Musculoskeletal adaptive quizzing

which statement by the nurse is an appropriate response to an older adult patient who states " i am frustrated by my flabby belly and rigid hips"

- "decrease muscle mass and strength and increased hip rigdity are normal changes of aging."

which patient statement about a bone scan for osteomyelitis indicates a need for further teaching?

- before the test, i should refrain from voiding

long term use of which medications increase a patients risk of developing a musculoskeletal ailment?

- corticosteroids -antiseeizure medications - postassium-depleting diuretics - hormone therapy for postmenopausal women

which question will the nurse include when assessing the health history of a patient with bachache?

- did you lift a heavy objectt? -describe your usual daily activities - do you find it difficult to perform your daily activites?

related to sleep-rest patterns, the nurse will ask the patient with severe lumbar back pain as part of the musculoskeletal system health history assessment?

- do you wake up at night because of pain? -do you require frequent postion changes at night? - do you use complementary and alternative thereapies to help you sleep at night? - do you experience any difficulty sleeping because of musculoskeletal problem?

what questions will the nurse ask when assessing health history of a patient with severe back pain in the lumbar region?

- does your work involve lifting any heavy objects? - has this pain affected your social or professional life? - fo you confusume any dietary supplements like calcium or vitamin D - do you require frequent change of position while you are sleeping because of the pain?

which interventions will the nurse include to prepare a patient for a CT scan of the knee joint?

- inform the patient of the importance of remaining still during the procedure. - if a contrast medium is being used, verify that patient does not have shellfish allergy

how will the nurse best assess the range of motion(ROM) in the affected leg of an older adult whose mobility has been decreasing progressively?

- observe the patient's unassisted ROM in thw affected leg

which techniques will the nurse use to assess a patient who presents with severe shoulder pain?

- palpation -inspection -obtain health history

Which intervention will the nurse include for a patient undergoing an MRI scan? a. Teach about the use of antihistamines to improve sleep. b. Suggest that the patient exercise regularly during the day. c. Make a referral to a massage therapist for deep massage of the legs. d. Assure the patient that the problem is transient and likely to resolve.

- turn on music

fluid aspirated during an arthrocentesis procedure for a patient with gout may have which characteristics?

- whitish-yellow color - presence of uric acid crystals

which patient statement indicates that he or she may be at risk for developing musculoskeletal problems?

-" i only exercise once in a while."

an older adult may experience which musculoskeletal system changes?

-earlier fatigue with activity - decrease basal metabolic rate -increase risk for cartilage erosion

which assessment finding are common symptoms of musculoskeletal impairment?

-stiffness -weakness - joint crepitation

Which intervention will the nurse include when preparing a patient for a MRI procedure? Select all that apply.a. offer ear plugs or musicb. inform the patient to remain still throughout the procedurec. ensure that patient is not wearing metal such as zippers or jewelryd. ensure that the patient is shaved completely, and also catheterize the patiente. explain that the machine will make loud tapping noises intermittently, and there is no cause for alarm

a, b, c, e The nurse should inform the patient that the procedure is painless. Offer ear plugs or music to listen to so that the patient will be relaxed during the procedure. The patient should have no metal on the clothing. Explain to the patient that the machine will make loud tapping noises intermittently, and there is no cause for alarm. Inform patients who are claustrophobic that they may experience symptoms during examination. Administer an antianxiety agent if indicated and ordered

Which statements by the student nurse indicate understanding of an arthroscopy study? Select all that apply.a. "The procedure will be performed under anesthesia"b. "Fluid from the joints will be aspirated during this procedure"c. " This procedure allows visualization of the interior portion of the joint capsule"d. "In case of inflammatory joint diseases, intraarticular injections of corticosteroids may be given"e. "A needle is inserted in the joint, it is distended with fluid or air, and the joint cavity is examined"

a. "the procedure will be performed under anesthesia"c. "this procedure allows for visualization of the interior portion of the joint capsule"e. "a needle is inserted in the joint, it is distended with fluid or air, and the joint cavity is examined"

Which medication therapy may be prescribed for a patient whose synovial fluid aspirated during an arthrocentesis is a whitish-yellow color and who has uric acid crystals?a. antigout medicationsb. anti-diabetic medicationsc. Lactated Ringer's solutiond. IV calcium supplements

a. antigout medications Presence of whitish-yellow synovial fluid with uric acid crystals in the synovial fluid indicates that the patient has gout; therefore, administering antigout medication will be the most beneficial for the patient. Lactated Ringer's solution helps maintain fluid and electrolyte balance but does not reduce symptoms of gout. IV calcium supplements prevent osteoporosis but do not alleviate symptoms of gout.

