function

osteogenesis

bone formation

callus

cartilaginous/fibrous tissue at fracture site

atonic

without tone; denervated muscle that atrophies

The nurse is conducting the admission assessment for a client who is to undergo an arthrogram. What is the priority question the nurse should ask?

"Do you have any allergies?"

What is the term for a rhythmic contraction of a muscle?

Clonus

Which term refers to the shaft of the long bone?

Diaphysis

A client is diagnosed with a fracture of a diarthrosis joint. What is an example of this type of joint?

Elbow

Which of the following describes a muscle that is limp and without tone?

Flaccid

Which assessment finding would cause the nurse to suspect compartment syndrome in the client following a bone biopsy?

Increased diameter of the calf

A client is scheduled to undergo an electromyography. When performed, what will this test evaluate?

Muscle weakness

A nurse knows that a person with a 3-week-old femur fracture is at the stage where angiogenesis is occurring. What are the characteristics of this stage?

New capillaries producing a bridge between the fractured bones.

Which of the following is the final stage of fracture repair?

Remodeling

A client experiences a musculoskeletal injury that involves the structure that connects a muscle to the bone. The nurse understands that this injury involves which structure?

Tendon

A client is seen in the emergency room for a knee injury that happened during a basketball game. Diagnostic tests reveal torn cords of fibrous connective tissue that connect muscles to bones. What type of tear has this client sustained?

Tendon

The nurse understands that bone maintenance requires a balance between forming and dissolving bone. What is a correct statement about the function of osteoblasts?

They secrete a matrix that consists of collagen.

paresthesia

abnormal sensation (e.g., burning, tingling, numbness)

contracture

abnormal shortening of muscle, joint, or both; fibrosis

osteoclast

bone resorption cell

osteoblast

bone-forming cell

epiphysis

end of long bone

isotonic contraction

muscle is shortened without a change in its tension; a joint is moved as a result

isometric contraction

muscle tension is increased without changing its length; there is no associated joint motion

clonus

rhythmic contractions of a muscle

ligament

ropelike bundles of collagen fibrils connecting bones

cartilage

tough, elastic, avascular tissue at ends of bone

The nurse is employed at a long-term care facility caring for geriatric clients. Which assessment finding is characteristic of an age-related change?

Loss of height

The nurse is assessing a new client with a musculoskeletal problem. What is the best question by the nurse to elicit more information related to the injury?

"Do you have any chronic disorder or recent injury?"

A patient tells the nurse, "I was working out and lifting weights and now that I have stopped, I am flabby and my muscles have gone!" What is the best response by the nurse?

"Your muscles were in a state of hypertrophy from the weight lifting but it will persist only if the exercise is continued."

An instructor is describing the process of bone development. Which of the following would the instructor describe as being responsible for the process of ossification?

Osteoblasts

The nurse is performing an assessment for a patient who may have peripheral neurovascular dysfunction. What signs does the patient present with that indicate circulation is impaired? (Select all that apply.)

Pale, cyanotic, or mottled color Cool temperature of the extremity More than 3-second capillary refill

crepitus

grating or crackling sound or sensation; may occur with movement of ends of a broken bone or irregular joint surface

diaphysis

shaft of long bone

The nurse is assessing a client's gait. What assessments indicate the client has a normal gait? Select all that apply.

smoothness knee flexion

cancellous bone

latticelike bone structure; trabecular bone

Which statement describes paresthesia?

Abnormal sensations

The nurse is planning care for a client with a musculoskeletal injury. Which nursing diagnosis would be the highest priority?

Acute Pain

Which hormone inhibits bone reabsorption and increases calcium deposit in the bone?

Calcitonin

Which of the following is an example of a hinge joint?

Knee

Which of the following is the most common site of joint effusion?

Knee

Which cells are involved in bone resorption?

Osteoclasts

A client is recovering from a fractured hip. What would the nurse suggest that the client increase intake of to facilitate calcium absorption from food and supplements?

Vitamin D

hypertrophy

enlargement; increase in the size of a muscle

lamellae

mature compact bone structures that form concentric rings of bone matrix; lamellar bone

Choose the correct statement about the endosteum, a significant component of the skeletal system:

Covers the marrow cavity of long bones

A nurse is caring for a client with an undiagnosed bone disease. When instructing on the normal process to maintain bone tissue, which process transforms osteoblasts into mature bone cells?

Ossification and calcification

A client undergoes an invasive joint examination of the knee. What will the nurse closely monitor the client for?

Serous drainage

The nurse is assessing the client for scoliosis. What will the nurse have the client do to perform the assessment?

Stand behind the client and ask the client to bend forward at the waist.

