Prep-U

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?" Explanation: The focus of the initial history depends on the nature of the musculoskeletal problem, whether the client has a chronic disorder or a recent injury. If the disorder is long-standing, the nurse obtains a thorough medical, drug, and allergy history. If the client is injured, the nurse finds out when and how the trauma occurred. The client's age, employment, or duration and location of discomfort or pain, while important, have little influence on the focus of the initial history and assessment of the client.

Which nerve is assessed when the nurse asks the client to spread all fingers?

Ulnar Explanation: Asking the client to spread all fingers allows the nurse to assess motor function affected by ulnar innervation, while pricking the fat pad at the top of the small finger allows assessment of the sensory function affected by the ulnar nerve. The peroneal nerve is assessed by asking the client to dorsiflex the ankle and to extend the toes. The radial nerve is assessed by asking the client to stretch out the thumb, then the wrist, and then the fingers at the metacarpal joints. The median nerve is assessed by asking the client to touch the thumb to the little finger.

A client is diagnosed with a bone tumor. What result would the nurse expect the blood tests to reveal?

Decreased serum calcium level Explanation: Decreased serum calcium level may indicate osteomalacia, osteoporosis, and bone tumors. With bone tumors, the alkaline phosphatase and serum phosphorus levels would be increased. Decreased red blood cell count may reflect anemia.

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 Explanation: Prednisone, a corticosteroid, causes increased bone resorption and decreased bone formation, resulting in increased risk for fractures. Furosemide, digoxin, and metoprolol do not interfere with bone resorption or predispose clients to fractures.

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

Elbow A diarthrosis joint, like the elbow, is freely movable. The skull is an example of an immovable joint. The vertebral joints and symphysis pubis are amphiarthrosis joints that have limited motion.

The nurse is performing a musculoskeletal assessment for a client whose right leg muscles exhibit no tone and are limp. Which descriptor should the nurse use to document this condition?

Flaccid Explanation: The term flaccid describes muscles that have no tone or are limp. Spastic describes muscles that have greater-than-normal tone. Atonic describes muscles that are not enervated and become soft and flabby. Atrophic describes muscles deterioration that occurs with lack of use and exercise.

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

Knee Explanation: The most common site for joint effusion is the knee. If inflammation or fluid is suspected in a joint, consultation with a provider is indicated. The elbow, hip, and shoulder are not the most common site of joint effusion.

Which nerve is being assessed when the nurses asks the client to dorsiflex the ankle and extend the toes?

Peroneal Explanation: The motor function of the peroneal nerve is assessed by asking the client to dorsiflex the ankle and to extend the toes, while pricking the skin between the great toe and center toe assesses sensory function. The radial nerve is assessed by asking the client to stretch out the thumb, then the wrist, and then the fingers at the metacarpal joints. The median nerve is assessed by asking the client to touch the thumb to the little finger. Asking the client to spread all fingers allows the nurse to assess motor function affected by ulnar innervation.

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

Remodeling Explanation: The final stage of fracture repair consists of remodeling the new bone into its former structural arrangement. During cartilage calcification, enzymes within the matrix vesicles prepare the cartilage for calcium release and deposit. Cartilage removal occurs when the calcified cartilage is invaded by blood vessels and becomes reabsorbed by chondroblasts and osteoclasts. Angiogenesis occurs when new capillaries infiltrate the hematoma, and fibroblasts from the periosteum, endosteum, and bone marrow produce a bridge between the fractured bones.