Chapter 21: Musculoskeletal Assessment - ML4

A client presents at the clinic with an enlarged, swollen, hot, and red metatarsophalangeal joint and bursa of the great toe. What medical diagnosis would the nurse suspect?

flexion

An older adult client visits the clinic and tells the nurse that she has had shooting pain in both of her legs. The nurse should assess the client for signs and symptoms of

herniated intervertebral disc.

A nurse is conducting a physical examination of the musculoskeletal system of a client who reports having joint pain. Which signs indicate there is inflammation in the joints? Select all that apply.

swelling warmth redness tenderness

Skeletal muscles are attached to bones by

tendons.

The nurse is performing an assessment of a client's musculoskeletal system. What would the nurse examine first?

the client's gait

A nurse is preparing a program on osteoporosis for a local women's group. Which of the following would the nurse include as a modifiable risk factor?

vitamin D deficiency

A nurse conducts a physical examination of the musculoskeletal system of a client who reports upper arm pain. Which instruction should the nurse provide the client when assessing flexion of the elbow?

"Bend your elbow."

A nurse wants to assess the prevertebral muscles of a client who reports neck stiffness. In order to effectively conduct the physical examination of this area, the nurse should give which instruction to the client?

"Bring your chin to your chest."

Inspection of a client's knee reveals swelling, and the nurse suspects that there is significant fluid in the knee. What test would the nurse perform to confirm the suspicion?

Ballottement test

Which nutrient deficiency should a nurse recognize as placing a client at risk for osteoporosis?

Calcium

The nurse asks the client to perform the action shown. What is the nurse assessing?

Carpal tunnel syndrome

A nurse is providing health education about osteoporosis to a community group. What ethnicity is considered to be an independent risk factor for osteoporosis?

Caucasian

A client presents to the health care clinic with reports of onset of neck pain 3 days ago. The nurse recognizes that the most common cause of neck pain is what condition?

Cervical strain

Risk factors in which of the following areas are most readily changed to reduce the potential risk for falls?

Environmental

A new client is admitted to a long term care facility. The nurse assesses the client with an unsteady gait and incontinence. Which problem should the nurse address when planning care for this client?

Falls

A 28-year-old graduate student comes to the clinic for evaluation of pain "all over." With further questioning, she can relate that the pain is worse in the neck, shoulders, hands, low back, and knees. She denies swelling in her joints; she states that the pain is worse in the morning; there is no limitation in her range of motion. On physical examination, she has several points on the muscles of the neck, shoulders, and back that are tender to palpation; muscle strength and range of motion are normal. Which of the following is likely the cause of her pain?

Fibromyalgia

What range of motion is the nurse testing by asking a client to stoop to pick an object off the floor?

Flexion

The nurse is assessing the range of motion (ROM) of a client's joints. What would the nurse use to assess flexion and extension of a joint if the client complains of pain on examination?

Goniometer

A client presents to the health care clinic with reports of a swollen, tender, reddened joint in the left big toe. The nurse recognizes this finding as an indication of what inflammatory process?

Gouty arthritis

During the physical exam, the nurse notes a very tender and painful, reddened, hot, and swollen metatarsophalangeal joint of the client's great toe. What would the nurse suspect?

Gouty arthritis

Inspection of a client's foot reveals an enlarged, painful, inflamed bursa on the medial side of the foot. The nurse should make a referral for what health problem?

Hallux valgus

Assessment of the musculoskeletal system usually proceeds from general to specific and from?

Head to toe

A nurse is testing the range of motion of the thoracic and lumbar spine. Which of the following would the nurse document as an abnormal finding?

Hyperextension of 20 degrees

A client presents to the health care clinic with reports of pain in the hands and right wrist. Additional history reveals that the client is a factory worker who spends all day performing the same repetitive task. The nurse performs the Phalen's test and Tinel's tests with positive results. The hand grips are unequal with the right weaker than the left. What nursing diagnosis can the nurse confirm from this data?

