MSN: Ch 60: Introduction to the Musculoskeletal System

A nurse is assessing a client's range of motion. To determine the client's ability to pronate the forearm, what question should the nurse ask the client?

"Can you turn your hand so that the palm is down?"

A nurse is providing discharge instructions following an arthroscopy. Which of the following statements by the client alerts the nurse to the client's lack of understanding?

"I need to wait to call the doctor because a high level of pain is normal."

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's blood test results reveal an elevated alkaline phosphatase. What might this indicate?

A bone tumor

A nurse is caring for a client with a diagnosis of cancer that has metastasized. What laboratory value would the nurse expect to be elevated in this client?

Alkaline phosphatase

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?

Apply a cold pack at the insertion site.

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

Apply ice to the joint.

Which of the following diagnostic studies are done to relieve joint pain due to effusion?

Arthrocentesis

Which is useful in identifying acute or chronic tears of the joint capsule or supporting ligaments of the knee, shoulder, ankle, hip, or wrist?

Arthrography

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?

Arthroscopy

During the physical assessment of a client with a musculoskeletal disorder, which techniques would enable the nurse to determine the client's ability to exhibit fine motor skills?

Asking the client to grasp objects

A client is seen in the emergency room for a possible fractured wrist from a fall on the ice. The client tells the nurse that he has not been able to straighten the fingers of the injured hand/wrist. What is the nurse's best action when hearing this?

Assess the client's neurovascular status on the affected hand.

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

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

Calcitonin

The nurse is assessing the client's circulation in the right leg following an injury. Which finding needs further action?

Capillary refill is longer than 3 seconds.

Which is an indicator of neurovascular compromise?

Capillary refill of more than 3 seconds

A client 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?

Contact the primary provider immediately.

Which term refers to the shaft of the long bone?

Diaphysis

A client is diagnosed with a fracture of a diarthrosis joint. What is an example of this type of joint?

Elbow

Which diagnostic test would the nurse expect to be ordered for a client with lower extremity muscle weakness?

Electromyograph (EMG)

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

A nurse is taking a health history on a new client who has been experiencing unexplained paresthesia. What question should guide the nurse's assessment of the client's altered sensations?

How does the feeling in the affected extremity compare with the feeling in the unaffected extremity?

The nurse's comprehensive assessment of an older adult involves the assessment of the client's gait. How should the nurse best perform this assessment?

Instruct the client to walk away from the nurse for a short distance and then toward the nurse.

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

Knee

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?

Kyphosis

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

Long bones

The nurse would expect which of the following age-related change of the musculoskeletal system?

Loss of bone mass

Each bone is composed of cells, protein matrix, and mineral deposits. Which type of bone cell works to repair a bone fracture?

Osteocytes

A patient comes to the clinic and informs the nurse of numbness, tingling, and a burning sensation in the arm from the elbow down to the fingers. What type of symptom would this be documented as?

Paresthesia

What would not be included in client and family teaching after a musculoskeletal injury?

Pursue any physical activities that are comfortable.

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?

Reactive phase, reparative phase, remodeling phase

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

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?

Serial x-rays will be taken.

A client is receiving ongoing nursing care for the treatment of Parkinson disease. When assessing this client's gait, what finding is most closely associated with this health problem?

Shuffling gait

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

Skull sutures are an example of which type of joint?

Synarthrosis

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?

Tear in the joint capsule.

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

Tendons are cordlike structures that attach muscles to the periosteum of the bone. Which is not true about tendons?

Tendons attach muscle to a bone in just one location.

A nurse admits a client to a medical unit and begins the assessment. Which of the following situations places this client at risk for fractures? Select all that apply.

The client has decreased intake related to cancer treatments. The client has a history of diabetic mellitus. The client periodically takes steroids for a long history of asthma.

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.

The nurse is teaching a client about a vitamin that supports calcium's absorption. What vitamin is the nurse teaching the client about?

Vitamin D

While reading a client's chart, the nurse notices that the client is documented to have paresthesia. The nurse plans care for a client with

abnormal sensations

The nurse is performing a musculoskeletal assessment of a client 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 client's right calf is 2 inches less in diameter than the left calf. The nurse attributes the decreased girth to

atrophy of right calf muscle.

An older adult client has come to the clinic for a regular check-up. The nurse's initial inspection reveals an increased thoracic curvature of the client's spine. The nurse should document the presence of

kyphosis