Musculoskeletal disorders

The nurse is caring for an elderly female patient who has osteoporosis. When teaching her, the nurse should include information about which major complication? A. Bone fracture B. Loss of estrogen C. Negative calcium balance D. Scoliosis

Correct answer A: Bone fracture is a major complication of osteoporosis that results when loss of calcium and phosphate increases the fragility of bones. (Option B) is incorrect because estrogen deficiencies result from menopause, not osteoporosis. (Option C) is wrong because calcium and vitamin D supplements may be used to support normal bone metabolism, but a negative calcium balance isn't a complication of osteoporosis. (Option D) is incorrect because, although the cause of scoliosis is unknown, it's not thought to be a complication of osteoporosis.

A patient undergoes cast placement for a fractured left radius. The nurse should suspect compartment syndrome if the patient experiences pain that: A. intensifies with the elevation of the left arm. B. disappears with the flexion of the left arm. C. increases with the arm in a dependent position. D. radiates up the arm to the left scapula.

Correct answer A: Pain is the most common symptom of compartment syndrome. Because the pain is the result of ischemia, elevating the limb reduces circulation, worsens the ischemia, and intensifies the pain. Options B and C are incorrect because these positions don't alter the pain of compartment syndrome. Option D is incorrect because the pain of compartment syndrome doesn't radiate up the arm to the scapula.

A 78 y/o patient has a history of osteoarthritis. Which signs and symptoms would the nurse expect to find on physical assessment? A. Joint pain, crepitus, Heberden's nodes B. Hot, inflamed joints; crepitus; joint pain C. Tophi, enlarged joints, Bouchard's nodes D. Swelling, joint pain, tenderness on palpation

Correct answer A: Signs and symptoms of osteoarthritis include joint pain, crepitus. Heberden's nodes, Bouchard's nodes, and enlarged joints. Joint pain occurs with movement and is relieved by rest. As the disease progresses, pain may also occur at rest. Heberden's nodes are bony growths that occurat the distal interphalangeal joints. Bouchard's nodes involve the proximal interphalangeal joints. Hot, inflamed joints (Option B) rarely occur with osteoarthritis. Tophi (Option C) are deposits of sodium urate crystals that occur with chronic gout, not osteoarthritis. Swelling, joint pain, and tenderness on palpation (Option D) occur with a sprain injury.

Which areas should be included in a neurovascular assessment? A. Orientation, movement, pulses, and warmth B. Capillary refill time, movement, pulses, and warmth C. Orientation, pupillary response, temperature and pulses. D. Respiratory pattern, orientation, pulses, and temperature

Correct answer B: A correct neurovascular assessment should include capillary refill time, movement, pulses, and warmth. Neurovascular assessment involves nerve and blood supply to an area. Orientation, pupillary response, temperature, and respiratory pattern (Options A, C, and D) aren't part of a neurovascular

A patient received a right hip prosthesis after a fall. In the immediate postoperative period, the nurse should: A. maintain the leg in an adducted position. B. maintain the leg in an abducted position. C. maintain the leg in a neutral position. D. maintain the leg with the hip flexed greater than 90 degrees.

Correct answer B: After receiving a hip prosthesis, the affected leg should be kept abducted. Adduction (Option A) may dislocate the hip. (Option C) would be correct if an internal fixation device was used. (Option D) is incorrect because the hip must not be flexed more than 90 degrees for the first 2 months and even less than that for the first 10 days.

What complication should the nurse be alert for in a diabetic patient who has been placed in skeletal traction after a motor vehicle collision? A. Osteoarthritis B. Osteomyelitis C. Osteoporosis D. Osteosarcoma

Correct answer B: This patient has a significant risk of developing osteomyelitis secondary to the skeletal pin. Osteoarthritis (Option A) is a degenerative joint disease, osteoporosis (Option C) is a metabolic bone disorder, and osteosarcoma (Option DO is an aggressive from of bone cancer; none occur secondary to skeletal traction.

What diagnostic test would be used to evaluate the presence of rhabdomyolysis? A. Glycosylated hemoglobin B. Serum troponin C. Serum myoglobin D. Bone biopsy

Correct answer C: A positive serum or urine myoglobin test indicates rhabdomyolysis. A glycosylated hemoglobin test (Option A) measures the amount of glycosylated hemoglobin in the blood and is used to monitor blood sugar. Serum troponin ( Option B) is used to detect acute coronary syndrome. A bone biopsy (Option D) would be used to diagnose osteoporosis.

Conservative treatment of a herniated nucleus pulposus would include which measures? A. Surgery B. Spinal fusion C. Bed rest, pain medication, and physiotherapy D. Strenuous exercise, pain medication, and physiotherapy

Correct answer C: Conservative treatment of a herniated nucleus pulposus may include bed rest, pain medication, and physiotherapy. Aggressive, not conservative, treatment may include surgery (Option A), including spinal fusion (Option B). A regimen of strenuous exercise, pain medication, and physiotherapy (Option D) isn't recommended.

Which of the following are considered signs and symptoms of a fracture? A. Tingling, coolness, and loss of pulses B. Loss of sensation, redness, and coolness C. Coolness, redness, and a new pain site D. Discoloration, deformity, and pain at the site of injury

Correct answer D: Signs of a fracture may include discoloration, deformity, and pain at the site of injury. Tingling, coolness( included in Option A,B, and C) and loss of pulses are signs of a vascular problem.

A patient in balanced suspension traction for a fractured femur needs to be repositioned toward the head of the bed. During repositioning, the nurse should: A. place slight additional tension on the reaction cords. B. release the weights, and replace them immediately after positioning. C. lift the traction and the patient during repositioning. D. maintain the same degree of traction tension.

Correct answer D: Traction is used to reduce the fracture and must be maintained at all times, including during repositioning. Options A,B, and C are incorrect because it isn't appropriate to increase traction tension or release or release or lift the traction during repositioning.