MS Musculoskel unit test

Lorraine Carr, a 55-year-old rental car agency manager, is being seen by a physician for her annual physical exam. She is postmenopausal and is taking medication to reverse bone loss. Although loss of bone mass accelerates after menopause, at what age do people begin to lose bone mass? a) 40 years of age b) *35 years of age c) 45 years of age d) 50 years of age

*35 years of age

Which of the following inhibits bone resorption and promotes bone formation? a) Parathyroid hormone b) Estrogen c) Corticosteroids d) Calcitonin

Calcitonin

A patient has had a cast placed for the treatment of a humeral fracture. The nurse's most recent assessment shows signs and symptoms of compartment syndrome. What is the nurse's most appropriate action? a) Assess the patient's joint function symmetrically. b) Contact the primary care provider immediately. c) Arrange for a STAT assessment of the patient's serum calcium levels. d) Perform active range of motion exercises.

Contact the primary care provider immediately.

A 78-year-old client is in the emergency department following involvement in a motor vehicle collision. Radiographs indicate a fractured humerus; the client is awaiting the casting of her upper extremity and admission to the orthopedic unit. What is the primary treatment for musculoskeletal trauma? a) Immobilization b) Enhancing complications c) Surgical repair d) External rotation

Immobilization

Which of the following aspects should a nurse include in the teaching plan for a patient with osteomalacia? a) Avoid dairy products b) Include the supplements of calcium, phosphorus, and vitamin D c) Avoid green leafy vegetables d) Avoid any activity or exercise

Include the supplements of calcium, phosphorus, and vitamin D

The physician tells a client with a traumatic musculoskeletal injury to take nonsteroidal anti-inflammatory drugs (NSAIDs) for pain relief. Which of the following pointers should the nurse emphasize with the client? a) Take medications with food. b) Avoid the intake of dairy products. c) Avoid exposure to direct sunlight. d) Stay on complete bed rest.

Take medications with food.

A client has been treated for migraine headaches for several months and comes to the clinic stating he is getting no better. The nurse is talking with the client and hears an audible click when the client is moving his jaw. What does the nurse suspect may be happening? a) Loose teeth b) Dislocated jaw c) Temporomandibular disorder d) Trigeminal neuralgia

Temporomandibular disorder

An orthopedic nurse is caring for a patient who is postoperative day one following foot surgery. What nursing intervention should be included in the patient's subsequent care? a) The foot should be elevated in order to prevent edema. b) Dressing changes should not be performed unless there are clear signs of infection. c) The surgical site should be cleansed with hydrogen peroxide once daily. d) The surgical site can be soaked in warm bath water for up to 5 minutes.

The foot should be elevated in order to prevent edema.

The nurse is caring for patient with a hip fracture. The physician orders the patient to start on a bisphosphonate. Which medication would the nurse document as given? a) Raloxifene (Evista) b) Teriparatide (Forteo) c) Denosumab (Prolia) d) Alendronate (Fosamax)

Alendronate (Fosamax)

Which of the following clinical manifestations would the nurse expect to find in a client who has had osteoporosis for several years? a) Diarrhea b) Increased heel pain c) Decreased height d) Bone spurs

Decreased height

A client with a fracture develops compartment syndrome that requires surgical intervention. The nurse would most likely prepare the client for which of the following? a) Bone graft b) Amputation c) Fasciotomy d) Joint replacement

Fasciotomy

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? a) Lordosis b) Scoliosis c) Diaphysis d) Kyphosis

Kyphosis

The nurse is caring for a client who had a surgical amputation of the left leg related to complication from diabetes. The client asks the nurse, "If my leg is really gone, then why am I having such bad pain?" What is the best response by the nurse? a) "It is called phantom pain and may come and go." b) "You are only imagining that you are having pain." c) "This is called false pain and is a brain dysfunction." d) "You will continue to have this pain, and you will have to learn to ignore it."

"It is called phantom pain and may come and go."

Which client would the nurse identify as having the greatest risk for osteoporosis? a) A small-framed, thin 45-year-old white woman b) A 20-year-old male athlete with repeated injuries c) A 16-year-old male with a history of asthma d) A 40-year-old overweight African American woman

A small-framed, thin 45-year-old white woman

The nurse is assigned to care for a client who has had a total knee arthroplasty yesterday. What type of pharmacologic therapy does the nurse anticipate administering to this client to prevent complications related to the surgery? a) Anticoagulation therapy b) Antianginal therapy c) Antineoplastic therapy d) Antidysrhythmia therapy

Anticoagulation therapy

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) Assist with performing ROM exercises. b) Provide a gentle massage. c) Apply a cold pack at the insertion site. d) Apply warm compresses to the insertion site.

