Prep-U questions chapter 35
The nurse is preparing the client for computed tomography. Which information should be given by the nurse?
"You must remain very still during the procedure."
Which is a circulatory indicator of peripheral neurovascular dysfunction?
Cool skin
A patient comes to the clinic and informs the nurse of numbness, tingling, and a burning sensation in the arm from the elbow down to the fingers. What type of symptom would this be documented as?
Paresthesia
Which of the following is the final stage of fracture repair?
Remodeling
A client undergoes an invasive joint examination of the knee. What will the nurse closely monitor the client for?
Serous drainage
Which nerve is assessed when the nurse asks the client to spread all fingers?
Ulnar
The nurse is assessing a new client with a musculoskeletal problem. What is the best question by the nurse to elicit more information related to the injury?
"Do you have any chronic disorder or recent injury?"
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?
Potential growth problems may result from damage to the epiphyseal plate
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?
"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?
"I should use my heating pad this evening to reduce some of the pain in my knee."
A nursing student asks the nurse why older adults are at risk for falls. The best response by the nurse is:
"Muscles atrophy with aging."
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."
A patient tells the nurse, "I was working out and lifting weights and now that I have stopped, I am flabby and my muscles have gone!" What is the best response by the nurse?
"Your muscles were in a state of hypertrophy from the weight lifting but it will persist only if the exercise is continued."
Which term refers to moving away from midline?
Abduction
Which statement describes paresthesia?
Abnormal sensations
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?
Administering the prescribed analgesic
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
The nurse is taking an initial history of a new client with a musculoskeletal problem. Which factor is most important for the nurse to keep in mind for this assessment?
Any chronic disorder or recent injury
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 of the following diagnostic studies are done to relieve joint pain due to effusion?
Arthrocentesis
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
A nurse provides health information to a postmenopausal woman who has been diagnosed with osteopenia. What mineral would the nurse recommend for this client?
Calcium
The orthopedic nurse is caring for a client diagnosed with a fracture of the radius. In which type of bone tissue does the nurse anticipate the fracture being?
Cancellous
Which is an indicator of neurovascular compromise?
Capillary refill of more than 3 seconds
A group of students are reviewing the structure and function of bones. The students demonstrate understanding of the information when they state that cortical bone is found primarily in which of the following?
Diaphyses
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
The nurse is teaching a client about osteoporosis. What diagnostic test will the nurse include with the client teaching?
Dual-energy x-ray absorptiometry
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
A nurse understands the influence of hormones on bone maintenance. Therefore, the nurse knows that a patient on long-term cortisol may experience:
Increased bone resorption
A client is exhibiting diminished range of motion, loss of flexibility, stiffness, and loss of height. The history and physical findings are associated with age-related changes of which area?
Joints
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
A client has an exaggerated convex curvature of the thoracic spine. What is this condition called?
Kyphosis
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?
Kyphosis
The human body has 206 bones, which are classified into four categories. Which types of bones are the femur and ulna?
Long bones
The client presents with an exaggeration of the lumbar spine curve. How does the nurse interpret this finding?
Lordosis
Which of the following deformity causes a exaggerated curvature of the lumbar spine?
Lordosis
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
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?
Osteoblasts
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
A nurse performs a neurovascular assessment on a client 2 weeks after a wrist cast had been removed. The nurse documents in the client's chart that there is normal sensation in the ulnar nerve. What finger assessment test will the nurse perform on this client?
Prick the distal fat pad on the small finger
Which nursing instruction is most important to stress when teaching on calcium intake?
Provide age-related calcium intake recommendations
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
A client comes to the emergency department with reports of pain in the left ankle. The client states, "I missed a step coming down the stairs, and landed funny." The ankle is swollen and tender to the touch. What will the nurse do to help control the swelling?
Raise the left leg above the level of the heart
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
A client has a fracture that is being treated with open rigid compression plate fixation devices. What teaching will the nurse reinforce to the client about how the progress of bone healing will be monitored?
Serial x-rays will be taken
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
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?
Tear in the joint capsule
A client experiences a musculoskeletal injury that involves the structure that connects a muscle to the bone. The nurse understands that this injury involves which structure?
Tendon
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
A client visits the health care provider for a routine checkup. The history reveals that the client was diagnosed with a spinal curvature. Which region of the spine should the nurse assess for complications?
Thoracic
Which data is most important for the nurse to record while assessing a client with an open wound?
When the client last received a tetanus immunization
Each bone is composed of cells, protein matrix, and mineral deposits. Which type of bone cell works to repair a bone fracture?
osteocytes
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
Which cells are involved in bone resorption?
Osteoclasts
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.)
- Pale, cyanotic, or mottled color - Cool temperature of the extremity - More than 3-second capillary refill
Which clinical manifestation would the nurse recognize as an indicator of peripheral neurovascular dysfunction? Select all that apply.
- Toes mottled and cool - Complaints of pins and needles in feet
A nurse knows that a person with a 3-week-old femur fracture is at the stage where angiogenesis is occurring. What are the characteristics of this stage?
New capillaries producing a bridge between the fractured 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 assessment finding would cause the nurse to suspect compartment syndrome in the client following a bone biopsy?
Increased diameter of the calf
A client is having repeated tears of the joint capsule in the shoulder, and the health care provider orders an arthrogram. What intervention should the nurse provide after the procedure is completed? Select all that apply.
- Apply a compression bandage to the area - Administer a mild analgesic - Inform the client that a clicking or crackling noise in the joint may persist for a couple of days
The nurse understands that bone maintenance requires a balance between forming and dissolving bone. What is a correct statement about the function of osteoblasts?
They secrete a matrix that consists of collagen
