Prep U #6 Chapter 39: Assessment of Musculoskeletal Function

The primary functions of cartilage are to reduce friction between articular surfaces, absorb shocks, and reduce stress on joint surfaces. Where in the human body is cartilage found? -between the ribs -covering elbow joints -between the vertebrae -All options are correct.

All options are correct.

Which of the following is the most common site of joint effusion? - Hip -Knee -Elbow -Shoulder

Knee -most common site for joint effusion is the knee

What is the term for a lateral curving of the spine?

Scoliosis

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 - involuntary twitch of muscle fibers. -absence of muscle movement suggesting nerve damage. -absence of muscle tone. -abnormal sensations.

abnormal sensations. - such as burning, tingling, and numbness, are referred to as paresthesias

lordosis

swayback, an exaggerated curvature of the lumbar spine.

Scoliosis

lateral curving deviation of the spine

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?

"Do you have any allergies?" -Many contrast dyes contain iodine. Therefore, it is essential for the nurse to determine whether the client has any allergies, especially to iodine, shellfish, and other seafood

The nurse is preparing the client with a right neck mass for magnetic resonance imaging (MRI). Which question should the nurse ask? Select all that apply. - "Did you take your medications this morning?" -"Have you removed your hearing aid?" -"When is the last time you had food or drink?" -"Do you have a pacemaker?" -"Are you wearing any jewelry?"

"Have you removed your hearing aid?" "Do you have a pacemaker?" "Are you wearing any jewelry?" -Magnetic resonance imaging (MRI) is a noninvasive imaging technique that uses magnetic fields, radiowaves, and computers to demonstrate abnormalities of soft tissue. Individuals with any metal implants, clips, or pacemakers are not candidates for MR

A client with a sports injury undergoes a diagnostic arthroscopy of the left knee. What comment by the client following the procedure will the nurse address first? - "My toes are numb." -"My foot is swollen." -"My knee aches." -"My feet are cold."

"My toes are numb." -Numbness would indicate neurological compromise of the extremity and requires immediate intervention to prevent permanent damage.

The nurse is providing care to a client following a knee arthroscopy. What would the nurse expect to include in the client's plan of care? - Applying warm packs to the insertion site. - Maintaining the client's NPO status. -Keeping the affected knee flexed. -Administering the prescribed analgesic.

Administering the prescribed analgesic. -After an arthroscopy, the client's entire leg is elevated without flexing the knee. A cold pack is placed over the bulky dressing covering the site where the arthroscope was inserted. A prescribed analgesic is administered as necessary

A client is scheduled to have an x-ray examination of the shoulder in which the synovial fluid will be aspirated and sent to the laboratory for analysis. This will be followed by administration of a contrast medium and x-rays. What procedure will the nurse prepare the client for? - Arthroscopy -Arthrogram -Bone densitometry -Arthrocentesis

Arthrogram -arthrogram is a radiographic examination of a joint, usually the knee or shoulder. The health care provider first injects a local anesthetic and then inserts a needle into the joint space.

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? -Bone scan -Electromyography -Arthrocentesis -Arthroscopy

Arthroscopy -Arthroscopy is a procedure that allows direct visualization of a joint through the use of a fiberoptic endoscope

The nurse is performing a neurological assessment. What will this assessment include? - Ask the client to plantar flex the toes. -Observe for capillary refill of the great toe. -Palpate the dorsalis pedis pulse. -Inspect the foot for edema.

Ask the client to plantar flex the toes. -neurological assessment evaluates sensation and motion Assessing plantar flexion of the toes would be included in a neurological assessment

A group of students are reviewing the structure and function of bones. The students demonstrate understanding of the information when they state that cortical bone is found primarily in which of the following? -Epiphyses -Diaphysis -Osteoblasts -Rounded irregular ends

Diaphysis -Cortical bony tissue is found chiefly in the long shafts, or diaphyses, of bones in the arms and legs

The nurse is performing a neurovascular assessment of a client's injured extremity. Which would the nurse report? - Dusky or mottled skin color -Skin warm to touch -Capillary refill of 3 seconds -Positive distal pulses

Dusky or mottled skin color

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

Electromyograph (EMG) -EMG provides information about the electrical potential of the muscles and the nerves leading to them. The test is performed to evaluate muscle weakness, pain, and disability

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? - Rigidity -Atonic -Tetanic -Flaccidity

Flaccidity -muscle that is limp and without tone is described as flaccid;

Which assessment finding would cause the nurse to suspect compartment syndrome in the client following a bone biopsy?

Increased diameter of the calf -Increasing diameter of the calf can be indicative of bleeding into the muscle.

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? - Osteoporosis -Kyphosis -Scoliosis - Lordosis

Kyphosis -Common deformities of the spine include kyphosis, which is an increased forward curvature of the thoracic spine that causes a bowing or rounding of the back, leading to a hunchback or slouching posture

The client presents with an exaggeration of the lumbar spine curve. How does the nurse interpret this finding? -Lordosis -Kyphosis -Scoliosis -Dowager's hump

Lordosis -Lordosis is an exaggeration of the lumbar spine curve.

