Chapter 35- Musculoskeletal Function

The nurse is conducting the admission assessment for a client who is to undergo an arthrogram. What is the priority question the nurse should ask?

"Do you have any allergies?"

The nurse is taking an initial history of a new client with a musculoskeletal problem. Which factor is most important for the nurse to keep in mind for this assessment?

Any chronic disorder or recent injury

The nurse is evaluating a client's peripheral neurovascular status. Which would the nurse report to the health care provider as a circulatory indicator of peripheral neurovascular dysfunction?

Cool skin

Which is a circulatory indicator of peripheral neurovascular dysfunction?

Cool skin

Which term refers to mature compact bone structures that form concentric rings of bone matrix?

Lamellae

Which description refers to an osteon?

Microscopic functional bone unit

The nurse is assessing a new client with a musculoskeletal problem. What is the best question by the nurse to elicit more information related to the injury?

"Do you have any chronic disorder or recent injury?"

Which statement by the client preparing for a bone scan indicates further teaching by the nurse is needed?

"I will need to limit my fluid intake so as not to interfere with the isotope."

Which nursing action is most important in caring for the client following an arthrogram?

Apply ice to the joint.

Which cells are involved in bone resorption?

Osteoclasts

A group of students are reviewing information about bones in preparation for a quiz. Which of the following indicates that the students have understood the material?

Osteoclasts are involved in the destruction and remodeling of bone.

Which of the following are the major hormonal regulators of calcium homeostasis? Select all that apply.

Parathormone Calcitonin

Which nerve is being assessed when the nurses asks the client to dorsiflex the ankle and extend the toes?

Peroneal

A nurse performs a neurovascular assessment on a client 2 weeks after a wrist cast had been removed. The nurse documents in the client's chart that there is normal sensation in the ulnar nerve. What finger assessment test will the nurse perform on this client?

Prick the distal fat pad on the small finger.

Which of the following is the final stage of fracture repair?

Remodeling

The nurse understands that bone maintenance requires a balance between forming and dissolving bone. What is a correct statement about the function of osteoblasts?

They secrete a matrix that consists of collagen.

A nursing student asks the nurse why older adults are at risk for falls. The best response by the nurse is:

"Muscles atrophy with aging."

The nurse is assessing a client with a musculoskeletal system condition. Which statement indicates to the nurse that the client is experiencing bone pain?

"The pain feels deep in my legs and keeps me awake at night."

Which is an indicator of neurovascular compromise?

Capillary refill of more than 3 seconds

A patient tells the nurse, "I was working out and lifting weights and now that I have stopped, I am flabby and my muscles have gone!" What is the best response by the nurse?

"Your muscles were in a state of hypertrophy from the weight lifting but it will persist only if the exercise is continued."

A client is scheduled for a bone scan. A bone scan may be ordered to detect metastatic bone lesions, fractures, and certain types of inflammatory disorders. Which nursing considerations are correct in preparing a client for a bone scan? Select all that apply.

Inform the client that the radiopaque isotope will be administered intravenously. Ensure that the client does not have any allergies to the isotope. Encourage the client to drink fluids to help distribute and eliminate the isotope.

A client is exhibiting diminished range of motion, loss of flexibility, stiffness, and loss of height. The history and physical findings are associated with age-related changes of which area?

Joints

The nurse is working on an orthopedic floor caring for a client injured in a football game. The nurse is reviewing the client's chart noting that the client has previously had an injured tendon. The nurse anticipates an injury between the periosteum of the bone and which of the following?

Muscle

A client visits the health care provider for a routine checkup. The history reveals that the client was diagnosed with a spinal curvature. Which region of the spine should the nurse assess for complications?

Thoracic

A client is diagnosed with a bone tumor. What result would the nurse expect the blood tests to reveal?

Decreased serum calcium level

The nurse is assessing a client's ulnar nerve. What technique will the nurse use?

Prick the distal fat pad of the small finger.

The nurse assesses soft subcutaneous nodules along the line of the tendons in a patient's hand and wrist. What does this finding indicate to the nurse?

The patient has rheumatoid arthritis.

A client has recently undergone an invasive joint examination to enable the identification of bone composition. Which signs and symptoms should the nurse monitor in this client?

swelling and bleeding

A client is having repeated tears of the joint capsule in the shoulder, and the health care provider orders an arthrogram. What intervention should the nurse provide after the procedure is completed? Select all that apply.

