Quiz 3 - Musculoskeletal Conditions

Although skin manifestations may occur in numerous locations, the classic presentation of systemic lupus erythematosus (SLE) includes (a) a butterfly pattern rash on the face across the bridge of the nose (b) dry, scaly patches in the antecubital area and behind the knees. (c) cracked, scaly areas in the webs of fingers. (d) lesions affecting the palms of hands and the soles of feet.

(a) a butterfly pattern rash on the face across the bridge of the nose.

The complication which is not likely to result from a compound, transverse fracture of the tibia and fibula is (a) air embolus (b) bone infection (c) fat emboli (d) compartment syndrome

(a) air embolus

People who have osteoporosis are at risk for (a) bone fractures (b) osteomalacia (c) osteomyelitis (d) rhabdomyolysis

(a) bone fractures

A fracture in which bone breaks into two or more fragments is referred to as (a) comminuted (b) open (c) stress (d) greenstick

(a) comminuted

The pathophysiology rheumatoid arthritis involves (a) immune cells accumulating in pannus and destroying articular cartilage. (b) free radicals attaching to the synovial membrane and tunneling into articular cartilage. (c) cysts developing in subchondral bone and creating fissures in articular cartilage. (d) excessive wear and tear and microtrauma that damage articular cartilage.

(a) immune cells accumulating in pannus and destroying articular cartilage.

Ankylosing spondylitis is characterized by (a) inflammation, stiffness, and fusion of spinal joints. (b) loss of articular cartilage in weight-bearing joints. (c) immune mechanisms leading to widespread joint inflammation. (d) excessive bone remodeling leading to soft bone

(a) inflammation, stiffness, and fusion of spinal joints.

During assessment of a patient with osteoarthritis pain, the nurse knows that which condition is a contraindication to the use of nonsteroidal anti-inflammatory drugs (NSAIDs)? (a) renal disease (b) rheumatoid arthritis (c) headaches (d) diabetes mellitus

(a) renal disease

Osteoclast activity leads to (a) resorption of bone (b) arthritis (c) deposition of bone (d) hardening of the bones

(a) resorption of bone

A unique characteristic feature of fibromyalgia is the presence of (a) tender point pain (b) head pain (c) contractures (d) muscle atrophy

(a) tender point pain

The nurse is reviewing the therapeutic effects of nonsteroidal anti-inflammatory drugs (NSAIDs), which include which effect? (a) antimicrobial (b) antipyretic (c) sedative (d) anxiolytic

(b) antipyretic

CASE STUDY: Julio is 10 years old and came to the urgent care center after falling from his bicycle. An x-ray reveals an oblique fracture of the radius. Julio is otherwise healthy, normal in his growth and development, and has no known allergies. What type of fracture generally occurs in children? (a) colles (b) greenstick (c) nightstick (d) stress

(b) greenstick

The correct sequence of bone healing following fracture is (a) hematoma formation, callous formation, fibrocartilage formation, remodeling, ossification. (b) hematoma formation, fibrocartilage formation, callous formation, ossification, remodeling. (c) hematoma formation, callous formation, fibrocartilage formation, ossification, remodeling. (d) callous formation, hematoma formation, fibrocartilage formation, ossification, remodeling.

(b) hematoma formation, fibrocartilage formation, callous formation, ossification, remodeling.

Is it true that scleroderma involves (a) autoantibodies against acetylcholine receptors. (b) inflammation and fibrosis of connective tissue. (c) inflammation caused by antigenic fragments of dead organisms. (d) infection by beta-hemolytic streptococcus.

(b) inflammation and fibrosis of connective tissue.

Which disorder usually causes skeletal pain and involves significant bone demineralization from vitamin D deficiency? (a) osteoporosis (b) osteomalacia (c) osteomyelitis (d) osteopenia

(b) osteomalacia

Osteomalacia (Rickets in children) is characterized by soft, weak bones resulting from a deficiency of (a) calcium (b) vitamin D (c) estrogen (d) phosphate

(b) vitamin D

CASE STUDY: Julio is 10 years old and came to the urgent care center after falling from his bicycle. An x-ray reveals an oblique fracture of the radius. Julio is otherwise healthy, normal in his growth and development, and has no known allergies. Julio's father asks the nurse if he should use aspirin to reduce the pain in Julio's arm. What is the best response by the nurse? (a) "You can use the aspirin, but watch for worsening symptoms." (b) "It's best to wait to see if the pain gets worse." (c) "Ibuprophen (Advil) should be used to reduce pain, not aspirin." "You can use aspirin, but be sure to follow the instructions on the bottle."

