chp 22
In which of the following ethnic groups has the lowest incidence of osteoporosis? A) African Americans B) Whites C) Asians D) American Indians
A) African Americans
Bundles of muscle fibers that compose skeletal muscle are identified as: A) fasciculi. B) fasciculations. C) ligaments. D) tendons.
A) fasciculi.
The production of red blood cells in the bone marrow is called: A) hematopoiesis. B) hemolysis. C) hemoptysis. D) hemianopsia.
A) hematopoiesis.
Heberden and Bouchard nodes are hard and nontender and are associated with: A) osteoarthritis. B) rheumatoid arthritis. C) Dupuytren contracture. D) metacarpophalangeal bursitis.
A) osteoarthritis.
The musculoskeletal system functions include: A) protection and storage. B) movement and elimination. C) storage and control. D) propulsion and preservation.
A) protection and storage.
When assessing for the presence of a herniated nucleus pulposus, the examiner would: A) raise each of the patient's legs straight while keeping the knee extended. B) ask the patient to bend over and touch the floor while keeping the legs straight. C) instruct the patient to do a knee bend. D) abduct and adduct the patient's legs while keeping the knee extended.
A) raise each of the patient's legs straight while keeping the knee extended.
Crepitation is an audible sound that is produced by: A) roughened articular surfaces moving over each other. B) tendons or ligaments that slip over bones during motion. C) joints that are stretched when placed in hyperflexion or hyperextension. D) flexion and extension of an inflamed bursa.
A) roughened articular surfaces moving over each other.
When testing for muscle strength, the examiner should: A) observe muscles for the degree of contraction when the individual lifts a heavy object. B) apply an opposing force when the individual puts a joint in flexion or extension. C) measure the degree of force that it takes to overcome joint flexion or extension. D) estimate the degree of flexion and extension in each joint.
B) apply an opposing force when the individual puts a joint in flexion or extension.
The divisions of the spinal vertebrae include: A) Cervical, thoracic, scaphoid, sacral, and clavicular. B) Scapular, clavicular, lumbar, scaphoid, and fasciculi. C) Cervical, thoracic, lumbar, sacral, and coccygeal. D) Cervical, lumbar, iliac, synovial, and capsular.
C) Cervical, thoracic, lumbar, sacral, and coccygeal.
The knee joint is the articulation of three bones, the: A) femur, fibula, and patella. B) femur, radius, and olecranon process. C) fibula, tibia, and patella. D) femur, tibia, and patella.
D) femur, tibia, and patella.
A patient has been diagnosed with a ganglion cyst over the dorsum of his left wrist. He asks the nurse, "What is this thing?" The nurse's best answer would be, "It is: A) a common benign tumor." B) a tumor that will have to be watched because it may turn malignant." C) caused by chronic repetitive motion injury." D) a skin infection that will need to be drained."
a
A patient states, "I can hear a crunching or grating sound when I kneel." She also states that "it is very difficult to get out of bed in the morning because of stiffness and pain in my joints." The nurse should assess for signs of what problem? A) Crepitation B) A bone spur C) A loose tendon D) Fluid in the knee joint
a
A patient tells the nurse that she is having a hard time bringing her hand to her mouth when she eats or tries to brush her teeth. The nurse knows that for her to move her hand to her mouth, she must perform which movement? A) flexion. B) abduction. C) adduction. D) extension.
a
A woman who is 8 months pregnant comments that she has noticed a change in posture and is having lower back pain. The nurse tells her that during pregnancy women have a posture shift to compensate for the enlarging fetus. This shift in posture is known as: A) lordosis. B) scoliosis. C) ankylosis. D) kyphosis.
a
Of the 33 vertebrae in the spinal column, there are: A) 5 lumbar. B) 5 thoracic. C) 7 sacral. D) 12 cervical.
a
The ankle joint is the articulation of the tibia, the fibula, and the: A) talus. B) cuboid. C) calcaneus. D) cuneiform bones.
a
The functional units of the musculoskeletal system are the: A) joints. B) bones. C) muscles. D) tendons.
a
The nurse is checking the range of motion in a patient's knee and knows that the knee is capable of which movement(s)? A) Flexion and extension B) Supination and pronation C) Circumduction D) Inversion and eversion
a
The nurse is examining a 6-month-old infant and places the infant's feet flat on the table and flexes his knees up. The nurse notes that the right knee is significantly lower than the left. Which of these statements is true of this finding? A) This is a positive Allis sign and suggests hip dislocation. B) The infant probably has a dislocated patella on the right. C) This is a normal finding for the Allis test for an infant of this age. D) The infant should return to the clinic in 2 weeks to see if this has changed.