Apply a cold pack at the insertion site.

A patient has been experiencing progressive increases in knee pain and diagnostic imaging reveals a worsening effusion in the synovial capsule. The nurse should anticipate which of the following? a) Arthrocentesis b) Electromyography c) Knee biopsy d) Arthrography

Arthrocentesis

If a dislocation is not treated promptly, tissue death due to anoxia can occur. This would be documented as which of the following? a) Osteomyelitis b) Avascular necrosis (AVN) c) Subluxation d) Heterotopic ossification

Avascular necrosis (AVN)

A client is experiencing symptoms that are suspected to be related to systemic lupus erythematosus. What cutaneous symptom occurs in about 50% of clients affected by this disease? a) Butterfly-shaped rash on the face over the bridge of the nose and cheeks b) Diffuse purplish lesions on the trunk c) Pustules scattered on the chest and back d) Fluid-filled vesicles clustered on the cheeks, chin, and forehead

Butterfly-shaped rash on the face over the bridge of the nose and cheeks

Which assessment findings would cause the nurse to suspect compartment syndrome after casting of the leg? a) Low-grade fever, dyspnea, tachycardia, and crackles b) Complaints of numbness and tingling in toes of affected leg c) Increased capillary refill and bounding pulses in affected leg d) Warm, pink foot and ability to move toes of affected leg

Complaints of numbness and tingling in toes of affected leg

The nurse is reading the admission note of a patient with a bone fracture that requires surgery. The note indicates the presence of crepitus. The nurse interprets this as being which of the following? a) Closed fracture b) Ecchymosis c) Crackling sound d) Bleeding

Crackling sound

A client who suffers an injury in a local high school hockey game presents with left shoulder pain. The client cannot move the left arm, and the left shoulder is lower than the right shoulder. The nurse recognizes the client most likely has a: a) Dislocated shoulder b) Clavicle fracture c) Dislocated elbow d) Cervical injury

Dislocated shoulder

Which suggestion would be most important to give a client who has a mild case of bunions? a) Avoid strenuous exercise. b) Don proper footwear. c) Avoid foot creams. d) Regularly use analgesics.

Don proper footwear.

The nurse is planning an education program for women of childbearing years. The nurse recognizes that primary prevention of osteoporosis includes: a) Engaging in non-weight-bearing exercises daily b) Ensuring adequate calcium and vitamin D intake c) Having a DXA beginning at age 35 years d) Undergoing assessment of serum calcium levels every year

Ensuring adequate calcium and vitamin D intake

The client with a fractured left humerus reports dyspnea and chest pain. Pulse oximetry is 88%. Temperature is 100.2 degrees Fahrenheit (38.5 degrees Centigrade); heart rate is 110 beats per minute; respiratory rate is 32 breaths per minute. The nurse suspects the client is experiencing: a) Complex regional pain sydrome b) Compartment syndrome c) Delayed union d) Fat embolism syndrome

Fat embolism syndrome

A client undergoes hip-pinning surgery to treat an intertrochanteric fracture of the right hip. The nurse should include which intervention in the postoperative care plan? a) Turning the client from side to side every 2 hours b) Maintaining the client in semi-Fowler's position c) Keeping a pillow between the client's legs at all times d) Performing passive range-of-motion (ROM) exercises on the client's legs once each shift

Keeping a pillow between the client's legs at all times

When caring for a client with a fracture, assessment of which of the following would be the priority? a) Cardiac problems b) Altered kidney function c) Hormonal imbalances d) Neurovascular compromise

Neurovascular compromise

The nurse teaches the patient which of the following interventions in order to avoid hip dislocation after replacement surgery? a) Keep the knees together at all times. b) Avoid placing a pillow between the legs when sleeping. c) Never cross the affected leg when seated. d) Bend forward only when seated in a chair.

Never cross the affected leg when seated.

