Assessment of Musculoskeletal Function Ch 39 (Brunner & Suddarth's) NCLEX

Which laboratory study indicates the rate of bone turnover? a) Serum osteocalcin b) Serum calcium c) Urine calcium d) Serum phosphorous

a) Serum osteocalcin Serum osteocalcin (bone GLA protein) indicates the rate of bone turnover.

What statement describes paresthesia? a) Absence of muscle mvmt suggesting nerve damage b) Abnormal sensations c) Involuntary twitch of muscle fibers d) Absence of muscle tone

b) Abnormal sensations **Abnormal sensations, such as burning, tingling, and numbness, are referred to as paresthesias. -Paralysis=absence of muscle tone suggesting nerve damage -Fasciculation=involuntary twitch of muscle fibers -Flaccid=absence of muscle tone

Which term refers to muscle tension being unchanged with muscle shortening and joint motion? a) Contracture b) Isotonic contraction c) Isometric contraction d) Fasciculation

b) Isotonic contraction **Exercises such as swimming and cycling are isotonic. -Isometric contraction=increased muscle tension, unchanged muscle length and no join motion. -Contracture=abnormal shortening of muscle, joint or both -Fasciculation=involuntary twitch of muscle fibers

Which term refers to mature compact bone structures that form concentric rings of bone matrix? a) Cancellous bone b) Lamellae c) Trabecula d) Endosteum

b) Lamellae **Lamellae are mineralized bone matrices. -Endosteum refers to the marrow cavity lining of hollow bone. -Trabecula refers to latticelike bone structure. -Cancellous bone refers to spongy, latticelike bone structure.

Which description refers to an osteon? a) Bone resorption cell b) Microscopic functional bone unit c) Bone-forming cell d) Mature bone cell

b) Microscopic functional bone unit **The center of an osteon contains a capillary, a microscopic functional bone unit. -Osteoblast=bone-forming cell -Osteoclast=bone resorption cell -Osteocyte=mature bone cell

Which nerve is being assessed when the nurses asks the client to dorsiflex the ankle and extend the toes? a) Ulnar b) Peroneal c) Median d) Radial

b) Peroneal **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.

Which statement reflects the progress of bone healing? a) All fx healing takes place at the same rate no matter the type of bone fx'd. b) Serial x-rays are used to monitor the progress of bone healing. c) The age of the client influences the rate of fx healing. d) Adequate immobilization is essential until ultrasound shows evidence of bone formation with ossification.

b) Serial x-rays are used to monitor the progress of bone healing. **Serial x-rays are used to monitor the progress of bone healing. -The type of bone fx'd, the adequacy of blood supply, the surface contact of the fragments, and the general health of the client influence the rate of fx healing. -Adequate immobilization is essential until x-ray shows evidence of bone formation with ossification.

Skull sutures are an example of which type of joint? a) Amphiarthrosis b) Synarthrosis c) Diarthrosis d) Aponeuroses

b) Synarthrosis **Skull sutures are considered synarthrosis joints and are immovable. -Amphiarthrosis joints allow limited mvmt. -Diarthrosis joints are freely movable joints (hip and shoulder) -Aponeuroses are broad, flat sheets of connective tissue

Which nerve is assessed when the nurse asks the client to spread all fingers? a) Radial b) Ulnar c) Peroneal d) Median

b) Ulnar **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.

An example of a flat bone is the a) vertebra b) sternum c) metacarpals d) femur

b) sternum

Which term refers to moving away from midline? a) Inversion b) Adduction c) Abduction d) Eversion

c) Abduction **Abduction moves away from the midline. -Adduction=moves towards the midline -Inversion=turning inward -Eversion=turning outward

Which body movement involves moving toward the midline? a) Eversion b) Pronation c) Adduction d) Abduction

c) Adduction

During which stage or phase of bone healing after fracture (fx) does callus formation occur? a) Inflammation b) Revascularization c) Reparative d) Remodeling

c) Reparative **Callus formation occurs during the reparative stage, but it is disrupted by excessive motion at the fx site. -Remodeling=final stage of fx repair during which the new bone is reorganized into the bone's former structural arrangement. -Inflammation=macrophages invade and debride the fx area -Revascularization=occurs within about 5 days after the fx.