a
The nurse is teaching a class on osteoporosis prevention to a group of postmenopausal woman. A participant shows that she needs more instruction when she states, "I will: A) start swimming to increase my weight-bearing exercise." B) try to stop smoking as soon as possible." C) check with my doctor about taking calcium supplements." D) get a bone-density test soon."
a
The nurse is teaching a class on osteoporosis prevention to a group of postmenopausal women. Which of these actions is the best way to prevent or delay bone loss in this group? A) Taking calcium and vitamin D supplements B) Taking medications to prevent osteoporosis C) Performing physical activity, such as fast walking D) Assessing bone density annually
a
The nurse should use which test to check for large amounts of fluid around the patella? A) Ballottement B) Tinel sign C) Phalen's test D) McMurray's test
a
When performing a musculoskeletal assessment, the nurse knows that the correct approach for the examination should be: A) proximal to distal. B) distal to proximal. C) posterior to anterior. D) anterior to posterior.
a
The bulge sign is a test for: a. swelling in the suprapatellar pouch. b. carpal tunnel syndrome c. Herberden's nodes d. olecranon bursa inflammation.
a. swelling in the suprapatellar pouch.
Examination of the shoulder includes four motions. These are: a.forward flexion, internal rotation, abduction, and external rotation. b. abduction, adduction, pronation, and supination. c. circumduction, inversion, eversion, and rotation. d. elevation, retraction, protraction, and circumduction.
a.forward flexion, internal rotation, abduction, and external rotation.
A 40-year-old man has come into the clinic with complaints of "extreme tenderness in my toes." The nurse notices that his toes are slightly swollen, reddened, and warm to the touch. His complaints would suggest: A) osteoporosis. B) acute gout. C) ankylosing spondylitis. D) degenerative joint disease.
b
A patient has been diagnosed with osteoporosis and asks the nurse, "What is osteoporosis?" The nurse explains to the patient that osteoporosis is defined as: A) increased bone matrix. B) loss of bone density. C) new, weaker bone growth. D) increased phagocytic activity.
b
A patient is able to flex his right arm forward without difficulty or pain but is unable to abduct his arm because of pain and muscle spasms; the nurse should suspect: A) crepitation. B) rotator cuff lesions. C) dislocated shoulder. D) rheumatoid arthritis.
b
A patient tells the nurse that "all my life I've been called 'knock knees.'" The nurse knows that another term for "knock knees" is: A) genu varum. B) genu valgum. C) pes planus. D) metatarsus adductus.
b
A patient's annual physical examination reveals a lateral curvature of the thoracic and lumbar segments of his spine; however, this curvature disappears with forward bending. The nurse knows that this abnormality of the spine is called: A) structural scoliosis. B) functional scoliosis. C) herniated nucleus pulposus. D) dislocated hip.
b
A woman who has had rheumatoid arthritis for years is starting to notice that her fingers are drifting to the side. The nurse knows that this condition is commonly referred to as: A) radial drift. B) ulnar deviation. C) swan neck deformity. D) Dupuytren's contracture.
b
An 80-year-old woman is visiting the clinic for a checkup. She states, "I can't walk as much as I used to." The nurse is observing for motor dysfunction in her hip and should have her: A) internally rotate her hip while she is sitting. B) abduct her hip while she is lying on her back. C) adduct her hip while she is lying on her back. D) externally rotate her hip while she is standing.
b
An 85-year-old patient comments during his annual physical that he seems to be getting shorter as he ages. The nurse should explain that decreased height occurs with aging because: A) long bones tend to shorten with age. B) of the shortening of the vertebral column. C) there is a significant loss of subcutaneous fat. D) there is a thickening of the intervertebral disks.
b
An imaginary line connecting the highest point on each iliac crest would cross the _____ vertebra. A) first sacral B) fourth lumbar C) seventh cervical D) twelfth thoracic
b
During an interview the patient states, "I can feel this bump on the top of both of my shoulders—it doesn't hurt but I am curious about what it might be." The nurse should tell the patient, "That is: A) your subacromial bursa." B) your acromion process." C) your glenohumeral joint." D) the greater tubercle of your humerus."
b
The nurse is assessing a patient's ischial tuberosity. To palpate the ischial tuberosity, the nurse knows that it is best to have the patient: A) stand. B) flex the hip. C) flex the knee. D) in the supine position.
b
The nurse is examining the hip area of a patient and palpates a flat depression on the upper, lateral side of the thigh when the patient is standing. The nurse interprets this finding as the: A) ischial tuberosity. B) greater trochanter. C) iliac crest. D) gluteus maximus muscle.