A patient with a lateral S-shaped curvature of the thoracic and lumbar spine may also have which clinical manifestation?a. asymmetric shouldersb. cross-knee movementc. fingers drift to ulnar side of forearmsd. abnormal flatness of the sole of the foot

a. asymmetric shouldersPresence of a lateral S-shaped curvature of the thoracic and lumbar spine indicates that the patient has scoliosis. Due to lateral spine curvature, the patient's shoulders rise asymmetrically; therefore the nurse would find asymmetric shoulders in the patient.

A middle-aged patient who complains of a sore shoulder after raking the yard may be suffering from which condition?a. bursitisb. fasciitisc. sprained ligamentd. achilles tendonitis

a. bursitisBursitis is common in adults over age 40 and with repetitive motion, such as raking.

The nurse may note which finding when assessing a fracture of a patient's hand as the bone fragments rub against each other?a. crepitationb. resorptionc. subluxationd. proliferation

a. crepitation Crepitation is the grating sensation and sound produced when broken bone fragments rub against one another.

Which questions about elimination patterns are important for the nurse to ask as part of a musculoskeletal system health history assessment? Select all that apply? a. do you experience constipation? b. does you functional ability make it difficult for you to reach the toilet in time? c. do you need any assistive devices or equipment to achieve a bowel movement? d. how many times in a day do you have to have a bowel movement? e. do you find that problems related to moving your bowels occur after eating a particular food?

a. do you experience constipation? b. does you functional ability make it difficult for you to reach the toilet in time? c. do you need any assistive devices or equipment to achieve a bowel movement?

Which term refers to the turning of the sole of the foot outward away from the midline of the body? a. eversionb. extensionc. abductiond. dorsiflexion

a. eversion Eversion is the turning of the sole outward away from the midline of the body.

Which joints are diarthrodial joints? Select all that apply.a. hinge joint of the kneeb. ligaments joining the vertebraec. fibrous connective tissue of the skulld. ball and socket joint of the shoulder or hipe. cartilaginous connective tissue of the pubis joint

a. hinge joint of the knee b. ball and socket joint of the shoulder or hip The diarthrodial (synovial) joints include the hinge joints of the knee and elbow, the ball and socket joints of the shoulder and hip, the pivot joint of the radioulnar joint, and the condyloid, saddle, and gliding joints of the wrist and hand.

Which nursing interventions are appropriate for a patient who is scheduled for a technetium [Tc]-99m bone scan? Select all that apply.a. increase fluid intake after examinationb. ensure that patient's bladder is emptied before scanc. explain to the patient that blood sample will be obtained in the testd. explain to the patient that raioisotope is given two hours before the proceduree. explain to the patient that it will be painless because general anesthesia will be administered

a. increase fluid intake after examination b. ensure that patient's bladder is emptied before scan d. explain to the patient that raioisotope is given two hours before the procedure

Which information will the nurse include when teaching a patient who is anxious about undergoing an athrocentesis? Select all that apply.a. local anesthetic and aseptic preparation are usedb. this procedure can be performed at the bedside or in an examination roomc. this procedure can be performed at the bedside or in an examination roomd. this procedure is performed to visualize and examine interior of the joint cavitye. there are serious complications, such as respiratory distress, related to the proceduref. this procedure is performed to obtain samples of synovial fluid or to remove excess fluid from the joint cavity

a. local anesthetic and aseptic preparation are usedb. this procedure can be performed at the bedside or in an examination roomf. this procedure is performed to obtain samples of synovial fluid or to remove excess fluid from the joint cavity