A client's fracture was reduced by surgically exposing the bone and realigning it. The nurse identifies this as which of the following? a) Open reduction b) Internal fixation c) Buck's traction d) Skeletal traction

Open reduction

Which cells are involved in bone resorption? a) Osteocytes b) Osteoblasts c) Chondrocytes d) Osteoclasts

Osteoclasts

A client with metastatic bone cancer sustained a left hip fracture without injury. What type of fracture does the nurse understand occurs without trauma or fall? a) Transverse fracture b) Pathologic fracture c) Impacted fracture d) Compound fracture

Pathologic fracture

A client is receiving subcutaneous heparin after surgery to repair a fractured hip. The nurse understands that the rationale for this therapy is to reduce the risk for which the following? a) Pulmonary embolism b) Shock c) Compartment syndrome d) Avascular necrosis

Pulmonary embolism

Which of the following would a nurse encourage a client with gout to limit? a) Carbohydrates b) Purine-rich foods c) Protein-rich foods d) Fluid intake

Purine-rich foods

The Emergency Department nurse teaches patients with sports injuries to remember the acronym RICE. This acronym stands for which of the following combinations of treatment? a) Rest, ice, compression, elevation b) Rotation, ice, compression, and examination c) Rest, ice, circulation, and examination d) Rotation, immersion, compression and

Rest, ice, compression, elevation

A patient diagnosed with a right ulnar fracture asks why the cast needs to go all the way up the arm. What is the best response by the nurse? a) "The method will allow for the fastest healing time and the greatest mobility." b) "This will allow for the strength in the arm to remain consistent." c) "When a spica cast is ordered, the arm must be immobilized." d) "The joint above the fracture and below the fracture must be immobilized."

The joint above the fracture and below the fracture must be immobilized."

Which of the following would the nurse expect to assess as the most common finding associated with fibromyalgia? a) Butterfly facial rash b) Jaw locking c) Heberden nodes d) Widespread chronic pain

Widespread chronic pain

A client is treated in the emergency department for acute muscle strain in the left leg caused by trying a new exercise. During discharge preparation, the nurse should provide which instruction? a) "Apply ice packs for the first 12 to 18 hours." b) "Apply heat packs for the first 24 to 48 hours." c) "Apply ice packs for the first 24 to 48 hours, then apply heat packs." d) "Apply heat packs for the first 24 hours, then apply ice packs for the next 48 hours."

"Apply ice packs for the first 24 to 48 hours, then apply heat packs."

The nurse is planning discharge instructions for the client with osteomyelitis. What instructions should the nurse include in the discharge teaching? a) "You need to perform weight-bearing exercises twice a week." b) "You will receive IV antibiotics for 3 to 6 weeks." c) "Use your continuous passive motion machine (CPM) 2 hours each day." d) "You need to limit the amount of protein and calcium in your diet."

"You will receive IV antibiotics for 3 to 6 weeks."

After a bone breaks, the muscles surrounding the bone go from being flaccid to going into spasm, often increasing the deformity and interfering with the vascular and lymphatic circulations. Tissue around the fracture swells from hemorrhage and edema. Healing begins when blood in the area clots, and a fibrin network forms between the broken bone ends. How long does it take for the bone to regain its former structural strength after a break? a) 1 year b) 2 years c) 8 months d) 6 months

1 year

Which one of the following would be essential when planning the care of a client in traction? a) Bed cradle b) Bed trapeze c) Electric bed d) Bed monitor

Bed trapeze

A nurse is caring for an elderly female client with osteoporosis. When teaching the client, the nurse should include information about which major complication? a) Loss of estrogen b) Bone fracture c) Negative calcium balance d) Dowager's hump

Bone fracture

The nurse is assigned to care for a client who has had an open reduction and internal fixation of a fractured right femur 2 days ago. The nurse is listening to the client's lungs and, when moving the gown, observes petechial hemorrhages on the skin of the chest. What is the first action by the nurse? a) Administer pain medication. b) Request an antihistamine for the allergic reaction. c) Call the physician to inform them of the findings. d) Increase the intravenous fluids for hemorrhage.

Call the physician to inform them of the findings.

