Med Surg. Chapter 40

Which body movement involves moving toward the midline?

Adduction

Which of the following is a neurovascular problem caused by pressure within a muscle area that increases to such an extent that microcirculation diminishes?

Compartment syndrome

Which of the following describes a muscle that is limp and without tone?

Flaccid

Which serum level indicates the rate of bone turnover?

Osteocalcin

Which of the following would be most important for the nurse to include in the teaching plan for a client who has undergone arthrography?

Report joint crackling or clicking noises occurring after the second day.

Which of the following is an appropriate priority nursing diagnosis for the client following an arthrocentesis?

Risk for infection

The human body has 206 bones, which are classified into four categories. Which types of bones are located in the digits?

Short bones

A client is recovering from a fractured hip. The nurse would suggest that the client increase intake of which of the following to facilitate calcium absorption from food and supplements?

Vitamin D

The nurse is preparing the client for computed tomography. Which information should be given by the nurse?

"You must remain very still during the procedure."

Ms. Wilson's blood test results have come back to the office and she had an elevated alkaline phosphatase. What might this indicate?

A bone tumor

The nurse is reviewing the client's admission assessment and notes that crepitus of the right knee joint was documented. The nurse recognizes that crepitus is:

A grating sound when a joint is put through range of motion

The primary functions of cartilage are to reduce friction between articular surfaces, absorb shocks, and reduce stress on joint surfaces. Where in the human body would you expect to find cartilage?

All options are correct.

A client is experiencing muscle weakness in the upper extremities. The client raises an arm above the head but then loses the ability to maintain the position. Muscular dystrophy is suspected. Which diagnostic test would evaluate muscle weakness or deterioration?

An electromyography

The nurse is performing a musculoskeletal assessment of a patient in a nursing home who had a stroke 2 years ago and who has right-sided hemiplegia. The nurse notes that the girth of the patient's right calf is 2 inches less in diameter than the left calf. The nurse attributes the decreased girth to which of the following?

Atrophy of right calf muscle

The nurse is discussing an older adults 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.

Which hormone inhibits bone reabsorption and increases calcium deposit in the bone?

Calcitonin

Which of the following is an indicator of neurovascular compromise?

Capillary refill of more than 3 seconds

Which of the following terms refers to the shaft of the long bone?

Diaphysis

A patient is diagnosed with a fracture of a diarthrosis joint. The nurse knows that an example of this type of joint is the:

Elbow.

The nurse would expect which of the following diagnostic tests to be ordered for a patient with lower extremity muscle weakness?

Electromyograph (EMG)

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

Hyaline cartilage

Which of the following is the most common site of joint effusion?

Knee

Mr. Roland is in your clinic undergoing an orthopedic assessment. It is noted that he has an exaggerated convex curvature of the thoracic spine. What is this condition called?

Kyphosis

A deoxypyridinoline (Dpd) level has been ordered. The nurse prepares to:

Obtain a clean-catch urine.

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

Which of the following is a characteristic of fracture pain?

Piercing

After a fracture, during which stage or phase of bone healing is devitalized tissue removed and new bone reorganized into its former structural arrangement?

Remodeling

The nurse working in the orthopedic surgeon's office is asked to schedule a shoulder arthrography. The nurse determines that the surgeon suspects which of the following findings?

Tear in the joint capsule

A 16-year-old patient 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. The nurse knows that the patient had sustained a tear of the:

Tendon.

A client undergoes an arthroscopy at the outpatient clinic. After the procedure, the nurse provides discharge teaching. Which response by the client indicates the need for further teaching?

"I should use my heating pad this evening to reduce some of the pain in my knee."

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

The nurse would include which of the following in a neurological assessment?

Ask the client to plantar flex the toes.

The homecare nurse is evaluating the musculoskeletal system of a geriatric patient whose previous assessment was within normal limits. The nurse initiates a call to the health care provider and/or emergency services when which of the following changes are found?

Decreased right-sided muscle strength

Which of the following is the priority nursing diagnosis for the client preparing for a bone marrow biopsy?

Deficient knowledge: procedure

A nurse performs a neurovascular assessment on a patient 2 weeks after a wrist cast had been removed. She documents in the patient's chart that there is normal sensation in the ulnar nerve. To reach this conclusion, the nurse performed an assessment test on the fingers that involves pricking the:

Distal fat pad on the small finger.

Which diagnostic test does the nurse expect the client with osteoporosis to undergo?

Dual-energy x-ray absorptiometry

The nurse is reporting on the results of client blood work to the oncoming nurse. Upon reviewing the data, it is noted that the client has an elevated uric acid level. Which inflammatory process would the nurse screen for on shift rounds?

Gout

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

Knee

The client presents with an exaggeration of the lumbar spine curve. The nurse interprets these findings as indicative of:

Lordosis

A client is scheduled to undergo an electromyography. The nurse understands that this test is performed to evaluate which of the following?

Muscle weakness

The nurse observes the client and notes a shuffling gait. The nurse recognizes this finding is consistent with:

Parkinson's disease

The nurse is caring for a client who experienced a crushing injury of the lower extremities. Which of the following symptoms is essential to be reported to the physician?

Pulselessness

What is the term for a lateral curving of the spine?

Scoliosis

Which of the following deformities causes a lateral curving deviation of the spine?

Scoliosis

A nurse practitioner assesses a patient's movement in his left hand after a cast is removed. The nurse asks the patient to turn his wrist so the palm of his hand is facing up. This movement is known as:

Supination.

A nurse provides nutritional health teaching to a 52-year-old who had two fractures in 1 year. Besides recommending supplemental calcium, the nurse suggests a high-calcium diet. The nurse would recommend that the patient increase her intake of:

Yogurt and cheese.

Which medication taken by the client in the previous 24 hours would be of greatest concern to the nurse caring for a client undergoing a bone biopsy?

aspirin

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

Red bone marrow produces which of the following? Select all that apply.

• White blood cells (WBCs) • Platelets • Red blood cells (RBCs)

Which assessment finding would cause the nurse to suspect compartment syndrome in the client following a bone biopsy?

Increased diameter of the calf