MLQ Ch 39
A 10-year-old boy who was brought to the emergency room after a skiing accident is diagnosed with a fracture of the distal end of the femur. Why is this type of fracture significant? A. Potential growth problems may result from damage to the epiphyseal plate. B. Red blood cell production will be temporarily reduced because of the damage to the medullar cavity. C. Periosteal blood vessels will be damaged, thus compromising blood flow to the compact bone. D. Osteoblast formation will stop during the time needed for fracture healing.
A
A client is scheduled to undergo an electromyography. When performed, what will this test evaluate? A. Muscle weakness B. Muscle composition C. Bone density D. Metastatic bone lesions
A
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. A. Inform the client that the radiopaque isotope will be administered intravenously. B. Ensure that the client does not have any allergies to the isotope. C. Encourage the client to drink fluids to help distribute and eliminate the isotope. D. Ensure the client is NPO for 12 hours before the test.
A, B, C
A client has undergone arthroscopy. After the procedure, the site where the arthroscope was inserted is covered with a bulky dressing. The client's entire leg is also elevated without flexing the knee. What is the appropriate nursing intervention required in caring for a client who has undergone arthroscopy? A. Apply a cold pack at the insertion site. B. Apply warm compresses to the insertion site. C. Provide a gentle massage. D. Assist with performing ROM exercises.
B
An instructor is describing the process of bone development. Which of the following would the instructor describe as being responsible for the process of ossification? A. Osteoclasts B. Osteoblasts C. Cancellous bone D. Cortical bone
B
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? A. Positive Babinski reflex B. Clonus C. Ankle reflex D. Hypertrophy
B
A client has an exaggerated convex curvature of the thoracic spine. What is this condition called? A. scoliosis B. diaphysis C. kyphosis D. lordosis
C
A client undergoes an invasive joint examination of the knee. What will the nurse closely monitor the client for? A. Signs of shock B. Signs of depression C. Serous drainage D. Lack of sleep and appetite
C
Choose the correct statement about the endosteum, a significant component of the skeletal system: A. Contains blood vessels and lymphatics B. Facilitates bone growth C. Covers the marrow cavity of long bones D. Supports the attachment of tendons to bones
C
A client experiences a musculoskeletal injury that involves the structure that connects a muscle to the bone. The nurse understands that this injury involves which structure? A. Cartilage B. Ligament C. Joint D.Tendon
D
A client is diagnosed with a fracture of a diarthrosis joint. What is an example of this type of joint? A. Skull B. Symphysis pubis C. Fifth thoracic vertebrae D. Elbow
D
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? A. Bones B. Muscles C. Ligaments D. Joints
D
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? A. "I should use my heating pad this evening to reduce some of the pain in my knee." B. "I may notice some bruising or swelling in my knee." C. "Elevating my leg will reduce swelling after the procedure." D. "My physician may prescribe pain pills after the procedure."
A
A patient is scheduled for a procedure that will allow the physician to visualize the knee joint in order to diagnose the patient's pain. What procedure will the nurse prepare the patient for? A. Arthroscopy B. Bone scan C. Arthrocentesis D. Electromyography
A
The nurse is preparing the client for computed tomography. Which information should be given by the nurse? A. "A radioisotope will be given through an IV." B. "You must remain very still during the procedure." C. "Fluid will be removed from you affected joint." D. "A small bit of tissue will be removed and sent to the lab."
B
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? A. Joint B. Muscle C. Ligament D. Cartilage
B
Which serum level indicates the rate of bone turnover? A. Creatinine kinase B. Osteocalcin C. Myoglobin D. Aspartate aminotransferase
B
A client has an elbow injury that involves the cartilage in that joint. The nurse understands that which type of cartilage has been affected? A. Costal cartilage B. Semilunar cartilage C. Hyaline cartilage D. Fibrous cartilage
C
The nurse is assessing the client who states a decline in muscle strength. Which is the primary source essential to allow muscle contraction? A. Acetylcholine B. Actin and myosin C. Myofibrils D. Sarcomeres
C
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? A. "Are you claustrophobic?" B. "When did you last eat?" C. "Do you have any allergies?" D. "When did you last urinate?"
C
After a person experiences a closure of the epiphyses, which statement is true? A. The bone grows in length but not thickness. B. The bone increases in thickness and is remodeled. C. Both bone length and thickness continue to increase. D. No further increase in bone length occurs.
D
An example of a flat bone is the A. femur. B. metacarpals. C. vertebra. D. sternum.
