Musculoskeletal PrepU

The nurse is assessing a client with a musculoskeletal system condition. Which statement indicates to the nurse that the client is experiencing bone pain? "The pain feels tender, hurts, and is worse when I move." "The pain is sharp in my arms but is relieved by not moving." "The pain feels deep in my legs and keeps me awake at night." "I have soreness and aching like cramps in both of my arms."

"The pain feels deep in my legs and keeps me awake at night."

Patient education for musculoskeletal conditions for the aging is based on the understanding that there is a gradual loss of bone after a peak of bone mass at age: 20 years. 50 years. 40 years. 30 years.

30 years.

Which statement describes paresthesia? Involuntary twitch of muscle fibers Absence of muscle movement suggesting nerve damage Abnormal sensations Absence of muscle tone

Abnormal sensations

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. Keeping the affected knee flexed. Maintaining the client's NPO status. Administering the prescribed analgesic.

Administering the prescribed analgesic.

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

Ask the client to plantar flex the toes.

Which is an indicator of neurovascular compromise? Pain upon active stretch Capillary refill of more than 3 seconds Diminished pain Warm skin temperature

Capillary refill of more than 3 seconds

Which is a neurovascular problem caused by pressure within a muscle area that increases to such an extent that microcirculation diminishes? Hypertrophy Compartment syndrome Remodeling Fasciculation

Compartment syndrome

Which diagnostic test would the nurse expect to be ordered for a client with lower extremity muscle weakness? Biopsy Electromyograph (EMG) Arthrocentesis Bone scan

Electromyograph (EMG)

Which diagnostic test would the nurse expect to be ordered for a client with lower extremity muscle weakness? Bone scan Arthrocentesis Biopsy Electromyograph (EMG)

Electromyograph (EMG)

The nurse is performing a musculoskeletal assessment for a client whose right leg muscles exhibit no tone and are limp. Which descriptor should the nurse use to document this condition? Atrophic Spastic Flaccid Atonic

Flaccid

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 Flaccidity Tetanic

Flaccidity

Which assessment finding would cause the nurse to suspect compartment syndrome in the client following a bone biopsy? Increased diameter of the calf Toes move freely without pain Bounding dorsalis pedis pulses Capillary refill < 3 seconds

Increased diameter of the calf

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 Lordosis Scoliosis Kyphosis

Kyphosis

The nurse is employed at a long-term care facility caring for geriatric clients. Which assessment finding is characteristic of an age-related change? Depressive symptoms Loss of height Increased muscle mass Cognitive decline

Loss of height

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

Osteocalcin

Which nerve is being assessed when the nurses asks the client to dorsiflex the ankle and extend the toes? Median Radial Peroneal Ulnar

Peroneal

Which of the following is the final stage of fracture repair? Cartilage calcification Remodeling Cartilage removal Angiogenesis

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

Serial x-rays will be taken.

Skull sutures are an example of which type of joint? Amphiarthrosis Synarthrosis Aponeuroses Diarthrosis

Synarthrosis

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 tuberosity. The fracture is on the diaphysis. The fracture is on the epiphyses.

The fracture is on the diaphysis.

The nurse recognizes that rheumatoid arthritis is characterized by: Clonus Ballottement sign Ulnar deviation Fasciculations

Ulnar deviation

A client is recovering from a fractured hip. What would the nurse suggest that the client increase intake of to facilitate calcium absorption from food and supplements? Vitamin D Vitamin B6 Dairy products Amino acids

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

abnormal sensations.

A client reports being consistently tired, with no energy. The client's CBC indicates low hemoglobin. Where is hemoglobin manufactured? ribs eyes femur ulna

ribs

The nurse is evaluating a client's peripheral neurovascular status. Which would the nurse report to the health care provider as a circulatory indicator of peripheral neurovascular dysfunction? Weakness Paresthesia Cool skin Paralysis

Cool skin

Which hormone inhibits bone resorption and increases the deposit of calcium in the bone? Growth hormone Calcitonin Vitamin D Sex hormones

Calcitonin

The nurse is caring for a pregnant patient with pregnancy-induced hypertension. When assessing the reflexes in the ankle, the nurse observes rhythmic contractions of the muscle when dorsiflexing the foot. What would the nurse document this finding as? Hypertrophy Ankle reflex Positive Babinski reflex Clonus

Clonus

What is the term for a rhythmic contraction of a muscle? Clonus Hypertrophy Atrophy Crepitus

Clonus

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

Knee

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 Ossification and calcification Resorption Epiphyses and diaphysis formation

Ossification and calcification

Which nursing instruction is most important to stress when teaching on calcium intake? Drink calcium- and vitamin D-fortified orange juice. Eat green, leafy vegetables. Maintain diary sources of calcium intake. Provide age-related calcium intake recommendations.

