Chapter 35- Musculoskeletal Function

The nurse is preparing the client with a right neck mass for magnetic resonance imaging (MRI). Which question should the nurse ask? Select all that apply. "Are you wearing any jewelry?" "When is the last time you had food or drink?" "Have you removed your hearing aid?" "Do you have a pacemaker?" "Did you take your medications this morning?"

"Are you wearing any jewelry?" "Have you removed your hearing aid?" "Do you have a pacemaker?"

A client with a sports injury undergoes a diagnostic arthroscopy of the left knee. What comment by the client following the procedure will the nurse address first? "My toes are numb." "My feet are cold." "My foot is swollen." "My knee aches."

"My toes are numb."

The older client asks the nurse how best to maintain strong bones. What is the nurse's best response? "Weight-resistance exercises can strengthen bones." "Range-of-motion exercises build bone mass." "Cardio training is the best way to build bones." "Weight-bearing exercises can strengthen bones."

"Weight-bearing exercises can strengthen bones."

While reading a client's chart, the nurse notices that the client is documented to have paresthesia. The nurse plans care for a client with absence of muscle tone. involuntary twitch of muscle fibers. abnormal sensations. absence of muscle movement suggesting nerve damage.

Abnormal sensations

Which assessment findings indicate to the nurse that a client may have peripheral neurovascular dysfunction? Select all that apply. Cool skin Capillary refill of 4 to 5 seconds Pain Absence of feeling Weakness in motion Redness of the skin

Absence of feeling Capillary refill of 4 to 5 seconds Cool skin Pain Weakness in motion

The nurse is providing care to a client following a knee arthroscopy. What would the nurse expect to include in the client's plan of care? Maintaining the client's NPO status. Applying warm packs to the insertion site. Administering the prescribed analgesic. Keeping the affected knee flexed.

Administering the prescribed analgesic

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 arthroscopy A serum calcium test A magnetic resonance imaging (MRI) An electromyography

An electromyography

During a general musculoskeletal assessment, what would help the nurse determine the client's muscle strength? Palpating each of the client's muscles and joints. Applying force to the client's extremity as the client pushes against that force. Examining extremities for symmetry, size, and contour. Asking the client to lift specified amounts of weights.

Applying force to the client's extremity as the client pushes against that force

Which of the following diagnostic studies are done to relieve joint pain due to effusion? Arthrocentesis Bone scan Biopsy Electromyography (EMG)

Arthrocentesis

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? Arthrocentesis Electromyography Arthroscopy Bone scan

Arthroscopy

The nurse is performing a neurological assessment. What will this assessment include? Ask the client to plantar flex the toes. Palpate the dorsalis pedis pulse. Inspect the foot for edema. Observe for capillary refill of the great toe.

Ask the client to plantar flex the toes

The nurse is performing a musculoskeletal assessment of a client in a nursing home who had a stroke 2 years ago and who has right-sided hemiplegia. The nurse notes that the girth of the client's right calf is 2 inches less in diameter than the left calf. The nurse attributes the decreased girth to increased use of left calf muscle. bruising in right lower extremity. atrophy of right calf muscle. edema in left lower extremity.

Atrophy of right calf muscle

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

Capillary refill of more than 3 seconds

What is the term for a rhythmic contraction of a muscle? Atrophy Clonus Hypertrophy Crepitus

Clonus

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

Compartment syndrome

The homecare nurse is evaluating the musculoskeletal system of a geriatric client whose previous assessment was within normal limits. The nurse initiates a call to the health care provider and/or emergency services when which change is found? Decreased flexibility Decreased agility Decreased right-sided muscle strength Increased joint stiffness

Decreased right-sided muscle strength

Which term refers to the shaft of the long bone? Lordosis Epiphysis Scoliosis Diaphysis

Diaphysis

The nurse is performing a neurovascular assessment of a client's injured extremity. Which would the nurse report? Capillary refill of 3 seconds Dusky or mottled skin color Skin warm to touch Positive distal pulses

Dusky or mottled skin color

A client is diagnosed with a fracture of a diarthrosis joint. What is an example of this type of joint? Symphysis pubis Skull Fifth thoracic vertebrae Elbow

Elbow

After bone fracture, fibrocartilaginous callus formation normally occurs at the same time as which process?