Apply a compression bandage to the area. Administer a mild analgesic. Inform the client that a clicking or crackling noise in the joint may persist for a couple of days.

The nurse is assessing a client for dietary factors that may influence her risk for osteoporosis. The nurse should question the client about her intake of what nutrients? Select all that apply.

Calcium Vitamin D

Which of the following is an example of a gliding joint?

Carpal bones in the wrist

The nurse is caring for a pregnant patient with pregnancy-induced hypertension. When assessing the reflexes in the ankle, the nurse observes rhythmic contractions of the muscle when dorsiflexing the foot. What would the nurse document this finding as?

Clonus

A patient has had a stroke and is unable to move the right upper and lower extremity. During assessment the nurse picks up the arm and it is limp and without tone. How would the nurse document this finding?

Flaccidity

The nurse is preparing to perform a musculoskeletal assessment for a client with chronic muscle pain. Which assessment technique would be an appropriate tool to evaluate this type of pain?

Flex the bicep against resistance.

A client has an elbow injury that involves the cartilage in that joint. The nurse understands that which type of cartilage has been affected?

Hyaline cartilage

Which of the following deformity causes a exaggerated curvature of the lumbar spine?

Lordosis

A nurse knows that a person with a 3-week-old femur fracture is at the stage where angiogenesis is occurring. What are the characteristics of this stage?

New capillaries producing a bridge between the fractured bones.

A nurse is caring for a client with an undiagnosed bone disease. When instructing on the normal process to maintain bone tissue, which process transforms osteoblasts into mature bone cells?

Ossification and calcification

The nurse is performing an assessment for a patient who may have peripheral neurovascular dysfunction. What signs does the patient present with that indicate circulation is impaired? (Select all that apply.)

Pale, cyanotic, or mottled color Cool temperature of the extremity More than 3-second capillary refill

The nurse is conducting a musculoskeletal assessment of a client in a nursing home. The client is unable to dorsiflex the right foot or extend the toes. The nurse evaluates this finding as an injury to which nerve?

Peroneal

Which nursing instruction is most important to stress when teaching on calcium intake?

Provide age-related calcium intake recommendations.

A client undergoes an invasive joint examination of the knee. What will the nurse closely monitor the client for?

Serous drainage

A group of students are studying for an examination on joints. The students demonstrate understanding of the material when they identify which of the following as an example of a synarthrodial joint?

Skull at the temporal and occipital bones

A client is seen in the emergency room for a knee injury that happened during a basketball game. Diagnostic tests reveal torn cords of fibrous connective tissue that connect muscles to bones. What type of tear has this client sustained?

Tendon

A client tells the health care provider about shoulder pain that is present even without any strenuous movement. The health care provider identifies a sac filled with synovial fluid. What condition will the nurse educate the client about?

bursitis

The nurse is admitting an older adult to a skilled nursing facility. What assessment parameters will the nurse expect to find with the musculoskeletal assessment? Select all that apply.

decreased endurance joint stiffness decreased range of motion

There are thousands of components of the musculoskeletal system that facilitate mobility and independent function. The function of skeletal muscle is promoting:

movement of skeletal bones.

A client reports being consistently tired, with no energy. The client's CBC indicates low hemoglobin. Where is hemoglobin manufactured?

ribs

Choose the correct statement about the endosteum, a significant component of the skeletal system:

Covers the marrow cavity of long bones

The nurse is discussing an older adult's risk for skeletal fractures with a group of students assigned to the clinical area. Which of the following would the nurse most likely explain as the underlying reason for the increased risk?

Bone resorption is more rapid than bone formation.

A client arrives at the orthopedic physician's office stating knee pain sustained while playing soccer. A history and physical assessment is completed. The knee appears reddened with edema. Which other diagnostic testing would the nurse anticipate?

An arthroscopy

A group of students are reviewing the structure and function of bones. The students demonstrate understanding of the information when they state that cortical bone is found primarily in which of the following?

Diaphyses

The nurse is educating a group of students about peroneal nerve damage. The nurse knows that which assessment will show this type of nerve damage?

Dorsiflexion of the foot and extension of the toes

A nurse provides nutritional health teaching to an adult client who had two fractures in 1 year. Besides recommending supplemental calcium, the nurse suggests a high-calcium diet. What would the nurse recommend that the client increase intake of?

Yogurt and cheese.

The nurse is teaching a client about osteoporosis. What diagnostic test will the nurse include with the client teaching?

dual-energy x-ray absorptiometry