Patho Final Prep U
Which substance helps maintain a smooth surface in joint cartilage?
Synovial fluid
While reviewing the following diagnostic findings on a group of clients with joint complaints, which finding would be a priority for further investigation and possible medical intervention?
Synovial fluid aspiration indicates the presence of monosodium urate crystals.
The nurse caring for a child with a deficiency of vitamin D knows that the deficiency places the child at risk for:
Rickets
When teaching a group of nursing students about rheumatic disorders, a nurse emphasizes which important differences when caring for the older adult?
Risk for falls
Which person is most at risk for hip fractures?
66-year-old white female with history of alcohol use disorder
Tuberculosis can spread from the lungs into the musculoskeletal system. What is the most common site in the skeletal system for tuberculosis to be found?
spine
The parents of a child diagnosed with rheumatic disease are shocked by the diagnosis and tell the nurse that they did not think children could acquire the disease. The best response would be:
"Children can be affected with almost all of the rheumatic diseases that occur in adults."
A client recently diagnosed with rheumatoid arthritis (RA) tells the nurse she is glad there is nothing "really wrong with her" besides some joint swelling. Which information should the nurse tell the client about RA?
"Extra-articular manifestations may include anemia and deformities of the affected joints."
What would be the best treatment option for a soft tissue contusion on the right ankle?
Keep the ankle elevated for the first 24 hours
While being tackled, a 20 year-old football player put out his hand to break his fall to the ground. Because the intense pain in his wrist did not subside by the end of the game, he was brought to an emergency department, where diagnostic imaging indicated an incomplete tear of the ligament surrounding his wrist joint. At the time of admission, his wrist was swollen with a severely restricted range of motion. What will his care team most likely tell the player about his diagnosis and treatment?
"It looks like a mild to moderate sprain and you'll need to keep it immobilized for a few weeks."
A nurse is teaching a group of nursing students about the presentation of systemic lupus erythematosus (SLE). Which statement is the nurse likely to make?
"More women than men are affected by lupus."
The nurse has just finished teaching a client newly diagnosed with rheumatoid arthritis about the disease. The nurse determines that teaching is effective when the client states:
"Rheumatoid arthritis includes joint involvement that is usually symmetric and polyarticular."
The nurse determines that additional client education is needed when a client with gout makes which statement?
"When I have an exacerbation of my symptoms, a glass of red wine will be helpful."
Following genetic testing and a thorough history from the child's mother and father, a 5 month-old boy has been diagnosed with osteogenesis imperfecta. What teaching point should the care team provide to the mother and father?
"You'll need to be very careful to avoid causing fractures to his fragile bones."
What information would the nurse include when teaching potential parents about prevention of congenital deformities? Select all that apply.
-"Limit exposure to alcohol." -"Do not take any medication without first talking to your health care provider."
Which symptoms are required for a diagnosis of psoriatic arthritis? Select all that apply.
-Evidence of nail changes -Characteristic skin changes are evident
What are typical assessment findings the nurse expects to observe in a client with a simple fracture of the leg? Select all that apply.
-Loss of function -Pain -Swelling
The nurse knows that which client listed below is at high risk for developing a hip fracture?
82-year-old female with macular degeneration who uses a walker to go to the bathroom.
Which individual is likely to have the highest risk of developing tuberculosis osteomyelitis?
A 79-year-old man who is immunocompromised following a bone marrow transplant.
Which newborn infant demonstrates the highest risk of presenting with developmental dysplasia of the hip (DDH)?
A girl who was born with toeing-in and who was in a breech presentation.
What is the definition of a congenital deformity?
Abnormalities present at birth
Which recent admission to an emergency department is most likely to be diagnosed with a greenstick fracture?
An 8-year-old boy who fell out of a tree and onto his arm. SUBMIT ANSWER
A client suffers a musculoskeletal injury while participating in a sporting event. Which treatment is most appropriate initially?
Applying ice and sitting out the rest of the game
What is among the most commonly occurring symptoms in the early stages of systemic lupus erythematosus (SLE)?
Arthritis
What is the term use to describe a tumor that while growing slowly does not destroy the surrounding tissues?
Benign
A client with confirmed low bone density asks the nurse if there is anything she can to decrease the risk of trauma. The best response would be:
Brisk walking three times per week on a flat surface
A child has been diagnosed with myopathic neuromuscular scoliosis. What other concurrent diagnosis may the child have?
Cerebral palsy
A 16-year-old male football player suffered a fracture of his radius and ulna. Assessment of the fracture includes the following data: (1) the fracture does not protrude through the skin, and (2) both bones broke completely through into two pieces. Select the best description of the injury.
Closed comminuted fracture
Which of the following statements is true about congenital clubfoot?
Clubfoot may be associated with congenital syndromes.
The nurse is assessing a client who sustained a fractured radius. A cast was applied to the extremity approximately 1 hour ago, and the client is now complaining of increased pain and numbness to the finger tips. The client is most likely experiencing:
Compartment syndrome
A basketball player collided hard with another player and suffered a soft tissue injury to the forearm from the impact. The injury did not break the skin. The nurse should recognize the presence of which type of injury?
Contusion
A client has developed osteomyelitis and asks the health care provider how the problem occurred. Which response is most accurate?
