PrepU - Chapter 41: Management of Patients With Musculoskeletal Disorders

A nurse is teaching a client who was recently diagnosed with carpal tunnel syndrome. Which statement should the nurse include?

"Ergonomic changes can be incorporated into your workday to reduce stress on your wrist."

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?

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

Which group is at the greatest risk for osteoporosis?

European American women

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

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."

A nurse is educating a client diagnosed with osteomalacia. Which statement by the nurse is appropriate?

"You may need to be evaluated for an underlying cause, such as renal failure."

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

Arthrodesis

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

Calcitonin (Miacalcin)

While the nurse is performing a physical assessment, the client reports numbness, tingling, and pain when the nurse percusses lightly over the median nerve. What should this assessment indicate to the nurse?

Carpal tunnel syndrome

The nurse is assessing the feet of a patient and observes an overgrowth of the horny layer of the epidermis. What does the nurse recognize this condition as?

Corn

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

Long bone bowing

An older adult client with a diagnosis of left-sided stroke is admitted to the facility. To prevent the development of disuse osteoporosis, which objective is most appropriate?

Promoting weight-bearing exercises

A client with Paget's disease comes to the hospital and reports difficulty urinating. The emergency department health care provider consults urology. What should the nurse suspect is the most likely cause of the client's urination problem?

Renal calculi

A client has Paget's disease. An appropriate nursing diagnosis for this client is:

Risk for falls

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

A nurse is performing discharge teaching for an elderly client with osteoporosis. Which instruction about a calcium supplement should the nurse include?

Take the supplement with meals or with orange juice.

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 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.

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

Surgical debridement

A nurse is teaching a client with osteoporosis about dietary selections. What client statement indicates the teaching was effective?

"I will eat more dairy products to increase my calcium intake."

A client with osteoporosis is prescribed calcitonin 100 units subcutaneously. The medication is available 200 units per ml. How many milliliters will the nurse administer to the client?

0.5

Localized rapid bone turnover, most commonly affecting the skull, femur, tibia, pelvic bones, and vertebrae, is characterized by which bone disorder?

Paget disease

In which deformity does the great toe deviate laterally?

Hallux valgus

Which of the following was formerly called a bunion?

Hallux valgus

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 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

A patient is diagnosed with osteomyelitis of the right leg. What signs and symptoms does the nurse recognize that are associated with this diagnosis? (Select all that apply.)

- Fever - Erythema - Pain

A nurse is caring for an older woman with a hip fracture. What are appropriate risk factors for the nurse to consider related to the client's hip fracture? Select all that apply.

- Presence of anemia - Female gender - Osteoporosis

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

Alkaline phosphatase

Which of the following is the only selective estrogen receptor modulator approved for osteoporosis in post menopausal women?

Raloxifene

A client diagnosed with carpal tunnel syndrome (CTS) asks the nurse about numbness in the fingers and pain in the wrist. What is the best response by the nurse?

"CTS is a neuropathy that is characterized by compression of the median nerve at the wrist."

The nurse is asked to explain to the client the age-related processes that contribute to bone loss and osteoporosis. What is the nurse's best response?

Decrease in estrogen

Dupuytren's contracture causes flexion of which area(s)?

Fourth and fifth fingers

Most cases of osteomyelitis are caused by which microorganism?

Staphylococcus aureus

Morton neuroma is exhibited by which clinical manifestation?

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

A client has been treated for migraine headaches for several months and comes to the clinic stating he is getting no better. The nurse is talking with the client and hears an audible click when the client is moving his jaw. What does the nurse suspect may be happening?

Temporomandibular disorder

A client with low back pain is being seen in the clinic. In planning care, which teaching point should the nurse include?

Use the large muscles of the leg when lifting items.

A nurse is planning discharge teaching regarding exercise for a client at risk for osteoporosis. Which exercise would the nurse be most likely to suggest?

Walking

Which term refers to a disease of a nerve root?

Radiculopathy

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 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."

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 on an older female client, a nurse notes that the client is 5 feet, 3/8 inches (1.6 m) tall. The client states, "How is that possible? I was always 5 feet and 1/2? (1.7 m) tall." Which statement is the best response by the nurse?

"After menopause, the body's bone density declines, resulting in a gradual loss of height."

When teaching a client how to prevent low back pain as a result of lifting, the nurse should instruct the client to:

avoid overreaching.

The nurse is preparing a client for a surgical procedure that will allow visualization of the extent of joint damage of the knee for a client with rheumatoid arthritis and also obtain a sample of synovial fluid. What procedure will the nurse prepare the client for?

Arthroscopy

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

What term refers to a flexion deformity caused by a slowly progressive contracture of the palmar fascia?

Dupuytren contracture

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.

A client is admitted with acute osteomyelitis that developed after an open fracture of the right femur. When planning this client's care, the nurse should anticipate which measure?

Administering large doses of I.V. antibiotics as ordered

The client diagnosed with osteosarcoma is scheduled for a surgical amputation. Which nursing diagnosis would be a priority for this client compared with other surgical clients?

Disturbed body image

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