The nurse working in the orthopedic surgeon's office is asked to schedule a shoulder arthrography. The nurse determines that the surgeon suspects which finding?

Tear in the joint capsule

joint

area where bone ends meet; provides for motion and flexibility

effusion

excess fluid in joint

lordosis

increase in concave curvature of the lumbar spine

flaccid

limp; without muscle tone

tone (tonus)

normal tension (resistance to stretch) in resting muscle

Patient education for musculoskeletal conditions for the aging is based on the understanding that there is a gradual loss of bone after a peak of bone mass at age:

30 years.

A client arrives at the orthopedic physician's office stating knee pain sustained while playing soccer. A history and physical assessment is completed. The knee appears reddened with edema. Which other diagnostic testing would the nurse anticipate?

An arthroscopy

A client is experiencing muscle weakness in the upper extremities. The client raises an arm above the head but then loses the ability to maintain the position. Muscular dystrophy is suspected. Which diagnostic test would evaluate muscle weakness or deterioration?

An electromyography

Which of the following factors would the nurse need to keep in mind about the focus of the initial history when assessing a new client with a musculoskeletal problem?

Any chronic disorder or recent injury

A client has undergone arthroscopy. After the procedure, the site where the arthroscope was inserted is covered with a bulky dressing. The client's entire leg is also elevated without flexing the knee. What is the appropriate nursing intervention required in caring for a client who has undergone arthroscopy?

Apply a cold pack at the insertion site.

A patient is scheduled for a procedure that will allow the physician to visualize the knee joint in order to diagnose the patient's pain. What procedure will the nurse prepare the patient for?

Arthroscopy

The nurse is performing a neurological assessment. What will this assessment include?

Ask the client to plantar flex the toes.

Which term refers to mature compact bone structures that form concentric rings of bone matrix?

Lamellae

A group of students are reviewing information about bones in preparation for a quiz. Which of the following indicates that the students have understood the material?

Osteoclasts are involved in the destruction and remodeling of bone.

A client comes to the emergency department with reports of pain in the left ankle. The client states, "I missed a step coming down the stairs, and landed funny." The ankle is swollen and tender to the touch. What will the nurse do to help control the swelling?

Raise the left leg above the level of the heart.

A client has a fracture that is being treated with open rigid compression plate fixation devices. What teaching will the nurse reinforce to the client about how the progress of bone healing will be monitored?

Serial x-rays will be taken.

The nurse is reviewing the client's admission assessment and notes that crepitus of the right knee joint was documented. What assessment will the nurse find as described by crepitus?

a grating sound when a joint is put through range of motion

periosteum

fibrous connective tissue covering bone

fascia (epimysium)

fibrous tissue that covers, supports, and separates muscles

joint capsule

fibrous tissue that encloses bone ends and other joint surfaces

bursa

fluid-filled sac found in connective tissue, usually in the area of joints

spastic

having greater-than-normal muscle tone

fasciculation

involuntary twitch of muscle fibers

scoliosis

lateral curving of the spine

trabeculae

latticelike bone structure; cancellous bone

osteocyte

mature bone cell

synovium

membrane in joint that secretes lubricating fluid

osteon

microscopic functional bone unit

There are thousands of components of the musculoskeletal system that facilitate mobility and independent function. The function of skeletal muscle is promoting:

movement of skeletal bones.

The nurse is conducting a medication reconciliation with a client admitted with a fracture. What medication predisposes a client for a risk for fractures?

prednisone

ossification

process in which minerals (calcium) are deposited in bone matrix

remodeling

process that ensures bone maintenance through simultaneous bone resorption and formation

osteopenic

refers to a reduction in bone mass to below normal levels

resorption

removal/destruction of tissue, such as bone

A client reports being consistently tired, with no energy. The client's CBC indicates low hemoglobin. Where is hemoglobin manufactured?

ribs

kyphosis

increase in the convex curvature of the thoracic spine

endosteum

a thin, vascular membrane covering the marrow cavity of long bones and the spaces in cancellous bone

atrophy

decrease in the size of a muscle

tendon

cord of fibrous tissue connecting muscle to bone

The older client asks the nurse how best to maintain strong bones. What is the nurse's best response?

"Weight-bearing exercises can strengthen bones."

Which is useful in identifying acute or chronic tears of the joint capsule or supporting ligaments of the knee, shoulder, ankle, hip, or wrist?

Arthrography

cortical bone

compact bone

A client tells the health care provider about shoulder pain that is present even without any strenuous movement. The health care provider identifies a sac filled with synovial fluid. What condition will the nurse educate the client about?

bursitis