Prep U for Brunner and Suddarth's Textbook of Medical Surgical Nursing, 13th Edition Chapter 42: Management of Patients With Musculoskeletal Disorders

During a routine physical examination on a 75-year-old female client, a nurse notes that the client is 5 feet, 3/8 inches (1.6 m) tall. The client states, "How is that possible? I was always 5 feet and 1/2? (1.7 m) tall." Which statement is the best response by the nurse?

"After menopause, the body's bone density declines, resulting in a gradual loss of height." pg.

The nurse is planning discharge instructions for the client with osteomyelitis. What instructions should the nurse include in the discharge teaching?

"You will receive IV antibiotics for 3 to 6 weeks." pg. 1138

A client with diabetes punctured his foot with a broken acorn in the yard. Within a week, the client developed osteomyelitis of the foot. The client was admitted for IV antibiotic therapy. How long does the nurse anticipate the client will receive IV antibiotics?

3 to 6 weeks pg. 1148

Which client would the nurse identify as having the greatest risk for osteoporosis?

A small-framed, thin 45-year-old white woman pg. 1141

The nurse is caring for a client with a hip fracture. The physician orders the client to start taking a bisphosphonate. Which medication would the nurse document as given?

Alendronate pg.

The nurse is preparing a client for a surgical procedure that will allow visualization of the extent of joint damage of the knee for a client with rheumatoid arthritis and also obtain a sample of synovial fluid. What procedure will the nurse prepare the client for?

Arthroscopy pg.

What food can the nurse suggest to the client at risk for osteoporosis?

Broccoli pg. 1141

Which medication directly inhibits osteoclasts, thereby reducing bone loss and increasing bone mass density (BMD)?

Calcitonin pg. 1144

Dupuytren contracture causes flexion of which area(s)?

Fourth and fifth fingers pg. 1137

Which of the following was formerly called a bunion?

Hallux valgus pg. 1140

The provider asks a nurse to test a patient for Tinel's sign to diagnose carpal tunnel syndrome. The nurse asked the patient to:

Hold his palm up while the nurse percussed over the median nerve. pg.

A physician prescribes raloxifene to a hospitalized client. The client's history includes a right hip fracture, hysterectomy, deep vein thrombosis, and hypertension. Which action by the nurse demonstrates safe nursing care?

Holding the raloxifene and notifying the physician pg.

A patient visits an orthopedic specialist because of pain that he feels beginning in his low back and radiating behind his right thigh and down below his right knee. The doctor suspects a diagnosis of sciatica. The nurse knows that the origin of the pain is between these intervertebral disks:

L4, L5, and S1 pg.

The client presents to the emergency department with fever, chills, restlessness, and limited movement of a fractured jaw. The nurse interprets these findings as indicating which of the following complications?

Osteomyelitis pg. 1148

The nurse is caring for a client following foot surgery. Which nursing intervention is most important for the nurse to include in the nursing care plan?

Perform neuromuscular assessment every hour. pg. 2061

The nurse is educating the patient with low back pain about the proper way to lift objects. What muscle should the nurse encourage the patient to maximize?

Quadriceps pg.

Which term refers to a disease of a nerve root?

Radiculopathy pg. 1133

A client with osteoporosis is prescribed a selective estrogen receptor modifier (SERM) as treatment. The nurse would identify which drug as belonging to this class?

Raloxifene (Evista) pg. 1144

Which of the following is the most important nursing diagnosis for an elderly patient diagnosed with osteoporosis?

Risk for injury related to fractures due to osteoporosis pg. 1145

Which is a risk-lowering strategy for osteoporosis?

Smoking cessation pg. 1141

A patient is having low back pain. What position can the nurse suggest to relieve this discomfort?

Supine, with the knees slightly flexed and the head of the bed elevated 30 degrees pg.

The nurse advises a patient that the best position to ease low back pain is:

Supine, with the knees slightly flexed and the head of the bed elevated 30 degrees. pg. 1134

In chronic osteomyelitis, antibiotics are adjunctive therapy in which situation?

Surgical debridement pg. 1148

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?

Temporomandibular disorder pg. 1236

Which is not a risk factor for osteoporosis?

being male pg. 1142

The nurse is reviewing the medication administration record of the client. Which of the following medications would lead the nurse to suspect that the client is at risk for osteoporosis?

raloxifene (Evista) pg. 1144

A patient is diagnosed with osteogenic sarcoma. What laboratory studies should the nurse monitor for the presence of elevation?

Alkaline phosphatase pg. 1152

A patient is evaluated for a diagnosis of Paget's disease. Which of the following is a diagnostic finding for this disease?

Alkaline phosphate of 165 IU/L pg. 1147

When performing a physical assessment of a client, the client reports numbness, tingling, and pain when the nurse percusses lightly over the median nerve. The nurse recognizes that this finding is consistent with:

Carpal tunnel syndrome pg.

To help prevent osteoporosis, what should a nurse advise a young woman to do?

Consume at least 1,000 mg of calcium daily.pg. 1144

What term refers to a flexion deformity caused by a slowly progressive contracture of the palmar fascia?

Dupuytren contracture pg. 1137

Which term refers to a flexion deformity caused by a slowly progressive contracture of the palmar fascia?

Dupuytren contracture pg. 1137

A client with chronic osteomyelitis has undergone 6 weeks of antibiotic therapy. The wound appearance has not improved. What action would the nurse anticipate to promote healing?

Surgical debridement pg. 1149

A patient had hand surgery to correct a Dupuytren's contracture. What nursing intervention is a priority postoperatively?

Performing hourly neurovascular assessments for the first 24 hours pg. 1137

Which sign may be helpful in identifying carpal tunnel syndrome?

Tinel's pg. 1136

A client with low back pain is being seen in the clinic. In planning care, which teaching point should the nurse include?

Use the large muscles of the leg when lifting items. pg. 1134

The nurse is assisting a client with removing shoes prior to an examination and observes that the client has a flexion deformity of several toes on both feet of the proximal interphalangeal (PIP) joints. What can the nurse encourage the client to do?

Wear properly fitting shoes. pg. 1139