After a person experiences a closure of the epiphyses, which statement is true? - The bone grows in length but not thickness. -The bone increases in thickness and is remodeled. -Both bone length and thickness continue to increase. -No further increase in bone length occurs

No further increase in bone length occurs. -After closure of the epiphyses, no further increase in bone length can occur.

Which serum level indicates the rate of bone turnover? -Aspartate aminotransferase -Osteocalcin -Creatinine kinase -Myoglobin

Osteocalcin -Serum osteocalcin (bone GLA protein) indicates the rate of bone turnover

The nurse is caring for a client who experienced a crushing injury of the lower extremities. Which of the following symptoms is essential to be reported to the physician? - Ischemia -Pain -Coolness -Pulselessness

Pulselessness -Neurovascular checks (circulation, sensation, motion) are essential with a crushing injury. The absence of a pulse is a critical assessment finding to report to the physician.

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 -process of fracture healing occurs over three phases. These include the following: Phase I: Reactive phase; Phase II: Reparative phase; and Phase III: Remodeling phase.

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 -Decreased bone density -Fracture of the clavicle -Injury to the radial nerve

Tear in the joint capsule -Arthrography is useful in identifying acute or chronic tears of the joint capsule or supporting ligaments of the knee, shoulder, ankle, hip, or waist

The emergency room nurse is reporting the location of a fracture to the client's primary care physician. When stating the location of the fracture on the long shaft of the femur, the nurse would be most correct to state which terminology locating the fractured site? -The fracture is ventrally located. The fracture is on the epiphyses. The fracture is on the tuberosity. The fracture is on the diaphysis.

The fracture is on the diaphysis. -A fracture that is on the diaphysis is understood to be chiefly found in the long shafts of the arms and legs.

The nurse working in the emergency department receives a call from the x-ray department communicating that the client the nurse is caring for has a fracture in the shaft of the tibia. The nurse tells the physician that the client's fracture is in the - epiphysis. -scoliosis. -lordosis. - diaphysis.

diaphysis. - diaphysis is primarily cortical bone

The nurse is preparing the client for computed tomography. Which information should be given by the nurse? - "Fluid will be removed from you affected joint." - "A radioisotope will be given through an IV." -"You must remain very still during the procedure." -"A small bit of tissue will be removed and sent to the lab."

"You must remain very still during the procedure." - computed tomography, a series of detailed x-rays are taken. The client must lie very still during the procedure

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 serum calcium test - An arthroscopy -An electromyography -A magnetic resonance imaging (MRI)

An electromyography -electromyography tests the electrical potential of muscles and nerves leading to the muscles It is done to evaluate muscle weakness or deterioration.

The nurse is conducting a medication reconciliation with a client admitted with a fracture. What medication predisposes a client for a risk for fractures?

prednisone -Prednisone, a corticosteroid, causes increased bone resorption and decreased bone formation, resulting in increased risk for fractures.

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 -bruising in right lower extremity. -increased use of left calf muscle. -edema in left lower extremity. -atrophy of right calf muscle.

atrophy of right calf muscle. -experience atrophy of the muscles from lack of use, which results in a subsequent decrease in the girth of the calf muscle.

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? - Cancellous bone -Osteoblasts -Osteoclasts -Cortical bone

Osteoblasts -Osteoblasts secrete bone matrix (mostly collagen), in which inorganic minerals, such as calcium salts, are deposited

The homecare nurse is evaluating the musculoskeletal system of a geriatric client whose previous assessment was within normal limits. The nurse initiates a call to the health care provider and/or emergency services when which change is found? - Decreased flexibility -Decreased agility -Decreased right-sided muscle strength -Increased joint stiffness

Decreased right-sided muscle strength -The nurse should contact the health care provider when decreased right-sided muscle strength is found, as this could indicate a stroke or transient ischemic attack

A nurse is caring for a client with an undiagnosed bone disease. When instructing on the normal process to maintain bone tissue, which process transforms osteoblasts into mature bone cells? - Remodeling - Resorption -Epiphyses and diaphysis formation -Ossification and calcification

Ossification and calcification -Ossification and calcifications the body's process to transform osteoblasts into mature bone cells called osteocytes. Osteocytes are involved in maintaining bone tissue

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? -Osteoblast formation will stop during the time needed for fracture healing. -Potential growth problems may result from damage to the epiphyseal plate. -Red blood cell production will be temporarily reduced because of the damage to the medullar cavity. -Periosteal blood vessels will be damaged, thus compromising blood flow to the compact bone.

Potential growth problems may result from damage to the epiphyseal plate. -The epiphyseal plate, which separates the epiphyses from the diaphysis, is the center for longitudinal growth in children

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? -An arthroscopy will be performed. -Serial x-rays will be taken. -The bone will heal on its own without intervention. -The plate will be removed to determine if the bone is growing back.

Serial x-rays will be taken. -Serial x-rays are used to monitor the progress of bone healing. The plate need not be disturbed. An arthroscopy is used to visualize joints

A nurse provides nutritional health teaching to an adult client who had two fractures in 1 year. Besides recommending supplemental calcium, the nurse suggests a high-calcium diet. What would the nurse recommend that the client increase intake of? -Salmon and sardines. -Yogurt and cheese. -Almonds and peanuts. -Canned mixed fruit

Yogurt and cheese. -Yogurt and cheese are excellent sources of calcium. The other choices are low-calcium foods.