b
A 2-year-old child has been brought to the clinic for a health examination. A common finding would be: a. kyphosis b. lordosis c. scoliosis d. no deviation is normal.
b. lordosis
Pronation and supination of the hand and forearm are the result of the articulation of the : a. scapula and clavicle b. radius and ulna c. patella and condyle of fibula d. femur and acetabulum
b. radius and ulna
A 14-year-old boy who has been diagnosed with Osgood-Schlatter disease reports painful swelling just below the knee for the past 5 months. Which response by the nurse is appropriate? A) "If these symptoms persist, you may need arthroscopic surgery." B) "You are experiencing degeneration of your knee, which may not resolve." C) "Your disease is due to repeated stress on the patellar tendon. It is usually self-limited, and your symptoms should resolve with rest." D) "Increasing your activity and performing knee-strengthening exercises will help to decrease the inflammation and maintain mobility in the knee."
c
A 68-year-old woman has come in for an assessment of her rheumatoid arthritis, and the nurse notices raised, firm, nontender nodules at the olecranon bursa and along the ulna. These nodules are most commonly diagnosed as: A) epicondylitis. B) gouty arthritis. C) olecranon bursitis. D) subcutaneous nodules.
c
A mother brings her newborn baby boy in for a checkup; she tells the nurse that he doesn't seem to be moving his right arm as much as his left and that he seems to have pain when she lifts him up under the arms. The nurse suspects a fractured clavicle and would observe for: A) a negative Allis test. B) a positive Ortolani's sign. C) limited range of motion during the Moro's reflex. D) limited range of motion during Lasègue's test
c
A patient is being assessed for range of joint movement. The nurse asks him to move his arm in toward the center of his body. This movement is called: A) flexion. B) abduction. C) adduction. D) extension.
c
A patient is complaining of pain in his joints that is worse in the morning, is better after he has moved around for awhile, and then gets worse again if he sits for long periods of time. The nurse should assess for other signs of what problem? A) Tendinitis B) Osteoarthritis C) Rheumatoid arthritis D) Intermittent claudication
c
A patient is visiting the clinic for an evaluation of a swollen, painful knuckle. The nurse notices that the knuckle above his ring on the left hand is swollen and that he is unable to remove his wedding ring. This joint is called the _____ joint. A) interphalangeal B) tarsometatarsal C) metacarpophalangeal D) tibiotalar
c
A patient who has had rheumatoid arthritis for years comes to the clinic to ask about changes in her fingers. The nurse will assess for signs of what problems? A) Heberden's nodes B) Bouchard's nodules C) Swan neck deformities D) Dupuytren's contractures
c
A teenage girl has arrived complaining of pain in her left wrist. She was playing basketball when she fell and landed on her left hand. The nurse examines her hand and would expect a fracture if the girl complains: A) of a dull ache. B) that the pain in her wrist is deep. C) of sharp pain that increases with movement. D) of dull throbbing pain that increases with rest.
c
During a neonatal examination, the nurse notices that the newborn infant has six toes. This finding is documented as: A) unidactyly. B) syndactyly. C) polydactyly. D) multidactyly.
c
During an examination, the nurse asks a patient to bend forward from the waist and notices that the patient has lateral tilting. When his leg is raised straight up, he complains of a pain going down his buttock into his leg. The nurse suspects: A) scoliosis. B) meniscus tear. C) herniated nucleus pulposus. D) spasm of paravertebral muscles.
c
The articulation of the mandible and the temporal bone is known as the: A) intervertebral foramen. B) condyle of the mandible. C) temporomandibular joint. D) zygomatic arch of the temporal bone.
c
The nurse is assessing a 1-week-old infant and is testing his muscle strength. The nurse lifts the infant with hands under the axillae and notices that the infant starts to "slip" between the hands. The nurse should: A) suspect a fractured clavicle. B) suspect that the infant may have a deformity of the spine. C) suspect that the infant may have weakness of the shoulder muscles. D) consider this a normal finding because the musculature of an infant this age is undeveloped.
c
The nurse is explaining the mechanism of the growth of long bones to a mother of a toddler. Where does lengthening of the bones occur? A) Bursa B) Calcaneus C) Epiphyses D) Tuberosities
c
The nurse suspects that a patient has carpal tunnel syndrome and wants to perform the Phalen's test. To perform this test, the nurse should instruct the patient to: A) dorsiflex the foot. B) plantarflex the foot. C) hold both hands back to back while flexing the wrists 90 degrees for 60 seconds. D) hyperextend the wrists with the palmar surface of both hands touching and wait for 60 seconds.
