NURS 309 Musculoskeletal-1

The nurse observes that an older patient has flexion contractures of the fourth and fifth fingers. The patient reports that he had a similar problem on the other hand and had a fasciotomy, which improved the function. What condition does the patient have? A. Dupuytren's contracture B. Ganglion cyst C. Bunion D. Volkmann's contracture

A. Dupuytren's contracture

Which patient has the greatest risk for acute hematogenous osteomyelitis? A. Older man with a catheter-related urinary tract infection B. Older patient in intensive care with poor dental hygiene C. Older woman with a methicillin-resistant Staphylococcus aureus infection D. Young patient with a leg fracture who has external skeletal pins

A. Older man with a catheter-related urinary tract infection

A patient tells the nurse that he has "soft bones". What additional information supports the likelihood of osteomalacia in this patient? A. Recent immigration from a country where famine is common B. Taking hormone replacement therapy for a prolonged time C. Unable to perform a prescribed exercise regimen D. History of recent episodes of venous thromboembolism

A. Recent immigration from a country where famine is common

Which person is following the recommendations for healthy bones related to alcohol consumption? A. Slender young woman drinks less than 5 ounces per day B. Obese older woman has 3 drinks on Friday, Saturday, and Sunday C. Older man has 2 drinks on weekdays and 5-6 drinks on weekend D. Young man drinks 60 ounces or more but only on Saturday nights

A. Slender young woman drinks less than 5 ounces per day

The nurse delegates the measurement of vital signs to an experienced unlicensed assistive personnel (UAP). Osteomyelitis has been diagnosed in a patient. Which vital sign value would the nurse instruct the UAP to report immediately for this patient? A. Temperature of 101 B. Blood pressure of 136/80 mm Hg C. Heart rate of 96 beats/min D. Respiratory rate of 24 breaths/min

A. Temperature of 101

A 40-year-old patient is admitted for acute osteomyelitis of the left lower leg. What does the nurse expect to find documented in the patient's admitting assessment? A. Temperature of greater than 101.5, swelling, tenderness, erythema, and warmth of area B. Ulceration resulting with sinus tract formation, localized pain, and drainage C. Aching pain, poorly described, deep, and worsened by pressure and weight bearing D. Shortening of the extremity with pain during weight bearing or palpation

A. Temperature of greater than 101.5, swelling, tenderness, erythema, and warmth of area

The nurse is interviewing a patient to help the health care provider determine the patient's risk for osteomalacia. Which assessment is the nurse most likely to perform? A. Typical 24-hour dietary intake B. Usual patterns for rest and sleep C. Type and frequency of exercise D. Presence of pain and pain management

A. Typical 24-hour dietary intake

The nurse is preparing to teach a patient with a new diagnosis of osteoporosis about strategies to prevent falls. Which teaching points should the nurse be sure to include? SATA A. Wear a hip protector when ambulating B. Remove throw rugs and other obstacles at home C. Exercise to help build strength D. Expect a few bumps and bruises when you go home E Rest when you are tired F. Avoid consuming three or more alcoholic drinks per day

A. Wear a hip protector when ambulating B. Remove throw rugs and other obstacles at home C. Exercise to help build strength E Rest when you are tired

The nurse's assessment reveals all of these data when a patient with Paget disease is admitted to the acute care unit. Which finding should the nurse notify the health care provider about first? A. There is bowing of both legs, and the knees are asymmetrical B. The base of the skull is invaginated (platybasia) C. The patient is only 5 feet tall and weighs 120 lb D. The skull is thick, soft, and larger than normal

B. The base of the skull is invaginated (platybasia)

The patient has a low-grade fever. How is this fact sometimes misinterpreted by the health care team in trying to evaluate musculoskeletal disorders? A. Osteoporosis is misdiagnosed for osteomalacia B. Ewing's sarcoma is thought to be osteomyelitis C. Osteoporosis is thought to be osteopenia D. Osteosarcoma is mistaken for secondary metastasis

B. Ewing's sarcoma is thought to be osteomyelitis

A patient comes to the emergency department after accidentally puncturing his hand with automatic nail gun. Which disorder is this patient primarily at risk for? A. Osteoporosis B. Osteomyelitis C. Osteomalacia D. Dupuytren's contracture