What is the term for lateral curving of the spine? a) Diaphysis b) Lordosis c) Scoliosis d) Epiphysis

c) Scoliosis **Scoliosis is a lateral curving of the spine. -Lordosis=increase in the lumbar curvature of the spine -Diaphysis=the shaft of a long bone -Epiphysis=the end of a long bone

Which hormone inhibits bone resorption and increases the deposit of calcium in the bone? a) Sex hormones b) Growth hormones c) Vitamin D d) Calcitonin

d) Calcitonin Calcitonin, secreted by the thyroid gland in response to elevated blood calcium levels, inhibits bone reabsorption and increases the deposit of calcium in the bone.

Which is a circulatory indicator of peripheral neurovascular dysfunction? a) weakness b) paralysis c) paresthesia d) cool skin

d) Cool skin Indicators of peripheral neurovascular dysfunction r/t circulation include pale, cyanotic, or mottled skin with a cool temperature. The cap refill is more than 3 seconds.

Which term refers to the shaft of the long bone? a) Lordosis b) Epiphysis c) Scoliosis d) Diaphysis

d) Diaphysis **The diaphysis is primarily cortical bone. -Epiphysis=end of long bone

After a fracture, during which stage or phase of bone healing is devitalized tissue removed and new bone reorganized into its former structural arrangement? a) Reparative b) Inflammation c) Revascularization d) Remodeling

d) Remodeling **Remodeling is the final stage of fx repair.

Which term refers to a grating or crackling sound or sensation? a) Crepitus b) Callus c) Clonus d) Fasciculation

a) Crepitus **Crepitus may occur w/mvmt of the ends of a broken bone or irregular joint surface. -Callus=fibrous tissue that forms at the fracture site -Clonus=rhythmic contraction of muscle -Fasciculation=involuntary twitch of muscle fibers

Fracture healing occurs in four areas, including the a) external soft tissue b) fascia c) cartilage d) bursae

a) external soft tissue Fx healing occurs in four areas: the bone marrow, bone cortex, periosteum, and the external soft tissue where a bridging callus stabilizes the fx.

Which is a neurovascular problem caused by pressure within a muscle area that increases to such an extent that microcirculation diminishes? a) Fasciculation b) Compartment syndrome c) Remodeling d) Hypertrophy

b) Compartment syndrome Compartment syndrome is caused by pressure within a muscle area that increases to such an extent that microcirculation diminishes.

Which is an indicator of neurovascular compromise? a) Warm skin temperature b) Pain upon active stretch c) Capillary refill of more than 3 seconds d) Diminished pain

c) Capillary refill of more than 3 seconds **Other indicators include cool skin temperature, pale or cyanotic color, weakness, paralysis, paresthesia, unrelenting pain, pain upon passive stretch, and absence of feeling.

Which is useful in identifying acute or chronic tears of the joint capsule or supporting ligaments of the knee, shoulder, ankle, hip, or wrist? a) Arthography b) Bone densitometry c) Meniscography d) EMG

a) Arthrography

What is the term for a rhythmic contraction of a muscle? a) Clonus b) Crepitus c) Hypertrophy d) Atrophy

a) Clonus

A client is exhibiting diminished ROM, loss of flexibility, stiffness, and loss of height. The H&P findings are associated with age-related changes of which area? a) Ligaments b) Bones c) Joints d) Muscles

c) Joints **H&P findings associated with age-related changes of the joints include diminished ROM, loss of flexibility, stiffness, and loss of height. -Age-related changes of bones include loss of height, posture changes, kyphosis, flexion of hips and knees, back pain, osteoporosis, and fracture. -Age-Related changes of muscles include loss of strength, diminished agility, decreased endurance prolonged response time, diminished tone, a broad base of support and a hx of falls. -Age-related changes of ligaments include joint pain on motion that resolves with rest, crepitus, joint swelling/enlargement, and degenerative joint disease (osteoarthritis).