Med-Surg PrepU Chapter 35: Assessment of Musculoskeletal Function

The nurse is assessing a client with a musculoskeletal system condition. Which statement indicates to the nurse that the client is experiencing bone pain?

"The pain feels deep in my legs and keeps me awake at night."

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."

The human body has 206 bones, which are classified into four categories. Which types of bones are the femur and ulna?

"You must remain very still during the procedure."

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.) -Cool temperature of the extremity -Pale, cyanotic, or mottled color -Limited range of motion -More than 3-second capillary refill -Tenting skin turgor

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

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

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

Which statement describes paresthesia?

Abnormal sensations

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

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.

Which nursing action is most important in caring for the client following an arthrogram?

Apply ice to the joint

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

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

Calcitonin

Which hormone inhibits bone resorption and increases the deposit of calcium in the bone?

Calcitonin

Which is an indicator of neurovascular compromise?

Capillary refill of more than 3 seconds

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

Carpal bones in the wrist

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

Covers the marrow cavity of long bones

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 right-sided muscle strength

Which term refers to the shaft of the long bone?

Diaphysis

The nurse is educating a group of students about peroneal nerve damage. The nurse knows that which assessment will show this type of nerve damage?

Dorsiflexion of the foot and extension of the toes

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

Elbow

Which diagnostic test would the nurse expect to be ordered for a client with lower extremity muscle weakness?

Electromyograph (EMG)

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

The nurse is preparing to perform a musculoskeletal assessment for a client with chronic muscle pain. Which assessment technique would be an appropriate tool to evaluate this type of pain?

Flex the bicep against resistance

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?

Gout

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

Increased diameter of the calf

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

The client presents with an exaggeration of the lumbar spine curve. How does the nurse interpret this finding?

Lordosis

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 working on an orthopedic floor caring for a client injured in a football game. The nurse is reviewing the client's chart noting that the client has previously had an injured tendon. The nurse anticipates an injury between the periosteum of the bone and which of the following?

Muscle

A client scheduled to undergo an electromyography asks the nurse what this test will evaluate. What is the correct response from the nurse?

Muscle weakness

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

Which serum level indicates the rate of bone turnover?

Osteocalcin

Which cells are involved in bone resorption?

Osteoclasts

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.

The nurse observes a client with a shuffling gait. What disease is commonly associated with a shuffling gait?

Parkinson's disease

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

During the interview an older adult client reports joint pain with movement. The client states, "But if I rest it, the pain gets better." What is the most likely cause of client's pain?

Relaxation of the ligaments

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

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

Remodeling

A client has just undergone arthrography. What is the most important instruction for the nurse to include in the teaching plan?

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?

Risk for infection

What is the term for a lateral curving of the spine?

Scoliosis

A group of students are studying for an examination on joints. The students demonstrate understanding of the material when they identify which of the following as an example of a synarthrodial joint?

Skull at the temporal and occipital bones

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.

A patient is scheduled for a bone marrow biopsy. The nurse explains to the family that the bone marrow is located mainly in four areas. The nurse tells the family that the site to be used would be the:

Sternum

Skull sutures are an example of which type of joint?

Synarthrosis

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 emergency room nurse is reporting the location of a fracture to the client's primary care physician. When stating the location of the fracture on the long shaft of the femur, the nurse would be most correct to state which terminology locating the fractured site?

The fracture is on the diaphysis

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

abnormal sensations

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

The nurse working in the emergency department receives a call from the x-ray department communicating that the client the nurse is caring for has a fracture in the shaft of the tibia. The nurse tells the physician that the client's fracture is in the

diaphysis

A client has an exaggerated convex curvature of the thoracic spine. What is this condition called?

kyphosis

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?

long bones

The nurse is assessing a young client during an annual sports physical at school. The assessment reveals that the client has lateral curving of the spine. The nurse reports to the health care professional that the assessment revealed

scoliosis

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

shuffling

Where on the spine is kyphosis assessed by the nurse?

thoracic vertebrae