(c) "Ibuprophen (Advil) should be used to reduce pain, not aspirin."

CASE STUDY: Julio is 10 years old and came to the urgent care center after falling from his bicycle. An x-ray reveals an oblique fracture of the radius. Julio is otherwise healthy, normal in his growth and development, and has no known allergies. Juilo's fractured arm is immobilized with a full length cast. With a new cast and possible continued swelling from the injury, Julio will be monitored for development of compartment syndrome. Signs or sympotoms of compartment syndrome include all of the following (a) the hand and fingers are cool to touch (b) decreased sensation of the hand or fingers (c) a capillary refill time of less than 2 seconds (d) decreased movement of the hand and/or fingers

(c) a capillary refill time of less than 2 seconds

The electrolyte that must be present in cellular cytoplasm for muscle contraction to occur is (a) sodium (b) magnesium (c) calcium (d) potassium

(c) calcium

Gouty arthritis is a complication of (a) excessive production of urea (b) group A streptococcal infection (c) inadequate renal excretion of uric acid (d) autoimmune destruction of joint collagen

(c) inadequate renal excretion of uric acid

CASE STUDY: Julio is 10 years old and came to the urgent care center after falling from his bicycle. An x-ray reveals an oblique fracture of the radius. Julio is otherwise healthy, normal in his growth and development, and has no known allergies. Assessment of Julio's arm six hours after surgical alignment and casting demonstrates pulselessness and pallor. The priority action to take is to (a) elevated the extremity to relieve swelling (b) note the increase in pain in his chart, and recheck the extremity in 30 minutes (c) initiate action to have the cast split or removed (d) increase the administration his pain medication

(c) initiate action to have the cast split or removed

A clinical finding consistent with a diagnosis of rheumatoid arthritis would be (a) reduced excretion of uric acid by the kidney (b) localized pain in weight-bearing joints (c) systemic manifestations of inflammation (d) firm, crystallized nodules or "top" at the affected joints

(c) systemic manifestations of inflammation

The structures that connect muscle to bone are referred to as (a) synovial sheaths (b) trabeculae (c) tendons (d) ligaments

(c) tendons

CASE STUDY: Julio is 10 years old and came to the urgent care center after falling from his bicycle. An x-ray reveals an oblique fracture of the radius. Julio is otherwise healthy, normal in his growth and development, and has no known allergies. Julio's father asks "how can you tell when the fracture has completely healed?" Complete healing of a bone fracture occurs when (a) the fracture site and surrounding soft tissue are pain free. (b) a cast is no longer required to stabilize the break (c) the callus has been completely replaced with mature bone. (d) no movement of the break is detectable.

(c) the callus has been completely replaced with mature bone.

Rheumatoid arthritis is commonly associated with the presence of rheumatoid factor autoantibodies in the bloodstream. This indicates that rheumatoid arthritis is likely to be (a) an infective process (b) because of an enzymatic defect (c) caused by bacterial infection (d) an autoimmune process

(d) an autoimmune process

Rheumatoid arthritis involves joint inflammation caused by (a) trauma (b) congenital hypermobility (c) bacterial infection (d) autoimmune injury

(d) autoimmune injury

CASE STUDY: Julio is 10 years old and came to the urgent care center after falling from his bicycle. An x-ray reveals an oblique fracture of the radius. Julio is otherwise healthy, normal in his growth and development, and has no known allergies. Following a bone fracture, the most likely event to occur is (a) leukocyte infiltration into bone tissue (b) blood vessel growth at the fracture site (c) migration of osteoblasts to the fracture site (d) development of a blood clot beneath the periosteum

(d) development of a blood clot beneath the periosteum

The nurse notes in a patient's medication history that the patient is taking allopurinol (Zyloprim). Based on this finding, the nurse interprets that the patient has which disorder? (a) rheumatoid arthritis (b) osteoarthritis (c) systemic lupus erythematosus (d) gout

(d) gout

Individuals diagnosed with systemic lupus erythematosus (SLE) are at risk for developing numerous complications of various organs because of (a) impaired tissue oxygen transport (b) formation of osteophytes in tissues (c) excessive production of connective tissue (d) immune injury to basement membranes

(d) immune injury to basement membranes

The final stage of gout, characterized by crystalline deposits in cartilage, synovial membranes, and soft tissue, is called (a) complicated gout (b) asymptomatic hyperuricemia (c) gouty arthritis (d) tophaceous gout

(d) tophaceous gout

Signs/symptoms of Lyme disease include all of the following, except (a) arthritic pain (b) myalgia (c) headache (d) fever and chills (e) diffuse rash

(e) diffuse rash