D
Skull sutures are an example of which type of joint? A. Amphiarthrosis B. Aponeuroses C. Diarthrosis D. Synarthrosis
D
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? A. NPH insulin B. digoxin C. furosemide D. aspirin
D
Which term refers to the shaft of the long bone? A. Diaphysis B. Epiphysis C. Scoliosis D. Lordosis
A
Which laboratory study indicates the rate of bone turnover? A. Serum phosphorous B. Urine calcium C. Serum calcium D. Serum osteocalcin
D
The client presents with an exaggeration of the lumbar spine curve. How does the nurse interpret this finding? A. Dowager's hump B. Scoliosis C. Lordosis D. Kyphosis
C
Which assessment finding would cause the nurse to suspect compartment syndrome in the client following a bone biopsy? A. Toes move freely without pain B. Capillary refill < 3 seconds C. Increased diameter of the calf D. Bounding dorsalis pedis pulses
C
Which elements of assessment of a traumatic musculoskeletal injury should be included when a client is evaluated. Select all that apply. A. Check the sensation of the injured part. B. Palpate the peripheral pulses. C. All should be included. D. Observe for swelling, external bleeding, or bruising.
C
The nurse is performing a neurovascular assessment of a client's injured extremity. Which would the nurse report? A. Dusky or mottled skin color B. Skin warm to touch C. Capillary refill of 3 seconds D. Positive distal pulses
A
A client has a fracture that is being treated with open rigid compression plate fixation devices. What teaching will the nurse reinforce to the client about how the progress of bone healing will be monitored? A. Serial x-rays will be taken. B. The plate will be removed to determine if the bone is growing back. C. The bone will heal on its own without intervention. D. An arthroscopy will be performed.
A
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? A. Osteoclasts are involved in the destruction and remodeling of bone. B. Osteocytes are transformed into osteoblasts or mature bone cells. C. The yellow marrow is responsible for manufacturing red blood cells. D. Long bones typically contain more red bone marrow than yellow.
A
The nurse is teaching a client about a vitamin that supports calcium's absorption. What vitamin is the nurse teaching the client about? A. Vitamin D B. Vitamin C C. Vitamin B12 D. Vitamin A
A
What is the term for a lateral curving of the spine? A. Scoliosis B. Epiphysis C. Diaphysis D. Lordosis
A
What is the term for a rhythmic contraction of a muscle? A. Clonus B. Hypertrophy C. Crepitus D. Atrophy
A
Which hormone inhibits bone resorption and increases the deposit of calcium in the bone? A. Calcitonin B. Growth hormone C. Sex hormones D. Vitamin D
A
Which of the following is the final stage of fracture repair? A. Remodeling B. Cartilage calcification C. Cartilage removal D. Angiogenesis
A
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.) A. Cool temperature of the extremity B. More than 3-second capillary refill C. Pale, cyanotic, or mottled color D. Limited range of motion E. Tenting skin turgor
A, B, C
The nurse is performing an assessment on an older adult patient and observes the patient has an increased forward curvature of the thoracic spine. What does the nurse understand this common finding is known as? A. Scoliosis B. Kyphosis C. Lordosis D. Osteoporosis
B
The nurse working in the orthopedic surgeon's office is asked to schedule a shoulder arthrography. The nurse determines that the surgeon suspects which finding? A. Decreased bone density B. Fracture of the clavicle C. Injury to the radial nerve D. Tear in the joint capsule
D
The older client asks the nurse how best to maintain strong bones. What is the nurse's best response? A. "Weight-bearing exercises can strengthen bones." B. "Weight-resistance exercises can strengthen bones." C. "Cardio-training is the best way to build bones." D. "Range of motion exercises build bone mass."
A
Which cells are involved in bone resorption? A. Osteoclasts B. Osteocytes C. Osteoblasts D. Chondrocytes
A
Which statement describes paresthesia? A. Involuntary twitch of muscle fibers B. Absence of muscle tone C. Abnormal sensations D. Absence of muscle movement suggesting nerve damage
C
The nurse is assigned to a client admitted with advanced Parkinson's disease. What type of gait correlates with Parkinson's disease? A. scissors B. steppage C. spastic hemiparesis D. shuffling
D
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? A. Between the vertebrae B. In the fingers C. Skull at the temporal and occipital bones D. At the hip
C
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? A. A serum calcium test B. An electromyography C. An arthroscopy D. A magnetic resonance imaging (MRI)
B
After a bone density test, an older adult female client tells the nurse, "I don't understand why I have osteoporosis because I eat well and take my calcium." What does the nurse explain as the reason that the client may have osteoporosis? A. Everyone gets osteoporosis and there is nothing you can do to prevent it. B. The loss is from withdrawal of estrogen and a decrease in activity levels. C. Men lose more bone mass than women but women still lose some. D. In order to prevent bone loss, women have to take hormones.
B
A patient has a fracture of the right femur sustained in an automobile accident. What process of fracture healing does the nurse understand will occur with this patient? A. First intention, secondary intention, third intention B. Primary phase, secondary phase, third phase C. Reactive phase, reparative phase, remodeling phase D. Active phase, dormant phase, restructure phase
C
The nurse is caring for a client who has a deficiency in the formation of cartilage in joints. Which essential substance is absent? A. Osteoblasts B. Myofibrils C. Sarcomeres D. Matrix
D
The nurse is conducting a medication reconciliation with a client admitted with a fracture. What medication predisposes a client for a risk for fractures? A. furosemide B. prednisone C. digoxin D. metoprolol
B