Impaired Physical Mobility

When preparing an education session for a group of women who have been identified as postmenopausal, the nurse should include which teaching point?

Increase intake of vitamin D and calcium.

A client expresses to the nurse that he has a "giving in" or "locking" sensation in the knee. Which test should the nurse perform to elicit related findings of a possible tear in the meniscus of the client's knee?

McMurray's

A nurse notices that a client's flexibility of the right elbow is less than the left elbow. What is an appropriate action by the nurse in regard to this finding?

Measure movement with a goniometer

The nurse is planning a presentation on osteoporosis to a group of high school students. Which of the following should the nurse plan to include in the presentation?

Moderate strenuous exercise tends to increase bone density.

Loss of bone density that occurs with greatest frequency in postmenopausal women is called?

Osteoporosis

The nurse is testing a client for carpal tunnel syndrome. The client flexes the wrists at an angle of 90° and holds the backs of the hands to each other for 60 seconds. The client tells the nurse that he is experiencing a burning pain as a result. Which test is the nurse performing on this client?

Phalen's

The nurse is assessing a client's gait. Which finding would alert the nurse to the need for a referral for further evaluation?

Shuffling of feet

When assessing the elbow, a nurse asks a client to hold the arm out and turn the palm down. The nurse is testing which of the following?

Pronation

The nurse is planning the care of a 77-year-old woman who has recently been diagnosed with osteoporosis. What nursing diagnoses should the nurse address in the client's plan of care? Select all that apply.

Risk for injury related to osteoporosis Activity intolerance related to osteoporosis Impaired physical mobility related to osteoporosis

A high school football player injured his wrist in a game. He is tender between the two tendons at the base of the thumb. Which of the following should be considered?

Scaphoid fracture

A 32-year-old warehouse worker presents for evaluation of low back pain. He notes a sudden onset of pain after lifting a heavier-than-usual set of boxes. He also states that he has numbness and tingling in the left leg. What test should the nurse perform to assess for a herniated disc?

Straight leg raise test

The client is facing the nurse with his forearm turned so that his palm is up. What movement is the client exhibiting?

Supination

Mrs. Fletcher presents to the office with chronic unilateral pain when chewing. She does not have facial or scalp tenderness. Which of the following is the most likely cause of her pain?

Temporomandibular joint syndrome

The nurse is assessing a client with joint pain and is trying to decide whether it is inflammatory or non-inflammatory. Which of the following symptoms is consistent with an inflammatory process?

Tenderness

The nurse is assessing an older adult with new onset dementia. The nurse is using the Morse Fall Scale; the client's score is 63. What does this tell the nurse?

That the client is at high risk for falling

The nurse is conducting a musculoskeletal assessment of an older adult client. What aspect of the client's medical history requires the nurse to alter the usual sequence or content of this assessment?

The client had a total hip replacement 2 years ago.

After assessing the client for posture and body alignment, how would the nurse document head position in relation to the spine if alignment is normal with noticeable defect?

The head is midline and aligned with the spine

A nurse is inspecting a client's gait. Which of the following would indicate an abnormal finding?

Toes point out

The nurse is assessing a client's ability to shrug her shoulders against resistance. The nurse is assessing which cranial nerve?

XI

A client visits the clinic and tells the nurse that she has joint pain in her hands, especially in the morning. The nurse should assess the client further for signs and symptoms of

arthritis.

Articulation between the head of the femur and the acetabulum is in the

hip joint.

While sitting a client raises both legs while the nurse holds the lower legs below the knee. What does this finding indicate?

normal quadriceps muscle strength

A client is unable to externally rotate the left shoulder. What health problem should the nurse suspect is occurring with this client?

rotator cuff tear

The nurse is assessing the spine of an adult client and detects lateral curvature of the thoracic spine with an increase in convexity on the left curved side. The nurse suspects that the client is experiencing

scoliosis.

The subacromial bursae are contained in the

shoulder joint.