Which method will the nurse use to measure the left leg of a patient who complains of severe pain in the left lower extremity, who has difficulty ambulating, and whose left leg appears to be slightly shorter than the right? Select all that apply.a. measure the muscle mass circumferentially at the largest areab. measure the muscle mass circumferentially at the smallest areac. measure the length and circumferences at the same points of opposite limbd. measure the length of the extremity from the anterior superior iliac spine to the toee. measure the length of the extremity from the anterior superior iliac spin to the medial malleolus

a. measure the muscle mass circumferentially at the largest areac. measure the length and circumferences at the same points of opposite limbe. measure the length of the extremity from the anterior superior iliac spin to the medial malleolus

Which musculoskeletal assessment findings are normal? Select all that apply.a. muscle strength 5/5b. no spinal curvaturec. no muscle atrophy or asymmetryd. no joint swelling, deformity, or crepitatione. full range of motion of all joints without pain or laxityf. no tenderness on palpation of spine, joints, or muscles

a. muscle strength 5/5b. b. no muscle atrophy or asymmetry C. no joint swelling, deformity, or crepitatione. D. full range of motion of all joints without pain or laxityf. E. no tenderness on palpation of spine, joints, or muscles

Festinating gait may present with which signs and symptoms while the patient is ambulating? Select all that apply.a. speed may increase as if patient is unable to stopb. patient displays delayed start with short, quick, shuffling stepsc. the patient is unable to walk for more than two steps at a timed. the patient is unable to walk in a straight line and walks diagonallye. while walking, the neck, trunk and knees flex while the body is rigid

a. speed may increase as if patient is unable to stopb. patient displays delayed start with short, quick, shuffling stepse. while walking, the neck, trunk and knees flex while the body is rigid

Which diagnostic test does the nurse expect will be prescribed for a patient with a history of falls who is suspected of having a fracture in the radius of the right hand?a. x-rayb. diskogramc. CT scand. MRI

a. x-ray X-ray is the preliminary diagnostic test for diagnosing fractures.

An electromyogram may need to be rescheduled based on which patient statement upon their arrival for the procedure?a. "I drank apple juice last night"b. "I drank 2 cups of coffee this morning"c. "I have been taking antibiotics for one week"d. "I have had knee pain since early this morning"

b. "I drank 2 cups of coffee this morning"An electromyagram helps record electrical activity of the muscles. The nurse should advise the patient to refrain from taking stimulants such as caffeine for 24 hours before the test. If the patient drinks two cups of coffee on the day of the scheduled test, it may alter the results. The nurse should alert the primary care provider of the finding so the test can be rescheduled for more accurate results.

Which statements by the student nurse indicate understanding of a straight-leg-raising test? Select all that apply.a. "patient should lie prone for the test"b. "the nerve root at the level of L4-5 or L5-S1 may be involved"c. "the patient is instructed to actively raise his or her legs to 60 degrees"d. "the test is positive if the patient complains of pain along the distribution of the sciatic nerve"e. "a positive test indicates nerve root irritations from intervertebral disc prolapse and herniation"

b. "the nerve root at the level of L4-5 or L5-S1 may be involved"d. "the test is positive if the patient complains of pain along the distribution of the sciatic nerve"e. "a positive test indicates nerve root irritations from intervertebral disc prolapse and herniation"

Which types of movements are possible at the shoulder joint? Select all that apply.a. inversionb. adductionc. abducctiond. oppositione. circumduction

b. adduction c. abduction e. circumduction The shoulder is considered a ball and socket, or spheroidal type of synovial joint. Movements of this type of joint include flexion, extension, adduction, abduction, and circumduction.

Which term will the nurse use to describe fixation of the knee joint of a patient with a long-standing history of rheumatoid arthritis?a. atrophyb. ankylosisc. crepitationd. contracture

b. ankylosisAnkylosis is stiffness or fixation of a joint, often caused by chronic joint inflammation, and destruction and may be associated with rheumatoid arthritis.

Which diagnostic study uses radioisotope to detect increased metastatic activity in a patient with cancer?a. MRIb. bone scanc. ultrasoundd. barium swallow

b. bone scanOf the choices listed, only bone scan involves the use of a radioisotope to detect increased metastatic activity.

Which pathological condition may have caused knee pain while a patient is walking and inflammation of the knee joint?a. tetanyb. bursitisc. lordosisd. scoliosis

b. bursitits Bursae are small saclike connective tissues that line the synovial membrane and produce synovial fluid. Inflammation of the bursae increases the production of synovial fluid and results in the swelling of the joint. The swelling causes joint stiffness and pain while walking, so based on the patient's symptoms, the nurse would suspect bursitis.