Fibroblast migration

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 Spastic Atonic Atrophic

Flaccid

The nurse is reporting on the results of client blood work to the oncoming nurse. Upon reviewing the data, it is noted that the client has an elevated uric acid level. Which inflammatory process would the nurse screen for on shift rounds? Lupus erythematosus Rheumatoid arthritis Gout Osteoporosis

Gout

Which of the following is an example of a hinge joint? Knee Joint at base of thumb Carpal bones in the wrist Hip

Knee

Which of the following is the most common site of joint effusion? Knee Elbow Hip Shoulder

Knee

The nurse is performing an assessment on an older adult patient and observes the patient has an increased forward curvature of the thoracic spine. What does the nurse understand this common finding is known as? Lordosis Osteoporosis Kyphosis Scoliosis

Kyphosis

After a person experiences a closure of the epiphyses, which statement is true? The bone grows in length but not thickness. The bone increases in thickness and is remodeled. Both bone length and thickness continue to increase. No further increase in bone length occurs.

No further increase in bone length occurs.

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? Resorption Ossification and calcification Epiphyses and diaphysis formation Remodeling

Ossification and calcification

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? Osteoclasts Osteoblasts Cancellous bone Cortical bone

Osteoblasts

Red bone marrow produces which of the following? Select all that apply. White blood cells (WBCs) Platelets Red blood cells (RBCs) Estrogen Corticosteroids

Platelets White blood cells (WBCs) Red blood cells (RBCs)

A 10-year-old boy who was brought to the emergency room after a skiing accident is diagnosed with a fracture of the distal end of the femur. Why is this type of fracture significant? Osteoblast formation will stop during the time needed for fracture healing. Red blood cell production will be temporarily reduced because of the damage to the medullar cavity. Periosteal blood vessels will be damaged, thus compromising blood flow to the compact bone. Potential growth problems may result from damage to the epiphyseal plate.

Potential growth problems may result from damage to the epiphyseal plate

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

Prednisone

The nurse is caring for a client who experienced a crushing injury of the lower extremities. Which of the following symptoms is essential to be reported to the physician? Pulselessness Pain Coolness Ischemia

Pulselessness

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

Remodeling

Which of the following is the final stage of fracture repair? Angiogenesis Cartilage removal Remodeling Cartilage calcification

Remodeling

A client has just undergone arthrography. What is the most important instruction for the nurse to include in the teaching plan? Avoid intake of dairy products. Gently massage joints with any crackling or clicking joint noises. Avoid sunlight or harsh, dry climate. Report joint crackling or clicking noises occurring after the second day.

Report joint crackling or clicking noises occurring after the second day.

Which of the following is an appropriate priority nursing diagnosis for the client following an arthrocentesis? Chronic pain Activity intolerance Risk for infection Deficient knowledge: procedure

Risk for infection

A nurse practitioner assesses a patient's movement in his left hand after a cast is removed. The nurse asks the patient to turn his wrist so the palm of his hand is facing up. This movement is known as: Supination. Extension. Pronation. Eversion.

Supination

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? Injury to the radial nerve Tear in the joint capsule Fracture of the clavicle Decreased bone density

Tear in the joint capsule

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? Bursa Fascia Ligament Tendon

Tendon

The nurse is teaching a client about a vitamin that supports calcium's absorption. What vitamin is the nurse teaching the client about? Vitamin C Vitamin D Vitamin A Vitamin B12

Vitamin D

Which medication taken by the client in the previous 24 hours would be of greatest concern to the nurse caring for a client undergoing a bone biopsy? aspirin furosemide digoxin NPH insulin

aspirin

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? osteoarthritis of the shoulder a fracture of the clavicle bursitis ankylosing spondylitis

bursitis

The nurse is admitting an older adult to a skilled nursing facility. What assessment parameters will the nurse expect to find with the musculoskeletal assessment? Select all that apply. joint stiffness decreased range of motion increase in height increased muscle strength decreased endurance

decreased endurance joint stiffness decreased range of motion

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. involuntary function. All options are correct. organ function.

movement of skeletal bones.

The nurse is assigned to a client admitted with advanced Parkinson's disease. What type of gait correlates with Parkinson's disease? spastic hemiparesis scissors shuffling steppage

shuffling

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? "Are you claustrophobic?" "When did you last eat?" "When did you last urinate?" "Do you have any allergies?"

"Do you have any allergies?"

A client undergoes an arthroscopy at the outpatient clinic. After the procedure, the nurse provides discharge teaching. Which response by the client indicates the need for further teaching? "My physician may prescribe pain pills after the procedure." "I should use my heating pad this evening to reduce some of the pain in my knee." "Elevating my leg will reduce swelling after the procedure." "I may notice some bruising or swelling in my knee."

"I should use my heating pad this evening to reduce some of the pain in my knee."

A client has recently undergone an invasive joint examination to enable the identification of bone composition. Which signs and symptoms should the nurse monitor in this client? swelling and bleeding nausea and vomiting hypersensitivity reaction tingling sensation or numbness

swelling and bleeding