Ch. 35: Musculoskeletal Function

*A client has symptoms of osteoporosis and is being assessed during an annual physical examination. The assessment shows that the client will require further testing related to a possible exacerbation of osteoporosis. The nurse should anticipate which diagnostic test? A. Bone densitometry B. Hip bone radiography C. Computed tomography (CT) D. Magnetic resonance imaging (MRI)

A

A 10-year-old client is growing at a rate appropriate for the client's age. Which cells are responsible for the secretion of bone matrix, which eventually results in bone growth? A. Osteoblasts B. Osteocytes C. Osteoclasts D. Lamellae

A

A client has been experiencing an unexplained decline in knee function and has consequently been scheduled for arthrography. The nurse should teach the client about what process? A. Injection of a contrast agent into the knee joint prior to ROM exercises B. Aspiration of synovial fluid for serologic testing C. Injection of corticosteroids into the client's knee joint to facilitate ROM D. Replacement of the client's synovial fluid with a synthetic substitute

A

A client has just had an arthroscopy performed to assess a knee injury. What nursing intervention should the nurse perform following this procedure? A. Wrap the joint in a compression dressing. B. Perform passive range of motion exercises. C. Maintain the knee in flexion for up to 30 minutes. D. Apply heat to the knee.

A

A nurse is caring for a client who has just had an arthroscopy as an outpatient and is getting ready to go home. The nurse should teach the client to monitor closely for what postprocedure complication? A. Fever B. Crepitus C. Fasciculations D. Synovial fluid leakage

A

A nurse is caring for a client whose cancer metastasis has resulted in bone pain. What should the nurse expect the client to describe? A. A dull, deep ache that is "boring" in nature B. Soreness or aching that may include cramping C. Sharp, piercing pain that is relieved by immobilization D. Spastic or sharp pain that radiates

A

A nurse is providing care for a client whose pattern of laboratory testing reveals long-standing hypocalcemia. Which other laboratory result is most consistent with this finding? A. An elevated parathyroid hormone level B. An increased calcitonin level C. An elevated potassium level D. A decreased vitamin D level

A

A nurse is taking a health history on a client with musculoskeletal dysfunction. What should the nurse prioritize during this phase of the assessment? A. Evaluating the effects of the musculoskeletal disorder on the client's function B. Evaluating the client's adherence to the existing treatment regimen C. Evaluating the presence of genetic risk factors for further musculoskeletal disorders D. Evaluating the client's active and passive range of motion

A

Diagnostic tests show that a client's bone density has decreased over the past several years. The client asks the nurse which factors contribute to bone density decreasing. Which response by the nurse would be best? A. "For many people, a lack of proper nutrition can cause a loss of bone density." B. "Progressive loss of bone density is mostly related to your genes." C. "Stress is known to have many unhealthy effects, including reduced bone density." D. "Bone density decreases with age, but scientists are not exactly sure why this is the case."

A

The nurse is performing an assessment of a client's musculoskeletal system and is appraising the client's bone integrity. Which action should the nurse perform during this phase of assessment? A. Compare parts of the body symmetrically. B. Assess extremities when in motion rather than at rest. C. Percuss as many joints as are accessible. D. Administer analgesia 30 to 60 minutes before assessment.

A

A nurse is explaining a client's decreasing bone density in terms of the balance between bone resorption and formation. What dietary nutrients and hormones play a role in the resorption and formation of adult bones? Select all that apply. A. Thyroid hormone B. Growth hormone C. Estrogen D. Vitamin B12 E. Luteinizing hormone

A, B, C

*A client is scheduled for a bone scan to rule out osteosarcoma of the pelvic bones. Which client status would be most important for the nurse to verify before the client's scan? A. Completion of the bowel cleansing regimen B. Empty bladder C. No allergy to penicillins D. Fast for at least 8 hours

B

A bone biopsy has just been completed on a client with suspected bone metastases. The nurse should prioritize assessments for which common complication of bone biopsy? A. Dehiscence at the biopsy site B. Pain C. Hematoma formation D. Infection

B

A client is receiving ongoing nursing care for the treatment of Parkinson disease. When assessing this client's gait, which finding is most closely associated with this health problem? A. Spastic hemiparesis gait B. Shuffling gait C. Rapid gait D. Steppage gait

B

A client is undergoing diagnostic testing for suspected Paget disease. What assessment finding is most consistent with this diagnosis? A. Altered serum magnesium levels B. Altered serum calcium levels C. Altered serum potassium levels D. Altered serum sodium levels

B

A nurse is assessing a client who is experiencing peripheral neurovascular dysfunction. Which assessment findings are most consistent with this diagnosis? A. Hot skin and a capillary refill of 1 to 2 seconds B. Absence of feeling, capillary refill of 4 to 5 seconds, and cool skin C. Pain, diaphoresis, and erythema D. Jaundiced skin, weakness, and capillary refill of 3 seconds

B

A nurse is caring for an older adult who has been diagnosed with geriatric failure to thrive. The nurse should perform interventions to prevent what complication? A. Muscle clonus B. Muscle atrophy C. Rheumatoid arthritis D. Muscle fasciculations

B

A nurse is performing a nursing assessment of a client suspected of having a musculoskeletal disorder. Which assessment should the nurse prioritize for a client who has a musculoskeletal disorder? A. Range of motion B. Activities of daily living C. Gait D. Strength

B

A public health nurse is organizing a campaign that will address the leading cause of musculoskeletal-related disability. The nurse should focus on what health problem? A. Osteoporosis B. Arthritis C. Hip fractures D. Lower back pain