A 35-year-old client is visiting a rheumatology group practice. The client has experienced increasing pain and progressing inflammation of the hands and feet. The rheumatologist has prescribed NSAID use to treat the condition. What client education is most important for the nurse to address with the use of these medications? a) Loading-dose schedule b) Dietary restrictions c) Common adverse effects d) Activity restrictions

Common adverse effects

A client sustains a fractured right humerus in an automobile accident. The arm is edematous, the client states that he cannot feel or move his fingers, and the nurse does not feel a pulse. What condition should the nurse be concerned about that requires emergency measures? a) Compartment syndrome b) Dislocation c) Subluxation d) Muscle spasms

Compartment syndrome

A nurse is providing discharge education to a patient who is going home with a cast on his leg. What teaching point should the nurse emphasize in the teaching session? a) Using crutches efficiently b) Removing the cast correctly at the end of the treatment period c) Exercising joints above and below the cast, as ordered d) Reporting signs of impaired circulation

Reporting signs of impaired circulation

A nurse is caring for a client with a cast on his left arm after sustaining a fracture. Which assessment finding is most significant for this client? a) Presence of a normal popliteal pulse b) Minimal pain in the left arm c) Fingers on the left hand are swollen and cool d) Cast edges are rough, with skin irritation present

Fingers on the left hand are swollen and cool

A client's x-ray looks similar to the image depicted. The nurse would recognize that the client likely has a a) Rheumatoid arthritis b) Bunion c) Hammer toe d) Paget's disease

Hammer toe

Which of the following is a factor that inhibits fracture healing? a) Increased vitamin D and calcium in the diet b) History of diabetes c) Immobilization of the fracture d) Patient age of 35

History of diabetes

Which assessment findings would the nurse expect in a client diagnosed with osteomyelitis? a) Thrombocytopenia and ecchymosis b) Petechiae over the chest and abnormal ABGs c) Leukocytosis and localized bone pain d) Pruritus and uremic frost

Leukocytosis and localized bone pain

The results of a nurse's musculoskeletal examination show an increase in the lumbar curvature of the spine. The nurse should recognize the presence of what health problem? a) Kyphosis b) Scoliosis c) Osteoporosis d) Lordosis

Lordosis

The nurse would expect which of the following age-related change of the musculoskeletal system? a) Loss of bone mass b) Muscle hypertrophy c) Increased elasticity of tendons d) Thickening of intervertebral discs

Loss of bone mass

Which of the following would the nurse most commonly assess in a client with ankylosing spondylitis? a) Patchy hair loss on the scalp b) Red, butterfly-shaped facial rash c) Low back pain d) Increased urine output

Low back pain

A patient in the early stage of rheumatoid arthritis has been admitted to your unit. What medication classification would the nurse expect to be ordered for this patient? a) Xanthine oxidase inhibitors b) NSAIDs c) Uricosuric agents d) Antimalarial agents

NSAIDs

A client is brought to the emergency department by a softball team member whostates the client and another player ran into each other, and the client is having severe pain in the right shoulder. What symptoms of a fractured clavicle does the nurse recognize? a) Right shoulder is elevated above the left. b) Right shoulder slopes downward and droops inward. c) Client complains of tingling and numbness in the right shoulder. d) Client complains of pain in the unaffected shoulder.

Right shoulder slopes downward and droops inward.

A nurse is writing a care plan for a patient admitted to the emergency department (ED) with an open fracture. The nurse will assign priority to what nursing diagnosis for a patient with an open fracture of the radius? a) Risk for Powerlessness b) Risk for Infection c) Risk for Ineffective Role Performance d) Risk for Perioperative Positioning Injury

Risk for Infection

A nurse's assessment of a teenage girl reveals that her shoulders are not level and that she has one prominent scapula that is accentuated by bending forward. The nurse should expect to read about what health problem in the patient's electronic health record? a) Scoliosis b) Lordosis c) Kyphosis d) Muscular dystrophy

Scoliosis

A client sustains an injury to the ligaments surrounding a joint. The nurse identifies this as which of the following? a) Strain b) Fracture c) Sprain d) Contusion

Sprain

The majority of bone infections are caused by which of the following organisms? a) Staphylococcus aureus b) Proteus c) Pseudomonas

Staphylococcus aureus

The nurse teaches the patient with a high risk for osteoporosis about risk-lowering strategies including which of the following actions? a) Walk or perform weight-bearing exercises b) Increase fiber in the diet c) Reduce stress d) Decrease the intake of vitamin A and D

Walk or perform weight-bearing exercises

A client is seen in the emergency department for an injury acquired from falling off of a bicycle and fracturing the arm. The client also has a long laceration that has been sutured in the same area. The client asks the nurse why a splint is applied and not a cast. What is the best explanation by the nurse? a) "The arm does not require the same immobilization that a leg fracture would." b) "We will need to monitor the status of the laceration to be sure it does not get infected." c) "The splint is less expensive than the cast." d) "You will be able to wear the splint longer than you would a cast."

We will need to monitor the status of the laceration to be sure it does not get infected."