B. Osteomyelitis

The nurse is caring for several patients on an orthopedic unit. What patient is most likely to need blood cultures? A. Patient is 2 days postop for limb salvage surgery B. Patient is admitted for acute osteomyelitis of right leg C. Patient has osteoporosis and sustained a hip fracture D. Patient has osteosarcoma that has metastasized to the lungs

B. Patient is admitted for acute osteomyelitis of right leg

A patient who is a long-distance runner reports severe pain in the arch of the foot, especially when getting out of bed and with weight bearing. What does the nurse suspect in this patient? A. Hypertrophic ungual labium B. Plantar fasciitis C. Hammertoe D. Hallux valgus deformity

B. Plantar fasciitis

In older adults, what is the most common cause of contiguous osteomyelitis? A. Malignant external otitis media B. Slow-healing foot ulcers C. Periodontal infections D. Gastrointestinal salmonella infections

B. Slow-healing foot ulcers

The charge nurse observes an LPN/ LVN assigned to provide all these interventions for a patient with Paget disease. Which action requires that the charge nurse intervenes? A. Administering 600 mg of ibuprofen to the patient B. Encouraging the patient to perform exercises recommended by a physical therapist C. Applying ice and gentle massage to the patient's lower extremities D. Reminding the patient to drink milk and eat cottage cheese

C. Applying ice and gentle massage to the patient's lower extremities

The patient is admitted for acute osteomyelitis of the right lower leg with severe vascular compromise. Upon assessment, the patient denies pain or discomfort in the leg. Based on the concept of perfusion, how does the nurse interpret the patient's response? A. Vascular compromise may be severe, but the distal tissue is still being perfused B. An order for Doppler flow studies should be obtained to validate lack of perfusion C. Patient has sustained extensive nerve damage because of inadequate perfusion D. Patient's current position in bed is allowing for adequate perfusion to distal tissues

C. Patient has sustained extensive nerve damage because of inadequate perfusion

Which patient is most likely to be a candidate for hyperbaric oxygen therapy? A. Patient with osteomalacia related to poverty B. Patient with an advanced case of osteosarcoma C. Patient with chronic, unremitting osteomyelitis D. Patient with osteoporosis and recurrent fractures

C. Patient with chronic, unremitting osteomyelitis

A patient is diagnosed with plantar fasciitis. What instruction does the nurse give to the patient about self-care for this condition? A. Use rest, elevation, and warm packs B. Perform gentle jogging exercises C. Strap the foot to maintain the arch D. Wear loose or open shoes, such as sandals

C. Strap the foot to maintain the arch

The nurse is caring for a patient with osteomyelitis. Which laboratory results are of primary concern for this disorder? A. Bone-specific alkaline phosphatase and osteocalcin B. Serum calcium level and alkaline phosphatase C. White blood cell count and erythrocyte sedimentation rate D. Thyroid function tests and uric acid levels

C. White blood cell count and erythrocyte sedimentation rate

The charge nurse is making assignments for the day shift. Which patient should be assigned to the nurse who was floated from the postanesthesia care (PACU) for the day? A. A 35-year-old patient with osteomyelitis who needs teaching before hyperbaric oxygen therapy B. A 62-year-old patient with osteomalacia who is being discharged to a long-term care facility C. A 68-year-old patient with osteoporosis given a new orthotic device whose knowledge of its use must be assessed D. A 72-year-old patient with Paget disease who has just returned from surgery for total knee replacement

D. A 72-year-old patient with Paget disease who has just returned from surgery for total knee replacement

Compared to acute osteomyelitis, which characteristic is more associated with chronic osteomyelitis? A. Fever B. Swelling C. Erythema D. Sinus tract formation

D. Sinus tract formation

The nurse is teaching a patient about antibiotic therapy for osteomyelitis. What information does the nurse give to the patient? A. Single-agent therapy is the most effective treatment for acute infections B. Chronic osteomyelitis may require 1 month of antibiotic therapy C. Patients usually remain hospitalized to complete the full course of antibiotic therapy D. The infected wound may be irrigated with one or more types of antibiotic solutions

D. The infected wound may be irrigated with one or more types of antibiotic solutions