Mgmt of Patients with Musculoskeletal D/O's Ch 41 (Brunner & Suddarth's) NCLEX

When an infection is blood-borne, the manifestations include which symptom? a) chills b) Hyperactivity c) bradycardia d) hypothermia

a) Chills Other Manifestations: high fever, rapid pulse, and generalized malaise

Localized rapid bone turnover, most commonly affecting the skill, femur, tibia, pelvic bones, and vertebrae, is characterized by which bone disorder? a) Osteitis deformans b) Osteomalacia c) Osteoporosis d) Osteomyelitis

a) Osteitis deformans Osteitis deformans (Paget Disease) results in bone that is highly vascularized and structurally weak, predisposing to pathologic fractures.

Which medication directly inhibits osteoclasts, thereby reducing bone loss and increasing BMD (bone mineral density)? a) Teriparatide b) Calcitonin c) Vit D d) Raloxifene

b) Calcitonin

Which group is at the greatest risk for osteoporosis? a) AA women b) Men c) Asian women d) Caucasian women

d) Caucasian women Small-framed, non-obese caucasian women are at greatest risk for osteoporosis.

Which condition is a metabolic bone disease characterized by inadequate mineralization of bone? a) Osteoporosis b) Osteoarthritis c) Osteomyelitis d) Osteomalacia

d) Osteomalacia

Which is a strategy for lowering risk for osteoporosis? a) Diet low in calcium and Vit D b) Low initial bone mass c) Increased age d) Smoking cessation

d) Smoking cessation

A nurse is educating a client diagnosed with osteomalacia. Which statement by the nurse if appropriate? a) "You will need to avoid foods high in phosphorus and Vit D." b) "You will need to engage in vigorous exercise 3x/wk for 30 min c) "You may ned to be evaluated for an underlying cause such as renal failure." d) "You will need to decrease the amount of dairy products you consume.

c) "You may ned to be evaluated for an underlying cause such as renal failure."

Which aspect should a nurse include in the teaching plan for a client with osteomalacia? a) Avoid dairy products b) Avoid green, leafy vegetables c) Include calcium, phosphorus, and Vit D supplements d) Avoid any activity or exercise

c) Include calcium, phosphorus, and Vit D supplements

A client with chronic osteomyelitis has undergone 6 wks of antibiotic therapy. The wound appearance has not improved. What action would the nurse anticipate to promote healing? a) Surgical debridement b) Wound irrigation c) Wound packing d) Vitamin supplements

a) Surgical debridement

Instructions for the client with low back pain include that, when lifting, the client should a) avoid overreaching b) bend the knees and loosen the abd muscles c) place the load away from the body d) use a narrow base of support

a) avoid overreaching

The majority of bone infections are caused by which organism? a) Proteus b) Staphylococcus aureus c) Pseudomonas

b) Staphylococcus aureus

Most cases of osteomyelitis are caused by which microorganism? a) Pseudomonas species b) Staphylococcus aureus c) Escherichia coli d) Proteus species

b) Staphylococcus aureus S. aureus causes 70-80% of bone infections.

Lifestyle risk factors for osteoporosis include a) an estrogen deficiency or menopause b) a low-protein, high-fat diet c) lack of exposure to sunshine d) lack of aerobic exercise

c) Lack of exposure to sunshine **Other risk factors: a diet low in calcium and Vit D, smoking, ETOH &/or caffeine, and lack of weight-bearing exercise.

Which term refers to a disease of a nerve root? a) Contracture b) Sequestrum c) Radiculopathy d) Involucrum

c) Radiculopathy **When the client reports radiating pain down the leg, the client is describing radiculopathy. -Involucrum=new bone growth around the sequestrum -Sequestrum=dead bone in an abscess cavity -Contracture= abnormal shortening of muscle of fibrosis of joint structures.

In chronic osteomyelitis, antibiotics are adjunctive therapy in which situation? a) Wound packing b) Wound irrigation c) Surgical debridement d) Vitamin supplements

c) Surgical debridement

The nurse teaches the client with a high risk of osteoporosis about risk-lowering strategies including which action? a) Decrease the intake of Vit A&D b) Reduce stress c) Walk or perform weight-bearing exercises outdoors d) Increase fiber in the diet

c) Walk or perform weight-bearing exercises outdoors

A client has been prescribed alendronate for the prevention of osteoporosis. Which is the highest priority nursing intervention associated with the administration of the medication? a) Assess for the use of corticosteroids b) encourage the client to get yearly dental exams c) have the client sit upright for at least 30 min following administration d) ensure adequate intake of Vit D in the diet.

c) have the client sit upright for at least 30 min following administration **Prevents irritation and potential ulceration of the esophagus.

A client diagnosed with osteoporosis is being discharged home. Which priority education should the nurse provide? a) increase calcium and vit D in the diet b) classify medications c) remove all small rugs from the home d) participate in weight-bearing exercises

c) remove all small rugs from the home **Client is at risk for fractures r/t falls.

The nurse is educating a group of women on the prevention of osteoporosis. The nurse recognizes the education as being effective when the group members make which statement? a) "We need to consume a low-calcium, high-phosphorus diet" b) "Estrogen deficiency increases bone density." c) "We need to increase aerobic exercise" d) We need an adequate amount of exposure to sunshine."

d) "We need an adequate amount of exposure to sunshine."

Which common problem of the upper extremity results from entrapment of the median nerve at the wrist? a) impingement syndrome b) Ganglion c) Dupuytren's contracture d) Carpal Tunnel Syndrome

d) Carpal tunnel syndrome