An electromyogram (EMG) is used to test which musculoskeletal function?a. evaluates potential of muscle contractionsb. evaluates electrical potential related to skeletal muscle contractionc. records variations in volume and pressure of blood passing through tissuesd. evaluates bone mineral density, elasticity and strength of bone using ultrasound

b. evaluates electrical potential related to skeletal muscle contraction An EMG evaluates electrical potential related to skeletal muscle contraction.

Which instruction will the nurse give the patient to assess abduction of the elbow joint?a. move your elbow toward the midline of your bodyb. move your elbow away from the midline of your bodyc. bend your elbow to decrease the angle between two bonesd. straighten your elbow to increase the angle between two bones

b. move your elbow away from the midline of your body The nurse should instruct the patient to move the elbow away from the midline of the body.

How are bone cells involved in bone remodeling?a. osteoclasts add canaliculib. osteoblasts deposit new bonec. osteocytes are mature bone cellsd. osteons create a dense bone structure

b. osteoblasts deposit new bone Bone remodeling is achieved when osteoclasts remove old bone and osteoblasts deposit new bone

Which methods will the nurse include when performing palpation of the knee of a patient suffering from extreme pain and weakness in this joint? Select all that apply.a. palpate only the affected regionb. palpate the muscles and jointsc. rub hands together before palpatingd. palpate from above to below (cephalopedal direction)e. do not palpate the knee region because it will cause discomfort for the patient

b. palpate the muscles and jointsc. rub hands together before palpatingd. palpate from above to below (cephalopedal direction)

Which illnesses are known to affect the musculoskeletal system? Select all that apply.a. pancreatitisb. poliomyelitisc. diverticulitisd. tuberculosise. diabetes mellitus

b. poliomyelitis d. tuberculosis e. diabetes mellitus A past medical history of tuberculosis, poliomyelitis, and diabetes mellitus can either directly or indirectly affect a person's musculoskeletal system.

Which term is used to describe enlargement of a joint due to fluid collection, which usually leads to pain and stiffness? a. myalgiab. swellingc. paresthesiad. subluxation

b. swelling Swelling is the term to describe enlargement, often of a joint due to fluid collection. This usually leads to pain and/or stiffness and is caused by trauma or inflammation.

Which teaching will the nurse include when preparing a patient for a somatosensory evoked potential (SSEP) test? Select all that apply.a. this test analyzes and determines the strength of the bonesb. the procedure is similar to EMG but does not involve needlesc. transcutaneous or percutaneous electrodes are applied to the skind. the test measures nerve conduction along the pathways not accessible by electromyogram (EMG)e. the electrodes are pierced in the superficial layer on the skin under anesthesia, so it is not painful

b. the procedure is similar to EMG but does not involve needles c. transcutaneous or percutaneous electrodes are applied to the skin d. the test measures nerve conduction along the pathways not accessible by electromyogram (EMG)

Which information will the nurse include when teaching a patient about electromyography test? Select all that apply.a. this test can be carried out at the bedsideb. there may be some discomfort because of the needlesc. small-gauge needles are inserted into certain musclesd. there may be severe bleeding and pain, and local anesthesia may be givene. it is useful in identifying any lower motor neuron dysfunction or primary muscle diseases

b. there may be some discomfort because of the needlesc. small-gauge needles are inserted into certain musclese. it is useful in identifying any lower motor neuron dysfunction or primary muscle diseases

Which instruction will the nurse give to the patient to assess inversion movement of the foot?a. flex your ankle and toes toward the shinb. turn the sole inward toward the midline of the bodyc. turn the sole outward away from the midline of the bodyd. flex your ankle and toes toward the plantar surface of the foot

b. turn the sole inward toward the midline of the body To perform inversion movements of the foot, the nurse should instruct the patient to turn the sole inward toward the midline of the body.