Provide age-related calcium intake recommendations.

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? Fascia Tendon Bursa Ligament

Tendon

During a general musculoskeletal assessment, what would help the nurse 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 patient has neurofibromatosis. The patient has lupus erythematosus. The patient has osteoarthritis.

The patient has rheumatoid arthritis.

A client visits the health care provider for a routine checkup. The history reveals that the client was diagnosed with a spinal curvature. Which region of the spine should the nurse assess for complications? Lumbar Cervical Sacral Thoracic

Thoracic

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

prednisone

What instructions should the nurse include in the discharge teaching for the client following an arthroscopy? "Keep the leg in the dependent position as much as possible." "Numbness and tingling in the foot are expected the first 24 hours." "The pain should be well-controlled with Tylenol." "It is normal to feel hot spots over the puncture site."

"The pain should be well-controlled with Tylenol."

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 warm compresses to the insertion site. Assist with performing ROM exercises. Provide a gentle massage. Apply a cold pack at the insertion site.

Apply a cold pack at the insertion site.

The nurse is performing an assessment for a patient who may have peripheral neurovascular dysfunction. What signs does the patient present with that indicate circulation is impaired? (Select all that apply.) Tenting skin turgor Cool temperature of the extremity More than 3-second capillary refill Limited range of motion Pale, cyanotic, or mottled color

Cool temperature of the extremity More than 3-second capillary refill Pale, cyanotic, or mottled color

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? osteoarthritis of the shoulder bursitis ankylosing spondylitis a fracture of the clavicle

bursitis

The older client asks the nurse how best to maintain strong bones. What is the nurse's best response? "Range-of-motion exercises build bone mass." "Weight-bearing exercises can strengthen bones." "Cardio training is the best way to build bones." "Weight-resistance exercises can strengthen bones."

"Weight-bearing exercises can strengthen bones."

A client arrives at the orthopedic physician's office stating knee pain sustained while playing soccer. A history and physical assessment is completed. The knee appears reddened with edema. Which other diagnostic testing would the nurse anticipate? An arthroscopy A bone densitometry An arthrocentesis A bone scan

An arthroscopy

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

An electromyography

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

Arthrography

Choose the correct statement about the endosteum, a significant component of the skeletal system: Facilitates bone growth Covers the marrow cavity of long bones Contains blood vessels and lymphatics Supports the attachment of tendons to bones

Covers the marrow cavity of long bones

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 Pulselessness Coolness

Pulselessness

A client has just undergone arthrography. What is the most important instruction for the nurse to include in the teaching plan? Report joint crackling or clicking noises occurring after the second day. Avoid sunlight or harsh, dry climate. Gently massage joints with any crackling or clicking joint noises. Avoid intake of dairy products.

Report joint crackling or clicking noises occurring after the second day.

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 right-sided muscle strength Decreased flexibility Decreased agility Increased joint stiffness

Decreased right-sided muscle strength

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? Cortical bone Osteoblasts Cancellous bone Osteoclasts

Osteoblasts

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. 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.

Potential growth problems may result from damage to the epiphyseal plate.

After a bone density test, an older adult female client tells the nurse, "I don't understand why I have osteoporosis because I eat well and take my calcium." What does the nurse explain as the reason that the client may have osteoporosis? Everyone gets osteoporosis and there is nothing you can do to prevent it. The loss is from withdrawal of estrogen and a decrease in activity levels. Men lose more bone mass than women but women still lose some. In order to prevent bone loss, women have to take hormones.

The loss is from withdrawal of estrogen and a decrease in activity levels.

The nurse is taking an initial history of a new client with a musculoskeletal problem. Which factor is most important for the nurse to keep in mind for this assessment? Duration and location of discomfort or pain Client's lifestyle Client's age Any chronic disorder or recent injury

Any chronic disorder or recent injury

During a general musculoskeletal assessment, what would help the nurse determine the client's muscle strength? Palpating each of the client's muscles and joints. Asking the client to lift specified amounts of weights. Applying force to the client's extremity as the client pushes against that force. Examining extremities for symmetry, size, and contour.

Applying force to the client's extremity as the client pushes against that force.

The nurse is reporting on the results of client blood work to the oncoming nurse. Upon reviewing the data, it is noted that the client has an elevated uric acid level. Which inflammatory process would the nurse screen for on shift rounds? Gout Rheumatoid arthritis Osteoporosis Lupus erythematosus

Gout

Fracture healing occurs in four areas, including the external soft tissue. bursae. fascia. cartilage.

external soft tissue.

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 may notice some bruising or swelling in my knee." "My physician may prescribe pain pills after the procedure." "I should use my heating pad this evening to reduce some of the pain in my knee." "Elevating my leg will reduce swelling after the procedure."

"I should use my heating pad this evening to reduce some of the pain in my knee."

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.