c
To palpate the temporomandibular joint, the nurse's fingers should be placed in the depression _____ of the ear. A) distal to the helix B) proximal to the helix C) anterior to the tragus D) posterior to the tragus
c
A 70-year-old woman has come for a health examination. Which of the following is a common age-related change in the curvature of the spinal column? a. lordosis b. scoliosis c. kyphosis d. lateral scoliosis
c. kyphosis
The examiner is going to measure the patient's legs for discrepancy. The normal finding would be: a. no difference in measurements. b. 0.5 cm difference. c. within 1 cm of each other. d. 2 cm difference.
c. within 1 cm of each other.
A man who has had gout for several years comes to the clinic with a problem with his toe. On examination, the nurse notices the presence of hard, painless nodules over the great toe; one has burst open with a chalky discharge. This finding is known as: A) a callus. B) a plantar wart. C) a bunion. D) tophi.
d
A professional tennis player comes into the clinic complaining of a sore elbow. The nurse will assess for tenderness at the: A) olecranon bursa. B) annular ligament. C) base of the radius. D) medial and lateral epicondyle.
d
A young swimmer comes to the sports clinic complaining of a very sore shoulder. He was running at the pool, slipped on some wet concrete, and tried to catch himself with his outstretched hand. He landed on his outstretched hand and has not been able to move his shoulder since then. The nurse suspects: A) joint effusion. B) tear of rotator cuff. C) adhesive capsulitis. D) dislocated shoulder.
d
Fibrous bands running directly from one bone to another that strengthen the joint and help prevent movement in undesirable directions are called: A) bursa. B) tendons. C) cartilage. D) ligaments.
d
The nurse has completed the musculoskeletal examination of a patient's knee and has found a positive bulge sign. The nurse interprets this finding to indicate: A) irregular bony margins. B) soft tissue swelling in the joint. C) swelling from fluid in the epicondyle. D) swelling from fluid in the suprapatellar pouch.
d
The nurse is examining a 2-month-old infant and notices asymmetry of the infant's gluteal folds. The nurse should assess for other signs of what disorder? A) Fractured clavicle B) Down syndrome C) Spina bifida D) Hip dislocation
d
The nurse is examining a 3-month-old infant. While holding the thumbs on the infant's inner mid thighs and the fingers outside on the hips, touching the greater trochanter, the nurse adducts the legs until the nurse's thumbs touch and then abducts the legs until the infant's knees touch the table. The nurse does not notice any "clunking" sounds and is confident to record a: A) positive Allis test. B) negative Allis test. C) positive Ortolani's sign. D) negative Ortolani's sign.
d
The nurse is explaining to a patient that there are "shock absorbers" in his back to cushion the spine and to help it move. The nurse is referring to his: A) vertebral column. B) nucleus pulposus. C) vertebral foramen. D) intervertebral disks.
d
The nurse is providing patient education for a man who has been diagnosed with a rotator cuff injury. The nurse knows that a rotator cuff injury involves the: A) nucleus pulposus. B) articular process. C) medial epicondyle. D) glenohumeral joint.
d
The nurse notices that a woman in an exercise class is unable to jump rope. The nurse knows that to jump rope, one's shoulder has to be capable of: A) inversion. B) supination. C) protraction. D) circumduction.
d
When assessing muscle strength, the nurse observes that a patient has complete range of motion against gravity with full resistance. What Grade should the nurse record using a 0 to 5 point scale? A) 2 B) 3 C) 4 D) 5
d
When reviewing the musculoskeletal system, the nurse recalls that hematopoiesis takes place in the: A) liver. B) spleen. C) kidneys. D) bone marrow.
d
Anterior and posterior stability is provided to the knee joint by the: a. medial and lateral menisci. b. patellar tendon and ligament c. medial collateral ligament and quadriceps muscle. d. anterior and posterior cruciate ligaments
d. anterior and posterior cruciate ligaments
During an assessment of the spin, the patient would be asked to: a. abduct and extend. b. supinate, evert, and retract. c. extend, adduct, invert, and rotate. d. flex, extend, abduct, and rotate.
d. flex, extend, abduct, and rotate.
The timing of joint pain may assist the examiner in determining the cause. The joint pain associated with rheumatic fever would: a. be worse in the morning b. be worse later in the day c. be worse in the moring but improve later in the day. d.occur 10-14 days after an untreated sore throat.
d.occur 10-14 days after an untreated sore throat
