Week 10 Chpts 47-50

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If a child with genu valgum does not self-correct after he or she begins weight-bearing, what condition could result?

Subluxation

A nurse is caring for a client who twisted his ankle while running. Tests reveal damaged connective tissue that connects the movable bones of the joint. Based on this finding, the nurse prepares to teach the client about which anatomical structure that is injured?

Ligaments

The nurse assessing a client with scleroderma with CREST variant would include an assessment for:

Raynaud's phenomenon.

In contrast to synarthrosis joints, which synovial joints allow for movement in all directions?

Shoulder joints

Hyaline cartilage is a firm but flexible type of connective tissue that forms which feature in the fetus?

Skeleton

The health care provider is assessing a client with a history of ankylosing spondylitis to note progression of the disease. On which area of the body will the provider focus the assessment?

Spine

Which statement will the nurse impart to the parent of a child with Legg-Calvé-Perthes disease?

"A genetic pattern for this disease has not been established."

It is suspected that a client has osteomalacia. What should the nurse teach the client about potential causes of this condition?

"Insufficient calcium absorption and phosphate deficiency are the causes."

The client asks, "What is reduction?" How will the nurse respond?

"It refers to realigning the bone."

A new mother asks, "Why are you examining my baby's hips?" What is the nurse's best response?

"Musculoskeletal screening is important to identify anything that needs intervention."

A client recently diagnosed with an injury to the articular cartilage of the knee asks the nurse how long it will take the injury to heal. Which statement is the best response from the nurse?

"Regeneration of most cartilage is slow. These injuries can take a long time to heal."

What information would the nurse include when teaching potential parents about prevention of congenital deformities? Select all that apply.

-"Limit exposure to alcohol." -"Do not take any medication without first talking to your health care provider."

The client has a bone neoplasm that is growing rapidly and spreading to other parts of the body through the blood stream or lymphatics. The nurse knows this malignant tumor is likely which type of neoplasm? Select all that apply.

-Multiple myeloma -Ewing sarcoma -Chondrosarcoma

A client has tendonitis. What will the nurse teach the client about this disorder?

A client has tendonitis. What will the nurse teach the client about this disorder?

In a child, the epiphyses and metaphysis are separated by:

A growth plate

A client who has a fractured ankle is complaining of knee and hip pain. What is the most likely cause of these symptoms?

All nerves that cross articulations innervate each joint of an extremity.

A child presents to the emergency room with suspected trauma to the growth plate in the ankle during a soccer game. Which step is the best intervention?

Assess the child for pain and prepare for diagnostic studies.

The health care provider has evaluated a client diagnosed with osteoporosis and determined that pharmacologic therapy will benefit the client. Select the medication options that the provider may prescribe. Select all that apply.

Bisphosphonates Selective estrogen receptor modulators (SERMs) Calcitonin RANKL inhibitor denosumab Recombinant parathyroid hormone

The physician is reviewing lab results for his client with cancer and finds the client to be hypercalcemic. What will the physician prescribe?

Calcitonin

A basketball player collided hard with another player and suffered a soft tissue injury to the forearm from the impact. The injury did not break the skin. The nurse should recognize the presence of which type of injury?

Contusion

Juvenile dermatomyositis is a chronic inflammatory myopathy that commonly manifests systemically. What is the treatment of choice for this myopathy?

Corticosteroids

The health care provider finds these assessment findings: (1) pain in the front of the knee; (2) swelling/tenderness with a prominent tibial tubercle. Which diagnosis correlates to these findings?

Osgood-Schlatter disease

When teaching a group of nursing students about rheumatic disorders, a nurse emphasizes which important differences when caring for the older adult?

Risk for falls

The client has an extra-articular condition. How does the nurse explain this diagnosis?

There is a problem outside of a joint.

An older adult client has recently been diagnosed with rheumatoid arthritis. The nurse should focus assessment on which aspects?

Weight and nutritional status

The elderly nursing home resident has a fractured humerus. In order to promote healing, the physician recommends:

including fish in the diet on a routine basis.

A daughter is concerned because her elderly parent has been diagnosed with osteomalacia. The daughter asks the nurse why this happened. The best response would be that:

intestinal absorption slows as natural aging occurs.

The nurse is assessing an infant with a possible head injury. When palpating the skull, the nurse feels for the joints that exist between the bones of the skull. How will the nurse document the name for these joints?

sutures

A client reporting bone pain has sought care. Diagnostic testing reveals that the client has developed osteonecrosis. When addressing the most likely cause of this complication, the nurse should focus on:

the quality and quantity of blood flow to the site.

Which assessment finding leads the nurse to suspect a child has Blount disease (tibia vara)?

unilateral rotational deformity of the proximal tibia

The nurse is educating caregivers of children ranging from infant through adolescent about how to prevent injury. Which leading cause of nonfatal injury in this age group will the nurse emphasize?

unintentional falls

A client sought care because of increasing pain and inflammation in the toe and ankle of one foot. Diagnostic testing has resulted in a diagnosis of gouty arthritis. When educating the client about the treatment and management of the disease, what should the nurse teach the client?

"Losing some weight and reducing your alcohol intake will likely be beneficial."

