NU144- Chapter 41: Management of Patients With Musculoskeletal Disorders

The nurse is educating a client on home care following removal of a ganglion cyst from the right wrist. Which statement by the client demonstrates that the nurse's teaching has been effective?

"I will leave the dressing on until I follow up with my doctor as scheduled."

A nurse is planning discharge instructions for the client with osteomyelitis. What instructions should the nurse include in the discharge teaching?

"You will receive IV antibiotics for 3 to 6 weeks."

Which client would the nurse identify as having the greatest risk for osteoporosis?

A small-framed, thin 45-year-old white woman

A patient is diagnosed with osteogenic sarcoma. What laboratory studies should the nurse monitor for the presence of elevation?

Alkaline phosphatase

What clinical manifestation would the nurse expect to find in a client who has had osteoporosis for several years?

Decreased height

The nurse has educated a patient with low back pain about techniques to relieve the back pain and prevent further complications. What statement by the patient shows understanding of the education the nurse provided?

"I will avoid prolonged sitting or walking."

An older woman's X-rays reveal a diagnosis of osteoporosis. The nurse advises the woman that the radiolucency seen in the bones indicates a minimal level of demineralization of which percentage?

25%

A client is scheduled for surgery to fuse a joint. The nurse identifies this as which of the following?

Arthrodesis

Which of the following is the first-line medication that would be used to treat and prevent osteoporosis?

Bisphosphonates

When an infection is bloodborne, the manifestations include which symptom?

Chills

A nurse is caring for a client with eczema. Which medication would be prescribed when an allergy is a factor causing the skin disorder?

Chlorpheniramine

A patient had hand surgery to correct a Dupuytren's contracture. What nursing intervention is a priority postoperatively?

Performing hourly neurovascular assessments for the first 24 hours

Which of the following presents with an onset of heel pain with the first steps of the morning?

Plantar fasciitis

A patient is having low back pain. What position can the nurse suggest to relieve this discomfort?

Supine, with the knees slightly flexed and the head of the bed elevated 30 degrees

In chronic osteomyelitis, antibiotics are adjunctive therapy in which situation?

Surgical debridement

contracture

abnormal shortening of muscle or fibrosis of joint structures

radiculopathy

disease of a spinal nerve root, often resulting in pain and extreme sensitivity to touch.

bursitis

inflammation of a fluid-filled sac in a joint

Assessment of a client reveals signs and symptoms of Paget's disease. Which of the following would be most likely?

Long bone bowing

Which term refers to a disease of a nerve root?

Radiculopathy

A nurse is teaching a client about preventing osteoporosis. Which teaching point is correct?

The recommended daily allowance of calcium may be found in a wide variety of foods.

sequestrum

dead bone in abscess cavity

osteopenia

low bone mineral density

The nurse is educating a client with low back pain on proper lifting techniques. The nurse recognizes that the education was effective when the client

places the load close to the body.

The nurse is educating the patient with low back pain about the proper way to lift objects. What muscle should the nurse encourage the patient to maximize?

Quadriceps

A client diagnosed with osteoporosis is being discharged home. Which priority education should the nurse should provide?

Remove all small rugs from the home

A client with chronic osteomyelitis has undergone 6 weeks of antibiotic therapy. The wound appearance has not improved. What action would the nurse anticipate to promote healing?

Surgical debridement

tendonitis

inflammation of muscle tendons

A client with diabetes punctured his foot with a broken acorn in the yard. Within a week, the client developed osteomyelitis of the foot. The client was admitted for IV antibiotic therapy. How long does the nurse anticipate the client will receive IV antibiotics?

3 to 6 weeks

A nurse is caring for a client following removal of a Morton's neuroma. Which nursing intervention would be most appropriate?

Assess the surgical dressing.

Which of the following inhibits bone resorption and promotes bone formation?

Calcitonin

Which medication directly inhibits osteoclasts, thereby reducing bone loss and increasing BMD?

Calcitonin (Miacalcin)

The nurse notes that the client's left great toe deviates laterally. This finding would be recognized as which condition?

Hallux valgus

Which area of the spinal column is subject to the greatest mechanical stress and degenerative changes?

Lower lumbar

Which of the following is the most important nursing diagnosis for an elderly patient diagnosed with osteoporosis?

Risk for injury related to fractures due to osteoporosis

The nurse teaches the client with a high risk for osteoporosis about risk-lowering strategies, including which action?

Walk or perform weight-bearing exercises outdoors

A client has low back pain and the healthcare provider needs to rule out the presence of a tumor. Which diagnostic procedure would the nurse anticipate to be ordered for the client?

Bone scan

A healthcare provider asks a nurse to test a client for Tinel's sign to diagnose carpal tunnel syndrome. What should the nurse do to perform this assessment?

Have the client hold the palm of the hand up while the nurse percusses over the median nerve.

A nurse is caring for a client who's experiencing septic arthritis. This client has a history of immunosuppressive therapy and the immune system is currently depressed. Which assignment is the most appropriate for the nurse caring for this client?

The nurse is caring for this client on the intensive care unit.

The nurse is assisting a client with removing shoes prior to an examination and observes that the client has a flexion deformity of several toes on both feet of the proximal interphalangeal (PIP) joints. What can the nurse encourage the client to do?

Wear properly fitting shoes.

A nurse is caring for an elderly female client with osteoporosis. When teaching the client, the nurse should include information about which major complication?

Bone fracture

A client is diagnosed with carpal tunnel syndrome. Which assessment findings would the nurse expect?

Inability to flex index and middle fingers

Which is not a risk factor for osteoporosis?

being male

Which of the following is the most common and most fatal primary malignant bone tumor?

Osteogenic sarcoma (osteosarcoma)

osteoporosis

degenerative disease of the bone characterized by reduced mass, deterioration of matrix, and diminished architectural strength

sciatica

inflammation of the sciatic nerve, resulting in pain and tenderness along the nerve through the thigh and leg

The nurse is caring for a client with a hip fracture. The physician orders the client to start taking a bisphosphonate. Which medication would the nurse document as given?

Alendronate

A home care nurse assesses for disease complications in a client with bone cancer. Which laboratory value may indicate the presence of a disease complication?

Calcium level of 11.6 mg/dl

During a routine physical examination of a client, the nurse observes a flexion deformity of the proximal interphalangeal (PIP) joint of two toes on the right foot. How would the nurse document this finding?

Hammer toe

A female client is at risk for developing osteoporosis. Which action will reduce the client's risk?

Initiating weight-bearing exercise routines

Morton neuroma is exhibited by which clinical manifestation?

Swelling of the third (lateral) branch of the median plantar nerve

involucrum

new bone growth around a sequestrum

A client visits an orthopedic specialist because of pain beginning in the low back and radiating behind the right thigh and down below the right knee. The doctor suspects a diagnosis of sciatica. The nurse knows that the origin of the pain is between which intervertebral disks?

L4, L5, and S1

A client with a musculoskeletal injury is instructed to alter the diet. The objective of altering the diet is to facilitate the absorption of calcium from food and supplements. Considering the food intake objective, which food item should the nurse encourage the client to include in the diet?

Vitamin D-fortified milk