B

When assessing a client's peripheral nerve function, the nurse uses an instrument to prick the fat pad at the top of the client's small finger. This action will assess what nerve? A. Radial B. Ulnar C. Median D. Tibial

B

While performing an assessment, the nurse notes that a client has soft subcutaneous nodules along the extensor tendons of the fingers. Which disorder does this client most likely have? A. Osteoarthritis B. Rheumatoid arthritis C. Gout D. Paget disease

B

A client has been experiencing progressive increases in knee pain and diagnostic imaging reveals a worsening effusion in the synovial capsule. The nurse should anticipate what diagnostic procedure? A. Arthrography B. Knee biopsy C. Arthrocentesis D. Electromyography

C

A client has sustained traumatic injuries that involve several bone fractures. A fracture of what type of bone may interfere with the protection of the client's vital organs? A. Long bones B. Short bones C. Flat bones D. Irregular bones

C

A client's fracture is healing and compact bone is replacing spongy bone around the periphery of the fracture. This process characterizes what phase of the bone healing process? A. Hematoma formation B. Fibrocartilaginous callus formation C. Remodeling D. Bony callus formation

C

A clinic nurse is caring for a client with a history of osteoporosis. What diagnostic test will best allow the care team to assess the client's risk of fracture? A. Arthrography B. Bone scan C. Bone densitometry D. Arthroscopy

C

A nurse is taking a health history on a new client who has been experiencing unexplained paresthesia. What question should guide the nurse's assessment of the client's altered sensations? A. How does the strength in the affected extremity compare to the strength in the unaffected extremity? B. Does the color in the affected extremity match the color in the unaffected extremity? C. How does the feeling in the affected extremity compare with the feeling in the unaffected extremity? D. Does the client have a family history of paresthesia or other forms of altered sensation?

C

A nurse's assessment reveals that a client has shoulders that are not level and one prominent scapula that is accentuated by bending forward. The nurse should expect to read about which health problem in the client's electronic health record? A. Lordosis B. Kyphosis C. Scoliosis D. Muscular dystrophy

C

The nurse's comprehensive assessment of an older adult involves the assessment of the client's gait. How should the nurse best perform this assessment? A. Instruct the client to walk heel-to-toe for 15 to 20 steps. B. Instruct the client to walk in a straight line while not looking at the floor. C. Instruct the client to walk away from the nurse for a short distance and then toward the nurse. D. Instruct the client to balance on one foot for as long as possible and then walk in a circle around the room.

C

The results of a nurse's musculoskeletal examination show an increase in the lumbar curvature of the spine. The nurse should recognize the presence of what health problem? A. Osteoporosis B. Kyphosis C. Lordosis D. Scoliosis

C

A client has come to the clinic for a regular check-up. The nurse's initial inspection reveals an increased thoracic curvature of the client's spine. The nurse should document the presence of which condition? A. Scoliosis B. Epiphyses C. Lordosis D. Kyphosis

D

A client has had a cast placed for the treatment of a humeral fracture. The nurse's most recent assessment shows signs and symptoms of compartment syndrome. What is the nurse's most appropriate action? A. Arrange for a STAT assessment of the client's serum calcium levels. B. Perform active range of motion exercises. C. Assess the client's joint function symmetrically. D. Contact the primary provider immediately.

D

A nurse is assessing a child who has a diagnosis of muscular dystrophy. Assessment reveals that the child's muscles have greater-than-normal tone. The nurse should document the presence of: A. tonus. B. flaccidity. C. atony. D. spasticity.

D

A nurse is caring for a client who has an MRI scheduled. What is the priority safety action prior to this diagnostic procedure? A. Assessing the client for signs and symptoms of active infection B. Ensuring that the client can remain immobile for up to 3 hours C. Assessing the client for a history of nut allergies D. Ensuring that there are no metal objects on or in the client

D

A nurse is performing a musculoskeletal assessment of a client with arthritis. During passive range-of-motion exercises, the nurse hears an audible grating sound. The nurse should document the presence of what assessment finding? A. Fasciculations B. Clonus C. Effusion D. Crepitus

D

During assessment, a client reports experiencing rhythmic muscle contractions when the nurse performs passive extension of the wrist. The nurse should recognize the presence of which condition? A. Fasciculations B. Contractures C. Effusion D. Clonus

D

A nurse on the orthopedic unit is assessing a client's peroneal nerve. The nurse should perform this assessment by doing what action? A. Pricking the skin between the great and second toe B. Stroking the skin on the sole of the client's foot C. Pinching the skin between the thumb and index finger D. Stroking the distal fat pad of the small finger

A

The nurse's musculoskeletal assessment of a client reveals involuntary twitching of muscle groups. How would the nurse document this observation in the client's chart? A. Tetany B. Atony C. Clonus D. Fasciculations

D

A nurse is caring for a client with a diagnosis of cancer that has metastasized to the bone. Which laboratory value would the nurse expect to be elevated in this client? A. Bilirubin B. Potassium C. Alkaline phosphatase D. Creatinine

C

A client injured in a motor vehicle accident has sustained a fracture to the diaphysis of the right femur. Of which tissue is the diaphysis of the femur mainly constructed? A. Epiphyses B. Cartilage C. Cortical bone D. Cancellous bone

C

A nurse is caring for a client who has been scheduled for a bone scan. Which statement should the nurse include when educating the client about this diagnostic test? A. "The test is brief and requires that you drink a calcium solution 2 hours before the test." B. "You will not be allowed fluid for 2 hours before and 3 hours after the test." C. "You will be encouraged to drink water after the administration of the radioisotope injection." D. "This is a common test that can be safely performed on anyone."

C