A nurse is evaluating the progress of a client with chronic fatigue syndrome. Which statement by the client indicates successful symptom management?

"My schedule includes yoga and a weekly club meeting."

A client who has been admitted for a pelvic fracture is diagnosed with osteoporosis. The client states, "How could I not have known I had this?" What is the nurse's best response?

"This is typically a silent disorder without symptoms until something like this happens."

The health care provider is evaluating a client with a suspected benign bone tumor. Which description on the radiology results correlates with this finding?

A uniform and well-defined area with well-demarcated edges

What is the definition of a congenital deformity?

Abnormalities present at birth

We have both red and yellow bone marrow in our bodies. What is yellow bone marrow largely composed of?

Adipose cells

Which statement about bone mass and older adults is accurate?

Bone resorption and formation are no longer perfectly coupled, and bone mass is lost.

A client asks the nurse if drinking more milk will prevent the release of calcium from her bones. The best response by the nurse would be that the release of calcium from the bone into the extracellular fluid is regulated by:

Calcitonin

A child has been diagnosed with myopathic neuromuscular scoliosis. What other concurrent diagnosis may the child have?

Cerebral palsy

The nurse is assessing a client who sustained a fractured radius. A cast was applied to the extremity approximately 1 hour ago, and the client is now complaining of increased pain and numbness to the finger tips. The client is most likely experiencing:

Compartment syndrome

A client has developed osteomyelitis and asks the health care provider how the problem occurred. Which response is most accurate?

Direct contamination of an open wound

Osteoporosis is a disease caused by demineralization of bone. What is the clinical method of choice for diagnosing osteoporosis?

Dual-energy x-ray absorptiometry (DXA) of the spine and hip

The nurse is caring for a client who sustained a femur fracture 3 days before. The nurse notes that the client, who was previously oriented, now doesn't know where he is. The nurse suspects which condition?

Fat embolism syndrome (FES)

When caring for a client with ankylosing spondylitis, the nurse tells the client that stiffness may be relieved by which intervention?

Gentle exercise

A nurse admitting a client to the emergency department with a suspected fracture notes a deep abrasion with bruising. The client reports receiving a hard tackle during a football game. Which grade of tissue damage accompanies this fracture?

Grade 2

The nurse is performing an admission assessment to a rehabilitation unit. Which assessment tools should she utilize to determine an alert client's normal activities, perceived level of activity tolerance, or level of fatigue?

Human Activity Profile

An older adult client has been diagnosed with metastatic bone disease. Which aspect of the client's care plan most directly addresses a common complication of this disease?

Implementing falls prevention measures

The client has a cast applied for a fractured tibia. Which physiologic response to the fracture places this client at risk for compartment syndrome?

Inflammation causes increase in volume but cast limits compartment size

The pediatric nurse is providing teaching to a parent of a child with toeing-out (slew foot). Which statement should the nurse include in the teaching?

It will most likely self-correct as the child becomes proficient in walking.

In general, how are children affected by a rheumatic disease such as juvenile idiopathic arthritis (JIA)?

It's characterized by synovitis and can influence epiphyseal growth, resulting in stunted growth.

Which characteristic differentiates cartilage from bone?

Its fibers are embedded in a firm gel.

A nurse is caring for a client with ankylosing spondylitis. For which associated symptom does the nurse assess?

Kyphosis

When a nurse is assessing a client with osteoarthritis, which factor poses a risk for the disease?

Obesity

A client has developed increased resorption of bone with removal of mineral content. This is most likely the result of:

Osteoclasts

A client presents with sudden onset of deep, localized pain and swelling in the proximal femur while undergoing diagnostic workup for suspected lung cancer. The nurse suspects the client may have developed which type of neoplasm of the skeletal system?

Osteosarcoma

Bones are covered, except at their articular ends, by what membrane?

Periosteum

Each joint capsule has tendons and ligaments. What are the tendons and ligaments of the joint capsule sensitive to?

Position and movement

The nurse is providing client education related to intra-articular corticosteroid injections. Which instruction should the nurse include?

The injections will be given only 3 to 4 times per year because they can increase joint

Magnetic resonance imaging of a client's knee reveals the presence of bursitis. What is the primary purpose of bursae?

To prevent friction at a tendon in a synovial joint

Which statement is true about treatment of developmental dysplasia of the hip?

Treatment needs to be individualized.

The nurse is teaching a client with rheumatoid arthritis about pannus, which develops in the affected joint area. What does the nurse include to describe pannus?

Vascular granulation tissue that destroys cartilage and bone

What are the major complications of bed rest? Select all that apply.

Venous stasis with the potential for development of deep venous thrombosis Redistribution and change in blood volume Increased cardiac workload Orthostatic hypotension

A 2-year-old has bowing of the legs (genu varum). When should the health care professional should be concerned?

When there is a large separation between the knees greater than 15 degrees

A client returns to the doctor's office for evaluation 6 weeks after a tibial fracture. Which assessment indicates the potential for nonunion?

X-ray shows minimal calcification at the fracture.

A client tells the nurse about being very concerned because the health care provider noted that the client's fractured arm is healing with malunion. The nurse recognizes this as:

healing with deformity, angulation, or rotation that is visible on x-ray films.


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