Direct contamination of an open wound
Osteoporosis is a disease caused by demineralization of bone. What is the clinical method of choice for diagnosing osteoporosis?
Dual-energy x-ray absorptiometry (DXA) of the spine and hip
Which diagnostic finding has been strongly linked to systematic lupus erythematosus (SLE)?
Elevated anti-nuclear antibodies (ANA)
A nursing student who is studying about disorders of the skeletal system is heard making the following statement, "Many skeletal disorders of early infancy are caused by intrauterine positions and need to be surgically fixed." Is this statement true or false?
False
A client who was involved in an automobile accident experienced major trauma and sustained a fractured femur. The nurse notices the following changes 4 hours after admission to the critical care unit: -Disorientation -Dyspnea -Tachycardia -Low-grade temperature -Diaphoresis -Substernal chest pain The nurse suspects:
Fat embolism syndrome (FES)
Which statement is true regarding the development of juvenile idiopathic arthritis?
Generalized stunted growth can occur.
A 16-year-old boy has been diagnosed with ankylosing spondylitis. Which etiology is responsible for his health problem?
Immune response
In a client diagnosed with osteomalacia, what would be recommended to aid with improvement of the condition?
Increasing dietary consumption of vitamin D
When assessing a client with rheumatoid arthritis, which statement about joint involvement is most accurate?
Involvement is symmetric and polyarticular, initially starting in the fingers, hands, and wrists.
Due to her progressing osteoarthritis (OA), an 80-year-old woman is no longer able to perform her activities of daily living without assistance. Which phenomenon most likely underlies the woman's situation?
Loss of articular cartilage and synovitis has resulted from inflammation caused when joint cartilage attempted to repair itself.
The nurse is caring for a client with newly diagnosed systemic lupus erythematosus (SLE). Which over-the-counter medication does the nurse recognize is useful in treating inflammation, arthritis, and pleuritis?
Nonsteroidal anti-inflammatory drugs (NSAIDs)
The primary care provider has positioned an infant in the supine position with both knees flexed and applied gentle downward pressure to both knees. The knee and thigh have been abducted while an upward and medial pressure was applied to the proximal thigh. What examination technique has been performed on this infant?
Ortolani maneuver
An older adult client has history of benign prostatic hyperplasia (BPH), osteoarthritis, loss of height by 1 in (2.5 cm), and presbycusis. Which disorder is not commonly attributed to age-related changes?
Osteoarthritis
An adult client has osteoarthritis in his left ankle that has been attributed to an old sports injury. When he plays on the weekends now, residual changes in the joint cause him significant pain. Which cause is most likely?
Osteophytes
A 75-year-old female has been admitted to the hospital with a hip fracture. She states, "All I did was fall into my chair, not even very hard." Upon diagnostic testing, the client's bones shows loss of trabeculae from cancellous bone and thinning of the cortex. Which diagnosis is most likely?
Osteoporosis
A client sustains a musculoskeletal injury of the wrist. Which manifestation would the nurse expect to accompany the strain?
Pain and stiffness
The client with a suspected diagnosis of osteoarthritis asks the health care provider, "How will this diagnosis be confirmed?" Which response is most appropriate?
Physical examination and x-ray studies
The health care provider is assessing a client with a history of ankylosing spondylitis to note progression of the disease. On which area of the body will the provider focus the assessment?
Spine
The nurse is providing client education related to intra-articular corticosteroid injections. Which instruction should the nurse include?
The injections will be given only 3 to 4 times per year because they can increase joint destruction.
Osgood-Schlatter disease is a disease that strikes children between the ages of 11 and 15. This disease involves microfractures, where the patellar tendon inserts into the tibial tubercle. What is Osgood-Schlatter disease characterized by?
Thickening of patellar tendon
Which statement is true about treatment of developmental dysplasia of the hip?
Treatment needs to be individualized.
The nurse is teaching a client with rheumatoid arthritis about pannus, which develops in the affected joint area. What does the nurse include to describe pannus?
Vascular granulation tissue that destroys cartilage and bone
An older adult client has recently been diagnosed with rheumatoid arthritis. The nurse should focus assessment on which aspects?
Weight and nutritional status
A 2-year-old has bowing of the legs (genu varum). When should the health care professional should be concerned?
When there is a large separation between the knees greater than 15 degrees
Following prosthetic joint replacement of the knee, the client continues to complain of pain and discomfort above what would be expected. There is poor incisional healing. The clinic nurse is concerned when she sees that the incision is still draining after 3 weeks post-op. The nurse suspects a prosthetic joint infection. The nurse should anticipate the physician will prescribe:
antimicrobial treatment depending on the microbe.
A client tells the nurse she is very concerned because the health care provider informed her that her fractured arm is healing with malunion. The nurse recognizes this as:
healing with deformity, angulation, or rotation that is visible on x-ray films.
A daughter is concerned because her elderly parent has been diagnosed with osteomalacia. The daughter asks the nurse why this happened. The best response would be that:
intestinal absorption slows as natural aging occurs.
When assessing a client with acute gout, for which of these signs and symptoms does the nurse assess? Select all that apply.
• Redness and swelling of the affected joint • Pain and swelling in one joint • Intake of alcohol