Which questions about dietary behavior are important for the nurse to ask as part of a musculoskeletal system health history assessment? Select all that apply.a. do you like to eat out?b. what is your usual daily intake of food?c. do you have difficulties preparing food?d. do you consume any calcium or vitamin D supplements?e. do you face any digestive problem after the consumption of specific food?

b. what is your usual daily intake of food? c. do you have difficulties preparing food? d. do you consume any calcium or vitamin D supplements?

What time will the nurse plan to send a patient for a bone scan if the radioisotope was given at 9:00AM?a. 9:30pmb. 10:00amc. 11:00amd. 1:00pm

c. 11:00AMA technician usually administers a calculated dose of radioisotopes 2 hours before a bone scan. If patient was injected at 9AM then the procedure should be done at 11AM.

An arthroscopy may be ordered to identify which condition?a. fracture of the boneb. the risk of osteoporosisc. articular cartilage abnormalityd. peripheral vasculature potency

c. articular cartilage abnormality An arthroscopy involves insertion of an arthroscope into a joint to see the interior of the joint cavity. This can be used for surgery, repair of joint structures, and diagnosis of abnormalities of meniscus, articular cartilage, ligaments, or joint capsules.

Which joint is a gliding joint?a. wristb. shoulderc. between carpal bonesd. carpometacarpal of thumb

c. between the carpal bones The joint between carpal bones is a gliding joint because the bones move over the surface of each other.

Which questions will the nurse include when assessing the health perception-health management pattern of a patient who presents with pain in the wrist joint radiating up the entire arm? Select all that apply.a. do you have problems preparing your food?b. do you wake up at night because of musculoskeletal pain?c. do you have any problems performing your usual daily activities?d. do you need any assistive devices or equipment to manage toiletries?e. do your work or exercise habits require repetitive motion or joint stress?

c. do you have any problems performing your usual daily activities? e. do your work or exercise habits require repetitive motion or joint stress

What instrument will the nurse use to assess range of motion?a. spirometerb. arthroscopec. goniometerd. funduscope

c. goniometer Range of motion is most accurately assessed with a goniometer, which measures the angle of the joint.

Which body parts are made up of smooth muscle? (Select all that apply) a. legsb. heartc. uterusd. arteriese. urinary bladder

c. uterus, d. arteries, e. urinary bladder

Active movement against gravity and some resistance is considered which muscle strength grade?a. 1/5b. 2/5c. 3/5d. 4/5

d. 4/5 A score of 4/5 means active movement against gravity with some resistance.

Which question related to the sexuality-reproductive pattern is important to ask a patient suffering from severe knee pain?a. what are your sexual preferences?b. how many sexual partners do you have?c. which method of contraception do you use?d. do you face any sexual concerns regarding your mobility?

d. do you face any sexual concerns regarding your mobility?In a patient suffering from knee pain, few questions related to sexual pattern should be asked. Knowing whether the person experiences any sexual concerns due to knee pain gives and indication of the severity of the complaint. The patient's sexual preferences, number of partners, and method of contraception are important in assessing a patient for sexually transmitted infections but not for musculoskeletal system.

Which information will the nurse include when teaching a patient about a bone scan procedure?a. 2 additional follow-up scans will be requiredb. there will be only mild pain associated with the procedurec. the procedure takes approximately 15 to 30 min to completed. it is important to drink increased fluids after t

d. it is important to drink increased fluids after the procedurePatients are asked to drink increased fluids after a bone scan to aid in excretion of the radioisotope, if not contraindicated by another condition. No follow-up scans and no pain are associated with bone scans, which take 1 hour of lying supine.

Which intervention may be included for a patient with musculoskeletal issues who complains of fatigue and difficulty sleeping?a. leave the door open at nightb. leave the room light on at nightc. keep the patient up during the dayd. provide pillows and blankets for comfort

d. provide pillows and blankets for comfort The nurse can promote rest by providing pillows and blankets for comfort and closing the doors to reduce noise at night. The nurse should also turn the light off at night. The patient can benefit from a nap during the day to reduce feelings of tiredness

Which condition may present with increased flexion in the hip and knee to clear the foot from the floor and footdrop? a. pes planusb. spastic gaitc. short-leg gaitd. steppage gait

d. steppage gait Steppage gait is a neurogenic disorder associated with increased hip and knee flexion to clear the foot from the floor, along with foot drop. The patient's foot may slap down and along the walking surface.